No abstract

Although awareness of postpartum depression (PPD) has increased, postpartum anxiety disorders (PPA) remain overlooked. Understanding women's knowledge of PPA and their effective treatments is needed given the underutilization of treatment and associated negative health outcomes. Two internet-based studies (OSF [https://osf.io/3fjvr] preregistered follow-up) were conducted to identify women's knowledge and familiarity with PPD and PPA and knowledge of cognitive behavioral therapy (CBT). Study 1 revealed that women who were planning to become pregnant, pregnant, or recently postpartum (N = 218) were less familiar with PPA than PPD and had limited familiarity with CBT. Women also reported low screening rates for PPA and low perceived treatment seeking for women with PPA and PPD. Study 2 (N = 290) revealed that recently postpartum women recognized fewer symptoms and recommended treatment less often for PPA than PPD and had limited CBT knowledge. Overall, results indicate limited knowledge of PPA compared with PPD, indicating a need for targeted information to perinatal women.

Clinician treatment fidelity, consisting of treatment adherence and clinician competence, is commonly assessed during the implementation of evidence-based treatments to ensure that clinicians are delivering care according to an intended service model. Although resources are often expended in fidelity measurement, associations between fidelity and client outcomes has not been well established in the psychotherapy literature. The relationship between clinician fidelity and treatment outcomes was investigated in a longitudinal sample of clinicians (n = 17) and parent-child dyads (n = 32) following a statewide implementation of Parent-Child Interaction Therapy. Observer-rated measures of adherence and coaching competence collected from early treatment sessions were used to predict intake levels and growth trajectories of parent-reported behavior problems and positive parenting skills. Hierarchical linear modeling results indicated that higher levels of coaching competence were associated with greater behavior problem frequency at intake. Neither early session adherence nor early session competence, as they were measured in the current study, predicted changes in treatment outcomes over time. These results suggest that additional variables should be modeled alongside early treatment fidelity to predict treatment outcome change. Possible explanations for these findings, limitations of the current study, and directions for future research are discussed.

Pediatric burn survivors experience increased risk for bullying, stigmatization, body image concerns, and problematic social functioning. Although coping behaviors are associated with engagement in social supports and positive self-concept in multiple pediatric illness populations, their relation has not been examined in pediatric burns. This study examined coping in relation to social functioning and self-concept in 51 pediatric burn survivors aged 7–17years (M=12.54; SD=2.65). Survivors and their caregivers completed the Child Coping Strategies Checklist (CCSC; youth report); the Burn Injury Social Questionnaire (BISQ; parent and youth report); and the Piers-Harris Children’s Self-Concept Scale-2 (PH-2; youth report). Associations between coping, social functioning, self-concept, demographic features, and burn injury characteristics were examined via bivariate correlations. Hierarchical linear regressions examined whether coping strategies predicted social functioning and youth self-concept beyond burn injury and demographic variables. Social functioning concerns were positively correlated with total body surface area (TBSA; r=0.63 and 0.40, respectively). TBSA was the only significant predictor of parent-reported social concerns (β=0.65, p<0.001). Greater distraction coping predicted fewer youth-reported social concerns (β=−0.39, p=0.01). Greater active coping (B=0.67, p=0.002) and lower avoidance coping (B=−0.36, p=0.03) predicted better youth-reported self-concept. This study advances our understanding of coping as potentially protective for psychosocial adjustment. Clinicians working with child burn survivors should incorporate active coping interventions into treatment. Further research including larger and more diverse samples is needed to understand the role of coping approaches on psychological adjustment during burn healing.