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Psychological Sequelae in Parents of Extreme Low and Very Low Birth Weight Infants

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Abstract

The current study evaluated the psychological sequelae in 66 parents of extreme low and very low birth weight infants (mean weight of 842 g). Parents who had given birth within a 3-year period prior to the study were chosen from the archives of a neonatal ward and surveyed regarding posttraumatic stress, coping strategies, and social support. Thirty-five percent of the parents reported that their child had a handicap. Twenty percent of the women met the criteria of posttraumatic stress disorder (PTSD) at the time of the study, and an additional 10% met the criteria for a subclinical PTSD diagnosis. Female gender, handicap of the child, general distress during hospitalization, distressing contact with hospital staff, experienced distress at homecoming, and emotional coping, explained 72% of the degree of traumatization. Psychological support and intervention is recommended during the hospital stay of a premature infant who has a handicap and after the homecoming to prevent the development of chronic PTSD and reduce the associated distress.

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References

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders IV. Washington, DC: Author.

  • Ballard, C. G. (1995). Posttraumatic stress disorder (PTSD) after childbirth. British Journal of Psychiatry, 166, 525–528.

    Article  PubMed  CAS  Google Scholar 

  • Beckwith, L. (1990). Adaptive and maladaptive parenting: Implications for intervention. In S. J. Meisels, & J. P. Shonkoff (Eds.), Handbook of early childhood intervention (pp. 53–77). Cambridge, MA: Cambridge University Press.

    Google Scholar 

  • Buunk, B. P., & Hoorens, V. (1992). Social support and stress: The role of social comparison and social exchange processes. British Journal of Clinical Psychology, 31, 445–457.

    PubMed  Google Scholar 

  • Cobb, S. (1976). Social support as a moderator of life stress. Psychosomatic Medicine, 38, 300–314.

    PubMed  CAS  Google Scholar 

  • Cronin, C. M., Shapiro, C. R., Casiro, O. G., & Cheang, M. S. (1995). The impact of very low-birth-weight infants on the family is long lasting. Archives of Pediatrics and Adolescent Medicine, 149, 151–158.

    PubMed  CAS  Google Scholar 

  • DeMier, R. L., Hynan, M. T., Harris, H. B., & Maniello, R. L. (1996). Perinatal stressors as predictors of symptoms of posttraumatic stress in mothers of infants at high risk. Journal of Perinatology, 16, 276–280.

    PubMed  CAS  Google Scholar 

  • DeMier, R. L., & Hynan, M. T. (2000). A measurement of perinatal stressors: Identifying risk for postnatal emotional distress in mothers of high-risk infants. Journal of Clinical Psychology, 56, 89–100.

    Article  PubMed  CAS  Google Scholar 

  • Elklit, A. (1996) Coping styles questionnaire: A further validation of a scale for measuring coping strategies. Personality and Individual Differences, 21, 809–812.

    Article  Google Scholar 

  • Elklit, A. (2002). Victimization and PTSD in a Danish national youth probability sample. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 174–181.

    Article  PubMed  Google Scholar 

  • Elklit, A., & Jind, L. (1999). Forældrereaktioner på spædbarnsdød, Copenhagen: Forlaget Skolepsykologi/Dansk Psykologisk Forlag [Parents’ reactions following death of infant].

  • Elklit, A., Pedersen, S. S., & Jind, L. (2001). The Crisis Support Scale: Psychometric qualities and further validation. Personality and Individual Differences, 31, 1291–1302.

    Article  Google Scholar 

  • Engelhard, I. M., van den Hout, M. A., & Arnoud, A. (2001). Posttraumatic stress disorder after pregnancy loss. General Hospital Psychiatry, 23, 62–66.

    Article  PubMed  CAS  Google Scholar 

  • Field, T., Sandberg, D., Garcia, R., Nitza, V. L., Goldstein, S., & Guy, L. (1985). Pregnancy problems, postpartum depression, and early mother-infant interactions. Developmental Psychology, 21, 1152–1156.

    Article  Google Scholar 

  • Goldberg, S., & DiVitto, B. A. (1983). Born too soon. Preterm birth and early development. San Francisco: W.H. Freeman and Company.

    Google Scholar 

  • Goldberg, S., & Marcovitch, S. (1986). Nurturing under stress: The care of preterm infants and developmentally delayed preschoolers. In A. Fogel & G. Nelson (Eds.), Origins of nurturance: Developmental, biological and cultural perspectives on caregiving (pp. 259–276). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Greisen, G. (1994). Meget for tidligt fødte børn. Månedskrift for Praktisk Lægegerning, 68, 851–860 [Extremely premature infants].

  • Guðmundsdóttir, H. S., Elklit, A., & Guðmundsdóttir, D. B. (2006). PTSD and psychological distress in Icelandic parents of chronically ill children: Does social support mediate psychological distress? Scandinavian Journal of Psychology, 47, 77–93.

    Article  Google Scholar 

  • Halpern, L. F., Brand, K. L., & Malone, A. F. (2001). Parenting stress in mothers of very-low-birth weight (VLBW) and full-term infants: A function of infant behaviorial characteristics and child rearing attitudes. Journal of Pediatric Psychology, 26, 93–104.

    Article  PubMed  CAS  Google Scholar 

  • Hobbie, W. L., Stuber, M., Meeske, K., Wissler, K., Rourke, M. T., Ruccione, K., et al. (2000). Symptoms of posttraumatic stress in young adult survivors of childhood cancer. Journal of Clinical Oncology, 18, 4060–4066.

    PubMed  CAS  Google Scholar 

  • Hughes, M., & McCollum, J. (1994). Neonatal intensive care: Mothers’ and fathers’ perceptions of what is stressful. Journal of Early Intervention, 18, 258–268.

    Google Scholar 

  • Joseph, S. A., Williams, R., & Yule, W. (1992). Crisis support, attributional style, coping style, and post-traumatic symptoms. Personality and Individual Differences, 13, 1249–1251.

    Article  Google Scholar 

  • Joseph, S., Andrews, B., Williams, R., & Yule, W. (1992). Crisis support and psychiatric symptomatology in adult survivors of the Jupiter cruise ship disaster. British Journal of Clinical Psychology, 31, 63–73.

    PubMed  Google Scholar 

  • Kazak, A. E., Alderfer, M., Rourke, M. T., Simms, S., Streisand, R., & Grossman, J. R. (2004). Posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms (PTSS) in families of adolescent childhood cancer survivors. Journal of Pediatric Psychology, 29, 211–219.

    Article  PubMed  Google Scholar 

  • Kazak, A. E., Barakat, L. P., Alderfer, M., Rourke, M. T., Meeske, K., & Gallagher, P. (2001). Posttraumatic stress in survivors of childhood cancer and mothers: Development and validation of the Impact of Traumatic Stressors Interview Schedule (ITSIS). Journal of Clinical Psychology in Medical Settings, 8, 307–323.

    Article  Google Scholar 

  • Kazak, A. E., Barakat, L. P., Meeske, K., Christakis, D., Meadows, A. T., Casey, R., et al. (1997). Posttraumatic stress, family functioning, and social support in survivors of childhood leukemia and their mothers and fathers. Journal of Consulting and Clinical Psychology, 65, 120–129.

    Article  PubMed  CAS  Google Scholar 

  • Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048–1060.

    PubMed  CAS  Google Scholar 

  • Kirkebæk, B., Clausen, H., Storm, K., & Dyssegaard, B. (1994). Skrøbelig Kontakt. For Tidligt Fødte Børn og Deres Samspil med Omgivelserne. Copenhagen: Dansk Psykologisk Forlag [Fragile contact. Premature infants and their interaction with the surroundings].

  • Kupst, M. J., Natta, M., Richardson, C., Schulman, J., Lavigne, J., & Das, L. (1995). Family coping with pediatric leukemia: Ten years after treatment. Journal of Pediatric Psychology, 20, 601–617.

    Article  PubMed  CAS  Google Scholar 

  • Landolt, M. A., Ribi, K., Laimbacher, J., Vollrath, M., Gnehm, H. E., & Sennhauser, F. H. (2002). Brief report: Posttraumatic stress disorder in parents of children with newly diagnosed Type 1 diabetes. Journal of Pediatric Psychology, 27, 647–652.

    Article  PubMed  Google Scholar 

  • Lin, N., Ensel, W. M., Simeone, R. S., & Kuo, W. (1979). Social support, stressful life events, and illness: A model and an empirical test. Journal of Health and Social Behavior, 20, 108–119.

    Article  PubMed  CAS  Google Scholar 

  • Lindy, J. D., Grace M. C., & Green, B. L. (1981). Survivors - outreach to a reluctant population. American Journal of Orthopsychiatry, 51, 468–478.

    Article  PubMed  CAS  Google Scholar 

  • Lyons, S. (1998). Post-traumatic stress disorder following childbirth: Causes, prevention and treatment. In S. Clement (Ed.), Psychological perspectives on pregnancy and childbirth New York: Harcourt.

    Google Scholar 

  • Macey, T. J., Harmon, R. J., & Easterbrooks, M. A. (1987). Impact of premature birth on the development of the infant in the family. Journal of Consulting and Clinical Psychology, 55, 846–852.

    Article  PubMed  CAS  Google Scholar 

  • Madsen, S. A., Lind, D., & Munk, H. (2002). Fædres tilknytning til spædbørn. Copenhagen: Hans Reitzels Forlag [Fathers’ attachment to infants].

  • Maroney, D. (1994). Helping parents survive the emotional “roller coaster ride” in the newborn intensive care unit. Journal of Perinatology, 14, 131–133.

    PubMed  CAS  Google Scholar 

  • Meyer, G. (1991). Gult Lys for Behandling af De Spædeste. Sygeplejersken, 91, 30–31 [Yellow light for treatment of the infants].

  • Mødrehjælpen af 1983. (1998). Sårbar Men Stærk. En Brugsbog om For Tidligt Fødte Børn. Copenhagen: Komitéen For Sundhedsoplysning [Vulnerable but strong. A workbook about premature infants].

  • Mollica, R. F., Caspi-Yavin, Y., Bollini, P., Truong, T., Tor, S., & Lavelle, J. (1992). The Harvard Trauma Questionnaire: Validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. Journal of Nervous and Mental Disease, 180, 111–116.

    Article  PubMed  CAS  Google Scholar 

  • O’Brien, M., Soliday, E., & McCluskey-Fawcett, K. (1995). Prematurity and the neonatal intensive care unit. In M. C. Roberts (Ed.), Handbook of pediatric psychology (pp. 463–478). New York: Guilford Press.

    Google Scholar 

  • Padden, T., & Glenn, S. (1997). Maternal experiences of preterm birth and neonatal intensive care. Journal of Reproductive and Infant Psychology, 15, 121–139.

    Google Scholar 

  • Pederson, D. R. (1987). Maternal emotional responses to preterm birth. American Journal of Orthopsychiatry, 57, 15–21.

    Article  PubMed  CAS  Google Scholar 

  • Porritt, D. (1979). Social support in crisis: Quantity or quality? Social Science and Medicine, 13A, 715–721.

    CAS  Google Scholar 

  • Roger, D., Jarvis, G., & Najarian, B. (1993). Detachment and coping: The construction and validation of a new scale for measuring coping strategies. Personality and Individual Differences, 15, 619–629.

    Article  Google Scholar 

  • Sarimski, K. (1996). Belastung von Eltern frühgeborener Babys nach der Entlassung. Frühförderung Interdisziplinär 15, 28–36.

    Google Scholar 

  • Singer, L. T., Danviller, M., Bruening, P., Hawkins, S., & Yamashita, T. S. (1996). Social support, psychological distress, and parenting strains in mothers of very low birthweight infants. Family Relations, 45, 343–350.

    Article  Google Scholar 

  • Solomon, Z., Avitzur, E., & Mikulincer, M. (1990). Coping styles and post-war psychopathology among Israeli soldiers. Personality and Individual Differences, 11, 451–456.

    Article  Google Scholar 

  • Stern, D. N., Bruschweiler, N., & Freeland, A. (1999). En mor bliver til. Copenhagen: Hans Reitzels Forlag [The birth of a mother].

  • Stjernquist, K. (1992). Extremely low birth weight infants less than 901 Grams. Impact on the family during the first year of life. Scandinavian Journal of Social Medicine, 20, 226–233.

    Google Scholar 

  • Stjernquist, K. (1996). The birth of an extremely low birth weight infant (ELBW) <901 g: Impact on the family after 1 and 4 years. Journal of Reproductive and Infant Psychology, 14, 243–264.

    Google Scholar 

  • Stjernquist, K. (1999). Född för tidligt. Hur Går Det Sedan? Borås, Sverige: Centraltryckeriet AB. [Born too soon. How does it go later in life?].

  • Subramanian, S., & Yoon, H. (2002). Extremely low birth weight infant. http://www.emedicine.com/ped/topic2784.htm.

  • Sylvest, A., & Peitersen, B. (1999). Forældregrupper. Kriseintervention til Forældre under Indlæggelse ved Ekstremt for Tidlig Fødsel. Ugeskrift For Læger, 162, 659–662 [Parental groups. Crisis intervention for parents during hospitalization following extremely premature birth].

  • Tracey, N. (Ed.) (2000). Parents of premature infants. Their emotional world. London: Whurr Publishers.

    Google Scholar 

  • Tucker, P., & Trautman, R. (2000). Understanding and treating PTSD: Past, present, and future. Bulletin of the Menniger Clinic, 64(Suppl. A), 37–51.

    Google Scholar 

  • Vonderlin, E. (1999). Die Bedeutung von Gesprächsgruppen für die Bewältigung einer Frühgeburt durch die Eltern. Frühförderung Interdisziplinär, 18, 19–27.

    Google Scholar 

  • Walker, A., Harris, G., Baker, A., Kelly, D., & Houghton, J. (1999). Posttraumatic stress responses following liver transplantation in older children. Journal of Child Psychology and Psychiatry, 40, 363–374.

    Article  PubMed  CAS  Google Scholar 

  • Weisæth, L. (1989). Importance of high response rates in traumatic stress research. Acta Psychiatrica Scandinavica, 80(Suppl. 355), 131–137.

    Article  Google Scholar 

  • Wilson, J. P., Raphael, B., Meldrum, L., & Bedosky, C. (2000). Preventing PTSD in trauma survivors. Bulletin of the Menninger Clinic, 64, 181–196.

    PubMed  CAS  Google Scholar 

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Correspondence to Ask Elklit.

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Elklit, A., Hartvig, T. & Christiansen, M. Psychological Sequelae in Parents of Extreme Low and Very Low Birth Weight Infants. J Clin Psychol Med Settings 14, 238–247 (2007). https://doi.org/10.1007/s10880-007-9077-4

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