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Background: In the USA, stillbirth (in utero fetal death ≥20 weeks gestation) is a major public health issue. Women who experience stillbirth, compared to women with live birth, have a nearly sevenfold increased risk of a positive screen for post-traumatic stress disorder (PTSD) and a fourfold increased risk of depressive symptoms.

Background: In the USA, stillbirth (in utero fetal death ≥20 weeks gestation) is a major public health issue. Women who experience stillbirth, compared to women with live birth, have a nearly sevenfold increased risk of a positive screen for post-traumatic stress disorder (PTSD) and a fourfold increased risk of depressive symptoms. Because the majority of women who have experienced the death of their baby become pregnant within 12–18 months and the lack of intervention studies conducted within this population, novel approaches targeting physical and mental health, specific to the needs of this population, are critical. Evidence suggests that yoga is efficacious, safe, acceptable, and cost-effective for improving mental health in a variety of populations, including pregnant and postpartum women. To date, there are no known studies examining online-streaming yoga as a strategy to help mothers cope with PTSD symptoms after stillbirth.

Methods: The present study is a two-phase randomized controlled trial. Phase 1 will involve (1) an iterative design process to develop the online yoga prescription for phase 2 and (2) qualitative interviews to identify cultural barriers to recruitment in non-Caucasian women (i.e., predominately Hispanic and/or African American) who have experienced stillbirth (N = 5). Phase 2 is a three-group randomized feasibility trial with assessments at baseline, and at 12 and 20 weeks post-intervention. Ninety women who have experienced a stillbirth within 6 weeks to 24 months will be randomized into one of the following three arms for 12 weeks: (1) intervention low dose (LD) = 60 min/week online-streaming yoga (n = 30), (2) intervention moderate dose (MD) = 150 min/week online-streaming yoga (n = 30), or (3) stretch and tone control (STC) group = 60 min/week of stretching/toning exercises (n = 30).

Discussion: This study will explore the feasibility and acceptability of a 12-week, home-based, online-streamed yoga intervention, with varying doses among mothers after a stillbirth. If feasible, the findings from this study will inform a full-scale trial to determine the effectiveness of home-based online-streamed yoga to improve PTSD. Long-term, health care providers could use online yoga as a non-pharmaceutical, inexpensive resource for stillbirth aftercare.

ContributorsHuberty, Jennifer (Author) / Matthews, Jeni (Author) / Leiferman, Jenn (Author) / Cacciatore, Joanne (Author) / Gold, Katherine J. (Author) / College of Health Solutions (Contributor)
Created2017-07-06
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Intense and enduring psychological distress has been well-documented in numerous studies on bereaved parents including anxious, depressive, and traumatic stress symptoms. A state of poverty is also known to increase the risk of psychological distress in the general population, yet this variable has not yet been sufficiently evaluated in outcomes

Intense and enduring psychological distress has been well-documented in numerous studies on bereaved parents including anxious, depressive, and traumatic stress symptoms. A state of poverty is also known to increase the risk of psychological distress in the general population, yet this variable has not yet been sufficiently evaluated in outcomes specifically for bereaved parents. This study is the first to investigate poverty, education, and parental bereavement while examining the relative risk of other variables as informed by the literature. The findings reveal that poverty was the strongest predictor of psychological distress when compared to others factors which have traditionally been considered significant in parental bereavement. Bereaved parents living in poverty may be less likely to seek support and have fewer available resources. Practice and policy implications are discussed.

Created2016-12
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Background: Postmortem memento photography has emerged in Western hospitals as part of compassionate bereavement care for parents facing perinatal death. Many parents endorse this psychosocial intervention, yet implementation varies greatly and little research on parents’ specific needs guides health care professionals. Parents are in crisis and vulnerable after the death of

Background: Postmortem memento photography has emerged in Western hospitals as part of compassionate bereavement care for parents facing perinatal death. Many parents endorse this psychosocial intervention, yet implementation varies greatly and little research on parents’ specific needs guides health care professionals. Parents are in crisis and vulnerable after the death of their child, thus best practice is crucial. This study contributes 104 parents’ experiences and opinions toward the understanding of best practice in perinatal bereavement photography.

Methods: Parents who experienced the perinatal death of their child were recruited from U.S.-based bereavement organizations and social media sites. Volunteers completed an anonymous internet survey with open- and closed-ended questions. Direct recommendations and pertinent statements regarding the process of postmortem photography were analyzed for thematic content in keeping with conventional content analysis. Recurrent themes and sub-themes were counted to identify response patterns.

Results: Of 93 parents with pictures, 92 endorsed them. Of 11 without pictures, nine wanted them. Parents made a variety of recommendations regarding appropriate psychosocial support, the consent process, obstacles to photography, logistics of photography, and material aspects of photographs themselves. Overall, parents wanted many pictures and much variety. Some wanted professional photography while others wanted support for taking their own pictures. Parents wanted guidance from staff who respected their particular needs. Many said decisions were difficult during their crisis. Parents who were initially resistant expressed current appreciation for pictures or expressed regret that they had not participated. Parents recommended that professionals strongly encourage parents to create memento photos despite parents’ initial reservations. Persistent cultural reasons against photography emerged in one case. Quotes by parents illuminate themes and enable respondents to speak directly to health care professionals.

Conclusions: Parents overwhelmingly support postmortem bereavement photography when conducted sensitively, even if imperfectly executed. Providers significantly influence parents during their crises; mindful, patient-centered care with appropriate respect for difference is necessary. Providers must understand the importance of postmortem photographs to parents who have limited opportunity to capture memories of their child. Hospitals should provide education and support for this important psychosocial intervention.

Created2014-06-23
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Background: Despite improvements in maternity healthcare services over the last few decades, more than 2.7 million babies worldwide are stillborn each year. The global health agenda is silent about stillbirth, perhaps, in part, because its wider impact has not been systematically analysed or understood before now across the world. Our

Background: Despite improvements in maternity healthcare services over the last few decades, more than 2.7 million babies worldwide are stillborn each year. The global health agenda is silent about stillbirth, perhaps, in part, because its wider impact has not been systematically analysed or understood before now across the world. Our study aimed to systematically review, evaluate and summarise the current evidence regarding the psychosocial impact of stillbirth to parents and their families, with the aim of improving guidance in bereavement care worldwide.

Methods: Systematic review and meta-summary (quantitative aggregation of qualitative findings) of quantitative, qualitative, and mixed-methods studies. All languages and countries were included.

Results: Two thousand, six hundred and nineteen abstracts were identified; 144 studies were included. Frequency effect sizes (FES %) were calculated for each theme, as a measure of their prevalence in the literature. Themes ranged from negative psychological symptoms post bereavement (77 · 1) and in subsequent pregnancies (27 · 1), to disenfranchised grief (31 · 2), and incongruent grief (28 · 5), There was also impact on siblings (23 · 6) and on the wider family (2 · 8). They included mixed-feelings about decisions made when the baby died (12 · 5), avoidance of memories (13 · 2), anxiety over other children (7 · 6), chronic pain and fatigue (6 · 9), and a different approach to the use of healthcare services (6 · 9). Some themes were particularly prominent in studies of fathers; grief suppression (avoidance)(18 · 1), employment difficulties, financial debt (5 · 6), and increased substance use (4 · 2). Others found in studies specific to mothers included altered body image (3 · 5) and impact on quality of life (2 · 1). Counter-intuitively, Some themes had mixed connotations. These included parental pride in the baby (5 · 6), motivation for engagement in healthcare improvement (4 · 2) and changed approaches to life and death, self-esteem, and own identity (25 · 7). In studies from low/middle income countries, stigmatisation (13 · 2) and pressure to prioritise or delay conception (9) were especially prevalent.

Conclusion: Experiencing the birth of a stillborn child is a life-changing event. The focus of the consequences may vary with parent gender and country. Stillbirth can have devastating psychological, physical and social costs, with ongoing effects on interpersonal relationships and subsequently born children. However, parents who experience the tragedy of stillbirth can develop resilience and new life-skills and capacities. Future research should focus on developing interventions that may reduce the psychosocial cost of stillbirth.

ContributorsBurden, Christy (Author) / Bradley, Stephanie (Author) / Storey, Claire (Author) / Ellis, Alison (Author) / Heazell, Alexander E. P. (Author) / Downe, Soo (Author) / Cacciatore, Joanne (Author) / Siassakos, Dimitrios (Author) / College of Public Service and Community Solutions (Contributor)
Created2016-01-19
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Description

Background: In the United States, approximately one in 110 pregnancies end in stillbirth affecting more than 26,000 women annually. Women experiencing stillbirth have a threefold greater risk of developing depressive symptoms compared to women experiencing live birth. Depression contributes negatively to health outcomes for both mothers and babies subsequent to stillbirth.

Background: In the United States, approximately one in 110 pregnancies end in stillbirth affecting more than 26,000 women annually. Women experiencing stillbirth have a threefold greater risk of developing depressive symptoms compared to women experiencing live birth. Depression contributes negatively to health outcomes for both mothers and babies subsequent to stillbirth. Physical activity may improve depression in these women, however, little is known about acceptable physical activity interventions for women after stillbirth. This is the purpose of this descriptive exploratory study.

Methods: Eligible women were between ages 19 and 45, and experienced stillbirth within one year of the study. An online survey was used to ask questions related to 1) pregnancy and family information (i.e., time since stillbirth, weight gain during pregnancy, number of other children) 2) physical activity participation, 3) depressive symptomatology, and 4) demographics.

Results: One hundred seventy-five women participated in the study (M age = 31.26 ± 5.52). Women reported participating in regular physical activity (at least 150 minutes of moderate activity weekly) before (60%) and during (47%) their pregnancy, as well as after their stillbirth (61%). Only 37% were currently meeting physical activity recommendations. Approximately 88% reported depression (i.e., score of >10 on depression scale). When asked how women cope with depression, anxiety, or grief, 38% said physical activity. Of those that reported using physical activity to cope after stillbirth, they did so to help with depression (58%), weight loss (55%), and better overall physical health (52%). To cope with stillbirth, women used walking (67%), followed by jogging (35%), and yoga (23%). Women who participated in physical activity after stillbirth reported significantly lower depressive symptoms (M = 15.10, SD = 5.32) compared to women who did not participate in physical activity (M = 18.06, SD = 5.57; t = -3.45, p = .001).

Conclusions: Physical activity may serve as a unique opportunity to help women cope with the multiple mental sequelae after stillbirth. This study provides data to inform healthcare providers about the potential role of physical activity in bereavement and recovery for women who have experienced stillbirth. Additional research is necessary in this vulnerable population.

ContributorsHuberty, Jennifer (Author) / Leiferman, Jenn A. (Author) / Gold, Katherine J. (Author) / Rowedder, Lacey (Author) / Cacciatore, Joanne (Author) / Bonds McClain, Darya (Contributor) / College of Health Solutions (Contributor)
Created2014-11-29
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N2 fixation and ammonia oxidation (AO) are the two most important processes in the nitrogen (N) cycle of biological soil crusts (BSCs). We studied the short-term response of acetylene reduction assay (ARA) rates, an indicator of potential N2 fixation, and AO rates to temperature (T, -5°C to 35°C) in BSC

N2 fixation and ammonia oxidation (AO) are the two most important processes in the nitrogen (N) cycle of biological soil crusts (BSCs). We studied the short-term response of acetylene reduction assay (ARA) rates, an indicator of potential N2 fixation, and AO rates to temperature (T, -5°C to 35°C) in BSC of different successional stages along the BSC ecological succession and geographic origin (hot Chihuahuan and cooler Great Basin deserts). ARA in all BSCs increased with T until saturation occurred between 15 and 20°C, and declined at 30–35°C. Culture studies using cyanobacteria isolated from these crusts indicated that the saturating effect was traceable to their inability to grow well diazotrophically within the high temperature range. Below saturation, temperature response was exponential, with Q10 significantly different in the two areas (~ 5 for Great Basin BSCs; 2–3 for Chihuahuan BSCs), but similar between the two successional stages. However, in contrast to ARA, AO showed a steady increase to 30–35°C in Great Basin, and Chihuhuan BSCs showed no inhibition at any tested temperature. The T response of AO also differed significantly between Great Basin (Q10 of 4.5–4.8) and Chihuahuan (Q10 of 2.4–2.6) BSCs, but not between successional stages. Response of ARA rates to T did not differ from that of AO in either desert. Thus, while both processes scaled to T in unison until 20°C, they separated to an increasing degree at higher temperature. As future warming is likely to occur in the regions where BSCs are often the dominant living cover, this predicted decoupling is expected to result in higher proportion of nitrates in soil relative to ammonium. As nitrate is more easily lost as leachate or to be reduced to gaseous forms, this could mean a depletion of soil N over large landscapes globally.

ContributorsZhou, Xiaobing (Author) / Smith, Hilda (Author) / Girardo Silva, Ana Maria (Author) / Belnap, Jayne (Author) / Garcia-Pichel, Ferran (Author) / College of Liberal Arts and Sciences (Contributor)
Created2016-10-24
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The 64-item Hare Self-Report Psychopathy Scale (Hare SRP; Paulhus, Neumann, & Hare, in press) is the most recent revision of the SRP, which has undergone numerous iterations. Little research has been conducted with this new edition; therefore, the goal of the current study was to elucidate the factor structure as

The 64-item Hare Self-Report Psychopathy Scale (Hare SRP; Paulhus, Neumann, & Hare, in press) is the most recent revision of the SRP, which has undergone numerous iterations. Little research has been conducted with this new edition; therefore, the goal of the current study was to elucidate the factor structure as well as the criterion-related, convergent, and discriminant validity of the measure in a large sample of college students (N=602). Confirmatory factor analyses revealed that the best-fitting model was the original four-factor model proposed by the authors of the Hare SRP (compared to a one-factor, two-factor, and four-factor random model). The four-factor model revealed superior fit for the data relative to the other alternative models. In addition, we elaborated on the psychometric properties of this four-factor model in this sample. The Hare SRP total and factor scores evidenced good internal reliability as well as promising criterion-related, convergent, and discriminant validity in terms of predicting scores on conceptually relevant external criteria. Implications for theory and future research are discussed.

ContributorsNeal, Tess M.S. (Author) / Sellbom, Martin (Author)
Created2012
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Two experiments examined how mock jurors’ beliefs about three factors known to influence eyewitness memory accuracy relate to decision-making (age of eyewitness and presence of weapon in Study 1, length of eyewitness identification decision time in Study 2). Psychology undergraduates rendered verdicts and evaluated trial participants after reading a robbery-murder

Two experiments examined how mock jurors’ beliefs about three factors known to influence eyewitness memory accuracy relate to decision-making (age of eyewitness and presence of weapon in Study 1, length of eyewitness identification decision time in Study 2). Psychology undergraduates rendered verdicts and evaluated trial participants after reading a robbery-murder trial summary that varied eyewitness age (6, 11, 42, or 74 years) and weapon presence (visible or not) in Study 1 and eyewitness decision length (2-3 or 30 seconds) in Study 2 (n=200 each). The interactions between participant belief about these variables and the manipulated variables themselves were the heart of this study. Participants’ beliefs about eyewitness age and weapon presence interacted with these manipulations, but only for some judgments – verdict for eyewitness age and eyewitness credibility for weapon focus. The exploratory meditational analyses found only one relation: juror belief about eyewitness age mediated the relation between eyewitness age and credibility ratings. These results highlight a need for juror education and specialized voir dire in cases where legitimate concerns exist regarding the reliability of eyewitness memory (e.g., child eyewitness, weapon presence during event, long eyewitness identification time). If erroneous juror beliefs can be corrected their impact may be reduced.

ContributorsNeal, Tess M.S. (Author) / Christiansen, Ashley (Author) / Bornstein, Brian H. (Author) / Robicheaux, Timothy R. (Author)
Created2012
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This study examined how manipulations of likeability and knowledge affected mock jurors’ perceptions of female and male expert witness credibility (N=290). Our findings extend the person perception literature by demonstrating how warmth and competence overlap with existing conceptions of likeability and credibility in the psycholegal domain. We found experts high

This study examined how manipulations of likeability and knowledge affected mock jurors’ perceptions of female and male expert witness credibility (N=290). Our findings extend the person perception literature by demonstrating how warmth and competence overlap with existing conceptions of likeability and credibility in the psycholegal domain. We found experts high in likeability and/or knowledge were perceived equally positively regardless of gender in a death penalty sentencing context. Gender differences emerged when the expert was low in likeability and/or knowledge; in these conditions the male expert was perceived more positively than the comparable female expert. Although intermediate judgments (e.g., perceptions of credibility) were affected by our manipulations, ultimate decisions (e.g., sentencing) were not. Implications for theory and practice are discussed.

ContributorsNeal, Tess M.S. (Author) / Guadagno, Rosanna E. (Author) / Eno, Cassie A. (Author) / Brodsky, Stanley L. (Author)
Created2012
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Aside from an article by Gutheil, Bursztajn, Hilliard, and Brodsky (2004), scant literature exists regarding why forensic mental health professionals refuse or withdraw from cases. The current study collected descriptive information about the reasons mental health experts decline or withdraw from forensic assessments, both early and late in the legal

Aside from an article by Gutheil, Bursztajn, Hilliard, and Brodsky (2004), scant literature exists regarding why forensic mental health professionals refuse or withdraw from cases. The current study collected descriptive information about the reasons mental health experts decline or withdraw from forensic assessments, both early and late in the legal process. In response to an online survey, 29 practicing forensic psychologists and psychiatrists presented examples of case withdrawal from their professional experiences. Their major reasons included ethical issues or conflicts, payment difficulties, and interpersonal or procedural problems with retaining counsel or evaluees. The results indicate that there are compelling personal and professional reasons that prompt forensic mental health experts to withdraw from or turn down cases.

ContributorsBrodsky, Stanley L. (Author) / Wilson, Jennifer Kelly (Author) / Neal, Tess M.S. (Author)
Created2013