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The number of people using social media has substantially increased over the past years. Previous studies have shown associations between social media overuse and mental health problems during pregnancy. The current study evaluates changes in social media use during pregnancy. Pregnant women were recruited at their first antenatal appointment between January 2020 and July 2022 (N = 1135). The time spent on social media, frequency of social media use and problematic social media use, using the Bergen Social Media Addiction Scale (BSMAS), were assessed at 12, 20 and 28 weeks of pregnancy. Pearson r correlations and repeated measures ANOVAs were performed to assess possible changes in social media use over the course of pregnancy. Lastly, we stratified social media use throughout pregnancy for parity. There was a significant change in social media use over time, for the time spent on social media, frequency of social media use and problematic social media use. Mean social media scores were the lowest at 12 weeks of pregnancy and increased significantly at 20 weeks of pregnancy, after which they remained stable at 28 weeks. Compared to multiparous women, primiparous women spent more time on social media at 20 weeks of pregnancy, but not at 12 or 28 weeks. Because overuse of social media has been associated with poor mental health, healthcare professionals should be aware of the intensity of social media use throughout pregnancy. [ABSTRACT FROM AUTHOR]

The WHO recommends breastfeeding for at least six months as breastfeeding has many benefits for both infant and mother. The association of breastfeeding continuation with trait mindfulness during pregnancy and trajectories of postpartum depressive symptoms has not been examined yet. The current study aimed to assess this association using cox regression analysis. The current research is part of a large longitudinal prospective cohort study following women from 12 weeks of pregnancy onwards in the South-East part of the Netherlands. A total of 698 participants filled out the Three Facet Mindfulness Questionnaire-Short Form (TFMQ-SF) at 22 weeks of pregnancy and completed both the Edinburgh Postnatal Depression Scale (EPDS) and questions on breastfeeding continuation one week, six weeks, four months, and eight months postpartum. Breastfeeding continuation was defined as exclusive breastfeeding or both breastfeeding and formula. The assessment eight months postpartum was used as a proxy for the WHO recommendation to continue breastfeeding for at least six months. Two trajectories (classes) of EPDS scores were determined using growth mixture modeling: 1) low stable (N = 631, 90.4%), and 2) increasing (N = 67, 9.6%). Cox regression analysis showed that the trait mindfulness facet non-reacting was significantly and inversely associated with the risk of breastfeeding discontinuation (HR = 0.96, 95% CI [0.94, 0.99], p =.002), while no significant association was found for belonging to the increasing EPDS class versus belonging to the low stable class (p =.735), adjusted for confounders. This study is the first to show that higher trait mindfulness non-reacting scores, but not persistently low levels of postpartum depressive symptoms, increase the likelihood of breastfeeding continuation. Improving non-reacting in perinatal women by meditation practice as part of a mindfulness-based intervention may lead to better breastfeeding continuation outcomes. Several mindfulness-based programs may be suitable. [ABSTRACT FROM AUTHOR]

Aims: This study investigated (factors related to) (a) the response to a screening procedure for depression and anxiety in people with type 2 diabetes in primary care, and (b) participation in a subsequent randomised controlled trial targeting depressive or anxiety symptoms.Methods: People with type 2 diabetes (n=1837) received a screening questionnaire assessing depressive symptoms (PHQ-9) and anxiety symptoms (GAD-7). Eligible persons who scored above the cut-off score (PHQ-9≥7 or GAD-7≥8) were offered to participate in the trial.Results: In total, 798 people (43%) returned the screening questionnaire. Non-responders were more often female (53% vs 44%, p<0.001), had higher LDL cholesterol levels (Cohen's d=0.17, p=0.001) and a higher albumin/creatinine ratio (Cohen's d=0.08, p=0.01). In total, 130 people (18%) reported elevated depressive or anxiety symptoms. Twenty-seven persons agreed to participate in the trial. Factors related to participation were a high education level, a higher level of diabetes distress and a history of psychological problems.Conclusions: Using screening as recruitment resulted in a small number of participants in a treatment trial for anxiety and depression. Research is needed to investigate whether screening is also followed by a low uptake of treatment in primary care outside a RCT setting. [ABSTRACT FROM AUTHOR]

Objective: A considerable proportion of pregnant women with a fetus in breech position refuses external cephalic version (ECV), with fear of pain as important barrier. As a consequence, they are at high risk for caesarean section at term. The current study investigated determinants of pain perception during ECV, with special attention to maternal mental state such as depression and fear of ECV. Design: Prospective study of 249 third-trimester pregnant women with breech position with a request for an ECV attempt. Setting: Department of Obstetrics and Gynaecology in a large teaching hospital in the Netherlands. Methods: Prior to the ECV attempts, obstetric factors were registered, participants fulfilled the Edinburgh Depression Scale (EDS) and reported fear of ECV on a 10-point visual analog scale. Perception of pain intensity was measured with a 10-point visual analog scale, immediately after ECV. Findings: Multivariate linear regression analyses showed success of ECV to be the strongest predictor of pain perception. Furthermore, scores on the depression questionnaire and degree of fear of ECV independently explained pain perception, which was not the case for obstetrical or ECV related factors. Conclusion: Apart from ECV outcome, psychological factors like depression and fear of ECV were independently related to pain perception of an ECV attempt. Implication for practice: Maternal mood state should be taken into account when offering an ECV attempt to women with a fetus in breech position. Due to the painful experience and the importance of successful outcome, ECV should only be attempted in institutions with experienced practitioners and with careful attention to maternal mood and the way a woman is coping with the ECV attempt. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: We examined whether the association between hormone therapy (HT) use and coronary heart disease (CHD) risk differed between women with and without vasomotor symptoms (VMS). Study design: We used data from a Dutch (EPOS) and Swedish (WHILA) population-based sample of 8865 women, aged 46–64 years, and free of CHD, stroke, venous thrombosis/pulmonary embolism or cancer at baseline. Data on HT use, VMS and potential confounders were collected by questionnaires. Main outcome measures: CHD endpoints, obtained via registries. Results: 252 CHD cases occurred during 10.3 years of follow-up. Neither for women with nor for women without flushing or (night) sweats ever HT use was associated with CHD risk, compared with never HT use. Among women with intense VMS, ever HT use borderline significantly decreased CHD risk compared with never HT use (HR 0.48 [95% CI 0.20–1.03]). Among women without intense VMS, ever HT use was associated with a borderline significant increased CHD risk (HR 1.28 [95% CI 0.96–1.70]; P for interaction=0.02). However, after multivariate adjustment, as compared to never HT use, ever HT use was not associated with risk of CHD among women with or without intense VMS. Conclusions: In both groups of women with and without VMS, HT use does not seem to be associated with the risk of CHD. Hence, our findings do not support the view that HT use increases the CHD risk among women with an indication, i.e. VMS, but this needs to be confirmed in specifically designed studies. [Copyright &y& Elsevier]

Abstract: A review of the earthworm fauna of the Carpathian Basin recorded a total of 97 earthworm species of which three: Dendrobaena vladeasa, Octodriloides izanus and Octodrilus parvivesiculatus spp. nov. are new to science. A biogeographic analysis of the earthworm fauna revealed an extraordinarily high rate of endemism (40.21%) which is explained by the special Quaternary and tectonic history of the region. [Copyright &y& Elsevier]

Breastfeeding has been associated with many health benefits for both infant and mother. Trait mindfulness during pregnancy may have a beneficial impact on breastfeeding intention. The current study aimed to examine whether trait mindfulness during pregnancy was associated with antenatal breastfeeding intention. The current study is part of a large prospective population-based cohort study among pregnant women in the south of the Netherlands. A subsample of participants completed the Three Facet Mindfulness Questionnaire-Short Form at 22 weeks of pregnancy and a question on their breastfeeding intention at 32 weeks of pregnancy (N=790). Moreover, the Edinburgh Depression Scale and Tilburg Pregnancy Distress scale were completed at 32 weeks of pregnancy to assess levels of distress. Univariate analyses showed that women with breastfeeding intention during pregnancy had significantly higher scores on the mindfulness facet non-reacting (p <.001, medium effect size) and significantly lower scores on acting with awareness (p =.035, small effect size). A subsequent multiple logistic regression analysis showed that only non-reacting remained significantly associated with antenatal breastfeeding intention (OR=1.09, 95% CI [1.03, 1.15], p =.001), after controlling for confounders. Women who eventually initiated breastfeeding had significantly higher non-reacting scores (p <.001, small to medium effect size). The mindfulness facet non-reacting was found to be associated with antenatal breastfeeding intention. More research is needed to confirm our results, since the current study is one of the first assessing the possible relation of trait mindfulness during pregnancy and breastfeeding intention. Mindfulness-based programs during pregnancy could be helpful in improving non-reacting in pregnant women, which may enhance breastfeeding intention and ultimately the initiation of breastfeeding. [ABSTRACT FROM AUTHOR]

Highlights from the article: We examined the association of human chorionic gonadotropin (hCG), thyroid hormones (thyroid-stimulating hormone (TSH) and thyroxin (FT4)) and psychological factors with nausea and vomiting during pregnancy NVP. The current study is the first to demonstrate that a combination of hCG hormone and psychological factors are independently related to nausea and vomiting during early pregnancy.

Abstract: Dendrobaena alpina (Rosa, 1884) has been considered by V.V. Pop [Relationships between lumbricid synusia and ecosystem types in the Apuseni Mountains (the Romanian Carpathians), in: Present and Perspective in Biology. Structure and Functions in Terrestrial and Aquatic Ecosystems. Tipo Agronomia, Cluj-Napoca, 1984, pp. 79–86 (Romanian, English summary); Density and biomass of earthworm synusia in forest ecosystems of the Romanian Carpathians, in: A.N. Bonvicini Pagliai, P. Omodeo, (Eds.), On Earthworms, Selected Symposia and Monographs, U.Z.I., vol. 2, Muchi, Modena, 1987, pp. 183–190; Structure and season dynamics of earthworm communities, in: I. Popovici (Ed.), Parcul Naţional Retezat. Studii ecologice, Ed. West Side Computers, Braşov, 1993, pp. 215–227 (Romanian, English summary); Earthworm–vegetation–soil relationships in the Romanian Carpathians, Soil Biol. Biochem. 29 (1997) 223–229] to be the most characteristic lumbricid species of the coniferous belts in the South-Eastern Carpathians, giving its name to the so called “Earthworm community with D. alpina”. Recent morphological and molecular taxonomy researches [Cs. Csuzdi, A.A. Pop, V.V. Pop, M. Wink, A. Zicsi, Revision of the Dendrobaena alpina (Rosa, 1884) species group (Oligochaeta, Lumbricidae), in: V.V. Pop, A.A. Pop (Eds.), Advances in Earthworm Taxonomy II, Cluj University Press, Cluj-Napoca, 2005, pp. 119–128] proved that the earthworm populations formerly attributed to D. alpina should be split into four taxa, namely: D. alpina alpina (Rosa, 1884), Dendrobaena alpina alteclitellata (Pop, 1938), Dendrobaena attemsi (Michaelsen, 1902), and Dendrobaena n. sp. Consequently, the structural patterns of the Carpathians earthworm communities are reconsidered, and new earthworm community types are described in this paper. [Copyright &y& Elsevier]

Abstract: The earthworm species Allolobophora dugesi var. getica Pop, 1947 due to the inadequate description has long been misinterpreted and consequently several synonym names were described. During a survey of the Pop collection kept in the Zoological Museum of the Babes-Bolyai University, Cluj we discovered the type specimens of Allolobophora dugesi var. getica. A detailed examination of the adult type specimen revealed that its male pore is located on the clitellum. Consequently, A. dugesi var. getica should be placed to the genus Cernosvitovia. For the specimen revealed a new and more complete description is given, furthermore the taxonomy of several other Cernosvitovia species are discussed. [Copyright &y& Elsevier]

Objectives: Research has shown the effectiveness of mindfulness-based interventions for a variety of emotional problems in different samples, but it is unknown which factors influence this effectiveness. Therefore, the aim of the current study was: which factors (demographic, personality, and baseline levels of mindfulness skills) moderate the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT)?Methods: Outpatients with diabetes (type 1 or type 2; N=139) and an elevated level of emotional distress participated in the Diabetes and Mindfulness (DiaMind) trial. They were randomized into MBCT (N=70) or a control group (N=69) that received treatment as usual and that was offered the intervention 6months later. Primary outcomes were anxiety, depressive symptoms, and perceived stress at post-intervention and at 6-month follow-up.Results: Mixed models analyses showed that sex, extraversion, and baseline acting with awareness were significant moderators of effectiveness. In the MBCT group, women showed larger decreases in anxiety and depression across time (large effects) compared to men (medium to small effects). For extraversion divided into quartiles, the three lowest quartiles generally exhibited large decreases in symptoms, whereas the high extraversion group showed medium (perceived stress) to small (depression) decreases.Conclusion: MBCT seems to be effective to decrease symptoms of anxiety, depression, and perceived stress for a broad range of person characteristics in patients with diabetes. However, men and those high in extraversion showed considerably lower effectiveness compared to the other groups. The small effect in high extraverts may be due to the large dropout in this subgroup. [ABSTRACT FROM AUTHOR]

Pregnant women may be specifically prone to experience pregnancy-specific distress, which has been associated with adverse maternal, pregnancy and child outcomes. Accurately identifying pregnancy-specific distress is thus crucial. The Tilburg Pregnancy Distress Scale (TPDS) – translated into many different languages - was previously developed to measure pregnancy-specific distress, resulting in a 16-item screening scale with a partner involvement dimension (PI) and a negative affect dimension (NA). A critical evaluation of the psychometric properties of the TPDS-NA items and feedback from pregnant women over the last decade has led to the need to revise the TPDS. Therefore, in the current study, we describe the procedure for revision and evaluate the psychometric properties of the revised TPDS (TPDS-R). More specifically, we describe the revision of the TPDS-R-PI (4 items) and the TPDS-R-NA (10 items: five-item pregnancy and five-item childbirth subcomponent). A sample of 1081 pregnant women participating in the Brabant Study completed the TPDS-R at 12, 20 and 28 weeks of pregnancy. An exploratory factor analysis and confirmatory factor analysis, descriptive statistics and repeated measures ANOVA demonstrated good test-retest reliability, concurrent validity, internal consistency, and construct validity of the TPDS-R. The TPDS-R provides a robust screening tool to accurately identify pregnant women at risk of pregnancy-specific distress. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The DiaMind trial showed beneficial immediate effects of mindfulness-based cognitive therapy (MBCT) on emotional distress, but not on diabetes distress and HbA1c. The aim of the present report was to examine if the effects would be sustained after six month follow-up. Methods: In the DiaMind trial, 139 outpatients with diabetes (type-I or type-II) and a lowered level of emotional well-being were randomized into MBCT (n=70) or a waiting list with treatment as usual (TAU: n=69). Primary outcomes were perceived stress, anxiety and depressive symptoms, and diabetes distress. Secondary outcomes were, among others, health status, and glycemic control (HbA1c). Results: Compared to TAU, MBCT showed sustained reductions at follow-up in perceived stress (p <.001, d =.76), anxiety (p <.001, assessed by HADS d =.83; assessed by POMS d =.92), and HADS depressive symptoms (p =.004, d =.51), but not POMS depressive symptoms when using Bonferroni correction for multiple testing (p =.016, d =.48). No significant between-group effect was found on diabetes distress and HbA1c. Conclusion: This study showed sustained benefits of MBCT six months after the intervention on emotional distress in people with diabetes and a lowered level of emotional well-being. Trial registration: Dutch Trial Register NTR2145, http://www.trialregister.nl. [Copyright &y& Elsevier]

Maternal love and caregiving are pillars for optimal child development and may affect infant outcomes from pregnancy onwards. The present study aimed to examine whether maternal trait mindfulness during pregnancy and pre- and postnatal maternal-infant bonding were associated with maternal perceptions of infant temperament and social-emotional development. In total, 408 Dutch women (M age = 31.33, SD = 3.59) participated in a prospective perinatal cohort study and completed questionnaires on trait mindfulness, prenatal bonding, postnatal bonding, infant temperament, and infant social-emotional development at 20 and 28 weeks of gestation, and 10 weeks, 6 and 12 months postpartum, respectively. Path analyses demonstrated that higher levels of the trait mindfulness facet non-judging (i.e., refraining from judgments about own feelings and thoughts) were associated with more pre- and postnatal maternal bonding and fewer social-emotional problems as perceived by the mother. Adopting an accepting and non-judgmental attitude may promote positive feelings of bonding and benefit the infant in terms of having fewer social-emotional problems in the first year of life. Mindfulness interventions may be offered to pregnant women in order to enhance maternal bonding and improve infant outcomes after birth. • Path analysis was used to evaluate predictors of social-emotional development. • The mindfulness facet non-judging was positively associated with maternal bonding. • Non-judging was also negatively associated with infant social-emotional problems. [ABSTRACT FROM AUTHOR]

Exploring possible protective factors against antenatal depression is important since antenatal depression is common and affects both mother and child. The person characteristic trait mindfulness may be such a protective factor. Because of the high variability in depressive symptoms over time, we aimed to assess the association between trait mindfulness and trajectories of depressive symptoms during pregnancy. A subsample of 762 women participating in the HAPPY study completed the Three Facet Mindfulness Questionnaire-Short Form at 22 weeks of pregnancy. Possible different trajectories of Edinburgh Postnatal Depression Scale (EPDS) scores, assessed at each pregnancy trimester, were explored with growth mixture modeling. Three EPDS trajectories (classes) were identified: low stable symptom scores (N = 607, 79.7%), decreasing symptom scores (N = 74, 9.7%) and increasing symptom scores (N = 81, 10.6%). Compared to belonging to the low stable class (reference), women with higher scores on the trait mindfulness facets 'acting with awareness' and 'non-judging' were less likely to belong to the decreasing class (OR = 0.81, 95% CI [0.73, 0.90] and OR = 0.77, 95% CI [0.70, 0.84]) and increasing class (OR = 0.88, 95% CI [0.80, 0.97] and OR = 0.72, 95% CI [0.65, 0.79]). Women with higher scores on 'non-reacting' were less likely to belong to the increasing class (OR = 0.89, 95% CI [0.82, 0.97]), but not the decreasing class (OR = 0.96, 95% CI [0.87, 1.04]). All analyses were adjusted for confounders. Characteristics of trait mindfulness predicted low stable levels of depressive symptoms throughout pregnancy. Mindfulness-based programs may be beneficial for pregnant women as a strategy to alleviate depression risks. • Growth mixture modeling was used to assess antenatal depressive symptoms. • We found a low stable (79.7%), decreasing (9.7%) and increasing (10.6%) EPDS class. • Trait mindfulness facets were associated with EPDS trajectories during pregnancy. • Characteristics of trait mindfulness predicted low stable depressive symptom levels. [ABSTRACT FROM AUTHOR]

Abstract: Objective: In cardiovascular research, Type D personality (high negative affectivity and social inhibition) has been associated with a more than 3-fold increased risk of adverse health outcomes. This study examined the validity and clinical correlates of the Type D construct as assessed by the Type D Scale-14 (DS14) in type 2 diabetes patients. Methods: 1553 primary care patients with type 2 diabetes were assessed for demographic, clinical, lifestyle and psychological characteristics in 2007. A subgroup (n=1012) completed the DS14 again 1year later. Results: The two-factor model of the Type D construct was confirmed in exploratory and confirmatory factor analyses; results were stable across gender. The Negative Affectivity (NA) and Social Inhibition (SI) subscales had adequate reliability in both men and women, as measured by Cronbach''s alpha (NA=0.87, SI=0.83), lambda2 (NA=0.87/0.88, SI=0.84), corrected item-total correlations (NA 0.47–0.77, SI 0.34–0.72) and mean inter-item correlations (NA=0.50/0.51, SI=0.42). One year test–retest reliability using intraclass correlation coefficients was 0.64/0.63 for NA and 0.73/0.65 for SI. Type D and non-Type D patients did not differ in vascular history or physiological risk factors, but Type D women had a more sedentary lifestyle (p=.003). Type D patients experienced less social support and more stressful life events, loneliness, and more depressed mood, anhedonia and anxiety (p<.001 for most variables). These differences were clinically significant (Cohen''s d>0.60 for most variables). Conclusion: Type D personality can be reliably assessed in primary care patients with type 2 diabetes, and is associated with increased loneliness, stress and emotional distress in these patients. [Copyright &y& Elsevier]

The incremental validity of repeated measurements of a short depression questionnaire was examined regarding the clinical diagnosis of depression. Participants were 951 randomly selected women of around menopausal age. They completed the Edinburgh Depression Scale (EDS) at two time points, with approximately 18 months in between. At the second time point, they participated in a structured clinical interview for depression diagnosis based on the Research Diagnostic Criteria (RDC). With repeated assessments, specificity and negative predictive value (NPV) did not change much relative to a single assessment, with a specificity of 95.0% and a NPV of 91.7% at a cut-off score of 12 on the EDS. As expected, sensitivity dropped, from 87.9% to 58.8%. However, positive predictive value (PPV) increased from 42.0% to 49.1% at a cut-off of 12. When using a cut-off score of 15 on the EDS, the PPV based on both EDS measurements reached 61.8%, yielding a 25-fold probability of being a case for women scoring above 15 at both time points (OR=24.54, 95% CI=14.24–42.28). In conclusion, the 10-item EDS is a reliable, valid and valuable screening instrument. When employed repeatedly, a more stable depression may be tapped, which can be of substantial value for both epidemiological research and clinical practice. [Copyright &y& Elsevier]

The European montane earthworm species Eisenia lucens (Waga, 1857) and the Central European Eisenia spelaea (Rosa, 1901) are highly similar morphologically, the only remarkable difference is in the presence of bioluminescence in case of E. lucens . Because of the difficulties in distinguishing the two species, majority of the distribution data is uncertain, and the minimal morphological differences do not necessarily justify the separation of E. spelaea as an independent species. To clarify the taxonomy of the E. spelaea / E. lucens species pair, a molecular phylogenetic analysis was carried out with the use of cytochrome c oxidase I sequences. Our results showed high genetic separation between the two species which confirms the validity of E. spelaea . Moreover, two highly divergent cryptic clades were revealed within E. lucens . [ABSTRACT FROM AUTHOR]

Objectives: Mindfulness skills have been associated with better mood and several health related outcomes. Because depressed mood during pregnancy has been related to worse child outcomes, the aim was to examine the association of mindfulness skills during pregnancy with the mother's depressive symptoms, gestational age, and neonatal birth weight.Methods: A subsample of 905 pregnant women who participated in the longitudinal cohort HAPPY study (Holistic Approach to Pregnancy and the first Postpartum Year) completed the 12-item Three Facet Mindfulness-Questionnaire-Short Form at 22weeks of gestation. The Edinburgh Depression Scale was completed to assess depressive symptoms at 12, 22 and 32weeks. The obstetric medical records were examined for gestational age and birth weight.Results: Mindfulness skills Acting with Awareness and Nonjudging at 22weeks were associated with less depressive symptoms at 22weeks and at 32weeks. When controlled for depressive symptoms at 22weeks, the association was still significant for Nonjudging predicting depressive symptoms at 32weeks (Beta=-0.12, p<0.01). Regarding the obstetric medical records, only Nonreacting was (positively) associated with birth weight (Beta=0.09, p<0.01). Controlling for gestational age, sex, parity, depressive symptoms, and health behavior, Nonreacting predicted a normal birth weight (OR=1.12, 95% CI=1.06-1.19), in contrast to low birth weight.Conclusion: It seems that different mindfulness skills during pregnancy are important in predicting mother's depressive symptoms compared to the prediction of child's birth weight. Potential mechanisms are discussed. [ABSTRACT FROM AUTHOR]

The first 1000 days after conception are considered critical for healthy development and well-being throughout life. Fundamental to health practices during pregnancy and positive parenting after birth is the development of maternal-infant bonding. Previous research has demonstrated the importance of having an involved partner during pregnancy and in parenting for optimal maternal-infant bonding. The current study examined maternal-infant bonding and partner support during pregnancy and the postpartum period, and their associations with early child social-emotional development. A total of 227 women completed the Pre- and Postnatal Bonding Scale (PPBS) and Tilburg Pregnancy Distress Scale (TPDS) during pregnancy (32 weeks of gestation) and at 8 months postpartum, assessing maternal-infant bonding and partner support. Additionally, a questionnaire on social-emotional behavior of the Bayley Scales of Infant and Toddler Development was administered to mothers to measure child development at 2 years of age. Path analyses revealed an indirect positive effect of prenatal maternal-infant bonding on child social-emotional development through postnatal maternal-infant bonding, as well as mediating effects of pre- and postnatal maternal-infant bonding on the association between pre- and postnatal partner support and child social-emotional development. Our findings support the notion that an emotional connection from mother to child originates in pregnancy and that experiencing positive feelings towards the fetus promotes positive maternal-infant bonding after birth and social-emotional capacities of the child. Additionally, having a supportive partner during pregnancy and postpartum, might be essential for the development of optimal maternal-infant bonding. • Path analysis was used to evaluate predictors of social-emotional development. • Pre- and postnatal bonding are positively associated with child development. • Postnatal bonding mediates the relation between prenatal bonding and child development. • Prenatal partner support is positively related to child development. • This association is mediated by pre- and postnatal bonding and postnatal support. [ABSTRACT FROM AUTHOR]

Background: There is increasing evidence that mindfulness-based interventions reduce psychological distress in various medical populations. However, it has hardly been studied if these effects are mediated by an increase in mindfulness. The aim of this study was to examine mediating effects of various mindfulness facets on effects of a Mindfulness Based Cognitive Therapy (MBCT) on perceived stress and mood.Methods: Outpatients with diabetes types 1 and 2 and low levels of emotional wellbeing were randomized into a group receiving MBCT (n=70) or a waiting-list control group (n=69). Primary outcomes were mood and perceived stress. Before, after and at follow-up (6months post intervention) relevant questionnaires were completed.Results: Mediation analysis using bootstrap resampling indicated that increases in total mindfulness and the facets observing and nonreactivity mediated the effects of the intervention on depressed and angry mood, anxiety (only observing), and perceived stress (only nonreactivity) from pre- to post-intervention. In contrast, from post-intervention to follow-up, besides total mindfulness the facets of acting with awareness and nonjudging mediated the effects on depressed, anxious, and angry mood, while only nonjudging mediated the effects on perceived stress.Discussion: The findings indicate that increases in levels of mindfulness mediate the effects of the Mindfulness-Based Cognitive Therapy in patients with diabetes. It is notable that different facets may be important for immediate change versus long-term outcome. These findings might be relevant for post-intervention care. [ABSTRACT FROM AUTHOR]

Emotional distress during pregnancy has been frequently related to adverse outcomes, not only for the pregnant woman but also for the developing fetus. Self-reported mindfulness has been associated with several indices of well-being such as life satisfaction, physical well-being, and mental health. This study focused on the relationship between self-reported mindfulness and psychological distress (depressive symptomatology and pregnancy-related distress) in pregnant women, as research on this association during pregnancy is largely lacking. In this study, a brief Three-Facet Mindfulness Questionnaire (TFMQ-SF) was tested and validated using explorative factor analysis (EFA) and confirmative factor analysis (CFA) in two large samples of pregnant women from the same study (total N = 905). The TFMQ-SF showed adequate psychometric properties and correlated negatively with symptoms of depression and pregnancy-related distress, with medium to large effect sizes. This study showed the 12-item TFMQ-SF to be a valid instrument to evaluate self-reported mindfulness in pregnant women. [ABSTRACT FROM AUTHOR]

Objective: Occurrence of psychological distress in hypertensive patients could have a negative synergistic effect on future cardiovascular events (CVEs). The aim of this study was to determine the association between anxiety or depressive symptoms in elderly hypertensive primary care patients and the development of new CVEs and all-cause mortality.Methods: A prospective cohort study was conducted in five Dutch general practices between June 2010 and January 2012. Patients with primary care managed hypertension, aged 60-85 years, were included and completed the GAD-7 and PHQ-9, measuring anxiety and depressive symptoms respectively. The incidence of new CVEs (coronary event, cerebrovascular disease, atrial fibrillation and heart failure) and all-cause mortality at 8 years' follow-up was recorded by data extraction of the digital information systems.Results: Among the 555 included participants (mean age 70 ± 6.6 years; 56% female), 29 (5.2%) had a new coronary event, 42 (7.6%) a cerebrovascular disease, 57 (10.3%) atrial fibrillation, 22 (4%) heart failure and 68 (12.3%) died. Elevated anxiety and depression scores increased the risk of a coronary event independently and significantly by 12% (HR 1.12; 95% CI [1.04-1.22], p = 0.005) and 18% (HR 1.18; 95% CI [1.08-1.28], p < 0.0001), respectively, adjusted for relevant (Framingham) baseline covariates. No associations were found with regard to other CVEs and all-cause mortality.Conclusion: In a random sample of elderly primary care hypertension patients there was a significant association between psychological distress and the occurrence of new coronary events after 8 years' follow-up but not with other CVEs and all-cause mortality. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To develop an instrument to the assess quality of care during pregnancy and delivery as perceived by women who recently gave birth. Study design: Prospective design from focus group interviews to validation of the questionnaire. The focus groups consisted of seven care providers, ten pregnant women and six women who recently gave birth. With the results of the focus group interviews, a draft questionnaire of 52 items was composed and its psychometric properties were tested in a first cohort of 300 women who recently gave birth (sample I) by means of exploratory factor analysis (EFA) and reliability analysis. The final version was further explored by confirmatory factor analyses (CFA) in another sample of 289 women (sample II) with similar characteristics as sample I. Results: EFA in sample I suggested an 18-item scale with two components concerning the quality of care during pregnancy: ‘personal treatment’ (11 items, Cronbach's alpha (α)=0.87) and ‘educational information’ (7 items, α =0.90); the ‘delivery’ scale showed a single domain (7 items, α =0.88). CFA in sample II confirmed both factor structures with an adequate model fit. Overall, satisfaction with care was highest among women who only received midwife-led care, while women who were referred to an obstetrician during pregnancy reported less satisfaction. Conclusions: The 25-item PCQ, primarily based on the experiences and perceptions of pregnant women and women who recently gave birth, showed adequate psychometric properties evaluating the quality of care during pregnancy and delivery. This user-friendly instrument might be a valuable instrument for future research to further evaluate the quality of care to pregnant women. [Copyright &y& Elsevier]

Background: Accumulating evidence suggests that dysregulation of the immune system represents an important vulnerability factor for mood disorders. Postpartum psychosis (PP) is a severe mood disorder occurring within 4 weeks after delivery, a period of heightened immune responsiveness and an altered endocrine set point. Therefore, the aim of this study was to examine immune activation in patients with first-onset PP at the level of monocytes, T cells, and serum cytokines/chemokines. Methods: We included 63 women admitted with first-onset PP. Control groups included healthy postpartum (n = 56) and nonpostpartum (n = 136) women. A quantitative-polymerase chain reaction monocyte gene expression analysis was performed with 43 genes previously identified as abnormally regulated in nonpostpartum mood disorder patients including the isoforms of the glucocorticoid receptor. Peripheral blood mononuclear cells percentages were measured by fluorescence-activated cell sorter analysis, whereas serum cytokines/chemokines were determined with a cytometric bead array. Results: In healthy women, postpartum T cell levels were significantly elevated compared with nonpostpartum. Patients with PP failed to show the normal postpartum T cell elevation. In contrast, these patients showed a significant elevation of monocyte levels and a significant upregulation of several immune-related monocyte genes compared with control subjects postpartum and nonpostpartum. Furthermore, the glucocorticoid receptor α/β gene expression ratio was decreased in monocytes of PP patients, strongly correlating with their immune activation. Conclusions: This study demonstrates a robust dysregulation of the immuno-neuro-endocrine set point in PP, with a notable over-activation of the monocyte/macrophage arm of the immune system. [Copyright &y& Elsevier]