Postpartum psychological distress can adversely affect the early mother-infant relationship; however, this has not been investigated in relation to posttraumatic stress disorder (PTSD) following childbirth. This article explores whether PTSD symptoms relating to labor and delivery are associated with mothers' early perceptions of their infant. Using labor and childbirth as the stressor criterion, 211 women were assessed at 6 weeks' postpartum for symptoms of intrusions, avoidance, and hyperarousal. Their perceptions of their infants, of mother-to-infant attachment, and infant behavioral characteristics also were evaluated. In sum, 3.8% of the women fulfilled full diagnostic criteria, and a further 21.3% reported clinically significant symptoms on at least one dimension of PTSD. Those meeting full or partial criteria perceived their attachment relationships to be significantly less optimal and reported more negative maternal representations in terms of their infants being less warm and more invasive. They also rated them as being temperamentally more difficult, prone to distress, and less easy to soothe. However, when the effects of depression were partialled, only the effect for perceived warmth remained. Posttraumatic stress symptoms relating to labor and delivery may adversely influence maternal perceptions of infants, with potentially adverse implications for the developing mother-infant relationship. The overlap with depressive symptoms requires further exploration.

Genetic factors dynamically interact with both pre-and postnatal environmental influences to shape development. Considerable attention has been devoted to gene-environment interactions (GxE) on important outcomes (Caspi & Moffitt, 2006). It is also important to consider the possibility that these GxE effects may vary across development, particularly for constructs like self-regulation that emerge slowly, depend on brain regions that change qualitatively in different developmental periods, and thus may be manifested differently. To illustrate one approach to explore such developmental patterns, the relation between variation in the TaqIA polymorphism, related to D2 dopamine receptor expression and availability, and prenatal exposure to tobacco, was examined in two exploratory studies. First, in 4-week-old neonates, genotype-exposure interactions were observed for attention and irritable reactivity, but not for stress dysregulation. Second, in preschool children, genotype was related to Trails-P task performance on conditions requiring executive control, and children with both the A1+ genotype and a history of prenatal tobacco exposure displayed disproportionately poor Address correspondence to Sandra A. Wiebe, Department of Psychology, Room 102, 501 Building, University of Nebraska-Lincoln, Lincoln, NE 68588-0206; fax 402-472-1707; swiebe2@unl.edu. Portions of these data were presented at the meetings of the Society for Neuroscience in Atlanta, 2006, and the International Society on Infant Studies in Vancouver, 2008. Publisher's Disclaimer:The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The published version is available at www.apa.org/pubs/journals/dev NIH Public Access performance. Despite study limitations, these results illustrate the importance of examining the interplay between genetic and prenatal environmental factors across development.Developmental scientists (e.g. Bronfenbrenner & Ceci, 1994) have long emphasized that genetic and environmental influences mutually and dynamically interact to produce observable phenotypes. Only recently has it become possible to identify specific examples of geneenvironment (GxE) interactions that are relevant to human psychological processes, typically by using the candidate gene approach (Caspi & Moffitt, 2006). Candidate gene designs involve comparison of groups of individuals with different alleles or forms of a gene. In a landmark study, Caspi and his colleagues (2002) found that individuals who had the monoamine oxidase A (MAOA) allele associated with higher activity and who had experienced substantial trauma in childhood were more likely to e...

No abstract

Objective The Mini Mental State Exam (MMSE) has enjoyed widespread use as a dementia severity staging instrument (Perneczky et al., 2006). More recently, the Montreal Cognitive Assessment (MoCA; Nasreddine, 2005) has been advanced as a potentially superior measure with enhanced sensitivity to Mild Cognitive Impairment (MCI). To the authors’ knowledge, there are no published guidelines for staging dementia severity with the MoCA. The aim of this study was to evaluate the utility of the MoCA for dementia severity staging. Method Participants (N = 162) were drawn from a diagnostically heterogeneous retrospective sample of referrals to a multidisciplinary memory clinic. Participants were categorized as MCI, mild dementia, or moderate dementia using the Quick Dementia Rating System (QDRS) sum of boxes score. Receiver operating characteristics of the MoCA were calculated using MATLAB and optimal cutpoints were determined using Youden’s Index. Results The MoCA demonstrated some utility in differentiating MCI from all severity dementia as defined by the QDRS, with an optimal cutpoint of 17 (AUC = .75). Cut points of 17 and 14 best separated MCI from mild dementia (AUC = .72) and mild from moderate dementia (AUC = .66), respectively. These cutpoints were associated with modest sensitivity (.50 - .53) and reasonable specificity (.76 - .87). Average diagnostic accuracy was 69.5%. Conclusions This study suggests that the MoCA has some utility for dementia severity staging. Future work should replicate these findings in other clinical cohorts. The use of the QDRS (an informant report measure) as the severity criterion is a significant limitation of the present study.

Objective The Test of Visuospatial Construction (TVSC) was designed as an easily administered measure of non-motor visuoconstruction, though only preliminary data exists regarding the clinical utility of this task. The current study examined the diagnostic accuracy of the TVSC by comparing performance between healthy subjects and various clinical groups. The authors also wanted to determine whether previous findings could be replicated regarding its effectiveness at tracking cognitive decline. Method Archival data collected over a period of more than 10 years were utilized and the overall sample consisted of 955 individuals, 372 healthy subjects, and 583 subjects who were categorized into various clinical groups. Only TVSC test data and demographic variables were utilized for statistical analyses in this study. Results The control group obtained significantly higher scores on the TVSC than the clinical groups. AUC values were indicative of excellent discrimination between cases and controls. Exploratory ROC curve analyses suggested adequate to excellent discrimination between the control group and the individual clinical groups as well as between the mild cognitive impairment (MCI) subgroups and the two dementia groups. Conclusions This study demonstrates that the TVSC can effectively differentiate between healthy subjects and neurologically compromised individuals. Additionally, the TVSC may be able to measure the progressive decline in visuoconstructive abilities that occurs as patients traverse the spectrum of MCI and dementia.