Postpartum depression: a review for perinatal social workers

Postpartum depression is a common and treatable clinical syndrome which effects up to fifty percent of all women and which can best be considered as a triad of disorders. Postpartum blues, postpartum affective disorders or major depressions, and postpartum psychosis have distinct symptoms with corresponding implications for social work interventions and treatment strategies. The role of prevention can be pivotal in terms of reducing negative impacts of psychological problems after birth and minimizing adverse consequences for the new baby and all family members.     

Bruxism: A critical review.

Bruxism, the nonfunctional gnashing and grinding of the teeth, has been primarily viewed as a dental phenomenon. The literature reviewed in this paper, however, demonstrates that bruxism may be viewed as a psychophysiological disorder. A brief discussion of the relevant literature on the incidence and effects of bruxism indicates that the behavior may have significant symptomatic effects for a substantial proportion of the population. The contribution of dental, psychological/behavioral, and systematic/neurophysiological factors to the development and maintenance of the disorder are extensively reviewed. Treatments derived from these models are also evaluated. Finally, methodological problems intrinsic to the study of this behavior are presented, and suggestions for future research are made. (139 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Postpartum depression

Depression following childbirth (postpartum depression) is a common psychiatric illness of women, postpartum. We review Japanese and English literature on postpartum depression. Problems with definition, study design and validity of the diagnosis prevented comprehensive understanding whether postpartum depression is a distinct subtype of endogenous depression. In general, postpartum depression seems to be the same illness as depression at other times in life. The biological and psycho-social pathogenetic factors, unique to the puerperal period, are not yet known. Clinicians caring for women and infants should learn to screen their patients for this multifactorial (genetic, temperamental, and environmental) disorder, and try to integrate a multidisciplinary (pharmaco-, psycho-, socio-, familial) approach.     

Postpartum depression

We investigated whether informing first-time mothers about postpartum depression affects their experience and behaviour during the depression occurring in the first two weeks after birth. METHOD: 138 first-time mothers who were participants in a longitudinal study sponsored by the Swiss National Fund were retrospectively surveyed concerning postpartum depression in the week after birth (response rate: 86.9%). RESULTS: 90% of the new mothers were affected. One fourth reported severe to very severe symptoms. The most popular sources of information about postpartum depression were books (65.8%) and magazines (59.2%). 10% of the mothers received information from their gynaecologist. 33% of the mothers with severe to very severe symptoms reported that after the birth no member of the medical or paramedical professions had discussed postpartum depression with them. Among the mothers who knew about postpartum depression, 30% did not feel adequately prepared for the degree of depression. Comparisons between informed and non-informed mothers show that the informed mothers had fewer symptoms, a shorter duration, and suffered less. In addition, the following reactions were noted: the informed mothers complained less and were less likely to believe that they were alone in their suffering. Also, they tended to have less negative thought patterns, felt less powerless, and were better able to explain their feelings and behaviour. RECOMMENDATIONS: Information about postpartum depression, especially to ensure that new mothers "feel prepared for it", has a positive influence on experience and behaviour in the week after birth. Therefore, it is useful to inform women about postpartum depression before the birth. This could be integrated into the neonatal care programme offered by the woman's gynaecologist. At the same time, training for nursing staff concerning postpartum depression is recommended.     

Custody evaluations: A critical review.

Discusses the role of evaluators in child custody litigations, current methods of custody evaluation, and the content of such evaluations. The value of clinical impressions and standardized assessment instruments is considered, and ways of eliciting the child's preference are examined. Ethical dilemmas associated with the performance of custody evaluations are discussed, and it is argued that mental health professionals should serve as strictly impartial evaluators. (34 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Autokinetic phenomenon: A critical review.

Reviews studies grouped under the areas of response problems, dynamic determinants, individual differences, clinical studies, reduction of movement, and theories of autokinesis (AK). Much of the work to date is concerned with the demonstration of various "suggestion effects" without regard to the basis of residual AK. Determinants of AK are many and varied but little can be said about their relative potencies. Although a modified version of the Gregory-Zangwill model may serve well, there is presently no single theory of AK which accounts for all the data. Further developments in the theory and control of AK hinge upon the sedulous development of improved techniques for measuring AK. 3 criteria for measuring AK are offered. (3 p. ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Structural priming: A critical review.

Repetition is a central phenomenon of behavior, and researchers have made extensive use of it to illuminate psychological functioning. In the language sciences, a ubiquitous form of such repetition is structural priming, a tendency to repeat or better process a current sentence because of its structural similarity to a previously experienced ("prime") sentence (J. K. Bock, 1986). The recent explosion of research in structural priming has made it the dominant means of investigating the processes involved in the production (and increasingly, comprehension) of complex expressions such as sentences. This review considers its implications for the representation of syntax and the mechanisms of production and comprehension and their relationship. It then addresses the potential functions of structural priming, before turning to its implications for first language acquisition, bilingualism, and aphasia. The authors close with theoretical and empirical recommendations for future investigations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Analogue versus clinical depression: A critical reappraisal.

Much of the existing psychological literature on depression is based on research with college students. An important question is whether depression in college students represents an appropriate analog of depression in clinical patients. The purpose of the present article is to review past evidence on this issue from a critical perspective. Past arguments are examined, and little support is found for the position that depression research with college students is not warranted. Moreover, the results of studies with student and clinical samples are compared, and the findings are generally similar across populations. Next, a number of methodological issues are identified that may actually favor the use of depressed college students, and some methodological recommendations for future research are outlined. Finally, an appeal is made for research that directly examines the analog–clinical issue and the nature of college student depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Postpartum depression and symbiotic illusion.

Discusses the phenomenon of postpartum depression from a transgenerational perspective. The concept of symbiosis is taken from the mother's point of view as well as from the baby's. Symbiosis is defined as a delusional 2-person fantasy of mutual dependence rather than as a normal phase of development. Analysis of a case of postnatal depression is presented to illustrate the clinical and theoretical implications of this viewpoint and how it was applied in treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Postpartum depression in primiparous parents.

Investigated the hypothesis that postpartum depression is a function of disruption of parents' prepartum functioning by the subsequent demands of infant caretaking. 78 primiparous middle SES married couples (mean age 25.5 yrs) completed a battery of questionnaires, including the Beck Depression Inventory, at 8 wks prepartum and 8 wks postpartum, assessing indicators of stress related to childcare. Results indicate that when the level of prepartum depression was controlled, the reported experience of positively reinforcing events was negatively related to postpartum depression for women. For men, the degree to which their infant's behavior was viewed as better than the average was negatively related to postpartum depression. The strongest predictor of depression in both men and women was prepartum depression level. It is concluded that the findings were consistent with the social stress and behavioral theories' interpretation of postpartum depression. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fibromyalgia. A critical review

Fibromyalgia is a chronic pain syndrome, more common in women. Its prevalence is estimated around 2% in the general population, and up to 20% among rheumatology outpatients. Besides musculoskeletal pain, symptoms as fatigue and sleep disturbance are considered characteristic. Research criteria have been set up, but their seemingly preciseness is unable to distinguish clearly between fibromyalgia and other functional somatic syndromes (chronic fatigue syndrome, irritable bowel syndrome) and psychiatric disorders (depression, anxiety), with which a striking comorbidity is documented. The diagnosis of fibromyalgia does not theoretically require the exclusion of muscle, joint, or metabolic diseases, but in clinical practice this problem proves to be of crucial importance. There are numbers of pathophysiological hypothesis for fibromyalgia, but none of them is fully satisfying: muscle is probably innocent; sleep disturbance, although sometimes considered a landmark of the syndrome, is unspecific; stress response studies show subtle anomaly; psychiatric disorders may represent factors of vulnerability and perpetuation rather than causes. We propose to include some of these etiological contributors in vicious circles leading to a "final common pathway" characterized by generalized hyperalgesia. Treatments of fibromyalgia, whether pharmacological (antidepressants) or psychological (cognitive-behavioral therapies) are of little efficacy, and the global prognosis of fibromyalgia is poor. However, the outcome might prove better outside the specialized clinics in which studies of chronic sufferers with severe abnormal illness behaviors are done. The social consequences of the popularization of the diagnosis of fibromyalgia should not be neglected.     

The open-field test: A critical review.

Examines the use in the literature of the open-field test, especially with regard to the development of a standard form. The various procedures and their shortcomings are discussed, with particular reference to the seemingly inconsequential details which have been shown to modulate open-field performance per se. Dependent parameters are considered both with regard to their reliability and their validity for the measurement of such underlying constructs as emotionality. (92 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A critical review of Seligman's laboratory experiments on learned helplessness and depression in humans.

Reviews 6 laboratory experiments reported by M. E. Seligman and his colleagues (W. R. Miller and Seligman, 1973; Miller and Seligman, 1975; Miller et al, 1975; Miller and Seligman, 1976; D. C. Klein and Seligman, 1976; Klein et al, 1976). The experiments are found to provide little or no support for the learned helplessness theory of depression. A number of methodological and conceptual problems are discussed. It is suggested that heuristic theories such as Seligman's should be closely examined before psychologists embark on an extensive series of experimental tests. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The adopted child's IQ: A critical review.

Summarizes all reliable published data about the nature and nurture of adopted children's IQs, and draws conclusions about the relative importance of heredity and environment on children's mental development. Any study that compares the central tendency of adopted children's IQs with a group mean of 100 IQ points for a normal population cannot be taken seriously until several methodological criteria have been met: (a) representative sampling, (b) no differential loss of Ss over time, (c) accurate, age-corrected information on biological and adoptive parents, (d) careful attention to early separation and placement of children, and (e) elimination of practice effects and regression to the mean artifacts. Analysis of the resemblance between individual adopted children's IQ scores and their adoptive and biological parents' mental abilities shows that the adoptive parents' home environment has only a modest effect on their adopted children's intellectual growth, while heredity and environment of the biological parents have a strong effect on their own children's intellectual growth. At present there is disagreement about the precise values of genetic and environmental effects on IQ, and several assumptions must be made before accurate statistics can be derived. But, the available data strongly suggest that under existing circumstances, heredity is much more important than environment in producing individual differences in IQ. (39 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of cognition in depression: A critical appraisal.

Examines 5 broad areas of cognitive functioning: expectations and evaluations of performance, perception of environmental information, recall of information, cognitive biases, and attributional processes. A review of the literature suggests that neither A. T. Beck's (1967, 1976) nor the learned helplessness model of depression has a strong empirical base. Depressed persons present themselves negatively on a variety of measures, but less consistently than either model suggests. Differences between depressed and nondepressed persons with respect to extralaboratory experiences and self-presentational strategies remain viable alternative explanations for those results that have been obtained. In addition, specificity to depression has not been demonstrated consistently for any measure of cognitive bias or distortion. Attention is given to conceptual and methodological difficulties in unambiguously establishing what people think, in demonstrating biased or distorted cognitive processes, and in testing hypotheses about the fundamental role of cognition in depression. (4? p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behaviour-therapy research with children: A critical review.

Evaluated behavior-therapy research with children published from 1965-1969 as to experimental design and execution. Studies were examined for use of control groups, base line, systematic variation of treatment, unbiased O, and follow up. Results indicate most studies to be inadequate. (French summary) (63 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dropping out of treatment: A critical review.

After a discussion of methodological issues, literature on dropping out of treatment is critically reviewed in 6 areas: hospital treatment of general psychiatric and tubercular patients, outpatient treatment of internal medical conditions, alcoholism, heroin addiction, general psychiatric outpatient psychotherapy, and double-blind drug studies. 15 factors were found to predict dropping out in 100%, 83-88%, and 60-75% of the relevant studies: (a) social isolation and/or unaffiliation, therapist attitudes and behavior, discrepancies between patient and therapist treatment expectations; (b) passive-aggressive behavior, family attitudes and behavior, motivation, behavioral and/or perceptual dependence, psychological mindedness and/or denial, symptom levels and symptom relief, socioeconomic status, sociopathic features, alcoholism and/or drug dependence; and (c) age, sex, and social stability. (101/2 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attributional style in depression: A meta-analytic review.

Conducted a meta-analysis of the attribution–depression relation in studies appearing in the clinical, social, personality, and educational literatures. In 104 studies involving nearly 15,000 Ss, several attributional patterns had reliable associations with depression scores. For negative events, attributions to internal, stable, and global causes had a reliable and significant association with depression. Studies in which the attribution factors of ability and luck were measured also showed a reliable association with depression. Ability and luck attribution factors for positive events were also associated with depression. The relations for positive events, however, were weaker than the corresponding ones for negative events. In general, these patterns of relations were independent of a number of potential mediators suggested by authors in this literature, including the type of S studied (psychiatric vs college student), the type of event about which the attribution is made (real vs simulated), the depression measure used, or the publication status of the research report. Conclusions are compared with those of other reviews. Implications for attributional models of depression are discussed. (81 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)