Browsing by Author "Kaplan, Bonnie"
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- ItemOpen AccessAdvancing Gestation Does Not Attenuate Biobehavioural Coherence Between Psychological Distress and Cortisol(Biological Psychology, 2013-04) Giesbrecht, Gerald; Campbell, Tavis; Letourneau, Nicole; Kaplan, Bonnie; APrON Study TeamBackground: Despite little evidence to suggest that HPA axis responses to psychological provocation are attenuated during pregnancy, it is widely held that dampening of the HPA axis response to psychological distress serves a protective function for the mother and fetus. The current study was designed to assess changes in biobehavioral coherence between psychological distress and cortisol over the course of pregnancy. Methods: Ambulatory assessment of ecologically relevant psychological distress and salivary cortisol were repeated in all three trimesters for 82 pregnant women. Samples were collected 5 times per day over the course of 2 days in each trimester. Results: Psychological distress and cortisol were positively associated, β = .024, p < .01, indicating that increases in psychological distress were associated with increases in cortisol. Gestational age did not moderate this association, β = .0009, p = .13, suggesting that negative psychological experiences remain potent stimuli for the HPA axis during pregnancy. Conclusion: Biobehavioral coherence between ecologically relevant experiences of psychological distress and cortisol is not attenuated with advancing gestation.
- ItemOpen AccessAffective Experience in Ecologically Relevant Contexts is Dynamic, and Not Progressively Attenuated During Pregnancy(Archives of Women's Mental Health, 2012-08) Giesbrecht, Gerald; Letourneau, Nicole; Campbell, Tavis; Kaplan, Bonnie; APrON Study TeamPregnancy is thought to diminish a woman’s appraisals of and affective responses to stressors. To examine this assumption, we used an electronic diary and an ecological momentary assessment strategy to record women’s (n=85) experiences of positive and negative affect five times each day over two days within each trimester of pregnancy. Women also completed the Edinburgh Postnatal Depression Scale each trimester. Multi-level modeling indicated non-linear patterns for both positive and negative affect that differed by level of depressive symptoms. The findings suggest that changes in psychological experience over the course of pregnancy are dynamic and not progressively attenuated.
- ItemOpen AccessThe Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study: rationale and methods(Maternal & Child Nutrition, 2014-01) Kaplan, Bonnie; Giesbrecht, Gerald; Leung, Brenda; Field, Catherine; Dewey, Deborah; Bell, Rhonda; Manca, Donna; O'Beirne, Maeve; Johnston, David; Pop, Victor; Singhal, Nalini; Gagnon, Lisa; Bernier, Francois; Eliasziw, Misha; McCargar, Linda; Kooistra, Libbe; Farmer, Anna; Cantell, Marja; Goonewardene, Laki; Casey, Linda; Letourneau, Nicole; Martin, Jonathan; APrON Study TeamThe Alberta Pregnancy Outcomes and Nutrition (APrON) study is an ongoing prospective cohort study that recruits pregnant women early in pregnancy and, as of 2012, is following up their infants to 3 years of age. It has currently enrolled approximately 5000 Canadians (2000 pregnant women, their offspring and many of their partners).The primary aims of the APrON study were to determine the relationships between maternal nutrient intake and status, before, during and after gestation, and (1) maternal mood; (2) birth and obstetric outcomes; and (3) infant neurodevelopment. We have collected comprehensive maternal nutrition, anthropometric, biological and mental health data at multiple points in the pregnancy and the post-partum period, as well as obstetrical, birth, health and neurodevelopmental outcomes of these pregnancies. The study continues to follow the infants through to 36 months of age.The current report describes the study design and methods, and findings of some pilot work. The APrON study is a significant resource with opportunities for collaboration.
- ItemOpen AccessThe Buffering Effect of Social Support on Hypothalamic-Pituitary-Adrenal Axis Function During Pregnancy(Psychosomatic Medicine, 2013) Giesbrecht, Gerald; Poole, Julia; Letourneau, Nicole; Campbell, Tavis; Kaplan, Bonnie; APrON Study TeamObjective: Recent studies suggest that effective social support during pregnancy may buffer adverse effects of maternal psychological distress on fetal development. The mechanisms whereby social support confers this protective advantage, however, remain to be clarified. The aim of this study was to assess whether individual differences in social support alter the co-variation of psychological distress and cortisol during pregnancy. Methods: Eighty two pregnant women’s psychological distress and cortisol were prospectively assessed in all three trimesters using an ecological momentary assessment strategy. Appraisal of partner social support was assessed in each trimester via the Social Support Effectiveness questionnaire. Results: In multilevel analysis, ambulatory assessments of psychological distress during pregnancy were associated with elevated cortisol levels, unstandardized β = .023, p < .001. Consistent with the stress buffering hypothesis, social support moderated the association between psychological distress and cortisol, unstandardized β = -.001, p = .039, such that the co-variation of psychological distress and cortisol increased with decreases in effective social support. The effect of social support for women with the most effective social support was a 50.4% reduction in the mean effect of distress on cortisol and a 2.3 fold increase in this effect for women with the least effective social support scores. Conclusions: Pregnant women receiving inadequate social support secrete higher levels of cortisol in response to psychological distress as compared to women receiving effective social support. Social support during pregnancy may be beneficial because it decreases biological sensitivity to psychological distress, potentially shielding the fetus from the harmful effects of stress-related increases in cortisol.
- ItemOpen AccessEvaluating treatments in health care: The instability of a one-legged stool(BMC Medical Research Methodology, 2011) Kaplan, Bonnie; Giesbrecht, Gerald; Shannon, Scott; McLeod, KevinBackground: Both scientists and the public routinely refer to randomized controlled trials (RCTs) as being the 'gold standard' of scientific evidence. Although there is no question that placebo-controlled RCTs play a significant role in the evaluation of new pharmaceutical treatments, especially when it is important to rule out placebo effects, they have many inherent limitations which constrain their ability to inform medical decision making. The purpose of this paper is to raise questions about over-reliance on RCTs and to point out an additional perspective for evaluating healthcare evidence, as embodied in the Hill criteria. The arguments presented here are generally relevant to all areas of health care, though mental health applications provide the primary context for this essay. Discussion: This article first traces the history of RCTs, and then evaluates five of their major limitations: they often lack external validity, they have the potential for increasing health risk in the general population, they are no less likely to overestimate treatment effects than many other methods, they make a relatively weak contribution to clinical practice, and they are excessively expensive (leading to several additional vulnerabilities in the quality of evidence produced). Next, the nine Hill criteria are presented and discussed as a richer approach to the evaluation of health care treatments. Reliance on these multi-faceted criteria requires more analytical thinking than simply examining RCT data, but will also enhance confidence in the evaluation of novel treatments. Summary: Excessive reliance on RCTs tends to stifle funding of other types of research, and publication of other forms of evidence. We call upon our research and clinical colleagues to consider additional methods of evaluating data, such as the Hill criteria. Over-reliance on RCTs is similar to resting all of health care evidence on a one-legged stool.
- ItemOpen AccessIs Prenatal Stress Bad for Babies? It Depends on Maternal Perception(2012) Sajid, Umair; Giesbrecht, Gerald; Kaplan, Bonnie
- ItemOpen AccessThe Psychobiology of Stress and its relationship to Maternal Sleep during Pregnancy(2012) Haig, Tiffany; Giesbrecht, Gerald; Campbell, Tavis; Kaplan, Bonnie; Giesbrecht, Gerald
- ItemOpen AccessPsychological distress and salivary cortisol covary within persons during pregnancy(Psychoneuroendocrinology, 2012) Giesbrecht, Gerald; Campbell, Travis; Letourneau, Nicole; Kooistra, Libbe; Kaplan, BonnieThe mechanisms whereby maternal stress during pregnancy exerts organizational effects on fetal development require elaboration. The aim of this study was to assess the plausibility of cortisol as a biological link between maternal psychological distress during pregnancy and fetal development. Previous research has resulted in equivocal findings for between-persons differences in stress and cortisol. Ecological Momentary Assessment was used to simultaneously assess mood and cortisol 5 times daily for 3 days in 83 women (gestational ages 6 - 37 weeks). Results from multilevel analysis indicated a robust within-person association between negative mood and cortisol. For each 1.0% increase in negative mood there was a corresponding 1.9% increase in cortisol. This association was unaffected by advancing gestational age. The results suggest that cortisol is a plausible biological mechanism for transducing the effects of maternal psychological distress during pregnancy to fetal development.
- ItemOpen AccessSalivary alpha-amylase during pregnancy: Diurnal course and associations with obstetric history, maternal demographics and mood(Developmental Psychobiology, 2013-03) Giesbrecht, Gerald; Granger, Douglas; Campbell, Tavis; Kaplan, Bonnie; APrON Study TeamDiurnal patterns of salivary alpha amylase (sAA) in pregnant women have not previously been described. The current study employed ecological momentary assessment to examine the association between the diurnal sAA, obstetric history, maternal demographics, and mood during pregnancy. Saliva was self-collected by 83 pregnant women (89% White, age 25.3-43.0 years; mean gestational age 21.9 weeks, range 6-37 weeks; gravida 1-6) at home over three days. Results indicated that current pregnancy (gestational age and fetal sex) and maternal demographics were not related to diurnal sAA. In contrast, a history of previous miscarriage (Parameter = -.17; SE = .05; p < .05) was associated with an atypical diurnal pattern. Even after accounting for obstetric history, trait anxiety (Parameter = .16; SE = .04; p < .001) was associated with increased sAA over the day while chronic levels of fatigue (Parameter = -.06; SE = .03; p < .05) were associated with decreased sAA. In a separate model, we also tested the time varying covariation of sAA and mood. The effects of momentary mood were in contrast to those for trait mood. Both momentary depression (Parameter = .22; SE = .09; p < .01) and vigour/positive mood (Parameter = .12; SE = .04; p < .001) were associated with momentary increases in sAA while momentary anxiety and fatigue were not related to sAA. The findings suggest that basal sAA during pregnancy is sensitive to emotional arousal. Evaluating diurnal patterns of sAA holds promise for advancing understanding of how emotional arousal during pregnancy may affect fetal development.
- ItemOpen AccessThe Determinants of Food Intake in Individuals with Mood Disorders(2010) Davison, Karen Michelle; Kaplan, Bonnie