Disturbances in Early Relationships

What is postpartum sadness often called?

The baby blues.

What percentage of new mothers experience postpartum sadness?

50–80%.

When does postpartum sadness usually occur?

Within the first 10 days after birth.

Does postpartum sadness usually require treatment?

No, it usually fades as mothers adjust and gain confidence.

What percentage of new mothers experience postpartum depression (PPD)?

8–15%.

How is postpartum depression different from postpartum sadness?

The negative feelings do not lessen and interfere with caring for the infant.

Which mothers are at greater risk for PPD?

Mothers with poor physical health, low social support, and low economic means.

Can fathers experience postpartum depression?

Yes.

What percentage of fathers with a partner who has PPD also experience PPD?

24–50%.

What is the most widely used screening tool for postpartum depression?

The Edinburgh Postnatal Depression Scale.

How many questions are on the Edinburgh Postnatal Depression Scale?

10 questions.

What time period does the Edinburgh Postnatal Depression Scale ask about?

The previous 7 days.

What symptoms do clinicians consider when diagnosing depression after childbirth?

Mood, sleep, appetite, energy, concentration, decisiveness, and ability to feel pleasure.

What are additional warning signs of postpartum depression?

Feelings of worthlessness, despair, and thoughts of harming oneself or the infant.

How do withdrawn mothers with PPD interact with their infants?

They interact less and are less sensitive and responsive.

How do withdrawn mothers with PPD show less interaction?

They smile, touch, and talk less.

How do intrusive mothers with PPD behave?

They may poke or prod their infants physically.

What determines how strongly PPD affects infants?

The duration of the depression.

When are the negative effects of PPD strongest?

When the depression persists.

How do infants of mothers with PPD often behave?

They show depressed behavior, including less eye contact and joint engagement.

Do infants of mothers with PPD show depressed behavior only with their mothers?

No, they show it even with non-depressed adults.

What does it mean that infants generalize interaction patterns?

They use the same interaction style with other adults.

How did non-depressed adults behave when interacting with infants of mothers with PPD?

They became less interactive.

Can effects of PPD be seen in newborns?

Yes.

What may contribute to effects seen in newborns?

Prenatal factors.

Without intervention, what cognitive outcome is associated with maternal PPD?

Poorer cognitive outcomes.

How does maternal PPD affect attachment?

It is linked to higher rates of insecure attachment.

What behavioral outcomes are linked to maternal PPD?

Higher risk for ADHD and more anger-management problems.

Why can drug treatments for PPD be difficult?

They may be problematic for breastfeeding mothers.

How are withdrawn mothers coached during intervention?

To increase face-to-face interaction and caring touch.

How are intrusive mothers coached during intervention?

To slow down and imitate the infant's behavior.

What therapies may improve the mother's mood?

Music therapy and massage therapy.

Does improving the mother's mood automatically improve interactions with the infant?

No.

Which family members can be involved in interventions?

Fathers, grandparents, and other non-depressed family members.

What benefits does infant massage therapy provide?

Reduced stress and increased sociability.

From 2009 to 2013, what happened to child victimization rates?

They declined from 9.3 to 9.1 per 1,000 children.

What percentage of maltreatment victims were neglected?

79.5%.

What percentage of maltreatment victims were physically abused?

18.0%.

What percentage of maltreatment victims were sexually abused?

9.0%.

What percentage of maltreatment victims were psychologically maltreated?

8.7%.

How many children died from abuse and neglect in 2013?

An estimated 1,520 children.

How does maltreatment affect development?

Negative effects occur in almost all areas of development.

What biological effect is linked to prolonged maltreatment?

Higher stress and cortisol levels.

How does maltreatment affect attachment?

It leads to poorer-quality attachment.

What social and school problems are linked to maltreatment?

Less empathy, learning problems, and behavioral problems.

What role does genotype play in maltreatment outcomes?

Genotype affects children's behavioral outcomes after maltreatment.

What neurotransmitters were mentioned in the genotype slide?

Dopamine and serotonin.

What is the most common form of maltreatment for infants under age 1?

Neglect.

What are the most common causes of neglect?

Parental drug abuse and abandonment.

What can help protect maltreated children?

A non-abusive caregiver or another emotionally supportive adult.

What prevention programs were mentioned for maltreatment?

Nurse home visitation programs and prenatal parent education.

In urgent cases, where should infants be placed?

With relatives or in foster care.

Why is foster care preferred over institutional care?

The slide states it is preferable to institutional care.

What major event led to many Romanian children being raised in institutions?

The fall of Nicolae Ceaușescu's Communist regime in 1989.

What did the Bucharest Early Intervention Project study?

The effects of institutional life on children.

How did developmental scores compare among children?

Never-institutionalized children scored highest, children placed in foster care before age 2 scored better than those placed after age 2, and institutionalized children scored lowest.

What do the foster-care findings suggest?

Earlier placement in foster care leads to better outcomes.

What did EEG studies show about children placed in foster care before age 2?

Their brain functioning at age 8 almost matched never-institutionalized children.

At age 8, which group showed the highest social skills?

Never-institutionalized children.

How did children placed in foster care before 20 months compare to those placed later?

They had better social skills.

What relationship was shown between attachment security at 42 months and social skills at age 8?

Higher attachment security was linked to better social skills.

What factor moderated the relationship between attachment security and social skills?

Brain alpha activity at age 8.

What can institutions do to improve outcomes for children?

Reduce child-caregiver ratios.

What caregiver practice can improve institutional care?

Assigning caregivers to specific children.

How can caregivers in institutions be trained?

To stimulate infants socially and cognitively.

What enrichment activities were suggested for institutions?

Music, dance, swimming, and massage.

Are the effects of postpartum depression, maltreatment, and deprivation limited to social development?

No, cognitive development is also affected.

What two things are especially important according to the summary?

Early detection and intervention.

What does the foster-care research suggest about sensitive periods?

Earlier foster placement leads to better outcomes.

According to the summary, what can buffer negative effects?

Genes and the caregiving environment.