Abstract Background Experiencing childbirth as traumatic is common and can have long-lasting negative consequences for women’s mental health. However, fostering a sense of social identity has been ...shown to protect psychological wellbeing and mental health during life transitions, such as entering parenthood. This study therefore investigated the relationship between traumatic childbirth and first-time mothers’ social identity and their psychological wellbeing, and more specifically whether strength of identity as a first-time mother protected psychological wellbeing following traumatic childbirth. Method Women over the age of 18 who were living in the UK and had given birth to their first child in the past nine months were recruited to the study from clinical and community settings. They completed digital self-report questionnaires about their birth experience, social identity, mental health, and psychological wellbeing. Women who perceived themselves to have had a traumatic birth (the trauma group; N = 84) were compared to women who did not perceive themselves to have had a traumatic birth (the control group, N = 39). T-tests and chi square tests assessed preliminary group differences before multivariate analyses of covariance controlled for covariates. Post-hoc tests identified the direction of differences. Multiple regression and moderation analyses analysed interaction effects. Results The trauma group had significantly lower psychological wellbeing (mean = 41.5, 95% CI 39.4–43.7, p = .008, partial η 2 = 0.059), compared to the control group (mean = 48.4, 95% CI 45.3–51.5), but the two groups did not differ in the strength of their first-time mother identity, which was high across both groups. Strength of identity did not moderate the relationship between traumatic childbirth and psychological wellbeing. Giving birth by caesarean section independently reduced the strength of the first-time mother identity ( p = .017, partial η 2 = 0.049). All analyses controlled for emotional and practical support, perceptions of healthcare staff, and mode of birth. Conclusions Having a traumatic birth was associated with lower psychological wellbeing, and the strength of first-time mother identity does not appear to moderate this relationship. Factors such as mode of birth may be more important. Further research, including longitudinal designs, is needed to understand the relationship between these constructs and identify more effective ways of protecting first-time mothers’ mental health.
Background
Viewing self‐harm and suicide‐related images online can precede these behaviours. We reviewed studies of potential impacts and mechanisms associated with viewing self‐harm‐related images ...on the internet and social media.
Method
CINAHL, Cochrane Library, EMBASE, HMIC, MEDLINE, PsycArticles, PsycINFO, PubMed, Scopus, Sociological s and Web of Science Core Collection databases were searched for relevant studies from inception to 22 January 2022. Inclusion criteria were English language, peer‐reviewed, empirical studies with data related to impacts of viewing self‐harm images or videos on the internet or social media. Quality and risk of bias were assessed using Critical Appraisal Skills Programme tools. A narrative synthesis approach was used.
Results
Of the 15 identified studies, all found harmful effects of viewing self‐harm‐related images online. These included escalation of self‐harm, reinforcement of engagement behaviours (e.g. commenting and sharing images), encouragement of social comparison (comparing own self‐harm with others), development of a self‐harm identity, social connection perpetuating or escalating self‐harm, and emotional, cognitive, and physiological impacts triggering self‐harm urges and acts. Nine studies found protective effects, including self‐harm mitigation or reduction, promotion of self‐harm recovery, encouraging social connection and help‐giving, and emotional, cognitive and physiological impacts mitigating or reducing self‐harm urges and acts. Causality of impact was not determined in any study. Most of the studies did not explicitly evaluate or discuss potential mechanisms.
Conclusions
Viewing self‐harm images online may have both harmful and protective effects, but harmful effects predominated in the studies. Clinically, it is important to assess individual's access to images relating to self‐harm and suicide, and the associated impacts, alongside pre‐existing vulnerabilities and contextual factors. Higher quality longitudinal research with less reliance on retrospective self‐report is needed, as well as studies that test potential mechanisms. We have developed a conceptual model of the impact of viewing self‐harm images online to inform future research.
Abstract Background There is considerable interest in identifying factors that predict outcome from psychological treatment. This review examines the relationship between readiness / stage of change ...at entry to CBT treatment and treatment attendance or outcome in people with mental health problems other than addiction. Methods Four databases: PsycINFO; MEDLINE; Embase and CINAHL were searched to identify relevant studies published in English from 1st January 1980 onwards. Following title and abstract screening, and full text review of potentially eligible studies, a total of 22 eligible studies were identified, of which 21 were included in the narrative synthesis. The review was registered on PROSPERO REF: CRD42020209173. Results Nineteen studies explored the relationship between readiness and symptom outcome, with a majority ( n = 13) identifying at least one statistically significant relationship between variables, either directly or in interaction with another measure. A number of these also tested other associations which were non-significant. In contrast, five studies explored the association between readiness and treatment attendance, and findings were inconclusive. Conclusions The systematic review found some evidence suggesting that readiness is linked to symptom outcome in CBT, regardless of the type of clinical problem or readiness measure used. The studies adopting an RCT design identified no evidence of differences in the relationship between readiness and outcome when comparing CBT to other psychotherapeutic interventions. Study quality was variable, and a range of methodological limitations and potential avenues for future work are discussed.
Research has shown that men are less likely than women to seek help for depression at any time of life due to barriers, including stereotypical masculine norms and stigma. The evidence suggests that ...approximately 10% of fathers experience postnatal depression, yet new and expectant fathers are not routinely offered screening or support in the same way as mothers. Therefore, this research explored the barriers fathers face to seeking help for paternal perinatal depression (PPD). Data were collected using an online survey. Initially, fathers with postnatal depression were compared to men experiencing depression at another time of their life in terms of their attitudes to seeking psychological help, conformity to masculine norms, self-stigma, and awareness of services. Secondly, a proposed model of help-seeking amongst fathers with postnatal depression was evaluated. Finally, additional barriers to help-seeking for paternal postnatal depression were explored qualitatively. A total of 125 participants took part in the quantitative comparison, and 50 of the fathers also provided qualitative data. No between-group differences were found, suggesting that the existing literature on barriers to seeking help for male depression is applicable to fathers with postnatal depression. The qualitative results also highlighted the need for better awareness of paternal postnatal depression and better access to services for fathers. Limitations, implications for policy, and directions for future research are discussed.
