Impact of Depression and Childhood Trauma in Mothers Receiving Home Visitation.

Impact of Depression and Childhood Trauma in Mothers Receiving Home Visitation.

J Child Fam Stud. 2012 Aug; 21(4): 612-625
Ammerman RT, Shenk CE, Teeters AR, Noll JG, Putnam FW, Van Ginkel JB

Research has documented the deleterious effects of maternal depression and childhood trauma on parenting and child development. There are high rates of both depression and childhood trauma in new mothers participating in home visitation programs, a prevention approach designed to optimize mother and child outcomes. Little is known about the impacts of maternal depression and childhood trauma on parenting in the context of home visitation. This study contrasted depressed and non-depressed mothers enrolled in the first year of a home visitation program on parenting stress, quality of home environment, social network, and psychiatric symptoms. Mothers were young, low income, and predominantly unmarried. Results indicated that depressed mothers displayed impairments in parenting, smaller and less robust social networks, and increased psychiatric symptoms relative to their non-depressed counterparts. Path analyses for the full sample revealed a path linking childhood trauma, depression, and parenting stress. Path analyses by group revealed several differential relationships between dimensions of social network and parenting. Number of embedded networks, namely the number of different domains in which the mother is actively interacting with others, was associated with lowered parenting stress among non-depressed mothers and increased parenting stress in their depressed counterparts with childhood trauma histories. In depressed mothers, social network size was associated with lower levels of parenting stress but decreased quality of the home environment, whereas number of embedded networks was positively related to quality of the home environment. Implications of findings for home visitation programs are discussed. HubMed – depression

Dynamic of Change in Pathological Personality Trait Dimensions: A Latent Change Analysis Among at-Risk Women.

J Psychopathol Behav Assess. 2013 Jun 1; 35(2): 173-185
Barbot B, Hunter SR, Grigorenko EL, Luthar SS

This study explores longitudinally a four-factor structure of pathological personality trait dimensions (PPTDs) to examine both its structural stability and intra-individual changes among PPTDs over time. Personality Disorder (PD) scales of the Millon Clinical Multiaxial Inventory-III were administered to 361 low-income women with various psychiatric conditions (drug dependence, depression), who were followed in a two-wave study over 5-years. Cross-sectional and longitudinal factor analyses outlined a robust factorial structure of PPTDs, extrinsically invariant over time, representing Negative Emotionality, Introversion, Antagonism and Impulsivity. Despite moderate rank-order stability in the PPTDs, results also indicated substantial intra-individual variability in the degree and direction of change, consistent with trajectories of change in participants’ clinical diagnoses. Results are discussed in light of current debates on the structure and dynamic of pathological personality. HubMed – depression

Research setting versus clinic setting: Which produces better outcomes in cognitive therapy for depression?

Cognit Ther Res. 2013 Jun 1; 37(3): 605-612
Gibbons CR, Stirman SW, Derubeis RJ, Newman CF, Beck AT

To compare the outcomes of cognitive therapy for depression under controlled and clinically representative conditions, while holding several therapist and clinical assessment factors constant.Treatment outcomes for a sample of 23 adults with a primary diagnosis of Major Depressive Disorder who received cognitive therapy in an outpatient clinic were compared with outcomes of 18 clients who were treated in the cognitive therapy condition of a large, multi-site randomized clinical trial of treatments for depression. All participants had been treated by one of two therapists who served as clinicians in both settings. Individuals in the two samples were diagnostically and demographically similar (approximately 50% Female, 83% White). A variety of client characteristics, assessed prior to treatment, as well as the outcomes of treatment, were examined.Significantly superior treatment outcomes were observed in the individuals treated in the research study, relative to clients in the outpatient clinic, and the difference was not accounted for by intake characteristics. Individuals treated by the therapists in the RCT experienced almost three times as much improvement in depressive symptoms as clients seen in the outpatient setting.If replicated, the findings suggest that differences exist between treatment outcomes in research and outpatient settings and that these differences may not simply be due to therapist experience and training, or differences in patient populations. Future research should further examine the impact of fidelity monitoring, treatment expectation and motivation, and the duration and timing of treatment protocols on clinical outcomes. HubMed – depression

Good Prognosis for Pericarditis With and Without Myocardial Involvement: Results from a Multicenter Prospective Cohort Study.

Circulation. 2013 May 24;
Imazio M, Brucato A, Barbieri A, Ferroni F, Maestroni S, Ligabue G, Chinaglia A, Cumetti D, Della Casa G, Bonomi F, Mantovani F, Di Corato P, Lugli R, Faletti R, Leuzzi S, Bonamini R, Modena MG, Belli R

BACKGROUND: The natural history of myopericarditis/perimyocarditis is poorly known and recently published data have presented contrasting data on their outcomes. The aim of the present article is to assess their prognosis in a multicenter, prospective cohort study. METHODS AND RESULTS: A total of 486 patients (median age 39 years, range 18-83, 300 men) with acute pericarditis or a myopericardial inflammatory syndrome (myopericarditis/perimyocarditis) (85% idiopathic, 11% connective tissue disease or inflammatory bowel disease, 5% infective) were prospectively evaluated from January 2007 to December 2011. The diagnosis of acute pericarditis was based on the presence of 2 of 4 clinical criteria (chest pain, pericardial rubs, widespread ST-segment elevation or PR depression, and new or worsening pericardial effusion). Myopericardial inflammatory involvement was suspected with atipycal ECG changes for pericarditis, arrhythmias, cardiac troponin elevation and/or new or worsening ventricular dysfunction on echocardiography, and confirmed by cardiac magnetic resonance. After a median follow-up of 36 months normalization of LV function was achieved in >90% of patients with myopericarditis/perimyocarditis. No deaths were recorded, as well as evolution to heart failure or symptomatic LV dysfunction. Recurrences (mainly as recurrent pericarditis) were the most common complication during follow-up and were more frequently recorded in patients with acute pericarditis (32%) than myopericarditis (11%) or perimyocarditis (12%; p<0.001). Troponin elevation was not associated with an increase of complications. CONCLUSIONS: The outcome of myopericardial inflammatory syndromes is good. Unlike acute coronary syndromes, troponin elevation is not a negative prognostic marker in this setting. HubMed – depression

Parental use of antidepressant medication and family type in the risk for incident psychiatric morbidity in offspring.

J Epidemiol Community Health. 2013 May 25;
Joutsenniemi K, Moustgaard H, Martikainen P

BACKGROUND: Maternal depression increases the risk for psychiatric morbidity in offspring but the effects of paternal depression and family type are less studied. METHODS: We assessed the effects of parental antidepressant use on offspring psychiatric morbidity in various family settings. RESULTS: Our register-based study followed 132637 children for incident psychiatric morbidity in 1998-2003. The highest risk for psychiatric morbidity was in children living with both parents on antidepressants or with a lone parent on antidepressants. We found little variation in the effects according to parental or offspring gender. CONCLUSIONS: Parental depression as measured by antidepressant use, and single parenthood pose a risk for psychiatric morbidity in offspring. HubMed – depression