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Purpose: This systematic review aimed to synthesize qualitative research on parents' psychological experiences following their child's diagnosis of congenital heart disease (CHD). Methods: A systematic search of six electronic databases (CINAHL, Embase, MEDLINE, PsycINFO, PubMed and Web of Science) was completed, inclusive of all years up to May 2022. Any included articles were synthesized using thematic synthesis and appraised using the Critical Appraisal Skills Programme Qualitative Checklist. Results: Twenty‐six articles were included. Four main themes, and 11 subthemes, emerged from the synthesis. Theme 1 (unpreparedness for the diagnosis) concerned parents' shock, guilt and anger regarding the diagnosis. Theme 2 (the overwhelming reality of CHD) described parental fear about decision‐making and the child's prognosis, and the influence of professionals on parents' well‐being. Theme 3 (mourning multiple losses) detailed parents' sadness at losing their envisioned pregnancy, birth and parenthood experiences. Theme 4 (redefining hopes to reach an acceptance of CHD) described parents' adjustment to the diagnosis. Conclusions: Receiving a child's CHD diagnosis was a uniquely challenging situation for parents. The findings provided insight into the emotions parents experienced and how they adjusted to the diagnosis psychologically. As parents' experiences were significantly influenced by their interactions with professionals, clinicians should offer compassion, validation and clear information throughout the diagnosis process. [ABSTRACT FROM AUTHOR]

Background: There is a significant risk of negative outcomes for families when a parent experiences serious mental illness. Family‐focused practice (FFP) emphasises the "whole family" as the unit of care and has been found to improve outcomes for service users and their families. Despite its benefits, FFP is not routinely implemented in UK adult mental health services. This study explores adult mental health practitioners' experiences and views of FFP within Early Intervention Psychosis Services in the UK. Methods: Sixteen adult mental health practitioners employed in three Early Intervention Psychosis teams in the Northwest of England were interviewed. Interview data were analysed using thematic analysis. Results: Five core themes were generated: (1) A limited understanding of FFP, (2) Our practitioners, (3) Our approach, (4) Our families and (5) Our services. Practitioners' understanding of FFP was limited and typically excluded dependent children. Practitioners' age, professional and personal experience, and preconceptions of families influenced delivery, and in turn, the engagement approach they adopted impacted families' responsiveness. The diversity and dynamics of service user families such as age, socioeconomic status, culture and stigma impacted FFP. An operational context characterised by insufficient resources reduced FFP; however, organisational structures such as leadership, clinical supervision and multi‐disciplinary teams facilitated FFP. Conclusions: FFP is not yet embedded within Early Intervention Services. Practice recommendations include agreeing on a formal definition of FFP and its scope; the development of FFP policy; clarity in relation to staff responsibilities and identities; the adoption of a collaborative approach which encourages service user choice and for time to be ring‐fenced to prioritise FFP. Future research should ascertain service user and family views on the facilitators and barriers to engaging with FFP in Early Intervention Services. [ABSTRACT FROM AUTHOR]

Objectives: Psychosis can present parents with complex parenting challenges and significant adverse outcomes for parents and their children have been reported. However, remarkably little is known about how parenting is experienced by these parents. Therefore, this qualitative study aimed to understand the lived experiences of parents with psychosis, including how parenting support was experienced. Design and Methods: Using interpretative phenomenological analysis (IPA), eight biological parents (five mothers and three fathers) with psychosis were recruited and interviewed from early intervention in psychosis services in the Northwest of England. Results: Three superordinate themes and seven subordinate themes were identified. Theme 1 'Living with the Struggle: Painfully Disconnected' captured a persistent parenting struggle that distanced parents from their children and support due to all‐consuming experiences of psychosis, fear and risk‐focused service support. Theme 2 'Desired and Vulnerable Position: Comfortably Connected' captured parental experiences of symptom relief through connection with their children, alongside parental need to be integrated with the systems around them. Theme 3 'Exposed: Parenting Under a Spotlight' represented parental experiences of inescapable observation and judgement from the systems around them. Conclusions: Novel insights into the role of misaligned parent and service priorities in parental perceptions of powerlessness, shame and disconnection from their children, valued parenting identities, and system supports are presented. Systemic interventions that target stigma, provide system‐wide psychoeducation and promote person‐centred, compassionate and meaningful connections between parents and the systems they live within are needed to promote better parenting outcomes. [ABSTRACT FROM AUTHOR]

Lysosomal storage disorders are rare multiorgan, degenerative conditions requiring invasive treatment. Rare disorders pose unique challenges; therefore, exploring their impact is crucial for understanding family needs. This novel review aimed to understand the psychosocial outcomes for parents of children with lysosomal storage disorders. Five electronic databases were systematically searched. Thirty‐eight (23 qualitative, 10 qualitative and 5 mixed methods) studies were included, analysed using a sequential explanatory narrative synthesis and appraised for their methodological quality. Quantitative data revealed the multifaceted impact on parents' psychological and social wellbeing. Qualitative data informed the challenges that these parents faced which were expressed within three main themes: (a) Uncertainty and the unknown, (b) All‐encompassing impact and (c) Finding a way forward. The synthesis demonstrated that factors associated with the condition (symptoms, behaviour and severity) had a substantial negative impact on parental outcomes, upheld by concurrent loss (deterioration and poor prognosis) and uncertainty. This substantive integrated review revealed considerable unmet parental psychosocial needs. [ABSTRACT FROM AUTHOR]

As prenatal exposure to certain older antiseizure medications (ASMs) has been linked with poorer neurodevelopmental outcomes in children, the use of newer ASMs throughout pregnancy has increased. The current review aimed to delineate the impact of in utero exposure to these newer ASMs on child neurodevelopment. A systematic search of MEDLINE, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature Plus, and PsycINFO was conducted, limiting results to articles available in English and published after the year 2000. Studies investigating neurodevelopmental outcomes following in utero exposure to the following ASMs were eligible for inclusion in the review: eslicarbazepine, gabapentin, lacosamide, lamotrigine, levetiracetam, oxcarbazepine, perampanel, topiramate, and zonisamide. Thirty‐five publications were identified, and a narrative synthesis was undertaken. Methodological quality was variable, with distinct patterns of strengths/weaknesses attributable to design. Most studies examined lamotrigine exposure and reported nonsignificant effects on child neurodevelopment. Comparatively fewer high‐quality studies were available for levetiracetam, limiting conclusions regarding findings to date. Data for topiramate, gabapentin, and oxcarbazepine were so limited that firm conclusions could not be drawn. Concerningly, no studies investigated eslicarbazepine, lacosamide, perampanel, or zonisamide. Exposure to certain newer ASMs, such as lamotrigine and levetiracetam, does not thus far appear to impact certain aspects of neurodevelopment, but further delineation across the different neurodevelopmental domains and dosage levels is required. A lack of data cannot be inferred to represent safety of newer ASMs, which are yet to be investigated. [ABSTRACT FROM AUTHOR]

There is increased recognition of the need for greater and more appropriate support to be offered to families in which a parent experiences mental illness and has dependent children. One way of meeting this need is for adult mental health services to take a more family‐focused approach. However, there are recognized difficulties in facilitating family‐focused practice (FFP). The current review systematically synthesized quantitative and qualitative literature of practitioner perspectives and experiences of FFP in adult mental health settings to identify modifiable factors associated with its successful implementation. Five databases were searched systematically leading to the inclusion and quality assessment of 19 papers, ten of which were quantitative and nine qualitative. Analysis was guided by a narrative synthesis approach. Factors shown to influence FFP functioned at both practitioner and workplace levels and included personal attitudes, beliefs about job role, and perceptions of workplace support. Practitioners who felt that a family‐focussed approach was inappropriate or detrimental to service users or outside of their remit as mental health professionals were less likely to adopt this approach. For those who saw the potential benefits of FFP, lack of confidence in their ability to deliver such an approach and lack of training can be barriers, as can lack of support and resources within services. This review highlights the need for actions to boost the awareness of adult mental health practitioners working with parents and to increase their confidence. It also makes the case for broader organizational support if family‐focussed practice is to be implemented successfully. [ABSTRACT FROM AUTHOR]

Objectives: There is a lack of research into parenting interventions for families which include a parent experiencing psychosis or other serious mental illness (SMI). Preliminary findings highlight the potential benefits of adult mental health practitioners supporting parents experiencing SMI by using self‐directed parenting interventions. This study explored beliefs relating to parenting and psychosis held by practitioners working in adult mental health settings, specifically examining their beliefs about the parenting needs of adults experiencing psychosis who have dependent children, as well as their role as adult mental health practitioners. Design: This study used Q methodology to explore the beliefs of mental health practitioners on psychosis and parenting. Methods: Twenty‐one adult mental health practitioners ranked 58 items according to how much they agreed with the belief statement presented. Participants also provided additional written information and interviews to contextualize the Q methodology data. Results: Three factors emerged representing three groups of practitioners with similar beliefs around psychosis and parenting. Factors were labelled: 'Parenting interventions are worthwhile, and I'd deliver them', 'Parenting interventions are worthwhile, but I'm not confident to deliver them', and 'Parenting interventions might be worthwhile, but it's not my responsibility'. Conclusion: Using parenting interventions as part of their clinical work was acceptable to most practitioners; however, some lacked confidence in their ability to work in a family‐focused way. Efforts now need to focus on enhancing practitioners' skill, knowledge, and confidence in family‐focused approaches to provide increased and improved support to families which include a parent experiencing psychosis or other SMI. Practitioner points: Parenting interventions need to be made more available and accessible to parents experiencing serious mental illness (SMI), such as psychosis.Adult mental health practitioners are willing to incorporate parenting interventions into their work with parents accessing their services, but some lack confidence to do this.These results highlight the importance of equipping practitioners with the skill, knowledge, and confidence to engage in family‐focused approaches.Further research needs to involve parents experiencing SMI as well practitioners working in adult mental health services. [ABSTRACT FROM AUTHOR]

Emotions are considered to be an important feature in eating disorders. The present study aimed to conduct a systematic review and metasynthesis of qualitative studies, which considered the role of emotions in eating disorders in order to gain further insight on how these individuals experience various emotions and the strategies they use to manage them. Databases including Web of Science, PsychInfo, EMBASE, Medline, and the Cochrane library were searched for qualitative studies. The search identified 16 relevant studies. Meta‐ethnography was used to synthesize the data, which involved identifying the key findings and concepts of the studies and creating metaphors. The synthesis involved reciprocal translations and lines of argument approaches being applied to the present data. Results of the synthesis identified four second‐order themes and one third‐order theme relating to the emotional experiences of such individuals. The second‐order themes were (a) negative emotional environments, (b) interpersonal vulnerability, (c) the experience of negative emotions in social contexts, and (d) the management of emotions. The third‐order theme was the emotional self within a social environment. This is the first metasynthesis on emotions and eating disorders, and our synthesis highlights the important role that emotions play in the development and maintenance of eating disorders. Our model demonstrates how poor emotional development whilst growing up results in development of poor socioemotional bonds and the inability to handle negative emotions. The most significant finding of the review is that individuals use their eating disorder to manage negative emotions. [ABSTRACT FROM AUTHOR]

Accessible Summary: We now have a much better understanding of the specific characteristics of the many and often rare conditions that are associated with intellectual disabilities [learning disabilities]We examined a condition called Mucopolysaccharidosis Type III [MPS III] sometimes called Sanfilippo syndromeMany children with MPS III also appear to show signs of autism but an additional diagnosis of autism is time‐consuming and not always available to familiesWe, therefore, measured autistic symptoms in children with MPS III and found that they often had problems in social responsivenessChildren with MPS III and their families might therefore routinely benefit from the types of support offered to children with autism Symptoms of autism spectrum disorder (ASD) are present in children with mucopolysaccharidosis type III (MPS III). Questionnaires measuring the two core domains of ASD (social responsiveness and repetitive behaviour) were completed by N = 17 parents of children with MPS III. Results indicated that scores consistent with ASD were reported by all parents on a measure of social responsiveness but lower scores were reported for repetitive behaviour. The findings provide support for the provision of additional interventions, focusing on social and communication difficulties, for children with MPS III across all phases of their disorder. [ABSTRACT FROM AUTHOR]

Phenylketonuria (PKU) is a rare inherited metabolic disorder which can cause neurological damage if left untreated. PKU is identified through newborn screening in developed countries, and treatment begins immediately to prevent these severe consequences. When a child is diagnosed, parents must assume immediate responsibility for the management of PKU and prevention of neurological damage. Quantitative studies have identified significant psychosocial stressors for parents, but little is known about how the parents experience this process. This study aimed to explore the experiences of parents of children with PKU under the age of two. It is the first study to examine these experiences in this way. Seven parents were interviewed about their experiences, and interpretative phenomenological analysis was used to analyse the data. Three main themes were identified: control, striving for normality and acceptance of PKU as a continuum. Links between the themes and processes underpinning the results were explored with relation to existing literature and theories from a clinical psychology perspective. The role of acceptance of PKU was central to the parent’s experiences. Clinical implications and suggestions for further research are discussed. [ABSTRACT FROM AUTHOR]

Abstract: Cognitive–behavioural and metacognitive approaches to emotional disorder implicate beliefs in social anxiety, but the types of beliefs differ across these perspectives. Cognitive models suggest that social beliefs about the self (i.e., high standards and conditional and unconditional beliefs) are central. In contrast, the metacognitive model gives centre stage to metacognitive beliefs (i.e., positive and negative beliefs about thinking) as main contributors to the maintenance of the disorder. Despite an expanding research interest in this area, the evidence for such contributions has not yet been reviewed. This study set out to systematically review relevant cross‐sectional, longitudinal, and experimental investigations of the direct and indirect (through cognitive processes, such as anticipatory processing, self‐focused attention, the post‐mortem, and avoidance) relationships of social and metacognitive beliefs with social anxiety. Clinical and nonclinical samples were included, and correlation and regression coefficients as well as results from group comparisons (e.g., t tests and analyses of variance) were extracted. Overall, 23 papers were located, through PsycINFO, PubMed, and Web of Science, and reviewed using narrative synthesis. The results showed a robust positive relationship between social beliefs and social anxiety that appeared to be mediated by cognitive processes. Specific metacognitive beliefs were found to positively contribute to social anxiety both directly and indirectly, through cognitive processes. The study's findings are limited to 2 models of social anxiety and other minor limitations (e.g., grey literature was excluded). With these accounted for, the results are discussed in terms of the conceptualization and treatment of social anxiety and suggestions for future research are made. [ABSTRACT FROM AUTHOR]

Introduction Postpartum depression (PPD) is a serious maternal disorder that can have adverse effects on maternal and infant health. The importance of offering effective and acceptable treatments is well recognized, particularly given the numerous barriers women in many settings face in accessing interventions for PPD. The aim of this systematic review was to synthesize qualitative research exploring women's experiences of professional psychological and psychosocial support for PPD. Methods A systematic review of the literature was conducted in April 2017 by searching 5 electronic databases (CINAHL, MEDLINE, PubMed, Ovid, and Web of Science). Qualitative research studies published in English that explored women's experiences of professional psychosocial support for PPD were included, whereas studies exploring women's experiences of antidepressant medication only were excluded. Seventeen articles met inclusion criteria and were appraised for methodologic quality. Data were synthesized using the interpretive thematic synthesis method. Results Four main themes were identified: the process of help-seeking, barriers to seeking and accepting support, valued aspects of support, and outcomes. Women found the process of seeking help difficult, with several barriers preventing them from both seeking and accepting professional support. Despite this, women described the support received as beneficial and particularly valued the therapeutic relationship. Women reported 1) feeling more positive and confident after receiving a psychological and/or psychosocial intervention and 2) experiencing better relationships with their infant and other family members. Discussion Although seeking and accepting professional support for PPD was a difficult process, women highly valued mental health care support and perceived it as beneficial. Clinical services should aim to address the barriers women face in accessing mental health care and empower women to feel in control throughout the process, offering interventions appropriate to each woman's personal circumstance. [ABSTRACT FROM AUTHOR]

Psychosis after childbirth is a rare but severe type of mental health difficulty experienced by perinatal women. Research has explored mothers' experiences of onset and recovery from psychosis after childbirth. This study explored the role of the baby in 12 mothers' experiences of recovery. A thematic analysis of the data identified three core themes that described the role of the baby in the mothers' recovery from psychosis after childbirth. Findings revealed that the baby was central to recovery, experienced by mothers as both helpful and unhelpful. The baby interacted with the mother, increasing self-efficacy, and reducing emotional distress. Findings also showed that the baby could act as a barrier to recovery by increasing the women's emotional distress and hindering access to help and self-care. The findings of the study add to the existing evidence based on recovery from psychosis after childbirth. The research and clinical implications of these findings are discussed with reference to the existing literature. Key Practitioner Message The baby has an important role in recovery from psychosis after childbirth., The baby can be perceived by mothers to both hinder and help their recovery., Interacting with the baby can be helpful for the mothers' recovery by improving their self-efficacy and reducing emotional distress., Specialist interventions offered by a mother and baby unit can provide practical support that facilitates mother-baby interactions, which helps move women forward in the recovery process. [ABSTRACT FROM AUTHOR]

Mothers with severe post-natal mental illness can be admitted with their infant to a psychiatric mother and baby unit (MBU) in the UK. MBUs provide specialist assessment, management and support. Partners of women admitted to MBUs are integral to their recovery but may show reduced wellbeing themselves, yet their support needs have not been investigated. This study aimed to identify how fathers experience the MBU and how they felt supported. A qualitative design was adopted by using a purposive sample of 17 fathers, recruited from a MBU during their partner's admission. Semi-structured interviews were used, and responses were analysed using an inductive thematic analysis. Four main themes were developed: (1) 'double whammy', (2) understanding the admission and illness, (3) support for fathers, and (4) personal stressors and coping. We identified the emotional struggle that fathers experienced when coping simultaneously with the arrival of a baby and their partner's illness. Furthermore, fathers sought support from many sources, but their knowledge of psychiatric services and mental illness was limited. Fathers felt uncertain about their partners' progression and when their partner would return home with their baby. The provision of an information pack and regular one-to-one meetings between fathers and MBU staff are recommended. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message Partners of mothers admitted to a psychiatric mother and baby unit have shown increased vulnerability to mental illness themselves; however, little is known about the support that these fathers need and receive during this time., Using interviews, this study sought to understand a) how fathers experienced the mental illness of their partner and the unit's services and b) how fathers could be better supported., Fathers face many emotional and practical challenges during their partner's admission and seek support from numerous sources, including the mother and baby unit., Fathers require more information from the mother and baby unit with regard to mental illness and the unit's services. Furthermore, the introduction of regular one-to-one updates between staff and fathers would provide an opportunity for fathers to understand how their partner is progressing and for staff to informally assess the father's wellbeing and outstanding support needs. [ABSTRACT FROM AUTHOR]

Background Postnatal depression affects women from all cultures and countries. The postnatal period is thought to be a vulnerable time for all mothers. Immigrant women may be at particular risk as they attempt to adhere to childbirth rituals in western societies which might exacerbate stress, while navigating through the multiple stressors they face from migration in the transition to motherhood. Methods This study utilized a meta-synthesis approach to synthesize qualitative studies exploring postnatal depression in immigrant mothers living in western countries. Searching six databases identified 16 studies that met criteria. Results The synthesis revealed two overarching themes of migration and cultural influences on immigrant mothers that interact and give rise to psychosocial understandings of postnatal depression, remedies and healthcare barriers. Mothers used self-help coping strategies in line with this. Conclusions Immigrant mothers living in western countries are subject to multifactorial stressors following childbirth, increasing their susceptibility to postnatal depression. These stressors relate to being an immigrant in a western society and cultural influences, which may be harder to comply with, when removed from their sociocultural context. Social support appears to play a mediating role for these immigrant mothers. There were several similarities between immigrant and non-immigrant mothers including their views of healthcare and medication, their health-seeking behaviours and their fears of having their baby removed. All these findings have implications for healthcare settings in terms of assessments and service delivery. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message In this meta-synthesis, we explored the experience of postnatal depression in immigrant women living in western countries, including the UK, the USA and Canada., Sixteen qualitative studies were reviewed, and their methodological quality was examined., The findings are based a total sample of 337 women., Two overarching themes were identified that are termed 'cultural influences' and 'migration factors', which influenced how these mothers coped with their postnatal depression., Social support played a mediating role for these immigrant mothers. [ABSTRACT FROM AUTHOR]

Objective To explore the construal of midwives by pregnant women with a body mass index greater than 30 kg/m2 (BMI ≥ 30 kg/m2). Method Ten pregnant women with a BMI ≥ 30 kg/m2 were recruited from antenatal clinics at a maternity hospital in the North West of England. Each participant completed a repertory grid. The participants chose people to match roles including themselves, pregnant women, midwives of different BMIs and hypothetical elements. They also generated psychological constructs to describe them. Results Pregnant women with a BMI ≥ 30 kg/m2 construed themselves as vulnerable and self-conscious. Some women endorsed obesity-related stereotypes for themselves and felt responsible for their weight. The midwife with a BMI 18 < 30 kg/m2 was considered to be most similar to the ideal midwife, while the midwife with a BMI ≤ 18 kg/m2 was construed as having an undesirable interpersonal style. The midwife with a BMI ≥ 40 kg/m2 was often construed as sharing similar experiences to the pregnant women with a BMI ≥ 30 kg/m2, such as struggling with the psychological consequences of a raised BMI. Some women construed the midwife with a BMI 30 < 40 kg/m2 in a positive way, whereas others viewed it as sharing similar feelings about weight as the midwife with a BMI ≥ 40 kg/m2. Conclusions The pregnant women with a BMI ≥ 30 kg/m2 in this study described perceptions of themselves and the midwives responsible for their care, which may affect their engagement and satisfaction with services. Pregnant women with a BMI ≥ 30 kg/m2 should be involved in service development activities to ensure the structure of services and the language used by midwives are acceptable and do not confirm weight-related stereotypes. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message Pregnant women with a BMI ≥ 30 kg/m2 construe themselves as vulnerable and self-conscious and perceive themselves responsible for their weight., Pregnant women with a BMI ≥ 30 kg/m2 construe midwives with a low BMI as having an undesirable, cold, interpersonal style., Midwives with a raised BMI are construed as similar to the women, because they share the uncomfortable psychological consequences of a raised BMI., The nature of pregnant women's construal may affect their engagement and satisfaction with maternity services and midwifery care. [ABSTRACT FROM AUTHOR]

The repertory grid technique was used to explore how 26 third-year trainee clinical psychologists construed their personal and professional selves over the course of training and into the future. Each trainee completed a demographic questionnaire and a repertory grid with 10 elements: four 'personal self' elements, four 'professional self' elements and two 'qualified clinical psychologist' elements. They then rated the 10 elements on 10 bipolar constructs of their choosing. Trainees' personal and professional selves were construed to be similar to each other. Trainees had low self-esteem and reported currently feeling anxious, stressed, unsettled and lacking an appropriate work-life balance. These difficulties were attributed to the demands of training and were expected to resolve once training was completed with future selves being construed as similar to ideal selves. Suggestions for future research with improved methodology are made, and the implications of the findings for trainees, training providers and employers of newly qualified clinical psychologists are given. The overall implication being that stress in training is normative and the profession has a duty to normalize this and ensure that self-care and personal development are recognized as core competencies of the clinical psychologist for the benefit of its members and their clients. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message Clinical psychology trainees experience training as demanding and stressful, which negatively impacts on their personal and professional self-image and self-esteem., However, they are optimistic that they will become more like their ideal self in the future., Stress in clinical training (and beyond) is normative, and thus, personal development and self-care should be recognized as clinical psychologist's core competencies. [ABSTRACT FROM AUTHOR]

Introduction: Postpartum depression is a disabling psychological disorder that, if left untreated, may have negative consequences for the mother, her partner, and the child. Although women with postpartum depression often experience symptoms of anxiety as well as depression, this has been underresearched. As metacognitive therapy assumes that the underlying mechanisms for both anxiety and depression are the same, it is a potentially useful psychological treatment for postpartum depression. Methods: A pilot study was carried out using a multiple-baseline single case series to examine the effects associated with metacognitive therapy in the treatment of depression. Six women with postpartum depression were assigned to no-treatment baselines of 3 to 6 weeks, followed by 8 to 12 sessions of metacognitive therapy. Follow-up with participants took place at 3 and 6 months posttreatment. Results: All participants experienced clinically significant reductions in symptoms of depression and anxiety, with corresponding reductions in metacognitive beliefs consistent with the idea that this may be the mechanism by which change occurred. Furthermore, all scores fell within the normal range posttreatment, and effect sizes were large. Treatment gains were maintained at 3 and 6 months posttreatment by all participants. Discussion: This pilot study suggests that metacognitive therapy may be an effective psychological treatment for postpartum depression. [ABSTRACT FROM AUTHOR]

Background: This study explored the attitudes of psychiatric nursing staff towards mothers with mental health difficulties. Working with mothers experiencing mental health problems can evoke negative reactions in staff that activate value-laden beliefs regarding the capacity of these women to care for their infants, which could diminish the provision of optimal care and treatment for patients. Method: Ten psychiatric nursing staff working in a specialist mother and baby unit in the North of England were interviewed about their views of various types of client by using the repertory grid technique. Findings: A total of 86 constructs that clustered under 21 headings were elicited. All staff made critical judgements about some clients. Staff often described the context in which these perceptions were reached such as the behaviour of clients and the quality of the nurse-client relationship. Conclusions: Clients with a personality disorder and those who were thought to be 'bad' mothers were construed as being furthest from the self and more negatively than clients with depression or psychosis. Further training is indicated for staff working with mothers displaying challenging interactional styles; however, training packages must consider the individuality of perception and experience present within staff groups. Copyright © 2011 John Wiley & Sons, Ltd. Key Practitioner Message Staff attributions and clients' interactional style influence the staff's ability to develop positive relationships with their clients., Clients labelled as having a personality disorder were differentially construed in a more negative manner than clients with depression or psychosis., Clinical supervision could help staff to manage challenging experiences with clients in an inpatient ward environment. [ABSTRACT FROM AUTHOR]

Objective. To examine the factor structure and psychometric properties of the Post-partum Bonding Questionnaire (PBQ) in a sample of psychiatric inpatients. Methods. One hundred and thirty-two women who were admitted to a Mother and Baby Unit for psychiatric inpatient treatment completed the PBQ and the Beck Depression Inventory (BDI-II). The factor structure of the PBQ was examined using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) techniques. Results. The original four-factor structure of the PBQ was not replicated by CFA and EFA in this sample. A three-factor solution was identified as the most stable and clinically meaningful solution. Factors pertaining to impaired bonding, anxiety and irritability, and anxiety about child core responsibilities were identified in the CFA but were not entirely replicated in the EFA. The internal consistencies of the three subscales were also acceptable. PBQ scores were also significantly associated with depression scores. Conclusion. The findings suggest that the original four factors of the PBQ should be used with caution. Items pertaining to risk of abuse had to be omitted alongside one other item, resulting in a 22-item solution. Further psychometric evaluation of this scale is recommended. [ABSTRACT FROM AUTHOR]

Linville's self-complexity (SC) theory suggests that reduced SC exacerbates the effects of stress, thereby creating a vulnerability to psychopathology. This exploratory study investigated SC in individuals experiencing auditory hallucinations. Twenty-two clinical participants experiencing auditory hallucinations were recruited from inpatient and outpatient services. Twenty-two control participants, matched on age and gender, were recruited from non-clinical settings. All participants completed a card sort task relating to the self, and questionnaires of affect, self-esteem and recent stress. Although groups did not differ in unitary SC, clinical participants displayed significantly reduced positive SC (pos-SC) compared with controls. Pos-SC was positively correlated with increased psychological well-being, while negative SC was inversely related, across both groups. No stress-buffering effects for SC were found. Findings are discussed with respect to previous literature, and clinical and research implications of the study are addressed, particularly in relation to the therapeutic potential for increasing pos-SC in patients distressed by auditory hallucinations. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aim: This paper reports a study exploring how individual psychiatric staff construes clients with psychosis who misuse substances. Background: A dual diagnosis of substance misuse is common in clients with psychosis. Previous studies have suggested that psychiatric staff feel ill-equipped to work with these clients, and hold negative views of them, affecting client care and recovery. Understanding staff attitudes can inform training and practice. Method: Twelve psychiatric nursing staff working in an inpatient service for adults with enduring mental health difficulties in England were interviewed. Using a repertory grid technique, staff were asked to describe clients and acquaintances who did and did not misuse substances, themselves and colleagues. Findings: All staff made critical judgements of some clients, particularly clients with dual diagnosis, but were less judgemental towards acquaintances who misused substances. Staff who used fewer dimensions to construe people appeared to make a clear distinction between clients and non-clients. This distinction was not apparent for staff with more cognitively complex construct systems. Specific factors that could be implicated in the organization of individuals' construct systems included personal experience of services as a carer; these staff made less distinction between clients and non-clients. Conclusion: Further training is needed for staff working with clients with a dual diagnosis. Training packages need to consider the personal experiences and views of staff. Reducing the boundaries between staff and clients might enable staff to better understand the actions of clients and improve client care. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The study examined associations between maternal mentalization ability, executive functioning, recognition of infant cues, and bonding in a non-clinical sample of mothers. It employed a correlational design. Sixty-four mothers of young infants completed assessments of mentalization ability, executive functioning, and bonding. Photographs of infant facial expressions were utilized to assess ability to recognize infant cues of emotion, but this was not found to correlate with either maternal mentalization or executive functioning ability. Whilst a trend towards a significant positive relationship between mothers' cued ability to attribute mental states and their ability to recognize infant facial expressions was observed, no significant relationships were found between bonding scores and performance on the executive functioning and mentalization measures. The present study contributes to our current understanding of the influence of maternal cognitive factors, specifically mentalization and executive functioning, on the development of the mother-infant relationship. Future research, methodological issues, and clinical and theoretical implications are discussed. [ABSTRACT FROM AUTHOR]