The aim of this study is to assess if an early therapeutic management focused on the mother-baby interaction using Interaction Guidance Therapy (IGT) with video feedback, brings an improvement of the maternal sensitivity in the interaction but also a decrease of the post-traumatic maternal symptoms. Post Natal Post traumatic stress is known as a disorder that impaired maternal mental health but also development of motherhood and the construction of the bond to the baby through interactive disturbances. The investigators will screen, among women who had a traumatic perception of an event related to the pregnancy or the childbirth, those who still present posttraumatic stress symptoms at 4 weeks post-partum. Four weeks from the traumatic event is the minimum delay to qualify a PTSD. After randomization IGT versus Treatment As Usual (TAU), the investigators planned an early therapeutic intervention, 3 sessions at 8, 10 and 12 weeks of post-partum. The investigators will assess the effect of the IGT on Maternal sensitivity and on the intensity of post-traumatic stress symptoms at 3 month post-partum and 1year.
The investigators will compare the efficacy of Interactive Guidance Therapy, a parent-infant psychotherapy using video feed back versus a dyadic treatment conduct as usual (TAU) in women who present a post traumatic stress disorder related to childbirth or pregnancy. The main assessment is the maternal sensitivity, assessed during a video recorded free play interaction between the mother and the baby and rate with the Coding of interactive Behaviour (CIB). This is a Single Blind Randomized clinical trial. Only the rating of the (CIB), which is the primary end point, will be done blind for the treatment the dyad received. The randomization will proceed after the inclusion visit and the first assessment that take place at 6 weeks of post partum. The following assessments will take place at 4 months and 12 months. The investigators will conduct a national multicentre study with 5 inclusions centres, which are all child psychiatry unit specialized in perinatal period and already train or in training for the IGT method. * Pre-screening in post partum ward or during post partum consultation. * Pre Inclusion at 5 (+-1) weeks to assess PTSD with Post traumatic checklist (PCL -5) * Inclusion and First assessment at 6 weeks post partum * Randomization: 3 session of IGT or TAU at 8 weeks, 10 weeks and 12 weeks Assessment at 4 months (+/-2W) and 12 months (+/- 1M)
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
90
Mother child psychotherapy based on video-feedback interaction after a free play session. The therapy usually enhances parent sensibility to the child.
Mother's representation of the event, mother's representation of the relation to her child, maternal emotions.
History and perception of the mother's issues.
Parental Self-Questionnaire to assess the perception of the evolution of the father, mother and child
CHU Besançon
Besançon, France
RECRUITINGCHU - Maternité
Besançon, France
NOT_YET_RECRUITINGCentre hospitalier Intercommunal André Grégoire
Montreuil, France
NOT_YET_RECRUITINGEtablissement Ville Evrard
Noisy-le-Sec, France
NOT_YET_RECRUITINGCentre hospitalier Saint Anne
Paris, France
NOT_YET_RECRUITINGHôpital Saint Joseph - Maternité
Paris, France
NOT_YET_RECRUITINGHôpital Necker - Enfants malades - pedospychiatrie
Paris, France
RECRUITINGHôpital Necker - Maternity
Paris, France
NOT_YET_RECRUITINGCHRU Reims
Reims, France
RECRUITINGCentre hospitalier - unité de périnalité
Reims, France
NOT_YET_RECRUITINGMaternal sensitivity
Evaluate by Coding Interactive Behaviour (CIB)
Time frame: At 4 months
Maternal sensitivity at 12 months
Evaluate by Coding Interactive Behaviour (CIB)
Time frame: At 12 months
Prevalence of PN-PTSD
Evaluate by Post-traumatic stress disorder Checklist version DSM-5 (PCL-5)
Time frame: At 4 months
Prevalence of PN-PTSD
Evaluate by Post-traumatic stress disorder Checklist version DSM-5 (PCL-5)
Time frame: At 12 months
Prevalence of post natal depressive symptoms
Evaluation by Edinburgh post natal depression scale (EPDS)
Time frame: At 4 months
Prevalence of post natal depressive symptoms
Evaluation by Edinburgh post natal depression scale (EPDS)
Time frame: At 12 months
Infant development ASQ
assessed with questionnaire fulfilled by both parents Age and Stage Questionnaire-12 (ASQ-12) Minimal score is 0 (worse) - Maximal score is \>= 30
Time frame: At 12 months
Infant symptoms SCL
assessed with questionnaire fulfilled by both parents : Symptoms Checklist (SCL) Minimal score is 0 (worse) - Maximal score is \>= 30
Time frame: At 12 months
fathers' Post-traumatic stress disorder
assessed with Post-traumatic stress disorder Checklist (PCL-5) Minimal score is 0 Maximal score is 80 (worse)
Time frame: At 4 months
fathers' Post-traumatic stress disorder
assessed with Post-traumatic stress disorder Checklist (PCL-5) Minimal score is 0 Maximal score is 80 (worse)
Time frame: At 12 months
Father's depressive symptoms
assessed with Edinburgh post natal depression scale (EPDS) Minimal score is 0 - Maximal score is 30 (worse)
Time frame: At 4 months
Father's depressive symptoms
assessed with Edinburgh post natal depression scale (EPDS) Minimal score is 0 - Maximal score is 30 (worse)
Time frame: At 12 months
both parents' anxiety
assessed with State Trait Anxiety Inventory (STAI) Minimal score is 20 - Maximal score is 80 (worse)
Time frame: At 4 months
both parents' anxiety
assessed with State Trait Anxiety Inventory (STAI) Minimal score is 20 - Maximal score is 80 (worse)
Time frame: At 12 months
both parents' perception of social support
assessed with Social Support Scale (SSQ) Minimal score is 0 (worse) - Maximal score is 54
Time frame: At 4 months
both parents' perception of social support
assessed with Social Support Scale (SSQ) Minimal score is 0 (worse) - Maximal score is 54
Time frame: At 12 months
both parents' perception of their marital relationship
assessed with Dyadic Adjustment Scale (DAS) Minimal score is 16 (worse) - Maximal score is 96
Time frame: At 4 months
both parents' perception of their marital relationship
assessed with Dyadic Adjustment Scale (DAS) Minimal score is 16 (worse) - Maximal score is 96
Time frame: At 12 months
both parents' bonding to the child
assessed with Post-partum Bonding questionnaire (PBQ). Minimal score is 0 - Maximal score is 125 (worse)
Time frame: At 4 months
both parents' bonding to the child
assessed with Post-partum Bonding questionnaire (PBQ). Minimal score is 0 - Maximal score is 125 (worse)
Time frame: At 12 months
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