Abstract A longitudinal follow-up study of postnatal depression was performed in the years 1995-2000 in the University of Oulu. A volunteer, ramdomly selected group of 187 mothers from maternal wards of the University Hospital of Oulu were studied with different questionnaires in the first postpartum week. Depressive symptoms were re-assessed with Edinburgh Postnatal Depression Scale four months postpartum when paternal depression was evaluated with Beck Depression Inventory. 16.2% of the women were immediately after delivery screened as being depressed. Four months postpartum 13.0% of the mothers were depressed whereas 5.1 % of the fathers were having depressive symptoms. The cumulative incidence of maternal postnatal depression within the first four months was 22.2%. These mothers who immediately showed depressive symptoms were at a higher risk to be depressed later. Maternal age 30 years or less predicted postnatal depression. The occurrence of maternal postnatal depression varied slightly during different seasons; during dark time immediate depressive symptoms increased and the spring seemed to protect from later postnatal depression. Analgesia during vaginal delivery, e.g. nitrous oxide, epidural analgesia or paracervical blockade, protected from postnatal depression as well. Caesarean section, either elective or emergency, did not predict postpartum mental well-being. Scores from the GHQ and the EPDS were strongly interrelated. Seven (5%) fathers were depressed four moths postpartum. They all were men whose partners also scored high in the EPDS. Those mothers who were depressed interpreted infant facial signals differently, seeing less joy, disgust and anger, but more sadness in the infant facial pictures. Cultural variability was found in complex blended facial features of emotions, e.g. distress, in the Infant Facial Expression from Looking at Picture scale, although remarkable agreement was achieved and reinforced. In the videotaped early mother-infant interaction small, but essential, changes were observed at 10 months postpartum. Overall, mothers who had had persistent depressive symptoms showed less negative expressions and had less anger and anxiety in their interaction. Their children were slightly less impulsive and seemed to have less visual and communicative contact with their mothers. The dyad was characterised by short periods of uninvolvement between the mother and the infant; e.g. the moments of reciprocity were less frequent than in the non-depressed mothers. At 42 months postpartum, the children of the persistently depressed mothers scored lower on the Expressive language scale than the children of the mothers who were depressed in one measurement or never.

The thesis deals with different types of smile of an infant during its early interaction with mother; or more specifically, it focuses on occurrence of smiles during social game routines as compared to other individual interactions, while also mapping the effect of mother's stimulating touch. The predictions were tested on data obtained by a quasi-experimental study, where natural interaction of 32 dyads of mothers with their four-month-old infants was coded for the occurrence and duration of four types of smile (simple, duchenne, play, and duplay), social game routines, and stimulating touch. The results showed the presence of all observed smiles in four-months old infants. Furthermore, there was a significantly higher incidence of all types of smiles during individual interactions as compared to social game routines, and at the same time the association of smiles with mother's stimulating touch was confirmed. Keywords: Smile, early interaction, play, social game routines, stimulating touch.

Cette recherche de thèse propose un travail pluridisciplinaire d’épistémologie de la clinique et d’analyse socio historique de l’émergence et de l’organisation des formes de prise en charge des femmes qui présentent des troubles psychopathologiques et de leur bébé pendant la période périnatale, des conduites thérapeutiques préconisées et des dispositifs de soins mis en place à cette période. Une attention particulière a été portée aux idées, concepts et processus qui ont façonné cette offre de soins récente. L’objet de la recherche se situe donc à l’intersection d’une réflexion clinique (scientifique), institutionnelle (prévention précoce) et organisationnelle (travail en réseau). Prenant la psychologie clinique en actes comme sujet d’étude, il se fonde sur un cadre méthodologique approprié pour produire et analyser une généalogie de savoirs et d’interventions ainsi que des données inédites sur ce que nous appellerons : l’invention, la fabrique d’un nouveau champ intellectuel et de pratiques cliniques qui s’est constitué comme une innovation organisationnelle autour de la prise en charge des vulnérabilités psychiques maternelles pendant la période périnatale. / This thesis proposes a multidisciplinary epistemology of the clinic and a socio-historical analysis of the emergence and organization of forms of care for women who present psychopathological disorders and their baby during the perinatal period, professional therapeutic response, and the care arrangements put in place during this period. Particular attention is paid to the ideas, concepts and processes that shape this novel provision of care. The object of this research rests, therefore, at the intersection of clinical (scientific), institutional (early prevention) and organizational (networking) axes. Taking clinical psychology into action as a subject of study, it is based on grounded theory and discourse analysis to produce and analyze a genealogy of knowledge and intervention as well as new data on what we call: the invention, the creation of a new intellectual field and clinical practice that has been constituted as an innovative organizational structure around the management of maternal psychic vulnerabilities during the perinatal period.

[pt] O luto vivenciado a partir de uma perda gestacional ou neonatal apresenta características e reações semelhantes a outros tipos de luto, entretanto, muitas vezes é não-reconhecido (Doka, 1989). Espera-se que a chegada de um novo bebê seja capaz de resolver o luto. O vínculo entre cuidador primário e a criança é fundamental para a sobrevivência física e emocional e, por isso, essa relação inicial é tão importante para o desenvolvimento de todos os indivíduos. O objetivo da pesquisa foi investigar as repercussões da perda gestacional ou neonatal prévia no processo de construção do vínculo da mãe com o bebê que nasce durante o processo de luto. O estudo de cunho qualitativo entrevistou 17 mulheres que tiveram ao menos uma perda gestacional ou neonatal e tiveram um novo bebê após a perda. Os resultados demonstraram a necessidade das mães explicarem detalhadamente a experiência de perda, em uma possível busca de construção de sentido. A tristeza e a culpa foram identificadas como principais reações frente ao luto que foi vivenciado de maneira silenciosa. A maioria das mães referiu medo relacionado à gravidez subsequente e à vinculação com o bebê durante o período gestacional. O contato corporal foi o principal sistema parental identificado nas interações. O trabalho concluiu que apesar de serem comuns e frequentes e, muitas vezes não- reconhecidas, perdas perinatais são vividas de maneira singular, repercutem nas interações e não são resolvidas com o nascimento de um novo bebê. Acredita-se que esse estudo possa contribuir para a legitimação e o reconhecimento do luto por perda gestacional e neonatal e para a maior atenção às interações iniciais nesse contexto. / [en] The grief experienced after a miscarriage, stillbirth, or neonatal loss presents characteristics and reactions similar to other types of bereavement although it is often unrecognized (Doka, 1989). It is expected that the arrival of a new baby should be able to resolve the grief. The bond between the primary caregiver and the child is fundamental for physical and emotional survival and that is why this initial relationship is so important for the development of all individuals. The objective of this research was to investigate the repercussions of a previous perinatal loss in the process of building the mother s bond with the baby born during the grieving process. The qualitative study interviewed 17 women who had at least one perinatal loss and had a new baby after such loss. The results demonstrated the need for mothers to explain the loss experience in detail, possibly searching for the meaning reconstruction. Sadness and guilt were identified as the main reactions to the grief, which was experienced silently. Most mothers reported fear related to the subsequent pregnancy and to bonding with the baby during the gestational period. Body contact was the main parental system identified in the interactions. The study concluded that, although common and frequent and, many times, unrecognized, perinatal losses are experienced in a unique way, impact on interactions, and are not necessarily resolved with the birth of a new baby. We believe that this study may contribute to the legitimacy and recognition of mourning from perinatal loss and to greater attention to the initial interactions in this context.

RYŠAVÁ, J. A child under 3 years of age at preschool. Prague, 2012. The thesis. Charles University in Prague. Faculty of Education. Department of Primary Education. Thesis supervisor E. Opravilová. The work followed the specifics of the educational work between 2-3 years of age in an ordinary preschool. The theoretical part is based on developmental psychological characteristics of this period. It monitored the impact of early interactions mother - child, influence of family environment and other factors affecting the child's separation from the mother and the subsequent adaptation and socialization in a preschool environment. The survey includes six case studies of selected two-year old children (position of the child), 24 selected parents of preschool children within one preschool (parents' position) and 51 preschools (teacher's position). The research followed the specific impact of key factors influencing the course of adaptation and socialization of a child under 3 years of age in a preschool environment, including the anticipated impact of key chronological age. In addition, it monitored and defined the conditions of preschools in the legislative, organizational and personnel conditions, and when their fulfillment can be considered suitable for education of a child under 3 years in a...