Objetivo: Analisar a influência dos cuidados maternos percebidos pelas mães sobre a frequência de aleitamento materno e aleitamento materno exclusivo, aos 3 e 6 meses de vida da criança em uma amostra expostas a diferentes ambientes intrauterinos. Métodos: Estudo observacional longitudinal, utilizando uma amostra de conveniência de mães e seus recém-nascidos, no qual os grupos foram classificados de acordo com as exposições maternas ocorridas no período gestacional, como diabetes mellitus, tabagismo ou desfecho do recém-nascido, como pequeno para idade gestacional, além de um grupo controle. Para algumas análises, os grupos em estudo foram subdivididos em grupo de condições intrauterinas adversas e grupo controle. A amostra foi selecionada em três hospitais de Porto Alegre, Rio Grande do Sul, Brasil, no período de 2011 a 2015. As mães e seus recém-nascidos foram avaliados ao nascimento, 7 e 15 dias, primeiro, terceiro e sexto mês de vida da criança. O aleitamento materno e o aleitamento materno exclusivo foram avaliados desde a entrevista do 15º dia até a entrevista do sexto mês de vida. Os questionários Parental Bonding Instrument (PBI), que avalia a percepção dos cuidados maternos e Edinburgh Postnatal Depression Scale (EPDS), que avalia a presença de sintomas depressivos após o parto, foram autoaplicados na entrevista do terceiro mês. Os testes utilizados foram ANOVA com post hoc de Tukey, teste Kruskal-Wallis com post hoc de Dunn, ANOVA de duas vias, ANCOVA e a Regressão de Poisson. As análises foram realizadas no programa Statistical Package for the Social Sciences versão 18.0. Resultados: A amostra foi composta de 212 duplas mãe/criança, 40 no grupo de mães com diabetes mellitus, 55 no grupo de tabagistas, 21 no grupo de nascidos pequenos para idade gestacional e 96 no grupo controle. A associação entre cuidado materno e amamentação entre os grupos em estudo mostrou que as mães que não praticavam mais o aleitamento materno no 3º mês de vida da criança apresentaram maiores escores na percepção de proteção e menores escores na percepção de cuidados maternos do que aquelas crianças que estavam em aleitamento materno exclusivo (p=0,038; p=0,017, respectivamente). O grupo controle apresentou maior escore na percepção de cuidados e menor escore na percepção de proteção materna em relação ao grupo de ambientes intrauterinos adversos (p=0,005, p=0,049, respectivamente). Em relação aos resultados da análise de regressão de Poisson entre amamentação, grupos, PBI e EPDS os dados mostram que, a cada um ponto a mais no protocolo de EPDS, o risco de não amamentar até 3 meses aumenta em 10,4% e até os 6 meses aumenta em 4,7% (p<0,001 e 0,004, respectivamente). Em relação ao aleitamento materno exclusivo, a cada um ponto a mais no protocolo de EPDS, o risco de não amamentar até 6 meses aumenta em 5,4% (p=0,002). As puérperas que perceberam restrição de carinho de suas mães aos 6 meses, apresentaram risco de 2,42% em relação à categoria de cuidado ótimo para não amamentar. Aquelas mães que perceberam suas mães como negligentes, apresentaram tendência de maior risco de 2,53% em relação à categoria de cuidado ótimo para não amamentar aos 6 meses de vida da criança. Conclusão: Os achados deste estudo sugerem que o estilo parental de baixo cuidado e de superproteção percebidos durante a infancia, interfere na frequencia do aleitamento materno e leva a sintomas depressivos após o parto. Demonstram, ainda, que os sintomas depressivos maternos após o parto influencia na frequencia da amamentação. / Objective: To analyze the influence of maternal care perceived by mothers on the frequency of breastfeeding and exclusive breastfeeding at 3 and 6 months of the child's life in a sample exposed to different intrauterine environments. Methods: A longitudinal observational study used a convenience sample of mothers and their newborns. They were classified according to maternal exposure occurring during pregnancy, such as diabetes mellitus, smoking or outcome newborn, the small for gestational age, and a control group. For some analyzes, the study groups were divided into two groups: the group of adverse intrauterine conditions and control group. The recruitment of participants was in three hospitals in Porto Alegre, Rio Grande do Sul, Brazil, from 2011 to 2015. The mothers and their newborns were evaluated at the newborns birth, 7 and 15 days, first, third and sixth month of child’s life. Breastfeeding and exclusive breastfeeding was evaluated from the 15th day to the sixth month of life, through questionnaires. The Parental Bonding Instrument questionnaires (PBI), which evaluates the perception of maternal care and Edinburgh Postnatal Depression Scale (EPDS), to assess the presence of depressive symptoms after delivery, were self-administered in the third month interview. The statistical tests used were ANOVA one-way with post hoc Tukey, Kruskal-Wallis test with post hoc Dunn, The two-way ANOVA, ANCOVA test and Poisson regression. Analyzes were performed using the Statistical Package for the Social Sciences version 18.0. Results: The sample was composed of 212 mothers with their child, 40 pairs in the diabetes mellitus group, 55 in the smokers group, 21 in small for gestational age group and 96 in the control group. The association between maternal care and breastfeeding among study groups showed that mothers who no longer practiced breastfeeding in the 3rd month of the child's life had higher scores in the perception of protection and lower scores in the perception of maternal care than those children who were in exclusive breastfeeding (p = 0.038, p = 0.017, respectively). The control group had higher scores of perceived care and lower perception of maternal protection in relation to the adverse intrauterine environment group (p=0.005, p=0.049, respectively). Regarding the results of the Poisson regression analysis between breastfeeding groups, PBI, and EPDS data show that each additional point on the EPDS protocol, the risk of not breastfeeding up to 3 months increased by 10.4% and up 6 months increases by 4.7% (p <0.001 and 0.004, respectively). Compared with exclusive breastfeeding, each additional point on the EPDS protocol, the risk of not breastfeeding up to 6 months increased by 5.4% (p = 0.002). The mothers realized that restriction affection from their mothers at 6 months had a risk of 2.42% compared to the great care category to not breastfeed. Those mothers who perceived their mothers as negligent tended to increase the risk of 2.53% compared to the great care category for not breastfeeding at 6 months of child's life. Conclusion: The findings of this study suggest that low care and overprotection parenting style perceived during childhood, interfere with the frequency of breastfeeding and leads to depressive symptoms after delivery. They also demonstrated those maternal depressive symptoms after birth influences breastfeeding frequency.

O presente estudo investigou eventuais modificações nas representações acerca da maternidade em mães com indicadores de depressão ao longo de uma psicoterapia breve pais-bebê. Participaram do estudo duas famílias com mães com indicadores de depressão, de acordo com o Inventário Beck de Depressão e uma entrevista diagnóstica. Foi utilizado um delineamento de estudo de casos coletivo, sendo que as representações maternas foram examinadas em três momentos: antes, durante e após a psicoterapia. As entrevistas e as sessões de psicoterapia foram analisadas a partir dos quatro eixos interpretativos que constituem a constelação da maternidade proposta por Stern (1997): vida-crescimento; relacionar-se primário; matriz de apoio; e reorganização da identidade. Os resultados revelaram que em ambos os casos as mudanças nas representações das mães acerca do relacionamento com suas próprias mães desempenharam um papel central na reelaboração de esquemas a respeito de si mesma, do bebê e do relacionamento conjugal. Verificou-se também que as representações de cada mãe estiveram atreladas às suas histórias de vida, sugerindo uma estreita associação entre seus conflitos pregressos e a interação atual com o marido e com o bebê. Apesar das particularidades verificadas em cada caso, não foram encontrados indicadores de depressão em nenhuma das mães ao final da psicoterapia. Discutem-se os alcances e limitações da psicoterapia breve paisbebê como intervenção no contexto da depressão materna, apontando-se para a efetividade da utilização dos temas da constelação da maternidade como eixos interpretativos na avaliação de processo psicoterápico envolvendo pais e bebê. / The present study investigated eventual changes in the representations concerning the motherhood in mothers with depression indicators along a brief parent-baby psychotherapy. This study sample was composed by two families whose mothers had presented depression indicators according to Beck Depression Inventory and a diagnostic interview. A collective case study design was used. The maternal representations were examined in three moments: before, during and after the psychotherapy. The interviews and the psychotherapy sessions were analyzed according the four interpretative axes of the motherhood constellation proposed by Stern (1997): life-growth; the primary relatedness; supporting matrix; and identity reorganization. The results revealed that in both cases the changes in the mothers representations concerning the relationship with their own mothers played a central part in the reorganization of squem regarding herself, the baby and the marital relationship. It was verified that each mothers representations were harnessed to their life histories, suggesting a narrow association between their past conflicts and the current interaction with the husband and with the baby. In spite of the particularities verified in each case, they were not found depression indicators in none of the mothers at the end of the psychotherapy. The limitations of the brief parent-baby psychotherapy reached in the context of maternal depression are discussed, being pointed for the effectiveness of the use of the themes of the motherhood constellation as interpretative axes in the evaluation of psychotherapic process involving parents and baby.

O presente estudo investigou eventuais modificações nas representações acerca da maternidade em mães com indicadores de depressão ao longo de uma psicoterapia breve pais-bebê. Participaram do estudo duas famílias com mães com indicadores de depressão, de acordo com o Inventário Beck de Depressão e uma entrevista diagnóstica. Foi utilizado um delineamento de estudo de casos coletivo, sendo que as representações maternas foram examinadas em três momentos: antes, durante e após a psicoterapia. As entrevistas e as sessões de psicoterapia foram analisadas a partir dos quatro eixos interpretativos que constituem a constelação da maternidade proposta por Stern (1997): vida-crescimento; relacionar-se primário; matriz de apoio; e reorganização da identidade. Os resultados revelaram que em ambos os casos as mudanças nas representações das mães acerca do relacionamento com suas próprias mães desempenharam um papel central na reelaboração de esquemas a respeito de si mesma, do bebê e do relacionamento conjugal. Verificou-se também que as representações de cada mãe estiveram atreladas às suas histórias de vida, sugerindo uma estreita associação entre seus conflitos pregressos e a interação atual com o marido e com o bebê. Apesar das particularidades verificadas em cada caso, não foram encontrados indicadores de depressão em nenhuma das mães ao final da psicoterapia. Discutem-se os alcances e limitações da psicoterapia breve paisbebê como intervenção no contexto da depressão materna, apontando-se para a efetividade da utilização dos temas da constelação da maternidade como eixos interpretativos na avaliação de processo psicoterápico envolvendo pais e bebê. / The present study investigated eventual changes in the representations concerning the motherhood in mothers with depression indicators along a brief parent-baby psychotherapy. This study sample was composed by two families whose mothers had presented depression indicators according to Beck Depression Inventory and a diagnostic interview. A collective case study design was used. The maternal representations were examined in three moments: before, during and after the psychotherapy. The interviews and the psychotherapy sessions were analyzed according the four interpretative axes of the motherhood constellation proposed by Stern (1997): life-growth; the primary relatedness; supporting matrix; and identity reorganization. The results revealed that in both cases the changes in the mothers representations concerning the relationship with their own mothers played a central part in the reorganization of squem regarding herself, the baby and the marital relationship. It was verified that each mothers representations were harnessed to their life histories, suggesting a narrow association between their past conflicts and the current interaction with the husband and with the baby. In spite of the particularities verified in each case, they were not found depression indicators in none of the mothers at the end of the psychotherapy. The limitations of the brief parent-baby psychotherapy reached in the context of maternal depression are discussed, being pointed for the effectiveness of the use of the themes of the motherhood constellation as interpretative axes in the evaluation of psychotherapic process involving parents and baby.

Latinos are the fastest-growing minority group in the United States and have higher dropout rates compared to other groups. Moreover, problem behaviors are common in preschool classrooms, and the incidence of these problems is higher for children from low-income families. The purpose of this study was to understand Latino children's problem behaviors in the context of peer play interactions and identify those variables that influence such behavior. 265 five and six-year-old Spanish-speaking children (53.6% female) attending Head Start or kindergarten participated in the study. Additionally, 198 mothers and 78 pre-kindergarten and kindergarten lead teachers participated in the study. Child level data were gathered through the Penn Interactive Peer Play Scale, Teacher (PIPPS-T), the Peabody Picture Vocabulary Test, Fourth Edition (PPVT-4), and the Test de Vocabulario en Imágenes Peabody (TVIP). Maternal data were obtained from the Demographic Parent Interview, the Brief Symptom Inventory (BSI), and the Breve Inventario de Síntomas (BIS). Both correlations and the multilevel models showed play disconnection related negatively to the child’s English proficiency and positively to maternal depression. Results suggest that children with lower English proficiency tend to be more disconnected from their peers as compared to children with higher English proficiency. Similarly, mothers with higher levels of depression symptoms had children with higher levels of play disconnection (internalizing behaviors). The current findings are consistent with previous studies and relevant to both researchers and practitioners.

Depression with peripartum onset, which was previously called maternal depression, or postpartum depression, is common among many pregnant women. The condition increases impairment in maintaining relationships, self-esteem, and parenting skills. The purpose of this phenomenological qualitative study was to explore how mothers who have experienced peripartum onset (postpartum) depression perceive their social support and their ability to parent effectively. The conceptual framework was based on Albert Bandura’s self-efficacy theory. Convenience and snowball sampling were both used to obtain 6 research participants who were interviewed face-to-face or by telephone. Participants shared their experiences with depression, perceptions of social support, and how both influenced their parenting efficacy. Two cycles of coding were used: initial and focus coding. Key themes of this research study were mother’s age of onset with depression, symptoms, coping strategies, supports received, results of social supports, recommendations to other mothers, and effects of depression on parenting. The results were that mothers’ depression negatively affected parenting, which resulted in receiving social supports such as postpartum trainings, talk therapy, and psychotherapy (counseling). This study may help to close the gap and extend the literature by exploring the influence of peripartum onset (postpartum) depression on parenting. Implications for positive social change may include more direction in how human services professionals address mothers during their pregnancy or postpregnancy related to peripartum onset (postpartum) depression.

The purpose of this study was to identify if the rate of behavioral health rehabilitation services (BHRS) impacts depressive symptoms of mothers with children receiving these services and if the perception of social support moderates the severity of depression. The stress-buffering hypothesis and Bowen's family systems theory were used for the theoretical framework. A quantitative, cross-sectional survey design was used to collect data from mothers of children receiving BHRS Provider 50 services in northeast Pennsylvania. The Beck Depression Inventory, Second Edition and Multidimensional Scale of Perceived Social Support were used to assess depression and perceived social support. A self-made demographic form was used to identify the rate of BHRS and demographic characteristics. Linear regression and hierarchical multiple regression analyses were used to identify relationships between the study variables. According to study results, the rate of BHRS did not predict the severity of maternal depression, and perceived social support did not moderate the relationship between rate of BHRS and maternal depression. However, it was found that perceived social support was negatively correlated with the severity of maternal depression. This study provides information to the behavioral health community about maternal depression and raises awareness of the importance of caregiver well-being within the BHRS Provider 50 programs. Specifically, mothers caring for a child with special needs may benefit from additional support within a wraparound program.

This study examined how the longitudinal associations among children’s negative emotionality, mothers’ depressive symptoms, parental warmth, and children’s school readiness and whether the associations vary as a function of fathers’ positive involvement in low-income South Korean families. Participants were 399 families including mothers (Mage = 32.54 years at Time 1), fathers (Mage = 35.23 years at Time 1), and children (Mage = 38.92 months at Time 1; 50.5% boys) in the Panel Study on Korean Children. Results revealed that children’s negative emotionality was indirectly associated with their school readiness three years later, through its association with mothers’ depressive symptoms and warmth. Mothers’ warmth mediated the association between mothers’ depressive symptoms and children’s school readiness, and fathers’ warmth mediated the association between fathers’ positive involvement and children’s school readiness. Our findings revealed the family processes underlying children’s school readiness development in low-income Korean family contexts. Our findings also provide information useful for efforts to detect family risks and to establish family policies to promote low-income children’s school readiness.

Paternal support is often linked to lower levels of maternal distress. However, this link is less established among the increasing numbers of Mexican-American families with a romantic partner social (RPS) father, that is, mothers' partners who are not formally identified as stepfathers. This study applied a bioecological systems framework to test linkages between RPS father support and maternal depression and parenting stress above and beyond ecological stressors, and to consider whether nonresident biological father support and general instrumental support moderate this link. Using data from the Fragile Families and Child Wellbeing Study, we analyze a subsample of Mexican-American mothers (N = 76) with three-year-olds, who are involved in a relationship with a RPS father and maintain contact with the nonresident biological father. Findings indicate that mothers who reported greater support from RPS fathers also reported lower depressive symptomatology when they also reported greater support from nonresident biological fathers or reported being in a recent relationship with the RPS father; mothers from more established relationships reported more depressive symptoms. However, mothers with lower perceived instrumental social support reported high maternal depressive symptoms, even while receiving support from RPS fathers. Neither source of support significantly predicted maternal parenting stress. Overall, our results reveal complex, interactive associations between these combined sources of support and maternal mental health in these increasingly common family structures.

Introduction: Prenatal maternal depression is associated with an increased risk of psychopathology in childhood. The understanding of the mechanisms underlying this association is limited. Further, despite high rates of prenatal depression in the developing world, no research investigating this issue exists from these settings. Objectives: The primary objectives of this thesis are to study the association between prenatal maternal depression and the following early offspring outcomes in a non-smoking, non-alcohol consuming prenatal sample from rural, South India: Foetal stress responsivity, measured through foetal heart rate (FHR). Infant stress responsivity, measured through infant cortisol response to immunisation. Infant temperament. Methods: 194 pregnant women from Solur, India were assessed for depression. The first 67 mothers with elevated symptoms of prenatal depression and the first 66 controls underwent FHR monitoring to study foetal stress responsivity. 58 mother-infant dyads returned at 1.5-3 months post birth. Infant salivary cortisol was measured before and after immunisation. Information on infant temperament and maternal postnatal depression (PND) was also collected. Results: Twenty nine mothers (14.9%) met a diagnosis of major depression during pregnancy while 67 (34.5%) had elevated symptoms of prenatal depression. Whilst there were no linear association between prenatal depression and foetal responsivity, a curvilinear (U shaped) association existed with the foetuses of mothers with very high and very low levels of prenatal depression having elevated stress responses compared to those with moderate levels of prenatal depression. Prenatal depression predicted infant cortisol responsivity independent of PND (B=13.08, p=0.02).The relationship between infant cortisol responsivity and prenatal depression was also U shaped. There was no association between prenatal depression and infant temperament. Conclusions: This is the first study from the developing world investigating the relationship between prenatal depression and offspring outcomes. It provides evidence suggestive of the programming influence of prenatal depression on the developing offspring.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.