A prospective longitudinal study of the impact of early postnatal vs. chronic maternal depressive symptoms on child development

Background Few studies of the effects of postnatal depression on child development have considered the chronicity of depressive symptoms. We investigated whether early postnatal depressive symptoms (PNDS) predicted child developmental outcome independently of later maternal depressive symptoms. Methods In a prospective, longitudinal study, mothers and children were followed-up from birth to 2 years; repeated measures of PNDS were made using the Edinburgh Postnatal Depression Scale (EPDS); child development was assessed using the Bayley Scales II. Multilevel modelling techniques were used to examine the association between 6 week PNDS, and child development, taking subsequent depressive symptoms into account. Results Children of mothers with 6 week PNDS were significantly more likely than children of non-symptomatic mothers to have poor cognitive outcome; however, this association was reduced to trend level when adjusted for later maternal depressive symptoms. Conclusion Effects of early PNDS on infant development may be partly explained by subsequent depressive symptoms.

Cortisol levels in response to starting school in children at increased risk for social phobia

Background: Research on depression has identified hyperactivity of the HPA axis as a potential contributory factor to the intergenerational transmission of affective symptoms. However, this has not yet been examined in the context of social phobia. The current study compared HPA axis activity in response to a universal social stressor (starting school) in children of 2 groups of women: one with social phobia and one with no history of anxiety (comparison group). To determine specificity of effects of maternal social phobia, a third group of children were also examined whose mothers had generalised anxiety disorder (GAD). Method: Children provided salivary cortisol samples in the morning, afternoon and at bedtime across 3 time-blocks surrounding the school start: a month before starting school (baseline), the first week at school (stress response), and the end of the first school term (stress recovery). Child behavioural inhibition at 14 months was also assessed to explore the influence of early temperament on later stress responses. Results: All children displayed an elevation in morning and afternoon cortisol from baseline during the first week at school, which remained elevated until the end of the first term. Children in the social phobia group, however, also displayed an equivalent elevation in bedtime cortisol, which was not observed for comparison children or for children of mothers with GAD. Children in the social phobia group who were classified as 'inhibited' at 14 months displayed significantly higher afternoon cortisol levels overall. Summary: A persistent stress response to school in the morning and afternoon is typical for all children, but children of mothers with social phobia also display atypical elevations in evening cortisol levels when at school - signalling long-term disruption of the circadian rhythm in HPA axis activity. This is the first study to report HPA axis disruption in children at risk of developing social phobia, and future research should aim to determine whether this represents a pathway for symptom development, taking early temperament into account.

An evaluation of the UK Food Standards Agency's salt campaign

Excessive salt intake is linked to cardiovascular disease and several other health problems around the world. The UK Food Standards Agency initiated a campaign at the end of 2004 to reduce salt intake in the population. There is disagreement over whether the campaign was effective in curbing salt intake or not. We provide fresh evidence on the impact of the campaign, by using data on spot urinary sodium readings and socio-demographic variables from the Health Survey for England over 2003–2007 and combining it with food price information from the Expenditure and Food Survey. Aggregating the data into a pseudo-panel, we estimate fixed effects models to examine the trend in salt intake over the period and to deduce the heterogeneous effects of the policy on the intake of socio-demographic groups. Our results are consistent with a previous hypothesis that the campaign reduced salt intakes by approximately 10%. The impact is shown to be stronger among women than among men. Older cohorts of men show a larger response to the salt campaign compared to younger cohorts, while among women, younger cohorts respond more strongly than older cohorts.

Cognitive, affective and behavioural characteristics of mothers with anxiety disorders in the context of child anxiety disorder

Parental emotional distress, particularly high maternal anxiety, is one of the most consistent predictors of child anxiety treatment outcome. In order to identify the cognitive, affective and behavioural parenting characteristics of mothers of children with anxiety disorders who themselves have an anxiety disorder, we assessed the expectations and appraisals of 88 mothers of anxious children (44 not anxious (NONANX) and 44 with a current anxiety disorder (ANX)) before and after interacting with their 7-12 year old children. There were no observed differences in anxiety and avoidance among children of ANX and NONANX mothers, but, compared to NONANX mothers, ANX mothers held more negative expectations and differed on observations of intrusiveness, expressed anxiety, warmth and the quality of the relationship. Associations were moderated by the degree to which children expressed anxiety during the tasks. Maternal reported negative emotions during the task significantly mediated the association between maternal anxiety status and the observed quality of the relationship. These findings suggest that maternal anxiety disorder is associated with reduced tolerance of children’s negative emotions. This may interfere with the maintenance of a positive, supportive mother-child interaction under conditions of stress, and as such impede optimum treatment outcomes. The findings identify potential cognitive, affective and behavioural targets to improve treatment outcomes for children with anxiety disorders in the context of a current maternal anxiety disorder.

Femininity, feminism and the terrorist

This chapter aims to discuss the relationship between femininity and representations of women involved in violence, focussing on visual representations. Miranda Alison has made the point that the repeated necessity to qualify the term 'combatant' with the descriptor 'female' draws attention to how women soldiers, female freedom fighters, female suicide bombers and female terrorists are exceptional figures. That the female combatant or the female terrorist is an aberration or a deviation from a masculine norm is undermined by the lengthy history of women as warriors, fighters, and terrorists. In that sense it is not so much that fighting women are rare but that there is amnesia within cultural memories concerning the woman fighter. However, in representations of conflict, the dominant image associated with femininity is passive; that is as the defenceless and the defended, or as the allegory of peace. Moreover, representations of men in wars as defeated or wounded means feminising such figures. Miriam Cooke, in her Women and the War Story, 1996, points out how a mythic war story provides men with political roles, in the politikon or public arena, whereas women are domesticated in the space of the oikon. In the mythic war story women may function as Mater Dolorosa, Patriotic Mother or Spartan Mother. It follows then that there are conditions in which it is permissible to represent women fighting on behalf of their children or in defence of the home, and in the absence of men. These images are also found in wider culture: Sarah Connor in Terminator or Ripley in Alien, for example. Images of the female terrorist raise new issues but I want to argue that it is also the case that discussing femininity and the terrorist must involve relating such imagery to representations of the female warrior over a longer timespan. Some questions have shifted since the late twentieth century. Dating from the early 1990s, most Western nations increasingly incorporated women into combat roles within their armed forces. This paper will aim to unpick some of the intricate connections between the increasing presence of women in the armed forces, what relationship this has to emancipation and the participation of women in violence classed as terrorist.

Childhood trauma: methods for the identification of physeal fractures in non-adult skeletal remains

Objectives Today, fractures at the growth plate (or physis) are common injuries in children, but provide challenges of identification in skeletonized remains. Clinical studies provide detailed information on the mechanisms, locations, age of occurrence, and complications associated with physeal fractures, enabling the development of new criteria for identifying this injury in non-adults. To test these criteria, skeletal remains from five rural and urban medieval cemeteries were examined. Methods The sample consisted of 961 skeletons (0-17 years) with open epiphyses. Macroscopic observation looked for any irregularities of the metaphysis or epiphysis which was consistent with the clinical appearance of physeal fractures or resulting complications. Radiographic examination was applied to identify fracture lines or early growth arrest. Results This study revealed 12 cases of physeal trauma (1.2%). Physeal fractures occurred predominantly at the distal end (75%), and while they were identified in all age categories, they were most frequent in those aged 12-17 years (0.2% TPR). The humerus was the most commonly affected location (3/12 or 25%). Conclusions This study highlights the potential for recognizing physeal fractures in children of all ages, enhancing our understanding of non-adult trauma, and enabling us to assign a more precise age of the injury to build up a picture of their activities in the past.

The relationship between size of living space and subjective well-being

Against a background of shrinking new homes and forebodings of “rabbit hutch Britain”, the relationship between size of living space and subjective well-being has never been more topical in the UK. Using the British Household Panel Survey (BHPS) and fixed effects regressions, this paper is the first to examine this relationship comprehensively. Two pathways are proposed between space and subjective well-being. First, space facilitates values and activities. Second, space signals wealth which in turn influences social status. It is proposed that wealth is a more important determinant of status for men than women, and that pathway two is therefore gendered. Part one of the paper examines the effect of a change in number of rooms per person on housing satisfaction and subjective well-being in the BHPS as a whole. Despite having a similar effect on the housing satisfaction of both genders, an increase in living space has only a (weak) positive linear effect on the life satisfaction and mental health of men. This suggests that space affects subjective well-being through pathway two, status. Part two of the paper tracks the housing satisfaction and subjective well-being over time of those individuals who move for “larger accommodation”. Consistent with various theories of adaptation, housing satisfaction increases in the year of the move; then decreases slightly before levelling out. Moving for “larger accommodation” has no positive impact on subjective well-being. Overall the results imply a weak positive relationship between size of living space and subjective well-being, but only for men.