Posttraumatic Stress Disorder In Mothers Research Articles

Psychological interventions to pregnancy-related complications in patients with post-traumatic stress disorder: a scoping review

ObjectiveThis scoping review sought to investigate the association between pregnancy-related complications and post-traumatic stress disorder (PTSD) among postpartum women, then summarize effective psychological interventions for pregnancy-related PTSD or sub-PTSD.MethodPublications in English and Chinese were searched in PubMed, Embase, Cochrane, ISI Web of Science, China National Knowledge Infrastructure (CNKI), and WanFang databases using the subject headings of “Stress Disorders, Post-Traumatic”, “Pregnant Women”, and “psychotherapy”. To ensure that as many relevant studies are incorporated as possible, free terms such as prenatal, postnatal, perinatal and gestation were also used. Intervention studies and related cases published by July 1st, 2023, were also searched.ResultsTwenty-one articles (including 3,901 mothers) were included in this review. Evidence showed that typical psychological interventions exhibited great effect, and family support programs, peer support, online yoga, and music therapy were also effective in reducing risk and improving the psychological well-being of the studied population.ConclusionFetal abnormalities, miscarriage, premature birth, infants with low birth weights, hypertension, pre-eclampsia, HELLP syndrome, and hyperemesis gravidarum are associated with an increased risk of PTSD. Moreover, high-risk pregnant women may benefit from psychological interventions such as cognitive behavioral therapy (CBT). It may also be feasible and well-accepted for music therapy and exposure therapy to lessen the intensity of PTSD in mothers.

Investigating the Relationship between Religiosity and Post-Traumatic Stress Disorder in Mothers of Children with Cancer Admitted to t Pediatric Oncology Department of Shahid Sadoughi Hospital , Yazd , 2019

Introduction: Religiosity can help in adapting to difficult situations and provide better care. Therefore, this study was conducted to determine the relationship between religiosity and post-traumatic stress disorder in mothers of children with cancer. Methods: This was a cross-sectional and descriptive-correlational study conducted on 115 mothers of children with cancer who were admitted to Shahid Sadoughi Hospital, in Yazd, in 2019. Sampling was done through convenience sampling method. Data collection tools were the demographic information questionnaire, and Mississippi PTSD and Glock and Stark questionnaires. . Descriptive (mean and standard deviation) and analytical (Pearson's correlation, chi-square) statistical tests and indicators were used; data were investigated and statistically analyzed using SPSS 21 software with a confidence level of 95%. Results: The findings showed that in the post-traumatic stress disorder questionnaire, the average score was 97/61±36/78 and the average score of the religiosity questionnaire was 26/77±61/85. Pearson's correlation coefficient showed a negative relationship between religiosity and PTSD (p= 0/160, r= -0/132). The average score of PTSD and religiosity among mothers was not significantly different according to various variables such as mother's occupation, child's gender, and education level. The difference in the average score of PTSD in mothers was different according to the characteristics such as education level and occupation. The average score of religiosity was more different when comparing working mothers with housewives. The average stress score after the accident showed a greater difference in mothers according to the type of child's illness. The average PTSD score was 83/87±25/79 for neuroblastoma and 92/33±24/98 for solid tumor disease. Conclusion: PTSD among mothers was close to the cut-off point for the disorder. Although there was no significant relationship between PTSD and mothers' religiosity, it can be said that the severity of mental situation of mothers with severe cancer was effective in the study.

501 Maternal PTSD and Child Brain Function During Implicit Emotion Regulation

OBJECTIVES/GOALS: Maternal mental health, such as post-traumatic stress disorder (PTSD), is closely linked to child mental health. PTSD in mothers is associated with their children’s emotional responses. We examined associations between maternal PTSD and child brain function during emotion regulation. METHODS/STUDY POPULATION: Eight children ages 10-12 years, whose mothers had trauma histories, performed the Emotional N-Back task during functional MRI scanning. Mothers and children each reported on their trauma exposure and PTSD symptom severity. BOLD response to fearful faces during the Emotional N-Back was extracted from two specific brain regions of interest, amygdala and anterior cingulate cortex. These regions are involved in emotional response and attentional control, which are processes intrinsic to emotion regulation. An independent samples t-test was conducted on children’s BOLD response to fearful faces, with maternal PTSD symptom severity (high, low) as the independent variable. A parallel analysis was conducted with child PTSD symptom severity (high, low) as the independent variable. RESULTS/ANTICIPATED RESULTS: We found a main effect of maternal PTSD within brain regions of relevance to implicit emotion regulation. Compared to children whose mothers reported low PTSD symptom severity (n=4), children whose mothers reported high PTSD symptom severity (n=4) showed greater responsiveness to fearful faces in anterior cingulate cortex (t=2.04, p=.09,d=1.44) and amygdala (t=2.44, p=.05, d=1.72) at trending significance. A parallel analysis with child PTSD symptom severity showed no differences in brain function by this factor (ps=.55-.61). DISCUSSION/SIGNIFICANCE: Our pilot study is the first, to our knowledge, to examine associations between maternal PTSD and brain function during emotion regulation in their children. This study lays a foundation for future work; our goal is to explore dysfunction in emotion regulation neurocircuitry as one mechanism linking maternal PTSD to their children’s mental health.

The Prevalence of PTSD of Mothers and Fathers of High-Risk Infants Admitted to NICU: A Systematic Review.

Admission of a preterm or sick full-term infant to the neonatal intensive care unit (NICU) is a stressful experience for parents. Indeed, the 'NICU experience' may constitute a traumatic event for parents, distinct from other birth-related trauma, leading to significant and ongoing posttraumatic stress disorder (PTSD) symptoms. However, the rates at which this outcome occurs are not well understood. This review aimed to identify the prevalence of PTSD in mothers and fathers of high-risk infants admitted to the NICU, specifically focusing on the NICU experience as the index trauma. The PRISMA-P: Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols were used to conduct this review. We searched PsycINFO, PubMed, Scopus, EMBASE, Web of Science, ProQuest Dissertations and Theses databases, and reference lists of included articles (1980-2021). Two independent reviewers screened titles and abstracts and conducted the full-text screening assessment. Of the 707 records identified, seven studies met the inclusion criteria. In this systematic review, PTSD symptomatology was assessed by self-report measures rather than a clinical interview. We identified significant variations in the methodologies and quality between studies, with a wide variation of reported prevalence rates of PTSD of 4.5-30% in mothers and 0-33% in fathers. Overall, the findings indicate that up to one-third of parents experience PTSD symptomatology related to the NICU experience. These results emphasize the importance of universal routine antenatal and postnatal screening for symptoms of PTSD to identify parents at risk of distress during the NICU experience and after discharge.Trial registration: The study protocol was registered with Prospero registration number CRD42020154548 on 28 April 2020.

Distress and post-traumatic stress in parents of patients with congenital gastrointestinal malformations: a cross-sectional cohort study

BackgroundCongenital gastrointestinal malformation (CGIM) require neonatal surgical treatment and may lead to disease-specific sequelae, which have a potential psychological impact on parents. The aim of this study is to assess distress and symptoms of post-traumatic stress disorder (PTSD) in parents of patients with CGIM. In this cross-sectional study, seventy-nine parents (47 mothers and 32 fathers) of 53 patients with CGIM completed the Distress Thermometer for Parents (DT-P) and the Self Rating Scale for Posttraumatic Stress Disorders (SRS-PTSD) as part of the multidisciplinary follow-up of their children (aged 5–35 months). Group differences were tested between parents and representative Dutch reference groups with regard to rates of (clinical) distress and PTSD, and severity of overall distress and PTSD, for mothers and fathers separately. Mixed model regression models were used to study factors associated with the risk of (clinical) distress, PTSD and with severity of symptoms of PTSD (intrusion, avoidance and hyperarousal).ResultsPrevalence of clinical distress was comparable to reference groups for mothers (46%) and fathers (34%). There was no difference in severity of overall distress between both mothers as well as fathers and reference groups. Prevalence of PTSD was significantly higher in mothers (23%) compared to the reference group (5.3%) (OR = 5.51, p < 0.001), not in fathers (6.3% vs 2.2.%). Symptoms of intrusion were commonly reported by all the parents (75%). Longer total length of child’s hospital stay was associated with more severe symptoms of intrusion, avoidance and hyperarousal. Child’s length of follow-up was negatively associated with severity of intrusion.ConclusionsHaving a child with CGIM has a huge impact on parents, demonstrated by a higher prevalence of PTSD in mothers, but not fathers, compared to parents in the general population. Monitoring of symptoms of PTSD of parents in follow-up is necessary.

Post-traumatic stress disorder (PTSD) in parents of children with type 1 diabetes during Covid-19 pandemic

IntroductionThe Post-traumatic Stress Disorder (PTSD) is a group of persistent psychological and physiological symptoms due to a traumatic, severe, event. Only few studies focused on the effects of Covid-19 on psychosocial outcomes in children with Type 1 Diabetes (T1D) and their parents.Aim of the studyThe aim of this study was to evaluate the presence PTSD in parents of children with T1D during COVID-19 pandemic lockdown.Patients and methodsIn the period between March and May 2020 we submitted the “Impact of Event Scale – Revised” (IES-R) questionnaire to the parents of 34 children with Type 1 Diabetes, asking them to express their emotions about the ongoing Covid-19 pandemic.ResultsA total of thirty mothers (mean age 43.0 ± 4.2 years) and 25 fathers (mean age 45.6 ± 5.9 years) participated in the survey and completed the questionnaires. 29.1% of parents had a score that allows to define a clinically relevant level of PTSD; ten mothers and 6 fathers had a PTSD clinically relevant score, corresponding, respectively, to 28.4 and 24% of total mothers and fathers. Finally, mothers and fathers, both express PTSD symptoms mainly in the form of intrusion and hyperarousal.ConclusionsThe present study confirms a high prevalence symptoms related to PTSD in mothers and fathers of children with Type 1 Diabetes. We believe that psychosocial outcomes of the COVID-19 pandemic should be taken into account in the planning of the next future assistance for children with T1D.

The Effect of Non-verbal Music on Posttraumatic Stress Disorder in Mothers of Premature Neonates.

Background:Hospitalization of a premature neonate in the Neonatal Intensive Care Unit (NICU) is stressful for mothers. They show symptoms of Post-Traumatic Stress Disorder (PTSD). It is important to use the proper strategy to manage PTSD. This study was designed to investigate the effect of non-verbal music on the PTSD in mothers of premature neonates hospitalized in NICU.Materials and Methods:In this clinical trial study, the convenience sampling method was applied and 45 mothers of premature neonates were selected and categorized randomly into the intervention (N = 23) and control (N = 22) groups in 2018. The babies were hospitalized in one of the NICUs in Yazd (Iran). The intervention group were supposed to listen to the non-verbal music for 20 minutes daily for two weeks using MP3 player and headphones. All participants completed the Perinatal PTSD Questionnaire (PPQ). The data were analyzed by SPSS 21 using paired t-test, independent t-test, and Chi-square test.Results:The PTSD mean (SD) scores before and after the intervention was 9.39 (1.67) and 4.39 (1.49), respectively, in experimental group. It was 8.54 (1.59) and 5.31 (1.71) in control group. The severity of PTSD decreased in the intervention (p = 0.003) and control (p < 0.001) groups after the intervention. The difference between the two groups was significant (F1,07 = 1058, p < 0.03), which confirmed the significant effect of the non-verbal music on decreasing the PTSD severity (0.92).Conclusions:Non-verbal music can be used as an effective and low-cost intervention for managing PTSD in mothers of premature neonates hospitalized in the NICU.

Acute and Post-traumatic Stress Disorder Symptoms in Mothers and Fathers Following Childbirth: A Prospective Cohort Study.

IntroductionUp to 30% of women view their childbirth as traumatic. This experience can lead to acute stress disorder or post-traumatic stress disorder. The negative impact of maternal post-traumatic stress disorder following childbirth reaches beyond the mother, potentially affecting her child's development and the couple's relationship. Research on paternal post-traumatic stress disorder following childbirth is scarce. Acute stress disorder is suggested to be an important predictor of post-traumatic stress disorder in mothers, but little is known about paternal acute stress disorder following childbirth. Furthermore, there is limited information about the comparison or relation of acute stress disorder and post-traumatic stress disorder following childbirth between parents.Aim[1] To compare the prevalence rates and severity of acute stress disorder and post-traumatic stress disorder symptoms between parents following childbirth by taking anxiety and depression symptoms, as well as obstetric variables and previous traumatic events into account and [2] To determine if acute stress disorder is a predictor of post-traumatic stress disorder.MethodA prospective population-based design was used. N = 647 participants were recruited from future parents who attended appointments at the Obstetrics and Gynecology unit at a Swiss university hospital. Self-report questionnaires were used: Post-traumatic Diagnostic Scale in the third trimester of pregnancy (T1) and 1 month post-partum (T3), Acute Stress Disorder Scale at 1 week post-partum (T2), and Hospital Anxiety and Depression Scale at all time points. Obstetric and neonatal variables were retrieved from hospital records.ResultsAt T2, 8.9% of mothers and 4.4% of fathers presented symptoms of acute stress disorder. At T3, 20.7% of mothers and 7.2% of fathers had symptoms of post-traumatic stress disorder. Acute stress disorder was a predictor of post-partum post-traumatic stress disorder (Odds ratio: 8.6, IC 95% [1.85; 40.42]). Depression symptoms was a significant confounder in the prediction of post-traumatic stress disorder following childbirth, but not anxiety or previous perinatal loss.ConclusionLittle is known about parental differences in acute stress disorder and post-traumatic stress disorder symptoms following childbirth. Results indicate that both parents may suffer from acute stress disorder and post-traumatic stress disorder symptoms after childbirth and that acute stress disorder is a predictor of post-traumatic stress disorder after childbirth for both parents. Sensitization of maternity staff to these results may assist in earlier identification of and appropriate treatment for at-risk parents.

A Recreational Games Program for Decreasing Post-Traumatic Stress Disorder in Mothers of Autistic Children

The current research aims to decrease post-traumatic Stress disorder in a sample of mothers of autistic children through a recreational games' Program. (8) mothers of autistic children with highest points on the Post-Traumatic Disorder Scale were recruited as a main sample for this research. The researcher used the Post-Traumatic Disorder Scale (by: Salah A. Ahmed 2019) for pre- and post-measurements. The Program was applied to the experimental group for (12) continuous weeks (from 7-12-2019 to 26-2-2020). Results indicated statistically significant differences between pre- and post-measurements of the experimental group on the Post-Traumatic Disorder Scale in favor of post-measurements. This improvement means that the recommended recreational games Program had positive effects on decreasing post-traumatic disorders in mothers of autistic children.

Post-Traumatic Stress Disorder in Homeless Migrant Mothers of the Paris Region Shelters.

Migrant women are disproportionately more likely to experience traumatic events in their country of origin, during migration and after arriving in the host country. Homeless women are more likely to be exposed to multiple victimizations in childhood (emotional or physical maltreatment) and in adulthood (sexual abuse, street victimization). This study’s objective was to describe the factors associated with the likelihood of post-traumatic stress disorder (PTSD) among homeless migrant mothers in the Paris region. Face-to-face interviews were conducted by bilingual psychologists and interviewers in a representative sample of homeless families in the Paris region. PTSD was ascertained using the Mini International Neuropsychiatric Interview (MINI) (n = 691 mothers). We studied PTSD in mothers using weighted Poisson regression. Homeless migrant mothers had high levels of PTSD (18.9%) in the 12 months preceding the study. In multivariate analysis, PTSD was associated with departure from the country of origin because of violence (PR = 1.45 95% CI 1.03; 2.04), depression in the preceding 12 months (PR = 1.82 95% CI 1.20; 2.76), and residential instability (PR = 1.93 95% CI 1.27; 2.93). Homeless migrant mothers have high levels of traumatic events and PTSD. Improvements in screening for depression and PTSD and access to appropriate medical care are essential for this vulnerable group.

Santé mentale des mères et des enfants de familles sans logement en Île-de-France. Résultats de l’enquête ENFAMS

IntroductionThe number of homeless families in the Greater Paris region has increased over time and given their vulnerability, it is necessary to better know their characteristics, especially in terms of mental health. Our objective was to study the prevalence of mental health difficulties among homeless women and their children and associated factors. MethodsThis study was based on the ENFAMS survey, conducted during the winter of 2012–2013 among 801 homeless families in the Greater Paris region, by trained interviewers and psychologists. Mothers’ depression was assessed by the Composite International Diagnostic Interview (CIDI) and their Post Traumatique Stress Disorders was assessed by the Mini International Neuropsychiatric Interview (MINI). Depression and PTSD of the mothers were studied in weighted Poisson regression models with robust error variance. The emotional and behavioural difficulties of children were assessed by the Strengths and Difficulties Questionnaire (SDQ) and studied by linear regression. ResultsHomeless women have a high prevalence of depression (28.8 %) and Post Traumatic Stress Disorder (PTSD) (18.9 %); their children have high levels of emotional and behavioral difficulties (20.8 %). Factors associated with maternal depression include fluency in French, suicidal risk, PTSD, and unmet medical needs. The risk of PTSD in mothers was associated with departure from the country of origin for a violent cause, depression and residential instability. Children's emotional and behavioral difficulties were associated with parents’ birth region, residential mobility, children's health and overweight, children's sleep patterns, mother's suicidal risk, the fact that children do not like their housing or are victim of school bullying. ConclusionThe standard health care system and primary care professionals must take advantage of the opportunity offered by each contact with homeless families to detect mental health disorders, which have a high prevalence in both mothers and their children, and refer them to existing structures to facilitate their access to health care.

Effects of Cognitive-Behavioral Counseling on Posttraumatic Stress Disorder in Mothers with Infants Hospitalized at Neonatal Intensive Care Units: A Randomized Controlled Trial

Background: Pregnancy and childbirth are among the most stressful experiences in women. This study was conducted to determine effects of cognitive-behavioral counseling on posttraumatic stress disorder in mothers with infants hospitalized in neonatal intensive care units. Methods: The present randomized, controlled, clinical trial was conducted during year 2016. A total of 90 eligible females, attending Kowsar Hospital (Qazvin, Iran), were recruited through convenience sampling and allocated to the intervention and control groups, using random blocks of four. A total of eight counseling sessions were held for the two groups. The post traumatic stress disorder (PTSD) symptom scale was distributed among the participants before, immediately after, and three weeks after the intervention. The collected data were analyzed using the SPSS 19.0 software. Results: The two groups were not significantly different in terms of baseline PTSD scores. According to the generalized estimation equation model, the two groups had significant differences in terms of the mean PTSD scores immediately and three weeks after the intervention (P = 0.002) and the mean scores were significantly lower in the intervention group on both occasions. Friedman test results confirmed the reducing trend in the intervention group’s mean PTSD scores at all three occasions (P = 0.000). Conclusions: Counseling had a positive effect on reducing PTSD symptoms in mothers with special conditions. This method can, hence, be recommended for improving the health status of these mothers.

Post-traumatic stress disorder in mothers of children who have undergone cancer surgery.

The aim of this study was to investigate the rate of post-traumatic stress disorder (PTSD) and associated risk factors among mothers of children who underwent cancer surgery. This cross-sectional, multi-center study included a total of 60 mothers whose children underwent major thoraco-abdominal surgery and were under follow up in the outpatient setting between February 2016 and May 2016. Clinical Data Form, Hospital Anxiety and Depression Scale (HADS), and Clinician-Administered PTSD scale were used. Of all participants, 13 (21.7%) were diagnosed with PTSD. These mothers had shorter duration of marriage, longer duration of hospital stay after surgery, and higher HADS scores, compared with the others without PTSD. Thoughts of guilt such as "I am being punished or tested" were more frequent in mothers with PTSD. Insomnia, irritability, concentration problems, and psychological reactivity were the most common symptoms. Post-traumatic stress disorder is a severe disorder that may worsen the daily functioning of mothers and may also have an unfavorable effect on child. It is therefore of utmost importance for clinicians to recognize PTSD and the associated risk factors in order to guide these parents.

Perinatal Dissociation and Post-traumatic Stress Disorder among Mothers of Preterm Infants: A Comparative Study

Preterm delivery is a particularly challenging experience that can be experienced by mothers as a traumatic event, causing dissociative reactions and authentic post-traumatic stress disorder (PTSD). In this work, we proposed to study the prevalence of perinatal dissociation and PTSD in mothers of preterm babies compared to a control group of mothers of term babies and to identify factors that may contribute to the occurrence of perinatal dissociation and PTSD following premature childbirth. We conducted a cross-sectional and comparative study, including 97 mothers of premature babies and 80 controls. We used the Perinatal Posttraumatic Stress Disorder Questionnaire to screen for PTSD, the peri-traumatic dissociation questionnaire to measure the level of perinatal dissociation, and the Perinatal Risk Inventory to assess perinatal risk. Compared to mothers of term infants, mothers of preterm infants had significantly higher rates of peri-traumatic dissociation and PTSD. Our results are consistent with previous studies, and add additional credit to the traumatic nature of preterm delivery. Setting up specific support modalities seems essential in the case of premature births in order to ensure a better quality of mother-child interactions and optimal development of the child.

Risk factors for the development of post-traumatic stress disorder and coping strategies in mothers and fathers following infant hospitalisation in the neonatal intensive care unit.

The aim of this study was to identify the potential risk factors for the development of post-traumatic stress disorder in mothers and fathers following infant hospitalisation in the neonatal intensive care unit. The development of neonatal intensive care units has increased the survival rate of infants. However, one of the major parental problems is post-traumatic stress disorder. An observational study covered 125 parents (72 mothers and 53 fathers) of infants aged 3-12months who were hospitalised in the neonatal intensive care unit during the neonatal period. Third-referral neonatal intensive care unit. Several standardised and self-reported research tools were used to estimate the level of post-traumatic stress symptoms (Impact Event Scale-Revised), perceived stress (Perceived Stress Scale) and coping strategies (COPE Inventory). The respondents also completed a Parent and Infant Characteristic Questionnaire. The mothers and fathers did not differ in their parental and infant characteristics. Post-traumatic stress disorder was present in 60% of the mothers and 47% of the fathers. Compared to the fathers, the mothers felt greater stress (p=.020) and presented a higher severity of post-traumatic stress disorder (p<.001). Previous miscarriages (p=.023) and the presence of chronic diseases (p=.032) were risk factors for post-traumatic stress disorder in the mothers. In the fathers, an Apgar test at 1min after birth (p=.030) and a partner's post-traumatic stress disorder (p=.038) were related to post-traumatic stress disorder. The mothers compared to the fathers were more likely to use strategies such as: positive reinterpretation and growth, focusing on and venting of emotions, instrumental social support, religious coping and acceptance. In the fathers, the predictors included an Apgar score at 1min after birth, a lack of congenital anomalies in the child and mental disengagement. Risk factors for post-traumatic stress disorder, as well as coping strategies, differ in women compare to men. Knowledge of risk factors for post-traumatic stress disorder, specific to men and women, may help identify the parents in whom probability of the occurrence of this disorder is increased.

Seeing Their Children in Pain: Symptoms of Posttraumatic Stress Disorder in Mothers of Children with an Anomaly Requiring Surgery at Birth.

Objective Assess the presence of posttraumatic stress disorder (PTSD) symptoms in mothers of newborns requiring early surgery. Study Design Mothers of newborns operated on for a congenital anomaly underwent a semi-structured interview on their experience 6 months postpartum. Interviews were audiotaped, transcribed verbatim, and analyzed for symptoms of the three major criteria of PTSD: re-experiencing, avoidance, and heightened arousal. Results A total of 120 mothers took part in the study; their children were affected by one of the following congenital anomaly: esophageal atresia (n = 29); congenital diaphragmatic hernia (n = 38); midgut malformations (n = 38); and abdominal wall defects (n = 15). Two mothers did not show any symptoms; 12 mothers (10%) had one posttraumatic symptom, 77 (64.2%) had two, and 29 (24.2%) had three. Overall, 106 mothers (88.4%) presented at least two symptoms. Conclusion PTSD can be considered a useful model to describe and comprehend mothers' reactions in this specific population. Preventive interventions and dedicated follow-up program should be offered to these families.

Women's posttraumatic stress symptoms and autism spectrum disorder in their children

Maternal posttraumatic stress disorder (PTSD) may be associated with autism spectrum disorder (ASD) in offspring through multiple pathways: maternal stress may affect the fetus; ASD in children may increase risk of PTSD in mothers; and the two disorders may share genetic risk. Understanding whether maternal PTSD is associated with child's ASD is important for clinicians treating children with ASD, as PTSD in parents is associated with poorer family functioning. We examined the association of maternal PTSD with offspring ASD in a large US cohort (N ASD cases=413, N controls=42,868). Mother's PTSD symptoms were strongly associated with child's ASD (RR 4–5 PTSD symptoms=1.98, 95% CI=1.39, 2.81; RR 6–7 symptoms=2.89, 95% CI=2.00, 4.18). Clinicians treating persons with ASD should be aware of elevated risk of PTSD in the mother. Genetic studies should investigate PTSD risk alleles in relation to ASD.

Posttraumatic stress disorder in mothers of individuals with anorexia nervosa: a pilot study

This pilot study aimed to investigate the prevalence of maternal posttraumatic stress (PTSD), anxiety and depressive symptoms and what aspects of having a child with anorexia nervosa (AN) are perceived as traumatic by the mothers. Thirty-one mothers of daughters with AN completed a range of self-report questionnaires and a structured clinical interview. Higher rates of anxiety, depression and PTSD symptoms were found in mothers than in the general UK population. Mothers reported acute traumatic stressors during the course of AN, such as ‘thinking their daughter was about to die or dead’, ‘seeing or consenting to their daughter being tube-fed’. We also found that mothers rated chronic aspects of their daughter's AN as very severely distressing, such as ‘worrying about permanent damage to daughter's health’. Results suggest that maternal mental health should be kept in mind during assessments of individuals with eating disorders and referral for a service in their own right might be indicated.

The Impact of Child Tube Feeding on Maternal Emotional State and Identity: A Qualitative Meta-Analysis

Literature on mothers' acceptance of their children's tube feeding is heterogeneous. When a child is fed via gastrostomy, parents may report higher quality of life and higher stress levels. Qualitative research suggests that tube feeding can conflict with fundamental expectations about the mothering role. In this qualitative meta-analysis, parental statements from various studies have been excerpted and theory-based analyzed. Data suggest that feeding a child orally is not only an important aspect of mothering but also a key element for the development of a motherhood identity. Nonoral feeding often results in psychological stress and a struggle to negotiate the motherhood identity successfully and may result in traumatization of the mother. Preventive psychological guidance is recommended to decrease the risk of posttraumatic stress disorder in mothers and disturbances in the mother-child relationship and to assist in maternal coping with a child's feeding disorder.

Military deployment: the impact on children and family adjustment and the need for care

Over a million children and their families have now experienced the stress of the deployment of a family member during the recent wars in Iraq and Afghanistan. Whereas there is an extensive clinical literature about the developmental challenges facing children and issues of family adjustment, there is a lack of systematic research. This review summarizes the findings of recent publications. Some veterans develop posttraumatic stress disorder as a consequence of their experiences. This condition drives many of the adverse changes in the families of returning veterans through the effects on intimacy and nurturance in their families of withdrawal, numbing and irritability that are components of posttraumatic stress disorder. There is the more general challenge that all families and children face when a partner/parent deploys of role ambiguity consequent on anxiety that is provoked by the threat that deployed family members experience. A study of Kuwaiti military showed that mothers' anxiety had the greatest impact on the children of deployed fathers, although absence of posttraumatic stress disorder in mothers could mitigate the effects of their fathers' posttraumatic stress disorder. Intervention programs are described, but there is a poverty of their evaluation. A substantial advantage of focusing on family adjustment is that it can facilitate access to mental healthcare for veterans while assisting families' positive adaptation.