Video feedback for young babies and maternal perinatal mental illness: intervention adaptation, feasibility and acceptability

Figures & data

Figure 1. Participant flow through the study.

Fig 1 is a series of boxes and arrows depicting participant flow through the study. It shows that 21 eligible women were given study information by perinatal mental health clinicians between September 2021 and February 2022, 14 eligible women completed informed consent and baseline questionnaires and video observation with a researcher between September 2021 and March 2022 and began VIPP sessions, and 11 women completed all 6 VIPP sessions.

Table 1. Inclusion and exclusion criteria.

Inclusion criteria	Exclusion criteria
1. Women/birthing persons	1. A sibling or co-parent is participating in the trial
2. Experiencing moderate to severe and/or complex perinatal mental health difficulties (as indexed by being under the care of specialist community perinatal mental health services)	2. The eligible child has a clinical diagnosis of a learning difficulty, developmental disorder or sensory impairment
3. A primary caregiver of a child aged 2 to 3 months old at intervention initiation	3. The eligible parent has English language or learning difficulties that are sufficiently severe to prevent them completing study measures even with assistance
4. Age 16 to 65 years old
5. Capable of giving informed consent

Table 2. Participant characteristics.

Age (years)	34 (4.3)
Ethnicity Arabic Black Hispanic South Asian White	2 (14%) 2 (14%) 2 (14%) 1 (7%) 7 (50%)
Highest education level A-levels Undergraduate degree Postgraduate degree	1 (7%) 5 (36%) 8 (57%)
Relationship status Married In an unmarried relationship	7 (50%) 7 (50%)
Primary psychiatric diagnosis Adjustment disorder Anxiety and/or depression Bipolar affective disorder Childhood onset emotional disorder Emotionally unstable personality disorder Post-traumatic stress disorder	1 5 2 1 3 2
Average time since first contact with psychiatric services (years) M(sd)	9.0 (6.6)
Previous psychiatric emergency department visit	5 (36%)
Previous self-harm	8 (57%)
Scoring above threshold on the McLean BPD Screen	5 (36%)

Table 3. Pre-post outcome measures.

Measure	Construct	Interpretation	Pre-intervention (mean, s.d.)	Post-intervention (mean, s.d.)	Change from pre-post intervention (mean, s.d.)	Pre-post effect size (Hedge’s g)
Parent Infant Interaction Observation Scale Svanberg et al. (2013)	Parental sensitivity	Lower scores indicate better maternal sensitive responsivity during mother-infant interaction	9.9 (8.1)	6.3 (5.2)	−3.0 (7.7)	0.41
Karitane Parenting Confidence Črnčec et al. (2008)	Parenting confidence	Higher scores indicate higher maternal parenting confidence	35.2 (5.1)	39.2 (3.6)	+4.2 (4.8)	0.87
Parental Stress Scale Berry & Jones (1995)	Parenting stress	Lower scores indicate lower maternal parenting stress	43.4 (11.5)	39.2 (10.2)	−4.1 (5.0)	0.34
Maternal Object Relations Scale Short Form – Warmth Oates & Gervai (2019)	Warmth in the parent-infant relationship	Higher scores indicate mothers’ perceptions of a warmer relationship between herself and her infant	23.0 (5.8)	28.4 (4.4)	+6.0 (3.7)	1.13
Maternal Object Relations Scale Short Form – Invasion Oates & Gervai (2019)	Invasion in the parent-infant relationship	Lower scores indicate mothers’ perceptions of feeling less invaded by her infant	9.5 (6.8)	8.2 (5.9)	−1.3 (5.8)	0.19
Ages & Stages Questionnaire -Social Emotional v. 2 Squires et al. (2002)^a	Infant socioemotional difficulties	Lower scores indicate mothers’ perception of fewer socioemotional difficulties in their infants	27.1 (23.0)	22.7 (14.1)	−5.0 (17.8)	0.24
Difficulties in Emotion Regulation Scale − 16 Bjureberg et al. (2016)	Maternal emotional dysregulation	Lower scores indicated lower maternal emotional dysregulation	42.8 (13.1)	38.1 (11.0)	−3.0 (7.7)	0.24

^aThe 1 to 3 months version was used at pre-intervention, and the 3 to 8 months version at post-intervention.

^bSvanberg et al. (2013); ^bČrnčec et al. (2008); ^cBerry and Jones (1995); ^dOates and Gervai (2019); ^eSquires et al. (2002), the 1 to 3 months version was used at pre-intervention, and the 3 to 8 months version at post-intervention; ^fBjureberg et al. (2016).

Figure 2. Themes and sub-themes from qualitative feedback interviews with mothers and clinicians.

Fig 2 is two boxes side by side within which the sub-themes falling under Theme 1, and the sub-themes falling under Theme 2, are listed.

Svanberg, P. O., Barlow, J., & Tigbe, W. (2013). The parent–infant interaction observation scale: Reliability and validity of a screening tool. Journal of Reproductive and Infant Psychology, 31(1), 5–14. https://doi.org/10.1080/02646838.2012.751586

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Berry, J. O., & Jones, W. H. (1995). The parental stress scale: Initial psychometric evidence. Journal of Social and Personal Relationships, 12(3), 463–472. https://doi.org/10.1177/0265407595123009

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Oates, J., & Gervai, J. (2019). Mothers’ perceptions of their infants. Journal of Prenatal & Perinatal Psychology and Health, 33(4), 282–300.

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Bjureberg, J., Ljótsson, B., Tull, M. T., Hedman, E., Sahlin, H., Lundh, L. G., Bjärehed, J., DiLillo, D., Messman-Moore, T., Gumpert, C. H., & Gratz, K. L. (2016). Development and validation of a brief version of the difficulties in emotion regulation scale: The DERS-16. Journal of Psychopathology and Behavioral Assessment, 38(2), 284–296. https://doi.org/10.1007/s10862-015-9514-x

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Data availability statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.