A randomized controlled trial of mother–infant psychoanalytic treatment: II. Predictive and moderating influences of qualitative patient factors

Sorjonen

2015

Infant Ment. Health J.

Self Cite

An earlier randomized controlled trial (RCT) compared 80 mother-infant dyads in a Stockholm sample. One had received mother-infant psychoanalytic treatment [mother-infant psychoanalytic therapies (MIP) group], and the other received Child Health Center care (CHCC group). Effects were found on mother-reported depression and expert-rated mother-infant relationship qualities and maternal sensitivity. When the children were 412 years, the dyads were followed up with assessments of the children's attachment representations, social and emotional development, and global functioning, and the mothers' psychological well-being and representations of the child as well as the mother-child interactions. We gathered data from 66 cases approximately 312 years' posttreatment. All scores involving the mothers had now approached community levels. We found effects on maternal depression in favor of MIP, but no other between-group differences. The MIP treatments seemed to have helped the mothers to recover more quickly on personal well-being, to become more sensitive to their babies' suffering, and to better support and appreciate their children throughout infancy and toddlerhood. If so, this would explain why the MIP children had a better global functioning and were more often "OK" and less often "Troubled" at 412 years.

Section: Discussionmentioning

confidence: 99%

A Long-Term Follow-Up Study of a Randomized Controlled Trial of Mother-Infant Psychoanalytic Treatment: Outcomes on Mothers and Interactions

Sorjonen

2015

Infant Ment. Health J.

Self Cite

Develop Med Child Neuro

“…Results for Scandinavian children with concerning screens from the ASQ/ASQ:SE were quite inconsistent compared with US studies where, at a minimum, children were routinely referred to Individuals with Disabilities Education Act EI/ECSE programmes (which are available in every county of every state). These Scandinavian children often had no clearly described follow‐up plan, or they received further assessment (typically with a psychologist or medical subspecialist) based on individualized research protocols . The literature also collectively indicates different follow‐up procedures in different regional municipalities throughout Denmark, Norway, and Sweden .…”

Section: Resultsmentioning

confidence: 99%

“…A main finding of this systematic review was that US professionals more commonly use the ASQ and/or ASQ:SE as it was originally intended: for the early detection and referral of developmental–behavioural concerns in general or at‐risk populations, most commonly in primary care medical settings. Scandinavian cohort studies more commonly report the use of the ASQ and ASQ:SE to longitudinally track differences between intervention/exposure groups and comparison groups . There are few studies of these tools being used routinely in clinical practice across Scandinavian countries, which lack up‐to‐date, national norms for the ASQ‐3 and ASQ:SE‐2.…”

Section: Discussionmentioning

confidence: 99%

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Comparative use of the Ages and Stages Questionnaires in the USA and Scandinavia: a systematic review

Marks

Sjö

Wilson

2018

Aim The aim of this systematic review was to investigate screening practices with the Ages and Stages Questionnaires (ASQ) and the Ages and Stages Questionnaires: Social‐Emotional (ASQ:SE) in the USA and Scandinavia and to identify practical lessons and research opportunities. Method The review was performed for ASQ‐ and ASQ:SE‐related studies in children from birth to 5 years. From nine databases and 1689 references (published from 1988–2018), 127 articles were included and categorized using Covidence online software. The Critical Appraisal Skills Programme Checklists were used before data synthesis. Results US studies primarily use the ASQ/ASQ:SE to detect delays in general and at‐risk populations in medical settings, which increases early detection, clinician‐referral, and intervention rates. Scandinavian studies commonly use the ASQ/ASQ:SE to monitor developmental–behavioural differences in intervention/exposure‐based cohorts. Pre‐visit screening yields completion/return rates of 83% to more than 90% and fosters same‐day interpretation. When referrals are indicated, systemwide care coordination or colocation with a developmental–behavioural specialist is beneficial. Interpretation Practical implementation lessons are reviewed. Research opportunities include investigating and measuring the ASQ/ASQ:SE's ‘overall’ sections. Danish, Norwegian, and Swedish translations are available but up‐to‐date norming and validation studies are needed throughout Scandinavia. Randomized controlled trials are needed to investigate outcomes in screened versus unscreened cohorts. What this paper adds General and at‐risk populations broadly benefited from periodic Ages and Stages Questionnaires (ASQ) and/or Ages and Stages Questionnaires: Social‐Emotional (ASQ:SE) screening. Pre‐visit ASQ and/or ASQ:SE screenining implementation systems work best. The ASQ and ASQ:SE ‘overall’ sections are not quantifiable and under‐researched.

Infant Mental Health Journal

“…Most concerning about the entire Axis II of the DC:0–3 , given its novelty and seeming centrality to the field of infant mental health, is how little research it inspired. A smattering of studies have examined reliability and validity of the PIRGAS as a scale (Aoki, Zeanah, Heller, & Bakshi, ; Muller et al., ; Salomonsson & Sandell, a, ), but there have been almost no attempts to assess the value of the typology of relationship disorders nor whether, for example, a rating of 40 on the PIRGAS is appropriate as a cutpoint for specifying relationship disorders.…”

Section: The Dc:0–3 An Initial Effort At Relationship Diagnosismentioning

confidence: 99%

DEFINING RELATIONAL PATHOLOGY IN EARLY CHILDHOOD: THE DIAGNOSTIC CLASSIFICATION OF MENTAL HEALTH AND DEVELOPMENTAL DISORDERS OF INFANCY AND EARLY CHILDHOOD DC:0–5 APPROACH

Zeanah

Lieberman

2016

Infant mental health is explicitly relational in its focus, and therefore a diagnostic classification system for early childhood disorders should include attention not only to within-the-child psychopathology but also between child and caregiver psychopathology. In this article, we begin by providing a review of previous efforts to introduce this approach that date back more than 30 years. Next, we introduce changes proposed in the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood DC:0-5 (ZERO TO THREE, in press). In a major change from previous attempts, the DC:0-5 includes an Axis I "Relationship Specific Disorder of Early Childhood." This disorder intends to capture disordered behavior that is limited to one caregiver relationship rather than cross contextually. An axial characterization is continued from the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood DC:0-3R (ZERO TO THREE, 2005), but two major changes are introduced. First, the DC:0-5 proposes to simplify ratings of relationship adaptation/maladaptation, and to expand what is rated so that in addition to characterizing the child's relationship with his or her primary caregiver, there also is a characterization of the network of family relationships in which the child develops. This includes coparenting relationships and the entire network of close relationships that impinge on the young child's development and adaptation.