Postpartum Depression from the Perspective of Third-Wave Psychotherapies

The last three decades have witnessed significant advances in psychotherapy. Numerous scholarly articles and books have been devoted to pertinent topics in the field, making it difficult for the practicing clinician to keep up with this rapidly growing area. The purpose of this article is to provide some guidelines on how to evaluate the empirical literature in psychotherapy and then to explore three key areas: evidence-based psychotherapies for patients with psychiatric disorders, individual variables that predict differential outcome to treatment, and the therapeutic alliance. Finally, two case examples will be presented to illustrate how knowledge of the empirical literature can facilitate an evidence-based approach to the daily practice of psychotherapy in general psychiatry.

Cognitive behavioural “third wave” therapies in the treatment of justice-involved individuals: A systematic review

Evolving an idionomic approach to processes of change: Towards a unified personalized science of human improvement

The application and adoption of four ‘third wave’ psychotherapies for mental health difficulties and aggression within correctional and forensic settings: A systematic review

Postpartum depression (PPD) has a high prevalence worldwide and adversely impacts both family and society. This study focuses on the association between parenting competence (PC), ruminative thinking (RT), and PPD among postpartum women, specifically examining the mediating role of RT. This quantitative study employed structural equation modeling and collected data using purposive sampling. Based on previous evidence,three-factor models require a minimum sample size of 86, though most studies recommend a value exceeding 200. After excluding missing data and outliers, the final sample consisted of 269 women, all within eight weeks postpartum, from three hospitals in China.The inclusion criteria were having at least a middle school diploma, voluntary participation, and no recent history of psychotherapy and medication treatment. The instruments used were the Edinburgh Depression Scale, Parenting Sense of Competence Scale, and Rumination Response Scale. The study sequentially performed descriptive statistics, tested measurement models and structural models, and calculated path coefficients. The results indicated that (i) PC negatively predicted PPD; (ii) PC negatively predicted RT; and (iii) RT positively predicted PPD. Furthermore, RT mediated the relationship between PC and PPD, with PC and RT exerting nearly equivalent effects on PPD. The study confirmed the impact of PC on PPD through RT among Chinese postpartum women. Both PC and RT are critical factors in PPD. The study establishes a structural framework for understanding the relationships between PC, PPD, and RT, emphasizing the significant roles of PC and RT in the development of PPD. This provides valuable insights into understanding the mechanisms of PPD and offering reference for future research. In practice,healthcare professionals and family members should consider these factors, particularly ruminative thinking. By improving treatment plans and care strategies, they can reduce the incidence of postpartum depression and enhance the quality of life for postpartum women.

Little is known about the pathophysiology of postpartum depression.While the same can be said for many (if not most) psychiatric illnesses, in the case of postpartum depression the need for pathophysiological studies to guide the development of novel treatments is particularly pressing because the illness affects not only the woman who experiences it, but also her newborn and other members of her family (1).But while pathophysiological studies of postpartum depression are particularly important, they are also very difficult to conduct, given the biological and logistical complexities that characterize the postpartum period.Therefore, the study by in this issue of the Journal is a welcome addition to the literature.The authors used functional magnetic resonance imaging (fMRI) to study 16 healthy women and 14 unmedicated unipolar depressed women within 12 weeks of giving birth.While being scanned, subjects completed a task that included shape and face matching blocks, with the latter including angry and sad faces.This task is designed to probe between-group differences in amygdala activity.Previous fMRI studies using similar tasks in patients with depression demonstrate abnormalities in amygdala activity and amygdala-medial prefrontal cortex connectivity in response to negatively valenced emotional faces (3).However, the precise nature of those abnormalities, and the extent to which they differ in unipolar versus bipolar depression, remains unclear.Given the previous literature, Moses-Kolko et al. focused their analysis on activity in the amygdala and the medial prefrontal cortex.Their major finding was a group-by-condition interaction in the dorsomedial prefrontal cortex (the finding was specifically in Brodmann's area 32).While both depressed and comparison mothers activated this region more in response to faces than to shapes, depressed mothers activated more in response to shapes than comparison mothers, and comparison mothers activated more in response to faces than depressed mothers.As discussed below, the dorsomedial prefrontal cortex is known to mediate important aspects of social cognition.Therefore, it is notable that depressed mothers, relative to comparison mothers, show decreased activation in this region in response to the social stimulus of a face.Moses-Kolko et al.'s finding indicates that it is important to focus research and treatment strategies not only on a mother's depression, but also on her ability to engage affectively with her infant.A hallmark of depression is increased self-focus, particularly in the form of self-referential negative thoughts; research suggests that this symptom may be mediated by the dorsomedial prefrontal cortex.For example, Johnson et al. (4) found associations between activity in the

IntroductionCognitive behavioral therapies (CBT) represent a heterogeneous group of psychotherapies in continuous development that share a directive, structured, collaborative approach. Due to a high degree of treatment-resistant cases of major depressive disorder (MDD), new augmentation therapies are urgently needed, in order to increase the chance of recovery in these patients.ObjectivesTo analyze data that may support the indication of third wave CBT in patients with MDD.MethodsA literature search was performed in the main electronic databases, and papers published between January 2000 and August 2020 were included.ResultsAcceptance and commitment therapy has been associated with positive results, but data are derived from low quality trials (n=2). Dialectical-behavioral therapy (DBT)-based skill group have been also associated with favorable outcome, in MDD patients (n=2). Mindfulness-based cognitive therapy (MBCT) was also proven effective in the treatment in MDD (n=4), treatment-resistant MDD included, but the difference between MBCT and active comparators was not always significant. Metacognitive therapy (MCT) has been evaluated in good quality clinical trials (n=4), and its efficacy was confirmed. Mild and moderate MDD patients may benefit from compassion-focused therapy (CFT) (n=1). Behavioral activation (BA) is dedicated to MDD patients and according to a meta-analysis (n=26 randomized controlled trials) BA is superior to other active comparators, although the quality of clinical trials was modest.ConclusionsThird generation CBT could be useful in MDD patients as augmentative strategy, but more good-quality data are necessary before recommending them in an evidence-based treatment guideline as a distinctive intervention from classical CBT.

The empirical status of the third-wave behaviour therapies for the treatment of eating disorders: A systematic review

The evolution of cognitive behavioural therapy – The third generation and its effectiveness

Background: Anxiety among teenagers may disturb their life, and it is no controlling results in severe problems. Therefore, the present research was designed and conducted by the aim of investigating the effectiveness of group counseling training based on metacognitive therapy & dialectic behavior therapy on reducing anxiety in boy adolescent of divorce. Methods: The present research conducted by quasi-experimental method and used a pretest-posttest with control group design. The statistical population of the current research included all boy students of divorced parents in Karaj in 2017-2018. Among them, 36 persons selected by convenience sampling method, and they were assigned into experimental and control groups (12 individuals per group) randomly. Before the intervention, the Beck Anxiety Inventory executed on participants. Group counseling therapy based on metacognitive therapy and dialectic behavior therapy provided for the experimental group subjects in sixteen 90-minute sessions, while the participants of the control group received no intervention. Posttest executed for all three groups after completing the training. The research data were analyzed by covariance analysis and by SPSS-22 software. Results: Covariance analysis findings indicated that metacognitive therapy and dialectic behavior therapy groups had significant decreasing than the control group after interventional (P>0.05). Also, results indicated than there was no significant difference between the effectiveness of metacognitive therapy and dialectic behavior therapy on anxiety decreasing among boy teenagers of divorced teenagers (P<0.05). Conclusion: Based on the results of the present research, we can state that dialectic behavior therapy and metacognitive therapy by changing negative cognitions reduce anxiety among divorced children.

Background: Raising a child diagnosed with cerebral palsy (CP) is a major challenge for parents and may greatly change the family’s lifestyle. The present study aimed to investigate the effects of metacognitive therapy (MCT) and compassion-focused therapy (CFT) on anxiety in the mothers of children with cerebral palsy.Methods: The research method was quasi-experimental with a pre-test, post-test, and follow-up design and a control group. Selected by convenience sampling, the sample consisted of 45 mothers of children with cerebral palsy who referred to Bahar Rehabilitation Center, Shiraz, Iran, in 2020. We randomly divided the participants into two experimental groups (metacognitive therapy and compassion-focused therapy) and a control group (n=15 per group). The research instrument included the Beck Anxiety Inventory. The first experimental group underwent 12 sessions (60-minute sessions per week) of metacognitive therapy and the second experimental group underwent eight sessions of compassion-focused therapy (60-minute sessions per week).Results: The mean±SD of the anxiety for metacognitive therapy, compassion-focused therapy, and control groups in the posttest stage were 24.30±6.21, 25.10±2.44, and 42.70±4.46, respectively. Based on the results, both metacognitive therapy (MTC) and compassion-focused therapy (CFT) were effective in reducing anxiety in the mothers of children with cerebral palsy (CP) (P=0.0001); also, there was no significant difference between the effects of MCT and CFT on anxiety in this group of mothers.Conclusion: Metacognitive therapy and compassion-focused therapy can be employed to reduce anxiety in mothers of children with cerebral palsy.

Chapter 16 - Third-Wave Cognitive-Behavioral Therapies for the Treatment of Anxiety Among Children and Adolescents

Integrating CBT and Third Wave Therapies: Distinctive Features

Psychological treatments targeting suicidal behavior disorder (SBD) have been evaluated here in their efficacy through different diagnoses. In particular, transference-focused psychotherapy (TFP), mentalization-based treatment (MBT), interpersonal psychotherapy (IPT), dialectical behavior therapy (DBT), schema-focused therapy (SFT), mindfulness-based cognitive therapy (MBCT), mindfulness-based stress reduction (MBSR), acceptance and commitment therapy (ACT), and cognitive behavior therapy (CBT) were the main structured treatments considered here in association with their impact on SBD. Some of them showed higher efficacy in suicide (DBT and MBT). Moreover, some treatments have been primarily studied in a specific diagnosis: TFP, MBT, DBT, and SFT in borderline personality disorder and IPT and CBT in depression. Concerning new treatments, promising preliminary results have been reported (SFT, MBCT, MBSR, and ACT) as well. Summarizing, consistent reduction in suicidal and self-destructive phenomena through psychotherapeutic treatments has been found throughout methodologically heterogeneous trials, in particular focused on DBT and MBT. In conclusion, two movies by the Italian documentarist/director Alina Marazzi have been illustrated in their connection with SBD.

Background:In today's global world, most women are experiencing midlife health problems which can affect their lives and mental status. Most of the diseases occurr after childbirth and during pregnancy or gestation period which can lead to severe problems such as postpartum depression (PPD), postmenopausal depression, perimenopausal depression which ultimately affects the mental health condition and develop various depressive episodes which ultimately lead to depression in women.Objective:The review paper gives the information that if there is untreated maternal depression then it can lead to anxiety, fear, negative effect on child development, disruption of the mother-infant relationship, and the occurrence of depressive symptoms in the early life of infants. Hormone levels are changed at the time of pregnancy.Methods:The data was collected by studying combination of research and review papers from different databases like PubMed, Medline, and Web of science by using search keywords like “Postpartum depression”, “Postmenopausal depression”, “Risk factors”, “Pathogenesis of PPD”, “Predictors of postpartum depression”.Results:This can lead to disrupting the quality of life of menopausal women like deficiency of nutrients, not properly regular physical activities, elevated Body Mass Index (BMI), loss of libido (loss of interest in sexual activities), due to the lack of education, and awareness among the people. Factors like increase in physical activity can naturally help in PPD condition. Mind body therapy, drug therapy and cognitive and mindfulness-based therapies help in hormonal imbalances.Conclusion:It was found that low birth weight and congenital abnormalities in babies lead to affect depression after delivery. It is recommended that health care providers and physicians are provided with information regarding factors contributing PPD and postmenopausal depression. Sleep timings and consumptions of nutraceuticals can help in natural healing with depression amongst women suffering from postpartum, postmenopausal and perimenopausal depression.