Identifying the most efficient and theoretically appropriate methods to assess patient anxiety in fastpaced medical environments may be beneficial for clinical purposes as well as for research. The purpose of this study was to examine the reliability and validity of two previously published six-item versions of the State form of the State-Trait Anxiety Inventory (STAI) and to identify the version that would be most appropriate to use with a sample of parents who had infants with normal or abnormal newborn screens. In the current study, confirmatory factor analyses were conducted to evaluate the fit of the two six-item forms with STAI data collected at three time points from 288 parents of 150 infants. Study groups of parents were based upon infant newborn screens and subsequent diagnostic testing to include cystic fibrosis (CF; n = 26), congenital hypothyroidism (CH; n = 39, CF Carriers (CF-C; n = 45), and healthy infants (H; n = 40). The results showed the version containing items 1, 3, 6, 15, 16, and 17 of the State form of the STAI to be a better fitting model across all three time points, and it had better internal consistency than the version containing items 5, 9, 10, 12, 17, and 20. Both short forms were highly correlated with the 20-item STAI score, and all internal consistency reliabilities were greater than .90. It was concluded that the version containing item 1, 3, 6, 15, 16, and 17 of the State Anxiety scale was a reliable and valid instrument for this study sample.

A postpartum depression treatment efficacy study showed both a mother-infant psychotherapy group and interpersonal psychotherapy to be superior to a waiting-list comparison group in reducing maternal depressive symptoms, improving mothers' perceptions of their infants' adaptability and reinforcement value, and increasing mothers' positive affect and verbalization with their infants. Clinical implications regarding the importance of early intervention for women experiencing major depression in the postpartum period and their families are discussed.

The waiting period from notification regarding positive NBS results to diagnostic test results can be psychologically distressing to parents, causing depressive symptoms that vary depending on their perceptions about the likelihood that their infant has CF. Implications for future research examining psychosocial interventions for NBS are discussed.

No abstract

A grounded, dimensional analysis described the experiences of five couples whose infants had equivocal diagnostic test results following positive genetic newborn screens for cystic fibrosis. We analyzed interview data collected at two times during each infant’s first year. Uncertainty emerged as the central thematic dimension. Results showed that parents passed through a series of stages similar to the process described by Mishel’s Uncertainty in Illness Theory (UIT), thus extending the application of the theory to circumstances in which the very presence of an illness is uncertain. Findings informed a modified version of the UIT comprised of five domains: stimuli frame, degree of uncertainty, opportunity-danger continuum, affective responses, and coping. This model incorporated Morse’s conception of suffering. Three contextual domains influenced parents’ experiences at various junctures along the uncertainty trajectory: individual characteristics, structure providers, and time. We discussed implications of the model for future research and clinical practice relative to genetic testing.

This study was designed to develop a framework for understanding parents’ perspectives about the psychosocial consequences of false-positive newborn screening (NBS) results for cystic fibrosis (CF). Through content analysis of interviews with 87 parents of 44 infants, we found that receipt of genetic information through NBS affected parents on intrapersonal and interpersonal levels within a relational family system. Repercussions included wondering about test accuracy, the child’s health, and the future; gaining new perspectives and strengthening relationships; questioning paternity; wondering if other relatives had CF/were carriers; searching for the genetic source; sharing genetic information; supporting NBS; and feeling empathy for parents of affected children. We concluded that abnormal NBS results that involve genetic testing can have psychosocial consequences that affect entire families. These findings merit additional investigation of long-term psychosocial sequelae for false-positive results, interventions to reduce adverse iatrogenic outcomes, and the relevance of the relational family system framework to other genetic testing.

Using a cross-sectional, grounded dimensional analysis study design, we collected demographic and health information and conducted telephone interviews with 37 expectant parents of 26 fetuses within 25 families. We describe a theoretical model with a core process of preparing heart and mind for becoming a parent following a diagnosis of fetal anomaly. The process of preparing was influenced by fetal and future child health, experiences of previous loss, and social interactions within both new and familiar settings. Expectant parents reported varying turning points and strategies associated with three distinct trajectories of relating to the fetus or "baby" yet to be born. These relational trajectories include claiming the child as one's own, delaying the connection to the fetus, and doing the routine of pregnancy. With the findings presented in this article, we extend the understanding of how parenting develops during pregnancy in the context of a fetal anomaly.

No abstract