Transition to Parenthood Challenges

Introduction to Health Psychology

• Health defined: World Health Organization (WHO) 1946 - state of complete physical, social, and spiritual well-being, not merely absence of illness.
• Expanded definition: Health encompasses satisfaction of physical, cultural, psychosocial, economic, and spiritual needs. Psychological and social factors significantly influence well-being.
• Social determinants: Social inequalities and poverty have strong links to health outcomes.
• Maslow's Hierarchy (1943): Physiological, Safety, Love/Belonging, Esteem, Self-actualization. A healthy individual has fulfilled all needs.
• Biological systems: Nervous (NS), Endocrine (ES), and Immune (IS) systems communicate to maintain homeostasis.
• Homeostasis: Maintaining internal body environment within tolerable limits for survival.
• Negative feedback loop: Counteracts changes, moving parameters toward a set point (e.g., body temperature).
• Positive feedback loop: Increases change away from a set point (e.g., type 1 diabetes).
• Allostasis: Maintaining/re-establishing homeostasis through adaptation (Sterling & Eyer, 1988), involving hormones and other mediators to respond to new situations.
• Allostatic load: Cumulative effect of stressors and resulting health behaviours on the body (e.g., poor sleep, diet).
• Nervous system: Composed of neurons and glial cells (support, nutrition, myelin, signal transmission).
• Neurotransmitters: Chemical messengers (e.g., serotonin, dopamine, glutamate) enabling communication between neurons.
• Neuromodulators: Affect neurotransmitter systems (synthesis, breakdown, reuptake).
• Nervous system organization: Central (brain, spinal cord), Peripheral (cranial & spinal nerves, somatic & autonomic).
• Autonomic nervous system (ANS): Sympathetic (fight-or-flight) and parasympathetic (conservation of energy) subsystems; regulating bodily functions.
• Endocrine system: Ductless glands releasing hormones (messengers) into the bloodstream. Maintains metabolic homeostasis and regulates circadian rhythms.
• Immune system: Two parts (innate and adaptive). Protects against illness.
  • Innate immunity: First line of defense (skin, cough reflex).
  • Adaptive immunity: More complex, involves specific cell types.

Research Methodology

• Measurement timing: Cross-sectional (one point in time) or longitudinal (multiple points).
• Intervention: Experiments manipulate variables, or observational studies do not.
• Data types: Quantitative (numeric data) or qualitative (non-numeric). Mixed methods use both.
• Causation: Cross-sectional studies only show associations, while longitudinal studies, if a control group is present, can establish causation.
• Qualitative research: Offers depth & understanding, participant voices; valuable for industry settings.
• Qualitative research fundamentals: Focuses on meaning, not numbers, appreciates context, considers ontological & epistemological assumptions. Includes one-on-one interviews, focus groups, diaries and qualitative surveys. Accepts subjectivity and reflexivity.

Prejudice and Inequality on Health Outcomes

• Macro-social influences: Large-scale social, economic, political, and culture influencing health and life outcomes. Social determinants of health.
• Social determinants of health: Shaped by economics, social policies, and politics. Include the circumstances in which people are born, grow up, live, work and age and the systems put in place to deal with illness.
• Neoliberalism: Reducing state oversight, opening markets, individual autonomy often leading to increased income inequality and health inequalities.
• Healthism: Health as a moral good, with implications for policies impacting health.
• Micro-social influences: Individual- or local-level factors. Health psychology often targets individual behavior change.
• Stigma: Mark or label associated with devalued groups leading to status loss discrimination and structural discrimination.
• Mechanisms linking stigma to health: Resource availability, social isolation, psychological responses, stress.

Genetics and Heritability

• Genotype vs. phenotype: Genotype is genetic makeup (e.g., eye color), phenotype observable characteristics. Genotype interacts with the environment.
• Nature vs nurture: Almost equal contribution of genes and environment to individual differences in traits.
• Epigenetics: Experience influences genes without changing DNA structure.
• Inheritance: Genetic inheritance transmits traits via DNA, while epigenetic inheritance changes gene expression without altering DNA sequence.
• Epigenetic changes: DNA methylation, histone modification.
• Developmental plasticity: Genotype can lead to various states due to diverse environments.
• Intergenerational transmission: Epigenetic changes in parents can affect offspring.
• Teratogens: Environmental agents causing developmental deviations in the fetus (e.g., smoking, alcohol).

Parental Health

• Becoming parents: Results in strains, reduced marital quality, and changes in relationship satisfaction.
• Adjustment to parenthood: Qualitative studies have identified themes like (adjustment phase, development of co-parenting, and positive relationship impact, focus on the baby–parents feel unprepared to changes in the relationship, focus on communication, and intimacy).
• Parental stress: Stress, particularly for mothers, leading to psychological distress.
• Prenatal and postnatal parental factors: Hormones, neural networks, social support.
• Paternal mental health: Affects father-child relationship, couple relationship, and parenting quality.
• Interrelated parental mental health: One parent's issues can trigger problems in the other.

Promoting Parent-Child Health

• Parent-child interactions: Quality interactions positively influence emotional regulation.
• Maternal sensitivity: Ability to interpret infant cues appropriately and promptly.
• Attachment theory: Maternal sensitivity is important for children's secure attachments.
• Dyadic synchrony: Shared positive emotions are essential for infants' self-regulation.
• Parental mind-mindedness: Attributing mental states to children.

Stress, Coping, and Health

• Different perspectives: Stimulus-based, response-based, & interactional perspectives on stress.
• Stress measures: Social Readjustment Rating Scale, Hassles and Uplifts Scale.
• General adaptation syndrome: Alarm reaction, resistance, and exhaustion stages; chronic stress.
• Interactional coping (Lazarus & Folkman, 1984): Evaluating stressors and available coping strategies.
• Coping strategies: Active coping, planning, positive reframing, humor, avoidance.
• Post-traumatic stress disorder (PTSD): Stress response to extreme stressors.
• Post-traumatic growth (PTG): Positive change resulting from struggle with a crisis.

Sleep

• Sleep architecture: Recurring state of suspended sensory & motor activity; characterized by unconsciousness, decreased ability to respond to stimuli, and easily reversible.
• Sleep measurement: Subjective questionnaires (Karolinska Sleepiness Scale, SF-36 questionnaire), actigraphy, polysomnography.
• Sleep stages: Wake, N1, N2, N3 (slow-wave sleep), REM.
• Sleep duration & mortality: Links between insufficient/excessive sleep and mortality.
• Sleep disorders: Insomnia, hypersomnia, narcolepsy, parasomnias, sleep paralysis, related with various mental disorders.
• Sleep & memory consolidation: Sleep is critical for memory processing, consolidation, and modulation.
• Sleep & immunity: Bidirectional relationship; sleep enhances immune function, illness increases sleepiness.

Psychotherapy and Sleep

• Reconsolidation: Psychotherapy can modify existing memories by moving them from long-term memory to short-term (hippocampus) and back again for modification.
• Brain plaque and Alzheimer's: Beta-amyloid accumulation linked to cell death potentially related to decreasing sleep efficiency.
• Immune system and cognitive functions: Sleep supports immune function, inflammation drives sleep.

Addictive Behaviors

• Addiction criteria: Diagnostic criteria for addiction (tolerance, withdrawal, craving).
• Addiction theories: Opponent-process theory (tolerance and withdrawal), Incentive-sensitization (increased attraction to substances).
• Neurophysiology of addiction: Reward and memory-related networks, Mesocorticolimbic pathway.
• Addiction stages: Binge/intoxication, withdrawal/negative effects, preoccupation/anticipation.

Information, Communication, and Patient-Centered Approach

• Patient-centered approach: Emphasizing empathy, shared decision-making between doctor and patient to improve compliance.
• Therapeutic alliance: Positive doctor-patient relationships improve outcomes.
• E-health and m-health: Digital technologies for health promotion and enabling patients to be more involved in decision making.
• Message framing: How messages are presented (gain vs. loss-framed) influences behavior change.
• Health literacy: Ability to access, understand, appraise, and use health information; three levels (functional, interactive, critical).

This quiz explores the various factors associated with parental depression and the challenges new parents face during the transition to parenthood. It addresses themes from recent systemic reviews and examines the impact of mental health on relationships and infant development. Test your knowledge on critical issues affecting new families.