Table Of ContentParenthood and
Mental Health
Parenthood and
Mental Health
A Bridge between Infant and Adult Psychiatry
Sam Tyano
ProfessorEmeritusofChildandAdolescentPsychiatry,
TelAvivUniversity,SacklerSchoolofMedicine,Israel.
VicePresidentoftheInternationalAssociationofChildand
AdolescentPsychiatryandAlliedProfessions
Miri Keren
HeadoftheInfantPsychiatryProgram,TelAvivUniversity,SchoolofMedicine,Israel.DirectorofInfant
MentalHealthUnit,GehaMentalHealthCenter,PetachTikvah.PresidentElectoftheWorldAssociation
forInfantMentalHealth
Helen Herrman
ProfessorofPsychiatry,OrygenYouthHealthResearchCentre,TheUniversityofMelbourne.Director,
WorldHealthOrganizationCollaboratingCentreinMentalHealth,Melbourne.SecretaryforPublications,
WorldPsychiatricAssociation
John Cox
ProfessorEmeritus,UniversityofGloucestershire,UK.ImmediatePastSecretaryGeneral,World
PsychiatricAssociation
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Contents
Foreword xix
Listofcontributors xxi
I Introduction 1
I.1 Ahistoricaloverview:infants,parents,andparentingfromancient
timestonowadays 2
I.2 Definitionofsomemajorconcepts 4
I.3 Structureofthebook 6
I.4 References 7
SECTION 1 Parental Orientations
Normal processes
1 Mothers’andfathers’orientations:patternsofpregnancy,
parentingandthebondingprocess 9
JoanRaphael-Leff
1.1 Introduction 9
1.2 Pregnancyandthe‘placentalparadigm’ 11
1.3 Themodelofmaternalorientations 13
1.4 Mothering 14
1.5 Postnataldisturbances 16
1.6 Contagiousarousal 19
1.7 Paternalorientations 20
1.8 Conclusion 21
1.9 References 21
vi CONTENTS
2 Thecompetentfetus 23
SamTyanoandMiriKeren
2.1 Introduction 23
2.2 Continuityfromintrauterinelifetoinfancy 24
2.3 Thecompetentfetusanditsreceptivesensorialcapacities 25
2.4 Fetusesrememberandthereforecanlearn... 26
2.5 Fetusescanfeelpain 26
2.6 Fetalpsychology:anemergingdomain 27
2.7 Conclusion:thefetuscannolongerbethoughtasa‘witlesstadpole’ 28
2.8 References 28
Challenging pregnancies
3 Singleparenthood:itsimpactonparentingtheinfant 31
SamTyanoandMiriKeren
3.1 Introduction 31
3.2 Single-parentfamiliescomeinavarietyofprofiles 32
3.3 Singleparenthoodasriskfactorforparentalmentalhealth 32
3.4 Riskfactorsformentalhealthproblemsamongsinglemothers 33
3.5 Single-fatherfamiliesversussingle-motherfamilies 34
3.6 Singlecustodialparenthood 34
3.7 Psychologicalcharacteristicsofsinglemothersbychoice 35
3.8 Adouble-edgerisksituation:beingasingleparentofan
infantatrisk 35
3.9 Clinicalimplications 36
3.10 Summary 36
3.11 References 37
4 Surrogatemothers 39
OlgaB.A.vandenAkker
4.1 Introduction 39
4.2 Characteristics,motivationsandexperiences 43
4.3 Attachment,bondingandpregnancy 44
4.4 Relinquishingthebabyandthesocialcontext 47
4.5 Conclusion 48
4.6 References 48
At-risk pregnancies
5 Theimpactofstressinpregnancyonthefetus,theinfant,
andthechild 51
MiriKeren
5.1 Introduction 51
5.2 Datafromanimalstudies 52
CONTENTS vii
5.3 Humanstudiesoftheimpactofmaternalstressonoffspring 52
5.4 Discussion 55
5.5 Conclusion:implicationsforsocialhealthpolicy 56
5.6 References 57
6 Unintendedpregnancies 59
MyriamSzejer
6.1 Introduction 59
6.2 Theinsistenceofdesire 59
6.3 Abortion 63
6.4 Rape,incestanddenialsofpregnancy 63
6.5 Pregnancyandmentalillness 64
6.6 Conclusion 65
6.7 References 65
7 Clinicalchallengesofadolescentmotherhood 67
GeorgeM.Tarabulsy,AnnieBernier,SimonLarose,FanieRoy,
CarolineMoisanandClaireBaudry
7.1 Introduction 67
7.2 Earlychallengesfacedbyyoungmothers 69
7.3 Adolescentmother–infantinteractionandtheelaborationof
attachment 73
7.4 Interventionwithadolescentmothersandtheirinfants 74
7.5 Conclusion 76
7.6 References 77
8 Psychopathologicalstatesinthepregnantmother 79
CarolHenshawMDFRCPsychFHEA
8.1 Introduction 79
8.2 Generalguidelines 86
8.3 Conclusions 87
8.4 References 87
9 Whensomethinggoeswrongwiththefetus:rights,wrongsand
consequences 89
JulioArboleda-Flo´rez
9.1 Reproductionandthreatstotheunborn 89
9.2 Therightsofthefetusandofthenewborn 91
9.3 Parentalreactions 93
9.4 Thefateofpersonswithdevelopmentaldisabilities 94
9.5 Conclusions 97
9.6 References 98
viii CONTENTS
10 Multiplefetusespregnancyandothermedicalhigh-risk
pregnancies 99
MichelineGarel,EliseCharlemaineandSylvainMissonier
10.1 Medicalhigh-riskpregnancies:definition 99
10.2 Psychologicalaspectsofmultiplepregnancies 100
10.3 PregnancyandHIV,apublichealthproblem 103
10.4 Conclusion 107
10.5 References 107
Assessment of prenatal parenting
11 Prenatalself-reportquestionnaires,scalesand
interviews 109
MassimoAmmanitiandRenataTambelli
11.1 Introduction 109
11.2 Semi-structuredinterviews 110
11.3 Self-reportquestionnairesandscales 115
11.4 Inventories 117
11.5 Conclusion 118
11.6 References 119
12 Observationaltool:theprenatalLausanneTriloguePlay 121
ElisabethFivaz-Depeursinge,FranceFrascaroloandAntoinette
Corboz-Warnery
12.1 Introduction 121
12.2 TheLausanneTriloguePlayparadigm 122
12.3 TheprenatalLTP 123
12.4 Discussion 125
12.5 Conclusion 126
12.6 References 126
Treatment of abnormal states during pregnancy
13 Psychopharmacologicaltreatmentsduringpregnancy:
risksandbenefitsforthemotherand
herinfant 129
MartinSt-Andre´andBrigitteMartin
13.1 Introduction 129
13.2 Depressionandanxietyduringpregnancy 130
13.3 Bipolardisorder 137
13.4 Schizophrenia 143
13.5 Post-partumpsychosis 144
13.6 Conclusion 145
13.7 References 145
Description:Across all cultures parenting is the foundation of family life. It is the domain where adult mental health meets infant development. Beginning in pregnancy, parenting involves many conscious and unconscious processes which have recently been shown to affect a child's development significantly. This
