Aims: The overall aims were to study depressive symptoms among mothers and fathers in early parenthood and how depressive symptoms are related to dyadic consensus (DCS), sense of coherence (SOC), perceiving of the child temperament, separation within the couple and bonding to the infant. Methods: Study I-III was based on the BiT-study, a longitudinal project where 393 couples answered 3 questionnaires including instruments measuring DCS at one week after childbirth, depressive symptoms at 3 months and parental stress at 18 months after childbirth. Study IV was based on the UPPSAT-study, a population based cohort project, where 727 couples answered questionnaires measuring depressive symptoms at 6 weeks and 6 months after childbirth, and impaired bonding at 6 months after childbirth. Results: In the BiT-study, 17.7% of the mothers and 8.7% of the fathers scored depressive symptoms at 3 months after childbirth, using the Edinburgh Postnatal Depression Scale (EPDS) cut-off of ≥10. There was an association between depressive symptoms and less consensus (DCS), and the parents partly differed regarding which areas of their relationship they perceived that they disagreed about. Parents with depressive symptoms had a poorer SOC and perceived their child as more difficult than parents without depressive symptoms. Among the couples, 20% were separated 6-8 years after childbirth. Separation was associated with less dyadic consensus, more depressive symptoms and parental stress. In the UPPSAT-study, 15.3% of the mothers and 5.1% of the fathers scored depressive symptoms 6 weeks after childbirth, using the EPDS cut-off of ≥10. Further, there was an association between impaired bonding at 6 months and the parents’ depressive symptoms, as well as experience of deteriorated relationship with the spouse. Conclusions and clinical implications: Health professionals need the knowledge that depressive symptoms are common in both mother and fathers in early parenthood. It is also important to understand how depressive symptoms are associated to dyadic consensus, SOC, separation and impaired bonding in order to optimize conditions for the whole family. This knowledge is also important for the public, so those who are pregnant and new parents as well as the society are aware that there might be problems in early parenthood as depressive symptoms.

Ätstörningar i samband med graviditet är ett växande, dolt problem. Kvinnor som lider av en ätstörning väljer i många fall att dölja sina symtom, inte minst under en graviditet. Tecken kan vara svåra att se, vilket ställer stora krav på att sjuksköterskan är väl insatt i de tecken och symtom som tyder på att en ätstörning förekommer. Syftet med studien var att beskriva tecken och symtom på att en ätstörning förekommer i samband med en graviditet. Metoden som användes var en litteraturstudie, där resultatdelen baserades på elva vetenskapliga artiklar. Analysen mynnade ut i fyra kategorier: kontrollerad kosthållning och vikt, utsatta livssituationer, förvrängd självbild samt depression och ångest. Resultatet påvisade en oro, starkt kopplad till den egna vikten, samt kroppens form. Smalhetsidealet i dagens samhälle sätter stor press på kvinnor och deras utseende. Kvinnor i sårbara livsituationer och med låg självkänsla, var mer benägna att utveckla en ätstörning i samband med en graviditet än kvinnor med stabil livsituation och god självkänsla. Sjuksköterskan behöver vara lyhörd för tecken och symtom på att en ätstörning förekommer i samband med graviditet. God kommunikation är av stor vikt för att nå fram till patientgruppen. Ytterligare forskning kring hur sjuksköterkor skall arbeta med gravida kvinnor, efter upptäckten av att en ätstörning förekommer, är av intresse. / Eating disorders in pregnancy is a growing, yet hidden problem. Women who suffer from an eating disorder often choose to hide their symptoms, especially during a pregnancy. Signs which indicate that an eating disorder occurs during the pregnancy may be difficult to detect. This is a dilemma and therefore the nurse has to be familiar with signs and symptoms which may occur. The aim of the study was to describe signs and symptoms of eating disorder during a pregnancy. A literature study was accomplished as a method, where the result was based on eleven scholarly articles. The analysis of the study culminated into four categories: controlled diet and weight control, tough circumstances in life, distorted self-image and depression and anxiety. The result demonstrates a concern, strongly related to the perception of an individual’s weight and body shape. The idea of being slim in today’s society puts a lot of pressure on women and their appearance. Women in vulnerable circumstances of life and with low self-esteem, were more likely to develop an eating disorder during pregnancy. Therefore the nurse has to be alert to detect symptoms and signs of eating disorders during pregnancy. Good communication is of importance to reach out to the patient group. Additional research about nursing of pregnant women after discovering that an eating disorder occurs, is of interest.

Typescript. / Bibliography: leaves 271-297. / Photocopy. / xiii, 297 leaves, bound 29 cm

Although a vast literature attests to the belief that psychosocial disturbance is an important component of functional gastrointestinal disorders (FGID), the relation of life stress, psychological distress and personality to the development of these disorders is poorly understood. The broad objective of this thesis is to provide data on relations between psychosocial factors and FGID, especially irritable bowel syndrome (IBS) and functional dyspepsia (FD), in representative outpatient samples. Issues not previously addressed are examined in a series of studies. The first two studies are concerned with relations between psychosocial factors, extraintestinal (somatic) symptoms and the number and type of FGID syndromes present at consultation and, in IBS patients, the prospective relation of psychosocial factors to changes in symptom intensity over 16 months. The last three studies relate psychosocial factors to gastrointestinal (GI) transit, motor, and sensory function in FGID, abnormalities in these parameters representing the putative origin of symptoms in FGID. In total, 350 patients participated, representing a 95% participation rate. Important features of the methodology include the use of a recently standardised symptom-based classification system for FGID, an objective and reliable interview-based life stress instrument (The Life Events and Difficulties Schedule), and sophisticated and sensitive technologies to assess GI transit, motor and sensory function. Novel measures, which conceptually take into account the chronic, fluctuating and recurrent course of IBS and FD syndromes, and the tendency of these syndromes to coexist, are also included. Thus, measures of symptom outcome assess the number of syndromes present, while the symptom intensity variable reflects the severity and frequency of both FD and IBS symptoms, if both are present. Similarly, with respect to altered transit, and motor and sensory function, physiological outcome variables reflect not only the presence of an abnormality but the number of regions affected, and the type and number of abnormalities present. Cross-sectional findings showed for the first time that psychosocial disturbance is associated with FGID symptomatology in a quantitative manner, that chronic life stress threat is central to this process and this stress-related process is a prominent feature of a particular group of syndromes (ie IBS/FD) defined primarily by the presence of pain and discomfort. A combination of psychological, social and biological factors combined to predict the number of FGID syndromes present at entry into the study. Prominent among them was an angry, reactive and anxious (neurotic) personality, chronic life stress threat, increased coping, poor emotional support and increased age. In addition to a greater number of FD/IBS syndromes, individuals with an anger-reactive response style had experienced more intense pain and discomfort, and displayed more complete sensorimotor disturbance. Longitudinal data demonstrated (also for the first time) the strength, consistency and unequivocal direction of the relation of chronic threat to symptom intensity over time. Almost all of the within subject variance in symptom intensity levels (assessed on 3 occasions over a 16 month period) was explained by the severity of chronic threat during the previous 6 months or more. For 76% of IBS patients, the presence vs the absence of one or more highly threatening chronic stressors predicted with considerable precision, the long-term clinical outcome. Thus, no patient exposed to even one such stressor improved clinically (ie by at least 50%) over the follow-up period, while in contrast, all patients who improved clinically did so in the absence of such a stressor. For 24% of patients, however, failure to improve clinically could not be explained by any psychological, social (including life stress) or demographic factor included in this study. Key risk indicators of a poor outcome at 16 months were identified - chronic life stress threat, the severity of baseline GI symptomatology, and female gender. Life stress is important because it alone determined the magnitude and direction of change in symptom intensity over time, while the severity of baseline GI symptomatology revealed the extent of improvement required to achieve a recovery, and female gender predicted the presence of a larger number of FD/IBS syndromes in women long-term. Widespread hypomotility, which was almost exclusive to women in this study, represents one factor that may inhibit improvement (or rate of improvement) for women over time. Finally, these findings have identified a psychophysiological subgroup, with underlying psychosocial, motor (and perhaps also sensory) dysfunctions that are more specific for women than men, and which does not seem to be distinctive of any particular FGID subgroup.

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 5 uppsatser.

Thesis (Ph. D.)--Michigan State University. Dept. of Psychology, 2006. / Title from PDF t.p. (viewed on Nov. 16, 2008) Includes bibliographical references (p. 71-78). Also issued in print.

Thesis (M.A.)--Trinity Evangelical Divinity School, 1996. / Abstract. Includes bibliographical references (leaves 167-184).

Thesis (M.S.)--University of Michigan, 1984.

Thesis (M.S.)--University of Michigan, 1984.

Thesis (M.A.) - Carleton University, 2006. / Includes bibliographical references (p. 41-49). Also available in electronic format on the Internet.