This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Premature infants face numerous medical problems, causing significant anxiety for their parents. Parents experience a range of negative emotions including concern for the health and well being of their fragile infant, guilt, and disappointment. Research has indicated that having an infant in the neonatal intensive care unit (NICU) is highly stressful for parents and multiple studies have demonstrated that parents can develop significant psychological reactions to this experience. Specifically, many parents develop clinically significant anxiety disorders such as acute stress disorder (ASD) and posttraumatic stress disorder (PTSD). This not only impacts the mental well-being of the parents, but also can lead to problems with the parent-infant relationship, and, in turn, negatively impact the infant and the family as a whole. Despite the reported negative effects parents experience due to the stress of having an infant on the NICU, surprisingly little research has examined how to reduce parents' symptoms of anxiety. Because parents play an essential role in the care of their infant after discharge from the NICU, treating the parent's emotional distress is very important. The purpose of this study is to examine the efficacy of a cognitive-behaviorally based intervention in reducing parents' symptoms of anxiety associated with having an infant in the NICU. This treatment is modeled after treatments that have proven effective with parents of children with other types of medical problems, for example, parents of children with cancer. It is the hope of the investigators that this intervention will effectively reduce symptoms of anxiety of NICU parents as well as the likelihood of developing subsequent psychological disorders. Specifically, we hypothesize that parents who receive the intervention will report fewer symptoms of anxiety than parents in the standard care group. Additionally, the intervention group will report lower levels of ASD and PTSD symptoms than parents in the standard care group. Finally, consistent with prior research, we hypothesize that mothers will report a higher level of symptoms than fathers. Research on treating anxiety-related disorders has revealed that cognitive-behavioral treatments are an effective treatment for reducing parent anxiety related to having a medically ill child. However, only one known study has examined the use of a cognitive behaviorally-based treatment to decrease the anxiety of NICU parents. Results of the current investigation should begin to fill the current gap in the research about how to provide the best treatment to parents. Based on the results of this study, future research could focus on determining which parents would best benefit from treatment, examining gender differences in anxiety and response to treatment, and looking at the role parent coping style plays in helping or hindering parent coping. Goals: In the current study, the researchers hope to gain information about how to best assist parents in coping with the highly anxiety-provoking situation of having an infant in the NICU. The primary goal of this study is to examine the effectiveness of the proposed intervention in reducing parent anxiety and their likelihood of developing significant psychological sequelae (i.e., ASD and PTSD). Secondary goals include the following: (1) to describe parent anxiety and add to the literature about the prevalence of ASD and PTSD among NICU parents; (2) to identify characteristics of parents who are at-risk for developing ASD and PTSD; (3) to identify the coping styles parents use while their infant is in the NICU and the relation between a parent's coping style and their symptoms of anxiety; (4) to provide preliminary information about possible differences between mothers and fathers in their symptom presentation and in their response to treatment. Because relatively few studies conducted in the NICU have included fathers, the data we gather about fathers will add to the research on this often under-studied population.
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