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Background: Dietary interventions are a widely available mediation for depression and anxiety among pregnant and/or postpartum (i.e., perinatal) persons, but their effectiveness is not well known., Objectives: We performed a systematic review and meta-analysis to assess the effectiveness of dietary interventions for the treatment of perinatal depression and/or anxiety., Methods: We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and Web of Science from their inception to 2 November, 2022. Studies were included if they were available in English and examined the effectiveness of a dietary intervention for perinatal depression and/or anxiety in a randomized controlled trial., Results: Our search identified 4246 articles, of which 36 were included and 28 were eligible for meta-analysis. Random-effects meta-analyses were performed. Polyunsaturated fatty acids (PUFAs) were not found to improve symptoms of perinatal depression compared to control conditions [standardized mean differences (SMD): -0.11; 95% CI: -0.26 to 0.04]. These results neither changed when examined during pregnancy or the postpartum period separately nor varied according to the fatty acid (FA) ratio. Elemental metals (iron, zinc, and magnesium) were also not found to be superior to placebo (SMD: -0.42; 95% CI: -1.05 to 0.21), although vitamin D yielded a small to medium effect size improvement (SMD: -0.52; 95% CI: -0.84 to -0.20) in postpartum depression. Iron may help in those with confirmed iron deficiency. Narrative synthesis was performed for studies ineligible for meta-analyses., Conclusions: Despite their widespread popularity, PUFAs and elemental metals do not appear to effectively reduce perinatal depression. Vitamin D taken in doses of 1800-3500 International Units per day may be, to some extent, promising. Additional high-quality, large-scale randomized controlled trials are needed to determine the true effectiveness of dietary interventions on perinatal depression and/or anxiety. This study was registered at PROSPERO (registration date: 5 July, 2020; CRD42020208830)., (Copyright © 2023 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Consistent with cumulative risk hypotheses of psychopathology, studies examining prenatal adversity and later mental health largely suggest that pre and postnatal stress exposures have summative effects. Fewer data support that a mismatch in stress levels between pre- and postnatal life increases risk (the mismatch hypothesis). In this retrospective cohort study using data from the 1983 Ontario Child Health Study (OCHS), we examined interactions between birth weight status and childhood/adolescent stress to predict major depression in adulthood. Ninety-five participants born at low birth weight (LBW; <2500 g) and 972 normal birth weight (NBW) control participants completed the Composite International Diagnostic Interview Short-Form Major Depression module at 21-34 years of age. A youth risk scale consisting of five stressful exposures (family dysfunction, socioeconomic disadvantage, parental criminality, maternal mental illness, exposure to other life stresses) indexed child/adolescent adversity. Birth weight groups did not differ by childhood risk score nor depression levels. A significant interaction was observed between birth weight and the youth risk scale whereby exposure to increasing levels of exposure to childhood/adolescent adversity predicted increased levels of depression in the NBW group, but lower rates in those born at LBW. Consistent with the mismatch hypothesis, data from a large, longitudinally followed cohort suggest that the mental health of adults born LBW may be more resilient to the adverse effects of childhood/adolescent stress. Taken in the context of previous studies of low birth weight infants, these findings suggest that the nature of associations between gestational stress and later mental health may depend on the magnitude of prenatal stress exposure, as well as the degree of resilience and/or plasticity conferred by their early-life environment.

The mental health of adult extremely low birth weight (ELBW) (<1000 g) survivors is poorer than their normal birth weight (NBW) peers. An understanding of the modifiable factors that affect this risk could provide targets for intervention. We set out to determine the extent to which a maternal history of mental health problems influenced mental health in ELBW and NBW offspring in adulthood. A total of 85 ELBW and 88 NBW individuals born between 1977 and 1982 in central west Ontario, Canada self-reported on internalizing (depression, anxiety) and externalizing (attention-deficit hyperactivity and antisocial) problems using the Diagnostic and Statistical Manual of Mental Disorders (DSM) scales of the Young Adult Self-Report at ages 22-26 and 30-35. They also reported on their mother's maternal mental health using the Family History Screen. An interaction was found between birth weight status and maternal history of an anxiety disorder such that ELBW survivors showed a greater increase in internalizing scores than NBW participants at 22-26 (β = 10.27, p = 0.002) and at 30-35 years of age (β = 12.65, p = 0.002). An interaction was also observed between birth weight and maternal history of mood disorder, with higher externalizing scores in ELBW survivors than NBW adults at 22-26 (β = 7.21, p < 0.0001). ELBW adults appear to be more susceptible to the adverse mental health effects of exposure to maternal mood and anxiety disorders than those born at NBW. These links further highlight the importance of detecting and treating mental health problems in the parents of preterm survivors as a means of attempting to reduce the burden of psychopathology in this population.

Introduction: Perinatal and later postnatal adversity (e.g., child sexual abuse) are predictors of psychopathology across the lifespan. However, little is known about the impact of the joint effects of perinatal and postnatal adversity on the longitudinal trajectories of mental health problems from adolescence through adulthood., Method: We utilized data from a prospective, longitudinal birth cohort of extremely low birth weight (ELBW; < 1000 g) survivors and normal birth weight (NBW; > 2500 g) control participants. Self-report data on internalizing (depression, anxiety) and externalizing (antisocial) problems were collected at 12-16, 22-26, and 30-35 years of age., Results: A birth weight by child sexual abuse (CSA) interaction was observed such that ELBW survivors exposed to CSA had higher levels of internalizing problems from adolescence through adulthood than NBW participants exposed to CSA. Differences remained significant after adjustment for covariates. Likewise, ELBW survivors exposed to CSA had higher levels of internalizing problems from adolescence through adulthood than ELBW participants who were not exposed to CSA., Limitations: Findings are limited by sample attrition due to the longitudinal nature of the study spanning over 30 years as well as the retrospective nature of child sexual abuse reporting., Conclusions: Exposure to both perinatal and later postnatal adversity leads to persistently higher internalizing problems than exposure to either adversity alone over more than two decades. These findings suggest that individuals exposed to perinatal adversity may be especially vulnerable to, and persistently affected by, childhood adversity, particularly in the form of depression and anxiety., Competing Interests: Declaration of Competing Interest All authors declare that they have no conflicts of interest., (Crown Copyright © 2020. Published by Elsevier B.V. All rights reserved.)

Women are at increased risk for developing depression and cardiovascular disease (CVD) across the lifespan and their comorbidity is associated with adverse outcomes that contribute significantly to rates of morbidity and mortality in women worldwide. Immune-system activity has been implicated in the etiology of both depression and CVD, but it is unclear how inflammation contributes to sex differences in this comorbidity. This narrative review provides an updated synthesis of research examining the association of inflammation with depression and CVD, and their comorbidity in women. Recent research provides evidence of pro-inflammatory states and sex differences associated with alterations in the hypothalamic-pituitary-adrenal axis, the renin-angiotensin-aldosterone system and the serotonin/kynurenine pathway, that likely contribute to the development of depression and CVD. Changes to inflammatory cytokines in relation to reproductive periods of hormonal fluctuation (i.e. the menstrual cycle, perinatal period and menopause) are highlighted and provide a greater understanding of the unique vulnerability women experience in developing both depressed mood and adverse cardiovascular events. Inflammatory biomarkers hold substantial promise when combined with a patient's reproductive and mental health history to aid in the prediction, identification and treatment of the women most at risk for CVD and depression. However, more research is needed to improve our understanding of the mechanisms underlying inflammation in relation to their comorbidity, and how these findings can be translated to improve women's health.

Objective: Maternal depression during pregnancy can affect both the mother and her family. Although research has suggested that iron deficiency is associated with depression in the general population, this link has not been examined during the antenatal period. Our objective was to determine whether iron deficiency is associated with maternal depression during middle to late pregnancy., Methods: A retrospective study was conducted using the medical records of patients seen at the Women's Health Concerns Clinic at St. Joseph's Healthcare Hamilton in Hamilton, Ontario between 2009 and 2016. Women with serum ferritin data during middle to late pregnancy (>20 weeks' gestation) (N = 142) were categorized as either iron deficient (ferritin <12 µg/L) or iron sufficient. Edinburgh Postnatal Depression Scale (EPDS) scores and the odds of developing antenatal depression (EPDS ≥12) between the two groups were compared., Results: Iron deficient pregnant women scored significantly higher on the EPDS (10.14 ± 5.69 vs. 7.87 ± 5.75; P = 0.03) and were more likely to develop antenatal depression (45% vs. 25%; P = 0.02) compared with women who were not. The odds of developing antenatal depression were two and one half times higher among iron deficient women (adjusted OR 2.51; 95% CI 1.14-5.52)., Conclusion: These findings suggest that iron deficiency is associated with higher levels of depression during pregnancy. Although these results require replication, iron deficiency may be an important risk factor for maternal depression during pregnancy., (Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.)

Extremely low birth weight (ELBW; <1000 g) infants have been exposed to stressful intrauterine and early postnatal environments. Even greater early adversity has been experienced by ELBW survivors who were also born small for gestational age (SGA; <10th percentile for GA) compared to those born appropriate for GA (AGA). ELBW survivors, particularly those born SGA, face increased risk for internalizing problems compared to normal BW (NBW; ≥2500 g) controls. Internalizing problems are related to allelic variations in the promoter region of the serotonin transporter linked polymorphic region gene (5-HTTLPR). We followed the oldest longitudinal cohort of ELBW survivors to adulthood. Participants provided buccal cells and reported on internalizing problems, using the Young Adult Self-Report when they were in their mid-20s (ELBW/SGA, N = 28; ELBW/AGA, N = 60; NBW, N = 81) and mid-30s (ELBW/SGA, N = 27; ELBW/AGA, N = 58; NBW, N = 76). The findings indicate that ELBW/SGAs carrying the 5-HTTLPR short allele reported increased internalizing problems, particularly depression, during the third and fourth decades of life. This is the first known report on gene-environment interactions predicting psychopathology among ELBW survivors. Our findings elucidate putative neurobiological pathways that underlie risk for psychopathology.

Little is known about the effectiveness of group cognitive behavioural therapy (CBT) in women with perinatal depression (PND) and psychiatric comorbidities. Thirty-four women with PND (sixty-two percent with comorbidity) completed a 9-week CBT group. Eighty percent showed a clinically significant improvement in depressive symptoms. Meaningful gains in social support, mother-infant bonding, and partner relationship quality were seen. Brief group CBT can be effective in the treatment of PND in women with psychiatric comorbidities and may be a less resource-intensive alternative to individual psychotherapy.

Background: Mortality rates among extremely low birthweight (ELBW) infants have declined since the advent of antenatal glucocorticoid use. However, the long term neuropsychiatric effects of exposure are not well understood. We utilized the world's oldest longitudinally followed cohort of ELBW survivors to compare psychopathology over two decades in adulthood in those exposed to prenatal betamethasone and those who were not., Methods: ELBW survivors (n=179) and matched normal birth weight (NBW) controls (n=145) completed the Young Adult Self-Report questionnaire at 22-26 and 29-36 years, and the Beck Depression and Anxiety Inventories at 29-36 years. Symptom levels and rates of clinically significant psychiatric problems were compared in ELBW survivors whose mothers were administered steroids during pregnancy (ELBW-S n=63), ELBW participants who were not (ELBW-NS, n=79), and NBW controls., Results: At 22-26, ELBW-S had higher levels of anxiety, depressive, and avoidant personality symptoms, and a 3 to 5-fold increase in the odds of clinically significant levels of these problems compared to NBW controls, whereas ELBW-NS did not. These associations were maintained at 29-36, when ELBW-S participants exhibited a 3 to 10-fold increase in the odds of clinically significant anxiety and avoidant personality problems compared to NBW controls. At both time points, the odds of clinically significant anxiety problems were more than 3 times higher among ELBW-S than in ELBW-NS., Conclusion: ELBW adults exposed to prenatal betamethasone manifest higher levels of anxiety and depression than those who were not, and may represent a group of preterm survivors at particularly high psychiatric risk., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Objective: This study examined associations of asthma and food allergy with symptoms of depression and anxiety at 14 and 21 years of age to determine whether condition-specific associations exist., Methods: Data come from 4972 adolescents in the Mater University Study of Pregnancy. Symptoms of depression and anxiety were assessed using the Youth Self-Report and Young Adult Self-Report., Results: Condition-specific associations between asthma and depression, OR = 1.37 [1.12, 1.67] and between food allergy and anxiety, OR = 1.26 [1.04, 1.76] were found during adolescence, but not in young adulthood. Whereas asthma was associated with resolved depression, OR = 1.70 [1.13, 2.55], food allergy was associated with persistent anxiety, OR = 1.26 [1.01, 1.59]., Conclusions: In adolescents, asthma is associated with an increased risk of clinically relevant symptoms of depression and food allergy with an increased risk of clinically relevant symptoms of anxiety. Future research is needed to clarify directionality and mechanisms explaining these relationships. Health professionals should be aware of the increased risk of mental health problems in adolescents with asthma or food allergy.

The co-morbidity of motor coordination and mental health problems is an increasing concern. While links between poor motor coordination and mental health have been examined extensively in individuals born at normal birth weight (NBW; >2500g), relatively little research has examined these associations in special populations, particularly those born at extremely low birth weight (ELBW; <1000g). In this study, we examined whether birth weight status (ELBW vs. NBW) moderated associations between motor coordination problems and levels of mental health problems from childhood into the fourth decade of life. The present study utilized the oldest known prospectively followed, population-based cohort of ELBW survivors (n=151). This group was born between 1977 and 1982 in Ontario, Canada and was compared to a matched group of NBW controls (n=145). Mental health problems were measured at age 8 using parent and teacher reports, and at age 22-26 and 29-36 using self-reports. Childhood motor coordination was retrospectively reported at age 29-36. In both ELBW and NBW groups, childhood coordination problems were associated with elevated levels of inattention and symptoms of anxiety and depression. However, we observed stronger associations between childhood motor coordination problems and mental health problems in NBW controls at 22-26 and 29-36 years of age than in ELBW survivors. Our findings highlight the importance of recognizing and screening for motor coordination problems not only in vulnerable, at-risk children, but in all children, as motor difficulties appear to be associated with mental health problems well into adult life., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Clinical studies have established an inherent comorbidity between depression and the development of cardiovascular disease (CVD). Furthermore, this comorbidity seems to be more amplified in women than in men. To further investigate this comorbidity, a thorough literature review was conducted on studies from 1992 to date. The PubMed database was accessed using the keywords: cardiovascular disease, inflammation, depression, and sex differences. Both human and animal studies were considered. This review takes the standpoint that depression and CVD are both inflammatory disorders, and that their co-occurrence may be related to how the hypothalamic-pituitary-adrenal axis, serotonergic transmission and circulation, and the renin-angiotensin-aldosterone system via angiotensin II are affected by the excess secretion of proinflammatory cytokines. More recently, preliminary research attributes this systemic inflammation to a global deficiency in CD4+CD25+FOXP3 regulatory T cells. 17-β estradiol and progesterone mediated modulation of cytokine secretion may partially explain the sex differences observed. These hormones and reproductive events associated with hormonal fluctuations are discussed in depth, including the analysis of perinatal models of depression and CVD, including preeclampsia. However, as evidenced by this review, there is a need for mechanistic research in humans to truly understand the nature and directionality of the relationship between depression and CVD.

Asthma has long been considered a condition in which psychological distress exerts a negative impact. Epidemiological studies confirm that depression and anxiety disorders, amongst the most common psychiatric disorders, occur in higher rates in people with asthma than in the general population. Alterations in the stress axis, immune and autonomic nervous systems appear to be involved in the pathogenesis of each disorder and may contribute to the observed associations between these conditions. Although there is increasing recognition of the importance of treating psychological distress to optimize symptom control in people with asthma, there are few studies examining whether specific treatments for depression or anxiety can improve symptom control in asthma and result in better overall function and outcome., (Copyright © 2012 S. Karger AG, Basel.)

To assess the measurement invariance of the Center for Epidemiologic Studies Depression Scale (CES-D) 2 months after delivery in 656 English-speaking immigrant and non-immigrant women who had at least one other child under 16 and who gave birth in one of two urban Canadian centers. We also compared levels of depression in these two groups using this scale. Multiple group confirmatory factor analysis showed that configural, metric and partial scalar invariances were present and allowed for meaningful substantive comparisons to be made between immigrants and non-immigrants using linear and logistic regressions on an invariant 15-item version of the scale. We observed a novel 4-factor structure for the CES-D in postpartum women and established a 15-item version of this scale that was invariant across immigrant and non-immigrant groups. This suggests that women conceptualize postpartum depression (PPD) in similar ways using the 15-item version of this scale and that meaningful substantive comparisons can be made using it. Indeed, immigrants manifested higher levels of depressive symptoms than non-immigrants (unstandardized b = 1.34, p = 0.02) and an increased risk of being a potential case of PPD (OR = 2.16, 95%CI 1.10-4.19), even after adjustment for other risk factors. Immigrant and non-immigrant women appear to conceptualize PPD in similar ways using this 15-item version of the CES-D. Immigrants may develop more depressive symptoms and be at increased risk of developing an episode of PPD.

Objectives: To test if being born at low birth weight (LBW; <2500 g) or being small for gestational age (SGA; <10th percentile for gestational age [GA]) are associated with increased levels of depressive symptoms in youth and, if so, when these first emerge, if the relation is sex-specific, and whether this effect is direct or mediated by early life difficulties., Method: Associations between LBW, SGA, and depressive symptoms at ages 4 to 7 years and 10 to 14 years were tested in 1230 children born to the female participants of the National Longitudinal Study of Youth using linear regression models adjusting for maternal age, ethnicity, education, weight, depressive symptoms, marital status, and income. We also adjusted for GA, the child's age, and depressive symptoms at ages 4 to 7 years. Attention-deficit hyperactivity disorder (ADHD) symptoms and short-term memory at ages 8 to 10 years were also assessed for their putative role in mediating this relation., Results: LBW and SGA were associated with increased levels of depressive symptoms in adolescent girls only. This persisted despite adjustment for perinatal factors and was not accounted for by putative mediators. In males and females, increased levels of depressive symptoms were associated with elevated maternal pre-pregnancy weight, depression, and single marital status, as well as childhood ADHD and depressive symptoms. Similar results were found for infants born SGA., Conclusions: Our results support the existence of a female-specific association between LBW, SGA, and adolescent depressive symptoms. Differences in exposures to maternal mediators of stress or developmental factors may underlie these findings.

Introduction: Myriad treatment barriers prevent birthing parents with postpartum depression (PPD) from receiving timely treatment. We aimed to determine whether a peer-delivered online 1-day cognitive behavioral therapy (CBT)-based workshop added to treatment as usual (TAU) improves PPD and its comorbidities and is more cost-effective than TAU alone. Methods: This parallel-group, randomized controlled trial took place in Ontario, Canada (June 7, 2021, to February 18, 2022). Participants were ≥18 years old, had an infant ≤12 months old, and an Edinburgh Postnatal Depression Scale (EPDS) score ≥10. Participants were allocated to receive the workshop plus TAU (n = 202) or TAU and waitlisted to complete the workshop 12 weeks later (n = 203). The primary outcome was change in PPD (EPDS score) from enrollment to 12 weeks later. The secondary outcome was cost-effectiveness and tertiary outcomes included anxiety, social support, partner relationship quality, the mother-infant relationship, parenting stress, and infant temperament. Results: Participants had a mean age of 32.3 years (SD = 4.30) and 65% were White. The workshop led to a significant reduction in EPDS scores (15.95–11.37; d = 0.92, p < 0. 01) and was associated with higher odds of exhibiting a clinically significant decrease in EPDS scores (OR = 2.03; 95% CI: 1.26–3.29). The workshop plus TAU was more cost-effective than TAU alone. It also led to improvements in postpartum anxiety, infant-focused anxiety, parenting stress, and infant temperament. Conclusions: Peer-delivered 1-day CBT-based workshops can improve PPD and are a potentially scalable low-intensity treatment that could help increase treatment access. [ABSTRACT FROM AUTHOR]

Background: Postpartum depression (PPD) affects up to one in five mothers and birthing parents, yet as few as 10% access evidence-based treatment. One-day cognitive behavioral therapy (CBT)-based workshops for PPD have the potential to reach large numbers of sufferers and be integrated into stepped models of care. Methods: This randomized controlled trial of 461 mothers and birthing parents in Ontario, Canada with Edinburgh Postnatal Depression Scale (EPDS) scores ⩾10, age ⩾18 years, and an infant <12 months of age compared the effects of a 1-day CBT-based workshop plus treatment as usual (TAU; i.e. care from any provider(s) they wished) to TAU alone at 12-weeks post-intervention on PPD, anxiety, the mother–infant relationship, offspring behavior, health-related quality of life, and cost-effectiveness. Data were collected via REDCap. Results: Workshops led to meaningful reductions in EPDS scores (m = 15.77 to 11.22; b = −4.6, p < 0.01) and were associated with three times higher odds of a clinically significant decrease in PPD [odds ratio (OR) 3.00, 95% confidence interval (CI) 1.93–4.67]. Anxiety also decreased and participants had three times the odds of clinically significant improvement (OR 3.20, 95% CI 2.03–5.04). Participants reported improvements in mother–infant bonding, infant-focused rejection and anger, and effortful control in their toddlers. The workshop plus TAU achieved similar quality-adjusted life-years at lower costs than TAU alone. Conclusions: One-day CBT-based workshops for PPD can lead to improvements in depression, anxiety, and the mother–infant relationship and are cost-saving. This intervention could represent a perinatal-specific option that can treat larger numbers of individuals and be integrated into stepped care approaches at reasonable cost. [ABSTRACT FROM AUTHOR]

Asthma has long been considered a condition in which psychological factors have a role. As in many illnesses, psychological variables may affect outcome in asthma via their effects on treatment adherence and symptom reporting. Emerging evidence suggests that the relation between asthma and psychological factors may be more complex than that, however. Central cognitive processes may influence not only the interpretation of asthma symptoms but also the manifestation of measurable changes in immune and physiologic markers of asthma. Furthermore, asthma and major depressive disorder share several risk factors and have similar patterns of dysregulation in key biologic systems, including the neuroendocrine stress response, cytokines, and neuropeptides. Despite the evidence that depression is common in people with asthma and exerts a negative impact on outcome, few treatment studies have examined whether improving symptoms of depression do, in fact, result in better control of asthma symptoms or improved quality of life in patients with asthma.

Objectives: To examine the effectiveness of group cognitive behavioural therapy (CBT) for postpartum depression (PPD) delivered by public health nurses with little to no previous psychiatric training at improving depression, worry, social support and the mother-infant relationship.Methods: Mothers (n = 141) living in Ontario, Canada with Edinburgh Postnatal Depression Scale Scores ≥10 and an infant <12 months of age were randomized to receive nine weekly 2-h sessions of in-person group CBT for PPD delivered by two public health nurses plus treatment as usual (TAU; experimental group) or TAU alone (control group). Primary outcomes were change in EPDS score and current major depressive disorder (Mini International Neuropsychiatric Interview) assessed immediately post-treatment (T2). Secondary outcomes included maternal worry, social support, and quality of the mother-infant relationship. All outcomes were assessed again six months post-treatment (T3).Results: Participants in the experimental group had statistically significantly greater reductions in PPD symptoms immediately post-treatment (T2) (B = -5.35, p < 0.01), were more likely to manifest a clinically significant improvement in EPDS scores (≥4 points; OR = 3.44, 95%CI: 1.49-7.94), and no longer have symptoms consistent with current MDD (OR = 5.31, 95% CI: 1.78-15.83). Six months post-treatment (T3), experimental group participants had higher odds of clinically significant PPD improvement (OR = 5.10, 95%CI: 1.89-13.78), while 25% of the experimental group and 70% of remaining control group participants reported current MDD (p < 0.01). Statistically significant improvements in worry and the mother-infant relationship were also observed, decreases maintained at six months post-treatment.Conclusions: Public health nurses with little to no previous psychiatric training can be trained to deliver effective group CBT for PPD to improve depression, worry, and the mother-infant relationship. Task shifting PPD treatment with group CBT to public health nurses could improve treatment uptake and lead to better outcomes for mothers, families, and the healthcare system.(Trial Registration NCT03039530). [ABSTRACT FROM AUTHOR]

Objectives: Public Health Nurses (PHNs) often provide support to women with postpartum depression (PPD) in the absence of specialized training. The objective of this study was to explore the experiences of six PHNs who were trained to deliver a group cognitive behavioral therapy (CBT) intervention for PPD in the public health setting, and to describe how learning and delivering this intervention affected their professional roles and personal lives. Design: This qualitative study employed a phenomenological approach. Sample: Six PHNs who completed the CBT training program and delivered at least one CBT group in their community. Measurements: Individual in‐depth interviews were conducted and transcribed verbatim. Transcripts were analyzed according to thematic derivation procedures. Results: The themes that emerged from the interviews with the PHNs included: (a) components of the CBT training program that nurses most valued, (b) benefits of training for their professional role as a PHN, (c) implications for practice, and (d) using CBT skills in their personal lives. Conclusions: The provision of CBT training to PHNs may not only positively impact their work with clients with mental illness, but may also have the potential to provide broader clinical and professional benefits for these skilled professionals and their other clients. [ABSTRACT FROM AUTHOR]

Background: Preterm birth is associated with an increased risk of depression and anxiety, but it is not known if this is due to greater exposure to risk, or if perinatal adversity amplifies the impact of traditional risk factors. This study sought to determine if exposure to perinatal adversity modifies associations between traditional risk and resilience factors and depression and anxiety in adulthood. Methods: A sample of 142 extremely low‐birth‐weight (ELBW < 1,000 g) survivors and 133 sociodemographically matched normal birth weight (NBW) control participants was followed longitudinally to 22–26 years of age. Separate postnatal risk and resilience scales were created using eight risk and seven resilience factors, respectively. Depression and anxiety were assessed using the internalizing scale of the Young Adult Self‐Report (YASR). This scale was also dichotomized at the 90th percentile to define clinically significant psychopathology. Results: While the average number of risk exposures did not differ between groups, ELBW survivors were more susceptible to risk than NBW control participants. For the ELBW group, each additional risk factor resulted in a 2‐point increase in internalizing scores, and two and a half times the odds of clinically significant internalizing symptoms (OR = 2.47, 95% CI = 1.63, 3.76). The protective effect of resiliency factors was also blunted among ELBW survivors. Conclusions: Extremely low‐birth‐weight survivors may be more sensitive to traditional risk factors for psychopathology and less protected by resiliency factors. Intervention strategies aimed at preventing or reducing exposure to traditional childhood risk factors for psychopathology may reduce the burden of mental illness in adult survivors of prematurity. [ABSTRACT FROM AUTHOR]

Resting frontal electroencephalogram (EEG) alpha asymmetry patterns reflecting different affective and motivational tendencies have been proposed as a putative mechanism underlying resilience among maltreated youth. This 2-year prospective study examined whether developmental stability of resting frontal alpha asymmetry moderated the relation between child maltreatment severity and psychopathology in female adolescents ( n = 43; ages 12-16) recruited from child protection agencies. Results identified two trajectories of resting frontal asymmetry: 60.5% displayed stable right and 39.5% displayed stable left frontal alpha asymmetry. Although individuals with these alpha asymmetry profiles experienced comparable childhood trauma severity, adolescents with stable left alpha asymmetry and lower levels of trauma were less likely to present symptoms or an episode of posttraumatic stress disorder (PTSD) and depression over 2 years than those with stable right alpha asymmetry and lower levels of trauma. These findings suggest that developmental patterns of resting left frontal brain activity may buffer against psychopathology in maltreated female youth. [ABSTRACT FROM AUTHOR]

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Objective: To determine if childhood motor coordination is associated with lifetime major depressive disorder (MDD), current generalized anxiety disorder (GAD), and attention-deficit/hyperactivity disorder (ADHD) in adulthood, and to examine if extremely low birth weight (ELBW; <1000 g) status moderates the strength of these associations.Method: Prospective study of a cohort of normal birth weight (NBW) controls and ELBW survivors. Participants completed the short form Bruininks-Oseretsky Test of Motor Proficiency (BOTMP-SF) at age 8. At age 29-36, participants completed the Mini International Neuropsychiatric Interview to diagnose the psychiatric disorders of interest.Results: Birth weight status significantly influenced the strength and direction of associations between childhood motor coordination and adult psychiatric outcomes such that the odds of MDD (Pinteraction=.02) and GAD (Pinteraction=.01) increased with worsening motor scores in NBW adults but not ELBW survivors. Stratified analyses indicated that in NBW adults, for each one-point decrease in BOTMP-SF score, the odds of lifetime MDD increased by 10% (OR=1.10, 95% CI: 1.01-1.20).Limitations: Participant attrition reduced sample size and that may have limited our ability to detect statistically significant results for some of our analyses.Conclusion: Poorer motor coordination in early life has a negative long-term impact on the development of MDD and GAD of individuals born at NBW. The long-term mental health risks of childhood motor coordination problems are significant and highlight the importance of recognizing motor deficits in all children, so that associated psychological difficulties can be identified and treated at an early age. [ABSTRACT FROM AUTHOR]