The neonatal intensive parenting unit: an introduction.

This paper describes a paradigm shift occurring in neonatal intensive care. Care teams are moving from a focus limited to healing the baby's medical problems towards a focus that also requires effective partnerships with families. These partnerships encourage extensive participation of mothers and fathers in their baby's care and ongoing bi-directional communication with the care team.

Recommendations for mental health professionals in the NICU.

This article describes recommended activities of social workers, psychologists and psychiatric staff within the neonatal intensive care unit (NICU). NICU mental health professionals (NMHPs) should interact with all NICU parents in providing emotional support, screening, education, psychotherapy and teleservices for families. NMHPs should also offer educational and emotional support for the NICU health-care staff.

Psychosocial program standards for NICU parents.

This article provides a rationale for and brief description of the process of developing recommendations for program standards for psychosocial support of parents with babies in the neonatal intensive care unit (NICU). A multidisciplinary workgroup of professional organizations and NICU parents was convened by the National Perinatal Association. Six interdisciplinary committees (family-centered developmental care, peer-to-peer support, mental health professionals in the NICU, palliative and bereavement care, follow-up support and staff education and support) worked to produce the recommendations found in this supplemental issue.

Screening parents of high-risk infants for emotional distress: rationale and recommendations.

Having a baby hospitalized in a neonatal intensive care unit (NICU) is a potentially traumatic event for parents. This article summarizes research documenting heightened symptoms of depression and post-traumatic stress in these parents and reviews studies of the relationship of parental distress with impaired infant and child development. We describe an array of validated screening devices for depression and post-traumatic stress, along with research on risk factors for elevated scores.

Are complex psychotherapies more effective than biofeedback, progressive muscle relaxation, or both? A meta-analysis.

A meta-analysis of 26 studies was conducted to assess whether more complex forms of psychotherapy would be superior to control treatments of either biofeedback, progressive muscle relaxation, or both. Consistent with hypotheses, more complex treatments provided a small, significant improvement over biofeedback and progressive muscle relaxation (r = .09).

Modification of the Perinatal PTSD Questionnaire to enhance clinical utility.

Objective: To enhance the clinical utility of the Perinatal Post-Traumatic Stress Disorder (PTSD) Questionnaire (PPQ), the current study sought to refine the measure by changing the item response options from dichotomous choices to a likert scale format.

Study Design: Using a convergent/divergent validity design and two data sources (traditional survey and World Wide Web), 58 high-risk and 86 low-risk mothers answered four questionnaires.

Results: Principal components analysis of items on the modified PPQ revealed three components conceptually similar to the diagnostic criterion associated with PTSD.

Identifying mothers at risk for postnatal emotional distress: further evidence for the validity of the perinatal posttraumatic stress disorder questionnaire.

Objective: We evaluated the construct validity of the Perinatal Posttraumatic Stress Disorder Questionnaire.

Study Design: Using a convergent/divergent validity design and two data sources (traditional survey and World Wide Web), 121 high-risk and 52 low-risk mothers answered four questionnaires.

Results: High-risk mothers scored higher than low-risk mothers on all measures of emotional distress.

A measurement model of perinatal stressors: identifying risk for postnatal emotional distress in mothers of high-risk infants.

A measurement model of perinatal stressors was first evaluated for reliability and then used to identify risk factors for postnatal emotional distress in high-risk mothers. In Study 1, six measures (gestational age of the baby, birthweight, length of the baby's hospitalization, a postnatal complications rating for the infant, and Apgar scores at 1 and 5 min) were obtained from chart reviews of preterm births at two different hospitals. Confirmatory factor analyses revealed that the six measures could be accounted for by three factors: (a) Infant Maturity, (b) Apgar Ratings, and (c) Complications.

Convergent and discriminant validity of the perinatal PTSD questionnaire (PPQ): a preliminary study.

We evaluated the validity of the Perinatal Posttraumatic Stress Disorder Questionnaire (PPQ) as a measure of posttraumatic stress symptomatology. Mothers of high-risk infants (N = 91) and healthy, full-term infants (N = 51) answered the PPQ and two other convergent measures of posttraumatic stress disorder symptoms, the Impact of Event Scale (IES) and the Penn Inventory (PI). The Need for Cognition Scale (NCS) was used as a divergent measure.

Perinatal stressors as predictors of symptoms of posttraumatic stress in mothers of infants at high risk.

We investigated the relationship between the stress of a high-risk birth and the development of symptoms of posttraumatic stress disorder in mothers. Six measures of perinatal stressors (gestational age of the baby, birth weight, length of hospital stay for the baby, a postnatal complications rating for the infant, and Apgar scores at 1 and 5 minutes) were used to predict the frequency of posttraumatic stress symptoms. Severity of infant complications, gestational age, and length of stay accounted for 35% of the variance in reports of posttraumatic stress symptoms.

Pneumogram recordings and cerebral computed tomography as predictors of the severity of infant apnea.

We studied several predictors of severity of apnea and caretakers' anxiety about home cardiorespiratory monitoring in 476 families with infants enrolled in a perinatal follow-up program. Thirty-six (8%) of the infants had apparent life-threatening events at home. These infants were compared with the remaining infants, who had benign outcomes.

Improved obstetric outcomes using hypnotic analgesia and skill mastery combined with childbirth education.

The benefits of hypnotic analgesia as an adjunct to childbirth education were studied in 60 nulliparous women. Subjects were divided into high and low hypnotic susceptibility groups before receiving 6 sessions of childbirth education and skill mastery using an ischemic pain task. Half of the Ss in each group received a hypnotic induction at the beginning of each session; the remaining control Ss received relaxation and breathing exercises typically used in childbirth education.

Influence of home-cage lighting conditions on shock-induced fighting.

A series of experiments was conducted to assess the influence of home-cage lighting conditions on shock-induced aggression in rats. The first two experiments tested rats six times within 24 hr and demonstrated that subjects maintained on a light/dark (LD) cycle fought more than rats maintained on a 24-hr light schedule (LL). In addition, a periodic trend could be identified in the data of the LD groups but not in the data of the LL groups.

The influence of the victim on shock induced aggression in rats.

In two studies, free-roaming male rats (aggressors) were shocked in the presence of male target rats restrained in either an upright or a supine posure. In addition, in Experiment II, two levels of aggressor shock intensity (0.8 mA or 2.