Browsing by Author "Giesbrecht, Gerald F."

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    Building Emotional Awareness and Mental Health (BEAM): an open-pilot and feasibility study of a digital mental health and parenting intervention for mothers of infants
    (2023-02-18) Xie, E. B.; Freeman, Makayla; Penner-Goeke, Lara; Reynolds, Kristin; Lebel, Catherine; Giesbrecht, Gerald F.; Rioux, Charlie; MacKinnon, Anna; Sauer-Zavala, Shannon; Roos, Leslie E.; Tomfohr-Madsen, Lianne
    Abstract Background Maternal mental health concerns and parenting stress in the first few years following childbirth are common and pose significant risks to maternal and child well-being. The COVID-19 pandemic has led to increases in maternal depression and anxiety and has presented unique parenting stressors. Although early intervention is crucial, there are significant barriers to accessing care. Methods To inform a larger randomized controlled trial, the current open-pilot trial investigated initial evidence for the feasibility, acceptability, and efficacy of a newly developed online group therapy and app-based mental health and parenting program (BEAM) for mothers of infants. Forty-six mothers 18 years or older with clinically elevated depression scores, with an infant aged 6–17 months old, and who lived in Manitoba or Alberta were enrolled in the 10-week program (starting in July 2021) and completed self-report surveys. Results The majority of participants engaged in each of the program components at least once and participants indicated relatively high levels of app satisfaction, ease of use, and usefulness. However, there was a high level of attrition (46%). Paired-sample t-tests indicated significant pre- to post-intervention change in maternal depression, anxiety, and parenting stress, and in child internalizing, but not externalizing symptoms. Effect sizes were in the medium to high range, with the largest effect size observed for depressive symptoms (Cohen’s d = .93). Discussion This study shows moderate levels of feasibility and strong preliminary efficacy of the BEAM program. Limitations to program design and delivery are being addressed for testing in adequately powered follow-up trials of the BEAM program for mothers of infants. Trial registration NCT04772677 . Registered on February 26 2021.
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    Building Emotional Awareness and Mental Health (BEAM): study protocol for a phase III randomized controlled trial of the BEAM app-based program for mothers of children 18–36 months
    (2022-09-05) Xie, E. B.; Simpson, Kaeley M.; Reynolds, Kristin A.; Giuliano, Ryan J.; Protudjer, Jennifer L. P.; Soderstrom, Melanie; Sauer-Zavala, Shannon; Giesbrecht, Gerald F.; Lebel, Catherine; Mackinnon, Anna L.; Rioux, Charlie; Penner-Goeke, Lara; Freeman, Makayla; Salisbury, Marlee R.; Tomfohr-Madsen, Lianne; Roos, Leslie E.
    Abstract Background The prevalence of maternal depression and anxiety has increased during the COVID-19 pandemic, and pregnant individuals are experiencing concerningly elevated levels of mental health symptoms worldwide. Many individuals may now be at heightened risk of postpartum mental health disorders. There are significant concerns that a cohort of children may be at-risk for impaired self-regulation and mental illness due to elevated exposure to perinatal mental illness. With both an increased prevalence of depression and limited availability of services due to the pandemic, there is an urgent need for accessible eHealth interventions for mothers of young children. The aims of this trial are to evaluate the efficacy of the Building Emotion Awareness and Mental Health (BEAM) app-based program for reducing maternal depression symptoms (primary outcome) and improve anxiety symptoms, parenting stress, family relationships, and mother and child functioning (secondary outcomes) compared to treatment as usual (TAU). Methods A two-arm randomized controlled trial (RCT) with repeated measures will be used to evaluate the efficacy of the BEAM intervention compared to TAU among a sample of 140 mothers with children aged 18 to 36 months, who self-report moderate-to-severe symptoms of depression and/or anxiety. Individuals will be recruited online, and those randomized to the treatment group will participate in 10 weeks of psychoeducation modules, an online social support forum, and weekly group teletherapy sessions. Assessments will occur at 18–36 months postpartum (pre-test, T1), immediately after the last week of the BEAM intervention (post-test, T2), and at 3 months after the intervention (follow-up, T3). Discussion eHealth interventions have the potential to address elevated maternal mental health symptoms, parenting stress, and child functioning concerns during and after the COVID-19 pandemic and to provide accessible programming to mothers who are in need of support. This RCT will build on an open pilot trial of the BEAM program and provide further evaluation of this evidence-based intervention. Findings will increase our understanding of depression in mothers with young children and reveal the potential for long-term improvements in maternal and child health and family well-being. Trial registration ClinicalTrials.gov NCT05306626 . Registered on April 1, 2022
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    Cluster-specific associations between the gut microbiota and behavioral outcomes in preschool-aged children
    (2024-03-21) van de Wouw, Marcel; Wang, Yanan; Workentine, Matthew L.; Vaghef-Mehrabani, Elnaz; Barth, Delaney; Mercer, Emily M.; Dewey, Deborah; Arrieta, Marie-Claire; Reimer, Raylene A.; Tomfohr-Madsen, Lianne; Giesbrecht, Gerald F.
    Abstract Background The gut microbiota is recognized as a regulator of brain development and behavioral outcomes during childhood. Nonetheless, associations between the gut microbiota and behavior are often inconsistent among studies in humans, perhaps because many host-microbe relationships vary widely between individuals. This study aims to stratify children based on their gut microbiota composition (i.e., clusters) and to identify novel gut microbiome cluster-specific associations between the stool metabolomic pathways and child behavioral outcomes. Methods Stool samples were collected from a community sample of 248 typically developing children (3–5 years). The gut microbiota was analyzed using 16S sequencing while LC-MS/MS was used for untargeted metabolomics. Parent-reported behavioral outcomes (i.e., Adaptive Skills, Internalizing, Externalizing, Behavioral Symptoms, Developmental Social Disorders) were assessed using the Behavior Assessment System for Children (BASC-2). Children were grouped based on their gut microbiota composition using the Dirichlet multinomial method, after which differences in the metabolome and behavioral outcomes were investigated. Results Four different gut microbiota clusters were identified, where the cluster enriched in both Bacteroides and Bifidobacterium (Ba2) had the most distinct stool metabolome. The cluster characterized by high Bifidobacterium abundance (Bif), as well as cluster Ba2, were associated with lower Adaptive Skill scores and its subcomponent Social Skills. Cluster Ba2 also had significantly lower stool histidine to urocanate turnover, which in turn was associated with lower Social Skill scores in a cluster-dependent manner. Finally, cluster Ba2 had increased levels of compounds involved in Galactose metabolism (i.e., stachyose, raffinose, alpha-D-glucose), where alpha-D-glucose was associated with the Adaptive Skill subcomponent Daily Living scores (i.e., ability to perform basic everyday tasks) in a cluster-dependent manner. Conclusions These data show novel associations between the gut microbiota, its metabolites, and behavioral outcomes in typically developing preschool-aged children. Our results support the concept that cluster-based groupings could be used to develop more personalized interventions to support child behavioral outcomes. Video Abstract
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    Comparison of sample characteristics in two pregnancy cohorts: community-based versus population-based recruitment methods
    (BioMed Central, 2013-12-06) Leung, Brenda; McDonald, Sheila W.; Kaplan, Bonnie J.; Giesbrecht, Gerald F.; Tough, Suzanne C.
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    Correction: Building Emotional Awareness and Mental Health (BEAM): study protocol for a phase III randomized controlled trial of the BEAM app-based program for mothers of children 18–36 months
    (2022-09-30) Xie, E. B.; Simpson, Kaeley M.; Reynolds, Kristin A.; Giuliano, Ryan J.; Protudjer, Jennifer L. P.; Soderstrom, Melanie; Sauer-Zavala, Shannon; Giesbrecht, Gerald F.; Lebel, Catherine; Mackinnon, Anna L.; Rioux, Charlie; Penner-Goeke, Lara; Freeman, Makayla; Salisbury, Marlee R.; Tomfohr-Madsen, Lianne; Roos, Leslie E.
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    Examining the Intergenerational Cascade from Parent Adverse Childhood Experiences to Child Chronic Pain: The Mediating Roles of Parent Chronic Pain and PTSD Symptoms
    (2020-09-19) Beveridge, Jaimie; Noel, Melanie; Madigan, Sheri L.; Yeates, Keith Owen; Giesbrecht, Gerald F.
    Introduction: Adverse childhood experiences (ACEs; exposure to abuse, neglect, household dysfunction as a child) are common and associated with poor mental and physical health outcomes in adolescence and adulthood. Emerging research suggests ACEs can also confer risk for the next generation. Indeed, parent ACEs have been found to relate to children’s general health, development, and psychosocial functioning. Research has yet to examine ACEs among parents of youth with chronic pain. Parent ACEs may play an important role in pediatric chronic pain, given their association with physical (e.g., parent chronic pain) and mental (e.g., parent PTSD) health conditions that are related to the functioning of youth with chronic pain. The current study sought to examine the relation between parent ACEs and child chronic pain as well as the potential mediating roles of parent chronic pain and PTSD symptoms in this relation. Methods: Parent-child dyads were recruited from tertiary-level pediatric chronic pain clinics in Canada. At baseline, parents completed self-report measures of exposure to ACEs, chronic pain status, and current PTSD symptoms. At 3-month follow-up, youth completed self-report measures of pain intensity and pain interference. The final sample included 195 youth with chronic pain (75.9% female, Mage = 14.39 years) and one of their parents (92.3% female, Mage = 44.91 years). Results: Over two-thirds (67.7%) of parents reported one or more ACEs and almost one-quarter (22.1%) reported four or more ACEs. Parent ACEs (total score, maltreatment score, and household dysfunction score) were related to parent chronic pain status but not parent PTSD symptoms. Moreover, parent ACEs were not related to youth pain outcomes either directly or indirectly through parent chronic pain or PTSD symptoms. Conclusions: These findings suggest that ACEs are prevalent among parents of youth seeking treatment for their chronic pain but are not directly related to the youth’s pain or impairment. Further research that examines the role of parent ACEs in the development of child chronic pain as well as other potential mediators of this association is needed to inform interventions that prevent the intergenerational transmission of risk for chronic pain.
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    Maternal Prenatal Anxiety, Attachment and Children’s Externalizing and Internalizing Behavioral Problems
    (2020-09-09) Ali, Elena; Letourneau, Nicole Lyn; Giesbrecht, Gerald F.; Benzies, Karen Marie
    Perinatal anxiety is common, and affects up to 15-20% of women during perinatal period (Abrar, Fairbrother, Smith, Skoll, & Albert, 2020). Regarded as a prenatal programming factor (Madigan et al., 2018), prenatal anxiety (PA) is associated with biological, cognitive, and behavioral development in offspring, increasing risk for later externalizing and internalizing problems and adult psychopathology (Finsaas et al., 2018; Vogel, Jackson, Barch, Tillman, & Luby, 2019). Child behavioral development is also influenced by the postpartum anxiety (Madigan et al., 2018; Vogel et al., 2019). Externalizing behaviors are more often observed in boys and internalizing behaviors are more often observed in girls (Martel, 2013). Maternal-child attachment is defined as an affectionate, mutually satisfying relationship between a child and a caregiver that is involved in making the child feel safe, secure, and protected (Bowlby, 1958). Maternal-child attachment may moderate the association between PA and externalizing and internalizing behavioral problems, and function differently for boys and girls. The first manuscript provides a review of women’s experiences with postpartum anxiety, showing that postpartum anxiety is common, and can have serious implications for the maternal-child relationship. The second manuscript consists of a concept analysis of parent-child attachment to advance the application of this concept in nursing practice. The third manuscript presents the results of testing associations between PA and children's behavioral problems, and the role of maternal-child attachment and child sex as moderators of this association. Maternal-child attachment security moderated the association between prenatal anxiety and children’s behavioral problems; however, the sex of the child did not. The final paper describes the sample from which the third paper was derived, the Alberta Pregnancy Outcomes and Nutrition (APrON) cohort, highlighting findings on maternal and paternal mental health from pregnancy to three years postpartum. The dissertation concludes with recommendations for nursing research, policy, education and practice.
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    Mindfulness-based cognitive therapy for psychological distress in pregnancy: study protocol for a randomized controlled trial
    (Springer Nature, 2016-10-13) Giesbrecht, Gerald F.; Dimidjian, Sona; Madsen, Joshua W.; Carlson, Linda E.; Letourneau, Nicole L.; Tomfohr-Madsen, Lianne M.; Campbell, Tavis S.
    Clinically significant psychological distress in pregnancy is common, with epidemiological research suggesting that between 15 and 25 % of pregnant women experience elevated symptoms of stress, anxiety, and depression. Untreated psychological distress in pregnancy is associated with poor obstetrical outcomes, changes in maternal physiology, elevated incidence of child physical and psychological disorders, and is predictive of maternal postpartum mood disorders. Despite the wide-ranging impact of antenatal psychological distress on mothers and their children, there is a gap in our knowledge about the most effective treatments that are available for psychological distress experienced in pregnancy. Additionally, no trials have focused on potential physiological changes that may occur as a result of receiving mindfulness training in pregnancy. The proposed trial will determine the effectiveness of an 8-week modified Mindfulness-based Cognitive Therapy (MBCT) intervention delivered during pregnancy.
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    Sleeping for two: study protocol for a randomized controlled trial of cognitive behavioral therapy for insomnia in pregnant women
    (2021-08-12) MacKinnon, Anna L.; Madsen, Joshua W.; Dhillon, Ashley; Keys, Elizabeth; Giesbrecht, Gerald F.; Williamson, Tyler; Metcalfe, Amy; Campbell, Tavis; Mrklas, Kelly J.; Tomfohr-Madsen, Lianne
    Abstract Background Insomnia and sleep disturbances are common in pregnancy and have potentially significant consequences for both maternal and infant health. There is limited research examining the effectiveness of cognitive behavioral therapy for insomnia (CBT-I) during pregnancy. With increased distress and limited access to services during the COVID-19 pandemic, there is also an unprecedented need for telehealth delivery of treatment programs for pregnant women. The aims of this trial are to evaluate the impact of the Sleeping for Two adaptation of CBT-I in pregnancy (in-person or telehealth) versus treatment as usual (TAU) in reducing symptoms of insomnia (primary outcome), as well as increasing gestational length and reducing symptoms of depression (secondary outcomes). Methods A two-arm, single-blinded, parallel group randomized controlled trial (RCT) design with repeated measures will be used to evaluate the impact of CBT-I compared to TAU among a sample of 62 pregnant women, enrolled between 12 and 28 weeks of gestation, who self-identify as experiencing insomnia. Five weekly individual sessions of CBT-I will be delivered in person or via telehealth depending on physical distancing guidelines. Assessment of insomnia diagnosis by structured interview, self-reported insomnia symptom severity and sleep problems, and sleep quantity and quality as measured by a daily diary and actigraphy will occur at 12–28 weeks of pregnancy (T1), 1 week post-treatment (T2), and 6 months postpartum (T3). Discussion CBT-I delivered in pregnancy has the potential to reduce symptoms of insomnia and depression and could lead to reduced risk of preterm birth, all of which can minimize risk of negative maternal and child health and developmental consequences in the short (e.g., infant death) and long terms (e.g., developmental delays). This RCT builds on a successful open pilot trial conducted by our team and will provide further evaluation of a novel evidence-based treatment for pregnancy-related insomnia, which can be widely disseminated and used to treat individuals that are most in need of intervention. Findings will enhance understanding of pregnancy-related sleep problems, as well as means by which to improve the health and sleep of mothers and their children. Trial registration ClinicalTrials.gov NCT03918057. Registered on 17 April 2019.