@article {10472, title = {Qualitative questionnaire on the psychosocial wellbeing of mothers of~children with BEEC.}, journal = {J Pediatr Urol}, volume = {13}, year = {2017}, month = {2017 Feb}, pages = {55.e1-55.e6}, abstract = {

INTRODUCTION: The bladder exstrophy-epispadias complex (BEEC) represents a spectrum of malformations that affect the anatomical and functional structure of the urogenital system. The parents of patients affected by this condition are subject to particularly stressful situations, such as worrying about their child{\textquoteright}s health, long hospital stays, concerns about the health and constant need for personal care for their children, that can profoundly compromise the quality of family life.

OBJECTIVE: The objective of this explorative qualitative study is to evaluate the social situation and the psychological strategies implemented by the mothers of children between 6 and 10 years of age who are affected by BEEC.

STUDY DESIGN: Fourteen mothers of children aged 6-10 years and affected by BEEC (9 boys and 5 girls) were interviewed. Data on the mothers{\textquoteright} experiences were collected through semi-structured interviews (Table).

RESULTS: The qualitative analysis of the interviews showed that participants described experiences that were characterised by emotions such as fear and anger. Each mother had implemented a different and, sometimes, dysfunctional strategy in order to cope with the complex situation of the son/daughter. The aspects that most clearly emerged from mothers{\textquoteright} descriptions were (1) the traumatic situation at the birth of the baby, (2) the sense of embarrassment concerning the pathological condition as the child was growing and the consequent sense of isolation of the mother, and (3) the fluctuation of feelings towards the multidisciplinary staff, which was sometimes seen as an important source of help and some other times as too destabilising and not helpful at all.

DISCUSSION: The study provided some insight into the psychological and social conditions experienced by mothers of children with BEEC, which could serve as a basis for developing multidisciplinary teams with greater awareness about families living with this condition and better timing in addressing their needs.

CONCLUSIONS: Mothers of children with BEEC show emotional and social difficulties. This is a crucial aspect to consider when planning a multidisciplinary approach to the treatment/therapy, especially considering that children examined in this study are approaching adolescence.

}, keywords = {Adaptation, Psychological, Adolescent, Bladder Exstrophy, Child, Epispadias, Female, Humans, Long-Term Care, Male, Mother-Child Relations, Mothers, Qualitative Research, Quality of Life, Stress, Psychological, Surveys and Questionnaires, Treatment Outcome}, issn = {1873-4898}, doi = {10.1016/j.jpurol.2016.07.015}, author = {Di Grazia, Massimo and Pellizzoni, Sandra and Tonegatti, Luca Giacomo and Rigamonti, Waifro} } @article {7786, title = {Intranasal adminsitration of oxytocin in postnatal depression: implications for psychodynamic psychotherapy from a randomized double-blind pilot study.}, journal = {Front Psychol}, volume = {6}, year = {2015}, month = {2015}, pages = {426}, abstract = {

Oxytocin is a neuropeptide that is active in the central nervous system and is generally considered to be involved in prosocial behaviors and feelings. In light of its documented positive effect on maternal behavior, we designed a study to ascertain whether oxytocin exerts any therapeutic effects on depressive symptoms in women affected by maternal postnatal depression. A group of 16 mothers were recruited in a randomized double-blind study: the women agreed to take part in a brief course of psychoanalytic psychotherapy (12 sessions, once a week) while also being administered, during the 12-weeks period, a daily dose of intranasal oxytocin (or a placebo). The pre-treatment evaluation also included a personality assessment of the major primary-process emotional command systems described by Panksepp () and a semi-quantitative assessment by the therapist of the mother{\textquoteright}s depressive symptoms and of her personality. No significant effect on depressive symptomatology was found following the administration of oxytocin (as compared to a placebo) during the period of psychotherapy. Nevertheless, a personality trait evaluation of the mothers, conducted in our overall sample group, showed a decrease in the narcissistic trait only within the group who took oxytocin. The depressive (dysphoric) trait was in fact significantly affected by psychotherapy (this effect was only present in the placebo group so it may reflect a positive placebo effect enhancing the favorable influence of psychotherapy on depressive symptoms) but not in the presence of oxytocin. Therefore, the neuropeptide would appear to play some role in the modulation of cerebral functions involved in the self-centered (narcissistic) dimension of the suffering that can occur with postnatal depression. Based on these results, there was support for our hypothesis that what is generally defined as postnatal depression may include disturbances of narcissistic affective balance, and oxytocin supplementation can counteract that type of affective disturbance. The resulting improvements in well-being, reflected in better self-centering in post-partuent mothers, may in turn facilitate better interpersonal acceptance of (and interactions with) the child and thereby, improved recognition of the child{\textquoteright}s needs.

}, issn = {1664-1078}, doi = {10.3389/fpsyg.2015.00426}, author = {Clarici, Andrea and Pellizzoni, Sandra and Guaschino, Secondo and Alberico, Salvatore and Bembich, Stefano and Giuliani, Rosella and Short, Antonia and Guarino, Giuseppina and Panksepp, Jaak} } @article {8076, title = {PRE- AND POSTNATAL MODIFICATIONS IN PARENTAL MENTAL REPRESENTATIONS IN THREE CASES OF FETAL GASTROSCHISIS DIAGNOSED DURING PREGNANCY.}, journal = {Infant Ment Health J}, year = {2015}, month = {2015 Nov 10}, abstract = {

The aim of this study was to identify possible effects of gastroschisis on parents{\textquoteright} intrapsychic dynamics by applying an observational clinical approach. More specifically, we intend to (a) evaluate the representational style of parents informed about the diagnosis of fetal gastroschisis during pregnancy using the Interview of Maternal Representations During Pregnancy and the Interview of Paternal Representations During Pregnancy (M. Ammaniti, C. Candelori, M. Pola, \& R. Tambelli, ) and (b) observe whether the baby{\textquoteright}s birth influences the parents{\textquoteright} representational styles through the application of the same tools (the Interview of Maternal Representations After the Birth, M. Ammaniti \& R. Tambelli, , and the Interview of Paternal Representations After the Birth, M. Ammaniti \& R. Tambelli, ), adapted to the postnatal period. During the prenatal period, all parents showed a restricted/disinvested style. Three parents-one mother and two fathers-changed their styles from restricted/disinvested to integrated between pregnancy and Month 6 after the birth of their child. Clinical data from the interviews and observations are discussed in an attempt at better defining intrapsychic dynamics of parents after a diagnosis of gastroschisis.

}, issn = {1097-0355}, doi = {10.1002/imhj.21534}, author = {Tripani, Antonella and Pellizzoni, Sandra and Giuliani, Rosella and Bembich, Stefano and Clarici, Andrea and Lonciari, Isabella and Ammaniti, Massimo} } @article {3546, title = {Pregnancy and postpartum following a prenatal diagnosis of fetal thoracoabdominal malformation: the parental perspective.}, journal = {J Pediatr Surg}, volume = {49}, year = {2014}, month = {2014 Feb}, pages = {353-8}, abstract = {

PURPOSE: The study{\textquoteright}s aim was to evaluate how information related to a prenatal diagnosis of fetal malformation could modify parenthood experience descriptions during pregnancy and after the child{\textquoteright}s birth.

METHODS: A longitudinal case-control clinical study was conducted. Data on parenthood experience descriptions collected using a validated semantic differential technique during pregnancy and after the child{\textquoteright}s birth were compared between seven couples of parents receiving a prenatal diagnosis of fetal malformation and seven couples without any fetal diagnosis.

RESULTS: Our results show that during pregnancy parents in the clinical group describe themselves as more fragile, passive, and timid [p=0.007] than those in the control group. On the other hand, after the child{\textquoteright}s birth, there are no significant differences between groups.

CONCLUSIONS: Data are discussed with reference to better knowledge of the psychological dynamics involved in becoming a parent and to rational planning of support for parents receiving a diagnosis of fetal malformation.

}, keywords = {Adult, Case-Control Studies, Counseling, Cystic Adenomatoid Malformation of Lung, Congenital, Female, Hernia, Diaphragmatic, Hernias, Diaphragmatic, Congenital, Humans, Hydronephrosis, Kidney Diseases, Longitudinal Studies, Male, Musculoskeletal Abnormalities, Parents, Pregnancy, Psychological Tests, Stress, Psychological, Ultrasonography, Prenatal, Urogenital Abnormalities}, issn = {1531-5037}, doi = {10.1016/j.jpedsurg.2013.07.025}, author = {Giuliani, Rosella and Tripani, Antonella and Pellizzoni, Sandra and Clarici, Andrea and Lonciari, Isabella and D{\textquoteright}Ottavio, Giuseppina and Schleef, Jurgen} }