Purpose This study aimed to investigate 2 dimensions of meaning in life—Presence of Meaning (i.e., the perception of your life as significant, purposeful, and valuable) and Search for Meaning (i.e., the strength, intensity, and activity of people's efforts to establish or increase their understanding of the meaning in their lives)—and their role for the well-being of chronically ill patients. Research design A sample of 481 chronically ill patients (M = 50 years, SD = 7.26) completed measures on meaning in life, life satisfaction, optimism, and acceptance. We hypothesized that Presence of Meaning and Search for Meaning will have specific relations with all 3 aspects of well-being. Results Cluster analysis was used to examine meaning in life profiles. Results supported 4 distinguishable profiles (High Presence High Search, Low Presence High Search, High Presence Low Search, and Low Presence Low Search) with specific patterns in relation to well-being and acceptance. Specifically, the 2 profiles in which meaning is present showed higher levels of well-being and acceptance, whereas the profiles in which meaning is absent are characterized by lower levels. Furthermore, the results provided some clarification on the nature of the Search for Meaning process by distinguishing between adaptive (the High Presence High Search cluster) and maladaptive (the Low Presence High Search cluster) searching for meaning in life. Conclusions The present study provides an initial glimpse in how meaning in life may be related to the well-being of chronically ill patients and the acceptance of their condition. Clinical implications are discussed.

After participating in this educational activity, the physician should be better able to 1. Identify the risk factors associated with persistence of postpartum depression. 2. Evaluate the limitations of the literature. 3. Determine the implications of the findings on women with postpartum depression and their children.This article aims to critically review studies published between 1985 and 2012 concerning the course of postpartum depression (PPD), as well as factors implicated in PPD with a chronic course. We provide a systematic, qualitative review of studies on the course of PPD, following PRISMA guidelines. The results show that although the majority of women recover from PPD, it becomes chronic in a relatively large subgroup of women. Several studies have identified risk factors predicting a chronic course of PPD. This review also emphasizes and discusses important conceptual and methodological limitations in existing research, which preclude drawing strong conclusions. Finally, the implications of these findings and suggestions for future research and clinical intervention are outlined.

This paper describes the rationale and treatment principles of a mother-infant unit for severely depressed mothers and their infants in Flanders (Belgium). The unit integrates systemic, psychodynamic, and cognitive behavioral treatment approaches, and aims at improvements on three levels: (1) improving mood and interpersonal relationships in depressed mothers, (2) fostering a positive mother infant relationship, and (3) establishing a supportive environment outside the treatment setting for both mother and infant. In addition, we present preliminary data of a 3.5-year naturalistic follow-up study of postpartum depressed mothers (n = 41) admitted at this mother-infant unit between April 2003 and April 2005. Results showed that at 3.5-year follow-up a considerable subgroup of mothers (61%) were functioning relatively well, as indicated by low levels of depressive symptoms, anxiety and anger, negative affect, and relatively high levels of positive affect. Yet, in line with other studies, a relatively large subgroup of mothers (39%) continued to suffer from (severe) depression during follow-up. Using a Life History Calendar method, it was found that, compared to currently nondepressed mothers, mothers who were depressed at follow-up did not have more depressive episodes but had longer depressive episodes, received more psychotherapy after hospitalization, and experienced more negative life events during the 3.5-year follow-up period. Implications of these findings for future research and intervention strategies in postpartum depression are discussed.

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Research suggests that parental reflective functioning-the parent's capacity to envision the mind of his/her child-may play an important role in the intergenerational transmission of attachment and reflective functioning. Studies also suggest the importance of this capacity for the transition to parenthood, and particularly parents' capacity to deal with parenting stress. This study focused on the potential mediating role of PRF dimensions in the relationship between parental attachment dimensions (attachment anxiety and avoidance) and parenting stress, using data from a 1-year longitudinal study in biological first-time parents (N=106). Structural Equation Modeling showed that parents' use of prementalizing modes of reflecting upon their child (PM) fully mediated the relationship between attachment anxiety and three parenting stress dimensions (marital relationship, role restriction, and social isolation) across a 1-year interval, while attachment avoidance was indirectly related to these parenting stress dimensions through PM. Further, PM partially mediated the relationship between parental attachment anxiety and avoidance and a fourth dimension of parenting stress, lack of trust in parental competence. In addition, multi-group analyses revealed some interesting gender differences. Implications of these findings for the conceptualization of the relationship between parental attachment, PRF, and parenting stress are discussed.

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This prospective longitudinal study investigated the role of the personality dimensions of dependency and self-criticism in the course of depressive symptoms in a sample of inpatient severely postpartum depressed mothers (n = 55). Depressive symptoms and personality were measured during hospitalization and on average 3 1/2 years later. In line with previous research, a considerable subgroup of mothers (39%) reported moderate to severe symptoms of depression at time 2. In addition, although these mothers did not exhibit more depressive episodes during follow-up period compared with mothers with a less chronic course of depression, their depressive episodes were considerably longer, and they had higher levels of severity of depression as well as of dependency and self-criticism at Time 1. Finally, self-criticism, but not dependency, assessed at Time 1, predicted both depression diagnosis and levels of depression at follow-up, supporting a vulnerability model positing that self-criticism confers vulnerability for depression over time.

There is increasing research evidence supporting the assumption that transactional associations between parent and child characteristics need to be taken into account in order to more fully understand the dynamics within emergent parent-child relationships. This study focuses on transactional associations among parental self-criticism and dependency, parenting stress, child temperament, and emotional availability. Data from a two-wave, 1-year longitudinal study in a community sample of 79 first-time parents and their children, followed-up from infancy to toddlerhood, were analyzed within a multilevel moderated mediation framework. results showed that parental self-criticism and dependency assessed in infancy predicted emotional availability in toddlerhood. Stress generation processes associated with self-criticism and dependency played a central role in these associations. in addition, findings suggested that child extraversion and