Trait vulnerability and coping strategies in the transition to motherhood

The role of emotion regulation in perinatal depression and anxiety: a systematic review

BACKGROUND

Major depressive disorder and anxiety disorders are highly prevalent and comorbid during the perinatal period. Although research and clinicians agree that emotion regulation (ER) is an important transdiagnostic factor underlying both disorders in the general population, ER during the perinatal period has received less research attention. The aim of this systematic review was to assess the literature regarding the role of ten commonly studied ER strategies in the onset and maintenance of perinatal depression and anxiety in pregnant women and young mothers, using the Process Model of Gross (1998) as a theoretical framework.

METHODS

We searched four electronic databases with variations of the following key words: women; emotion regulation (i.e., behavioral approach, behavioral avoidance, problem solving, support seeking, distraction, rumination, reappraisal, acceptance, expressive suppression, and expressive engagement); perinatal period; and psychopathology. The aim was to identify peer-reviewed, and quantitative studies published between January 1999 and January 2023. Six articles were selected for analysis.

RESULTS

Similar ER strategies emerged as risk and protective factors in perinatal depression and anxiety. Overall, behavioral avoidance, distraction, rumination, and expressive engagement appeared as risk factors, while problem solving, emotional and instrumental support seeking, cognitive reappraisal, and acceptance, emerged as protective factors in the onset and maintenance of perinatal depression and anxiety. These findings align with previous research in perinatal community samples, as well as in non-perinatal clinical samples.

CONCLUSIONS

Our results support the role of ER as a transdiagnostic factor underlying both perinatal depression and anxiety. Clinicians are encouraged to implement ER strategies into the screening, prevention, and treatment of perinatal depression and anxiety. Further research is needed to strengthen these findings and to examine the role of emotion regulation during antenatal depression and anxiety more closely.

Pre-COVID-19 predictors of low-income women's COVID-19 appraisal, coping, and changes in mental health during the pandemic

Study examined predictors and mental health consequences of appraisal (threat, support satisfaction) and coping (active, avoidant) in a sample of low-income women during coronavirus disease 2019 (COVID-19). Pre-COVID-19 contextual risk and individual resources and COVID-19-specific risk factors were examined as predictors of COVID-19 appraisal and coping, which, in turn, were tested as predictors of changes in depression and anxiety across the pandemic. Pre-COVID-19 resilience predicted more active coping, whereas pre-COVID-19 anxiety and depression predicted more avoidant coping and lower support satisfaction, respectively. Increases in anxiety were predicted by lower pre-COVID-19 self-compassion and higher concurrent threat appraisal and avoidant coping. Increases in depression were related to lower pre-COVID-19 self-compassion, active coping and support satisfaction, and higher COVID-19 hardships and health risk. Findings highlight contextual and individual factors and processes that contribute to mental health problems in a vulnerable population during community-level stressors, with implications for prevention and intervention.

Coping as a Mediator between Attachment and Depressive Symptomatology Either in Pregnancy or in the Early Postpartum Period: A Structural Equation Modelling Approach

Peripartum depression (PPD) is a major complication of pregnancy, and numerous risk factors have been associated with its onset, including dysfunctional coping strategies and insecure attachment styles, both during pregnancy and postpartum. The aim of our study was to investigate the role of coping strategies in mediating the relationship between women's attachment style and depressive symptomatology in pregnancy and one week after giving birth in a large sample of women (N = 1664). Our hypothesis was that the relationship between anxious and avoidant attachment and depressive symptomatology would be mediated by use of maladaptive coping strategies. The assessment instruments were Edinburgh Postnatal Depression Scale (EPDS), Brief Coping Orientation for Problem Experiences (COPE), and Experiences in Close Relationship Scale (ECR). The results indicated that the effect of insecure attachment styles (anxious and avoidant attachment) on antepartum depressive symptomatology was partially mediated by dysfunctional coping styles. Anxious attachment also has an indirect significant effect on postpartum depressive symptomatology through emotional coping; however, avoidant attachment does not seem to be significantly related to postpartum depressive symptoms. Our findings revealed that not only is it important to consider attachment in understanding peripartum depressive symptomatology, but also that coping plays an important role in these relationships. These findings would help a preventive coping-based intervention strategy to enhance the capacity of women with insecure attachment styles to use more adaptive coping during and after pregnancy.

Dysfunctional Attitudes Toward Motherhood and Depressive Symptoms in Portuguese Pregnant Women During COVID-19 Pandemic: the Mediating Roles of Self-Compassion and Mindful Self-Care

Objectives

There is evidence that the coronavirus disease 2019 (COVID-19) pandemic had a negative impact on the mental health of pregnant women, such as an increase in the prevalence of depression. Given the negative consequences that depressive symptoms can pose for pregnant women, it is crucial to understand how cognitive processes influence women's depressive symptoms during the COVID-19 pandemic among this specific vulnerable population. The present study aimed to examine the relationship between pregnant women's dysfunctional attitudes toward motherhood and their depressive symptoms, considering the mediating roles of self-compassion and mindful self-care.

Method

A cross-sectional online survey was conducted in Portugal between October 2020 and April 2021. A sample of 244 pregnant women answered a set of questionnaires to assess dysfunctional attitudes toward motherhood, depressive symptoms, self-compassion, and mindful self-care.

Results

More dysfunctional attitudes toward motherhood were associated with higher levels of depressive symptoms, and this relation was mediated through self-compassion and mindful self-care.

Conclusions

These results highlight that self-compassion and mindful self-care are important psychological mechanisms and the importance of considering them in psychological interventions to prevent and/or treat depressive symptoms in pregnant women with dysfunctional attitudes toward motherhood during stressful events such as a pandemic.

Personality traits as a risk factor for postpartum depression: A systematic review and meta-analysis

BACKGROUND

Certain personality traits increase vulnerability to depression, but the evidence linking personality and postpartum depression (PPD) is less robust. This systematic review aimed to identify personality traits that increase the risk of PPD.

METHODS

We systematically reviewed studies retrieved from PubMed/Medline, PsycINFO, Scopus, CINAHL, and Cochrane, following the PRISMA guidelines for reporting. We carried out a meta-analysis on the association between neuroticism and PPD.

RESULTS

A total of 34 studies were analyzed. Of these, 31 considered at least one trait associated with PPD; 10 studies considered at least one trait not associated with PPD. The meta-analysis included 13 studies, concluding that neuroticism was associated with PPD (OR: 1.37; 95%CI: 1.22-1.53; p<0.001).

LIMITATIONS

Study design and approach to personality assessment influence results. Prospective longitudinal studies of persons with no prior history of mood disorder would provide stronger evidence about whether particular personality traits predict PPD. Most studies reviewed used self-report measures to assess personality. Study design and approach to personality assessment influence results, and indications of publication bias were found.

CONCLUSIONS

Neuroticism is the personality trait most widely studied in relation to PPD. Our meta-analysis found this trait is strongly related with PPD. Moreover, vulnerable personality style and trait anxiety are also associated with PPD. Screening for these traits might help identify women at risk, improving prevention, early detection, and possibly treatment.

The role of personality in defeat: a revised social rank model

This study sought to test the role of personality within the social rank theory of depression. Specifically, self‐criticism was hypothesised to be a risk factor for mechanisms underlying involuntary subordination, while self‐efficacy was hypothesised to have a protective function. Involuntary subordination has been implicated as an underlying cause of depression and it was therefore important to determine the personality variables and other intrapsychic mechanisms that lead to this condition. The sample consisted of 115 participants (average age of 20.2 years) who were involved in athletic competition. Participants were evaluated at baseline for personality and social rank variables and for mood immediately before and after a competitive match. Two models were tested: the first model showed that self‐criticism and neuroticism predicted a heightened perception of defeat following a loss. Self‐criticism also predicted an inability to accept defeat which was associated with a latent variable interpreted as involuntary subordination. The second model demonstrated that self‐efficacy was associated with a more adaptive response to defeat, being negatively related to the perception of defeat. Both models proved to be viable and suggest that different personality styles confer specific vulnerabilities to involuntary subordination in the context of defeating events. Copyright © 2007 John Wiley & Sons, Ltd.

Interventions to Empower Adults with Eating Disorders and Their Partners around the Transition to Parenthood

The transition to parenthood is perceived as a stressful life event, when parents experience an immense change of their psychological focus and a reorientation of roles and responsibilities in the family system. This process may be even more challenging in the presence of a parental eating disorder history. This paper reviews the impact of parental eating disorders on the parents, the couple relationship, and their child during the perinatal period. A parental eating disorder is associated with more negative expectations of parental efficacy as well as specific difficulties in couple communication over the child's feeding, shape, and weight. Providers who better understand the effects of an eating disorder on parental functioning can more effectively intervene early on. We also present couple- or parent-based, empirically supported interventions for adults with eating disorders and their partners in the prenatal and postnatal periods: Uniting Couples in the treatment of Anorexia Nervosa (UCAN) and Uniting couples In the Treatment of Eating disorders (UNITE) both enhance recovery from the eating disorder through a couple-based intervention; the Maudsley Model of Treatment for Adults with Anorexia Nervosa (MANTRA) incorporates the support of partners, when appropriate; Parent-Based Prevention (PBP) focuses on improving parental functioning and reducing risk of negative parental and child outcomes. Finally, we discuss the clinical implications of addressing parental eating disorders and encourage more research on these families.

Testing a Theory-Based Model of Suicidality in a Community Sample

The aim of the present study is to test a theory-based model of suicide in a low-risk nonclinical sample. A community sample of convenience of 200 adults, 102 men and 98 women, responded to the Depressive Experiences Questionnaire, the Center for the Epidemiologic Studies of Depression Scale, the Psychache Scale, the Interpersonal Needs Questionnaire, and the Suicide Behaviors Questionnaire Revised. The hypothesized structural equation model, including trait dimensions of self-criticism and neediness, and state dimensions of depression, psychache, perceived burdensomeness, and thwarted belongingness, fit the observed data well and significantly explained 49% of the variance of suicidality.

Psychometric properties of the Postpartum Women Health Quotient Scale among Chinese post partum women

OBJECTIVE

to examine the psychometric properties of a newly developed Postpartum Women's Health Quotient Scale (PWHQS) for Chinese post partum women.

DESIGN

a cross-sectional survey of post partum women was conducted.Categorical confirmatory factor analysis (CCFA) models were applied to examine the factorial structure of the PWHQS; test information function (TIF) was used to examine reliability of PWHQS subscales; and measurement invariance was examined by testing differential item functioning (DIF) using a multiple indicators multiple causes (MIMIC) model.

SETTING

two large hospitals with a level 3A designation in Suzhou, Jiangsu Province, China.

PARTICIPANTS

a convenience sample of 395 post partum women was recruited from April to September 2014.

MEASUREMENT

the PWHQS consists of 31 items with 5 subscales: health consciousness (HC, 6 items), maternal health knowledge (MHK, 8 items), infant health knowledge (IHK, 6 items), maternal health care ability (MHCA, 5 items), and infant health care ability (IHCA, 6 items).

FINDINGS

PWHQS has a valid factorial structure with five dimensions as theoretically designed. Each of its subscales has adequate reliability that is particularly high over the lower-moderate range of the factor score scale. Measurement non-invariance in PWHQS is very limited as only two of the 31 items displayed DIF related to one grouping variable (Age).

KEY CONCLUSION

PWHQS is a valid and reliable instrument that can be readily used as a screening tool to assess health quotient (HQ) among Chinese post partum women. PWHQS will also be useful for the development of interventions to help post partum women maintain and improve maternal and infant health. Further research to confirm the findings of the present study is desirable.

Coping strategies for postpartum depression: a multi-centric study of 1626 women

The transition to motherhood is stressful as it requires several important changes in family dynamics, finances, and working life, along with physical and psychological adjustments. This study aimed at determining whether some forms of coping might predict postpartum depressive symptomatology. A total of 1626 pregnant women participated in a multi-centric longitudinal study. Different evaluations were performed 8 and 32 weeks after delivery. Depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) and the structured Diagnostic Interview for Genetic Studies (DIGS). The brief Coping Orientation for Problem Experiences (COPE) scale was used to measure coping strategies 2-3 days postpartum. Some coping strategies differentiate between women with and without postpartum depression. A logistic regression analysis was used to explore the relationships between the predictors of coping strategies and major depression (according to DSM-IV criteria). In this model, the predictor variables during the first 32 weeks were self-distraction (OR 1.18, 95 % CI 1.04-1.33), substance use (OR 0.58, 95 % CI 0.35-0.97), and self-blame (OR 1.18, 95 % CI 1.04-1.34). In healthy women with no psychiatric history, some passive coping strategies, both cognitive and behavioral, are predictors of depressive symptoms and postpartum depression and help differentiate between patients with and without depression.

Coping strategies and postpartum depressive symptoms: A structural equation modelling approach

BACKGROUND

Variables such as the mother's personality, social support, coping strategies and stressful events have been described as risk factors for postpartum depression. Structural Equation Modelling (SEM) analysis was used to examine whether neuroticism, perceived social support, perceived life events, and coping strategies are associated with postpartum depressive symptoms at the 8th and 32nd weeks.

METHODS

A total of 1626 pregnant women participated in a longitudinal study. Different evaluations were performed 8 and 32weeks after delivery. Several measures were used: the Edinburgh Postnatal Depression Scale (EPDS), the Diagnostic Interview for Genetic Studies (DIGS), the Eysenck Personality Questionnaire (EPQ-RS), the St. Paul Ramsey life events scale and the Duke-UNC Functional Social Support Questionnaire. The brief COPE scale was used to measure coping strategies. SEM analysis was conducted for all women and in those women with a clinical diagnosis of postpartum depression.

RESULTS

Passive coping strategies were associated with postpartum depressive symptoms at both visits (8th and 32nd weeks). Neuroticism was associated with more passive coping strategies and less active coping strategies. Neuroticism and life stress were positively correlated, and social support was negatively correlated with life stress and neuroticism.

CONCLUSIONS

Early identification of potential risk for symptomatology of depression postpartum should include assessment of neuroticism, life events, social support and coping strategies.

Paths to Depression Among Two Different Cultural Contexts

Over the past two decades, there has been an increase in the number of Bedouin Arab students studying at institutions of higher education in Southern Israel. To date, research on Bedouin students is limited, particularly with regard to their coping and adjustment. The main aim of the current study is to shed more light on potential pathways between vulnerability factors and depression among Bedouin Arab and Jewish students. This study was designed to explore cultural differences in the levels of self-criticism, depression, coping, and social support among Bedouin Arab college/university students and their Jewish peers, and to examine the effects of self-criticism on depression in the two cultural contexts. To that end, we conducted a cross-sectional study of 108 Bedouin students and 109 Jewish students. The participants completed the Depressive Experiences Questionnaire, Medical Outcomes Study Social Support Survey, Orientations to Problems Experienced Inventory, the Center for Epidemiological Studies Depression Scale, and demographic questionnaire. In this work, we observed differences in the levels of self-criticism, depression, avoidant coping, and social support in the different groups. Moreover, among the Jewish participants, self-criticism affected depression directly. However, among the Bedouin Arabs, self-criticism affected depression only indirectly, through avoidant coping. The present study highlights the possibility that specific cultural contexts underscore the role of avoidant coping in the pathways between self-criticism and depression, whereas other cultural contexts underscore the direct effect of self-criticism on depression levels. Furthermore, the current research underscores the importance of cross-cultural perspectives in studies of vulnerability factors and depression.

Extending the construct validity of dependency among conjugally bereaved adults

The Relationship Profile Test is a widely used measure of dependency, detachment, and healthy dependency that has been examined in both clinical and nonclinical settings, though researchers have yet to validate this measure among conjugally bereaved adults. The present study examines the construct validity of a three-facet model of dependency-detachment by comparing relationships among self-report, semistructured interview-rated, and knowledgeable informant-rated functioning among conjugally bereaved adults. Participants (N = 112) included bereaved adults (M = 51.1 years; SD = 9.7) who had experienced the loss of a spouse 1.5 to 3 years prior to taking part in this study. Findings indicate adequate psychometric properties and theoretically expected associations with various measures of wellness and health including satisfaction with life, coping flexibility, somatic complaints, and ego resiliency. Results draw attention to adaptive correlates of dependency, suggesting potentially beneficial mental health interventions.

The relationship between maternal attitudes and symptoms of depression and anxiety among pregnant and postpartum first-time mothers

Two studies examined the relationship between maternal attitudes and symptoms of depression and anxiety during pregnancy and the early postpartum period. In the first study, a measure of maternal attitudes, the Attitudes Toward Motherhood Scale (AToM), was developed and validated in a sample of first-time mothers. The AToM was found to have good internal reliability and convergent validity with cognitive biases and an existing measure of maternal attitudes. Exploratory and confirmatory factor analyses determined that the measure comprises three correlated factors: beliefs about others' judgments, beliefs about maternal responsibility, and maternal role idealization. In the second study, we used the AToM to assess the relationship between maternal attitudes and other psychological variables. The factor structure of the measure was confirmed. Maternal attitudes predicted symptoms of depression and anxiety, and these attitudes had incremental predictive validity over general cognitive biases and interpersonal risk factors. Overall, the results of these studies suggest that maternal attitudes are related to psychological distress among first-time mothers during the transition to parenthood and may provide a useful means of identifying women who may benefit from intervention during the perinatal period.

Translation and validation of the German version of the Mother-Generated Index and its application during the postnatal period

OBJECTIVE

the Mother-Generated Index (MGI) is a validated tool to assess postnatal quality of life. It is usually administered several weeks or months after birth and correlates with indices of post partum mood states and physical complaints. The instrument had not been translated into German before or validated for use among German-speaking women, nor have the results of the tool been assessed specifically for the administration directly after birth. This paper aims to describe the systematic translation process of the MGI into German and to assess the convergent validity of the German version of the instrument directly after birth and seven weeks post partum.

DESIGN

prospective two-stage survey.

SETTING

two rural hospitals in the south of Germany and in the north of Switzerland.

PARTICIPANTS

all women giving birth between 1st October and 15th December 2012 with sufficient knowledge of German and whose babies were not referred to a neonatal care unit; 226 women were eligible to participate.

MEASUREMENT INSTRUMENTS

two questionnaires including questions relating to socio-demographic factors and perinatal care, and incorporating the MGI, the Hospital Anxiety and Depression Scale (HADS) and the Postnatal Morbidity Index (PMI). All instruments were subjected to forward and back translation and pilot-tested; the first questionnaire was then administered in the first two days after birth and the second six weeks post partum. Parametric and non-parametric tests were computed using SPSS.

FINDINGS

129 surveys were returned an average of three days after birth and 83 after seven weeks. Higher postnatal quality of life showed a significant correlation with a lower anxiety and depression score (p<0.01), fewer maternal physical complaints (p<0.05) and more favourable baby adjective scores (p<0.05) after birth. Significant associations were found between MGI scores and sufficient help (p=0.03) as well as ability to cope at home (p<0.01). MGI scores three days and seven weeks after birth correlated highly significantly and positively (p<0.001).

KEY CONCLUSIONS

convergent validity of the MGI with the HADS and the PMI suggests that the German version of the MGI is a valid indicator of physical and emotional post partum well-being.

IMPLICATION FOR PRACTICE

the German version of the MGI can be used in the post partum period to identify women whose quality of life is impaired during the first days after birth, in order to initiate extended midwifery care and referral if necessary.

Neediness and depression in women

In a 6-month longitudinal design, the authors examined the links between neediness and increases in depressive symptoms in women. Neediness was assessed with the self-report Depressive Experiences Questionnaire (DEQ), supplemented by a projective measure that assessed an important component of dependency, oral dependency, on the Rorschach. Results indicate that neediness correlated significantly with increases in depressive symptoms over the 6 months. Orality interacted with neediness to substantially increase the prediction of increases in depressive symptoms.

Coping during pregnancy: a systematic review and recommendations

Extensive evidence documents that prenatal maternal stress predicts a variety of adverse physical and psychological health outcomes for the mother and baby. However, the importance of the ways that women cope with stress during pregnancy is less clear. We conducted a systematic review of the English-language literature on coping behaviours and coping styles in pregnancy using PsycInfo and PubMed to identify 45 cross-sectional and longitudinal studies involving 16,060 participants published between January 1990 and June 2012. Although results were often inconsistent across studies, the literature provides some evidence that avoidant coping behaviours or styles and poor coping skills in general are associated with postpartum depression, preterm birth and infant development. Variability in study methods including differences in sample characteristics, timing of assessments, outcome variables and measures of coping styles or behaviours may explain the lack of consistent associations. To advance the scientific study of coping in pregnancy, we call attention to the need for a priori hypotheses and greater use of pregnancy-specific, daily process, and skills-based approaches. There is promise in continuing this area of research, particularly in the possible translation of consistent findings to effective interventions, but only if the conceptual basis and methodological quality of research improve.

Recollections of parental rejection, self-criticism and depression in suicidality

The present study examines whether self-criticism and depressive symptoms mediate the relationship between recollections of parental rejection and suicidality. A community sample of 200 Portuguese adults completed, in counterbalanced order, a socio-demographic questionnaire, the short form of the Inventory for Assessing Memories of Parental Rearing Behaviour (EMBU), the Depressive Experiences Questionnaire (DEQ), the Center for Epidemiologic Studies Depression Scale (CES-D), and reports of any suicide intention and/or ideation and suicide attempts. Structural Equation Modeling (SEM) indicated that recollections of parental rejection are significantly associated with depressive symptoms and suicidality. Recollections of parental rejection are indirectly associated with depressive symptoms and suicidality through self-criticism. The association between self-criticism and suicidality is mediated by depressive symptoms. In addition to a significant direct association between recollections of parental rejection and suicidality, the final model indicated that recollections of parental rejection are significantly associated with self-criticism. That same self-criticism is significantly associated with depressive symptoms which, in turn, are significantly associated with suicidality. Individuals with recollections of parental rejection are at greater risk for suicide ideation and behavior, possibly because such experiences predispose them to intense self-criticism which is a risk factor for depression associated with suicidal ideation and behavior.

Distress mediates the association between personality predispositions and suicidality: a preliminary study in a Portuguese community sample

The present study examined whether distress mediates the relationship between suicidality and the personality predispositions of Self-Criticism, Dependency/Neediness, and Efficacy. A community sample of Portuguese young adults (N = 105) completed, in a counterbalanced order, a sociodemographic questionnaire, the Depressive Experiences Questionnaire (DEQ), the Brief Symptom Inventory (BSI), and reports of any suicide attempts and/or ideation. Structural equation modeling indicated that Self-Criticism is significantly associated with suicidality, but Dependency and Efficacy are not. High levels of Self-Criticism and of Dependency and low levels of Efficacy are associated with distress. Distress mediates the association between Self-Criticism and suicidality; whereas Dependency and Efficacy are indirectly associated with suicidality through their associations with distress. Self-Critical and Dependent individuals are at greater risk for suicide because of their vulnerability to distressful events; whereas certain levels of Efficacy may decrease vulnerability to distress and suicide risk.

Do humor styles mediate or moderate the relationship between self-criticism and neediness and depressive symptoms?

This study examined whether, in a community sample of Israeli adults (N = 335), benign (i.e., affiliative and self-enhancing) and injurious (i.e., aggressive and self-defeating) humor styles mediated or moderated the relationship between self-criticism and neediness, two traits that confer vulnerability to depression, on the one hand, and levels of depressive symptoms, on the other. There was no evidence of any moderating effect of humor styles on the relationship between self-criticism and neediness and depressive symptoms. However, results indicated that the use of injurious styles of humor mediated the relationship between self-criticism and depressive symptoms as well as the relationship between neediness and depressive symptoms. Moreover, the relationship between neediness and depressive symptoms was also mediated by low levels of benign humor. These findings may have important implications for theories concerning vulnerability to depressive symptoms and intervention strategies.

The mediating role of self-criticism and dependency in the association between perceptions of maternal caring and depressive symptoms

BACKGROUND

This study examined a theoretically based mediation model including participants' perceptions of early relationships with their mother, self-criticism, dependency, and current depressive symptoms. We expect that (a) early relationships characterized by low levels of care and high levels of overprotection will be positively associated with both current depressive state and self-criticism and dependency; (b) high levels of self-criticism and dependency will be positively associated with depressive symptoms; and (c) self-criticism and dependency will play a mediating role in the association between participants' perceptions of early relationships characterized by low levels of care and high levels of overprotection and their current depressive symptoms.

METHODS

A nonclinical community sample of 200 Portuguese adults participated in the study. Perceptions of early relationships were measured using the mother scales of the Parental Bonding Instrument (Parker et al. [1979: Br J Med Psychol 52:1-10]), levels of self-criticism and dependency were measured using the Depressive Experiences Questionnaire (Blatt et al. [1976: J Abn Psy 6:383-389]), and depressive symptoms were measured using the Center for the Epidemiological Studies of Depression Scale (Radloff [1977: Appl Psychol Meas 1:385-401].

RESULTS

Structural equation modeling showed that the link between participants' perceptions of early caretaking relationships with their mothers and their current depressive symptoms is mediated by high levels of self-criticism--a personality trait associated with vulnerability to depression--but not Dependency. However, an ancillary analysis indicated that the link between participants' perceptions of early maternal overprotective relationships and their current depressive symptoms is mediated by high levels of Neediness.

CONCLUSIONS

Findings underscore the role of perceived early relationships in psychological vulnerability to depression among highly self-critical and among highly needy individuals and highlight the negative role played by perceived mothers' early dysfunctional practices, characterized by low levels of caring and high levels of overprotection, for the self-critical vulnerability to depression and by perceived mothers' high levels of overprotection, for the neediness vulnerability to depression. These potential causal mechanisms warrant longitudinal evaluation. Theoretical and clinical implications of the findings are discussed.

Origins of Mothers' and Fathers' Beliefs about Infant Crying

Origins of mothers' and fathers' beliefs about infant crying were examined in 87 couples. Parents completed measures of emotion minimization in the family of origin, depressive symptoms, empathy, trait anger, and coping styles prenatally. At 6 months postpartum, parents completed a self-report measure of their beliefs about infant crying. Mothers endorsed more infant-oriented and less parent-oriented beliefs about crying than did fathers. Consistent with prediction, a history of emotion minimization was linked with more parent-oriented and fewer infant-oriented beliefs about infant crying for both mothers and fathers either as a main effect or in conjunction with the partners' infant-oriented beliefs. Contrary to expectation, parents' own emotional dispositions had little effect on parents' beliefs about crying. The pattern of associations varied for mothers and fathers in a number of ways. Implications for future research and programs promoting sensitive parenting are discussed.

Stability and change in levels of depression and personality: a follow-up study of postpartum depressed mothers that were hospitalized in a mother-infant unit

This prospective longitudinal study investigated the role of the personality dimensions of dependency and self-criticism in the course of depressive symptoms in a sample of inpatient severely postpartum depressed mothers (n = 55). Depressive symptoms and personality were measured during hospitalization and on average 3 1/2 years later. In line with previous research, a considerable subgroup of mothers (39%) reported moderate to severe symptoms of depression at time 2. In addition, although these mothers did not exhibit more depressive episodes during follow-up period compared with mothers with a less chronic course of depression, their depressive episodes were considerably longer, and they had higher levels of severity of depression as well as of dependency and self-criticism at Time 1. Finally, self-criticism, but not dependency, assessed at Time 1, predicted both depression diagnosis and levels of depression at follow-up, supporting a vulnerability model positing that self-criticism confers vulnerability for depression over time.

Stressful events, social support and coping strategies of primiparous women during the postpartum period: a qualitative study

OBJECTIVE

to identify problems and events perceived as stressful by primiparous mothers during the postpartum period, and to explore the social support and coping strategies they used to face these situations.

DESIGN

a qualitative study. Data were collected via semi-structured interviews and analysed using a content-analysis method.

SETTING

Geneva University Hospitals, Geneva, Switzerland from October 2006 to March 2007.

PARTICIPANTS

60 women interviewed six weeks after the birth at term of their first child.

FINDINGS

during the early postpartum period, interaction with caregivers was an important source of perceived stress. Upon returning home, the partner was considered as the primary source of social support, but the first need expressed was for material support. Breast feeding was perceived negatively by the new mothers, and this may be due to the difference between the actual problems encountered and the idealised expectations conveyed by prenatal information. Educational information dispensed by medical staff during the prenatal period was not put into practice during the postpartum period. Mothers expressed the need to be accompanied and counselled when problems arose and regretted the lack of long-term postpartum support.

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

both the prenatal education and postpartum social support seem to mismatch women's needs and expectations. Concerted efforts are required by health professionals at the maternity unit and in the community to provide mothers with more adequate postpartum assistance.

DEPRESSION AMONG MOTHERS WITH PRETERM INFANTS AND THEIR STRESS-COPING STRATEGIES

This study examined the level of maternal depressive symptoms and ways of coping among mothers with preterm infants as compared with those of 50 mothers with full-term babies. It was conducted in a hospital in Pretoria, South Africa, using the Edinburgh Postnatal Depression Scale (EPDS; Cox, Holden, & Sagovsky, 1987) and the Ways of Coping Questionnaire (Folkman & Lazarus, 1988). No significant difference was found in the level of depression between the two groups. The overall level of depression found with both combined groups, was 2–3 times higher than those suggested in the literature. A positive correlation was found between the “Seeking Social Support” coping strategy and higher levels of depression among mothers of preterm infants. A positive correlation was also found among mothers of full-term infants who used the “Accepting Responsibility” coping strategy and higher levels of depression. The high number of mothers in this study identified as suffering from a depressive illness of varying severity raises concern. A clear need for professional help among this population is emphasized. Future research in this area is needed in order to better understand and effectively address this problem.

The apple does not fall far from the tree: attachment styles and personality vulnerabilities to depression in three generations of women

The intergenerational transmission of attachment insecurity was examined in a community sample of 300 participants consisting of 100 three-generation triads of women. It was hypothesized that personality vulnerabilities mediate the association between attachment insecurity and depression within each generation. Findings show significant intergenerational congruence of trait vulnerabilities and attachment styles. Moreover, the second generation's attachment dimensions and personality vulnerabilities were found to mediate the association between first- and third-generation scores on attachment and vulnerability variables. Findings supported the following hypothesized within- and between-generation paths: Within generations, self-criticism was found to mediate the association between attachment insecurity and depression; between generations, depression, but not self-criticism, mediated the association between assessments of attachment insecurity in mothers and their daughters. This study constitutes a first approach to the delineation of the role played by self-criticism in the association between negative models of the self and depression across generations.

INTERPERSONAL RELATEDNESS AND SELF-DEFINITION IN LATE ADULTHOOD DEPRESSION: PERSONALITY PREDISPOSITIONS, AND PROTECTIVE FACTORS

This study addresses depression in late adulthood within the context of Blatt's (1974; 1991) theory of development and vulnerabilities to depression. Participants were a sample of 237 Israeli community-dwelling old adults (age 65–75) in good health and functioning well. The authors assumed that in this developmental period, normally beset with questions about self-identity and interpersonal relatedness, the associations among Self-criticism, the Neediness component of dependency, and depressive symptomatology are moderated by participants' perceived social support as well as by their fear of death. As expected, the correlational results confirmed that depression in late adulthood is associated with Self-criticism, Neediness, fear of death, and low perceived social support. Additional results illustrated the protective role of Efficacy and Connectedness, as well as the buffering roles of social support and low fear of death in the relation between vulnerabilities to depression and depressive symptoms in late adulthood. The overall findings highlight the relevance of personality vulnerability factors in depression in late adulthood and the need to consider a range of moderating factors that may serve to protectively buffer or exacerbate the impact of personality vulnerability factors.

Conceptualizing and measuring personality vulnerability to depression: comment on Coyne and Whiffen (1995)

J. C. Coyne and V. E. Whiffen (1995) reviewed research on personality vulnerability to depression, focusing on S. J. Blatt's (1974, 1990) concepts of dependency and self-criticism and A. T. Beck's (1983) concepts of sociotropy and autonomy. The authors discuss 6 issues raised in that review: (a) the typological or dimensional nature of vulnerability, (b) the theoretical implications of "mixed" vulnerability, (c) the relations of vulnerability to Neuroticism. (d) the potential confounding of vulnerability with concurrent depression, (e) the potential confounding of vulnerability with social context, and (f) the differentiation of dependency from relatedness. The authors conclude that Blatt's and Beck's concepts are continuous, nearly orthogonal dimensions that can be identified and measured independently from Neuroticism, depression, and social context.

SELF- AND BEST-FRIEND ASSESSMENTS OF PERSONALITY VULNERABILITY AND DEFENSES IN THE PREDICTION OF DEPRESSION

The associations are explored between personality vulnerability and the use of defense mechanisms in the prediction of depression. A nonclinical community sample of 187 respondents and their same-sex best friends reported on participants' personality vulnerability factors (Self-criticism, Dependency and Efficacy), defense mechanisms (Mature, Immature and Emotion-avoiding), and depression (Center for Epidemiological Studies Depression Scale: CES-D; Radloff, 1977). It was found that Mature defenses were associated only with Efficacy. Extensive use of Immature and Emotion-avoiding defenses was associated with vulnerability to depression. Furthermore, Immature defenses interacted with personality vulnerabilities. Specifically, highly self-critical participants who reported low levels of Immature defense were less depressed than were participants high on both Self-criticism and Immature defense. High Immature defense scores mediated the effect of Dependency on depression. Finally, more severe vulnerability was found when targets both rated themselves and were rated by their best friends as higher on Dependency and/or on Emotion-avoiding defenses. The implications of these findings for the study of the role of defense mechanisms in personality configurations and their susceptibility to depression, as well as for the use of multisource assessment strategies in the study of personality, are discussed. Finally, the practical and theoretical implications of these findings are discussed.