Are women with traits of perfectionism more likely to develop perinatal depression? A systematic review and meta-analysis

The interplay of depressive symptoms and self-efficacy in adolescents: a network analysis approach

Background

Self-efficacy, a critical psychological construct representing an individual's belief in their ability to control their motivation, behavior, and social environment. In adolescents, self-efficacy plays a crucial role in mental health, particularly concerning depressive symptoms. Despite substantial research, the complex interplay between self-efficacy and depressive symptoms in adolescents remains incompletely understood.

Aims

The aim of this study is to investigate the complex interrelationships between self-efficacy and depressive symptoms in adolescents using psychological network analysis.

Methods

The cross-sectional study involved 3,654 adolescents. Self-efficacy was assessed using the General Self-Efficacy Scale (GSES), and depressive symptoms were measured with the Patient Health Questionnaire-9 (PHQ-9). Network analysis, incorporating the least absolute shrinkage and selection operator (LASSO) technique and centrality analysis, constructed and compared self-efficacy networks between depressive symptoms and healthy control groups.

Results

Of the 3,654 participants, 560 (15.32%) met criteria for moderate to severe depressive symptoms (PHQ-9 scores ≥10). Among those with depressive symptoms, 373 (66.61%) had moderate, 126 (22.50%) had moderate-severe, and 61 (10.89%) had severe symptoms. Bivariate correlation analyses revealed a significant negative correlation between depressive symptoms and self-efficacy (r = -0.41, p < 0.001). The results of the network analysis showed significant differences in self-efficacy networks between adolescents with and without depressive symptoms (global strength: S = 0.25, p < 0.05). Depressed participants showed a network with reduced global strength, suggesting diminished interconnectedness among self-efficacy items. Specific connections within the self-efficacy network were altered in the presence of depressive symptoms. Bridge analysis revealed that effort-based problem-solving (bridge strengths = 0.13) and suicidal ideation (bridge strengths = 0.09) were the key bridge nodes.

Conclusion

Adolescent depressive symptoms significantly impacts the self-efficacy network, resulting in diminished integration of self-efficacy and highlighting the complex interplay between self-efficacy and depressive symptoms. These findings challenge the traditional unidimensional view of self-efficacy and emphasize the need for tailored interventions focusing on unique self-efficacy profiles in adolescents with depressive symptoms.

A life lost to anorexia nervosa: A case report of rapid progressive disease and its psychological aspects

The prevalence of anorexia nervosa has been on the rise. Exploring key factors in treating this condition as well as psychological factors influencing the onset and maintenance of the disorder can increase the chance of treatment success.

Postpartum depression and its relationship with the positive and negative perfectionism

BACKGROUND

Depression is a common mental disorder after childbirth, which has serious consequences for the mother, baby, and family. A wide range of causes, including some personality traits of mothers, are involved in its etiology. Therefore, this study was conducted aiming to determine the factors related to postpartum depression (PPD) and its relationship with positive and negative perfectionism in Qom, Iran.

MATERIALS AND METHODS

This cross-sectional analytical study was conducted on 162 mothers who had been referred to health centers in Qom during 6-8 weeks after normal vaginal delivery (NVD) in 2020. After randomly classifying the health centers, the convenience sampling method was carried out. Data collection tools included social-individual information form, Edinburg Postnatal Depression Scale (EPDS), and Positive and Negative Perfectionism Questionnaire of Terry-Short. The data were analyzed using the Chi-square and Pearson correlation tests and multivariate logistic regression analysis.

RESULT

The prevalence of PPD in this study was 29.6%. The results showed that with the increase in the negative dimension of perfectionism, the chance of PPD in people increases by 14% (OR = 1.14, CI = 1.06-1.21), while there was no significant correlation between the positive dimension of perfectionism and PPD (r = 0.006, P > 0.05). Furthermore, the chance of PPD was higher in student mothers, mothers who had a history of PPD, and unintended pregnancy. Moreover, some factors such as multigravidity, breastfeeding, and not worrying about body image reduce the chance of occurrence.

CONCLUSION

Since mothers' negative perfectionism is associated with PPD, it is recommended to identify perfectionist individuals during pregnancy and after delivery and provide counseling service to them.

Associations of rumination, behavioral activation, and perceived reward with mothers' postpartum depression during the COVID-19 pandemic: a cross-sectional study

Introduction

The COVID-19 pandemic has led to increased social isolation for mothers, and rumination exacerbates postpartum depression in mothers with poor social support. Although behavioral activation can help to decrease their depressive symptoms, the mechanism by which behavioral activation reduces postpartum depression remains unclear.

Methods

We examined the effects of rumination and behavioral activation on depression in postpartum women by examining a model mediated by subjective reward perception. A questionnaire was administered to 475 postpartum women (Age: Mean = 30.74 years, SD = 5.02) within 1 year of childbirth using an Internet survey. The measurements included perinatal depression, rumination, and behavioral activation, and we assessed environmental reward. To control for confounding variables, we assessed psychiatric history, social support, parenting perfectionism, and COVID-19 avoidance.

Results

Eighty-four (17.68%) mothers had possible postpartum depression. The covariance structure analysis showed that not only was there a direct positive path from rumination to postnatal depression but also a negative path via reward perception.

Discussion

This finding indicated that the COVID-19 pandemic could have increased depression in many of the mothers. Rumination not only directly relates to postpartum depression, but it could also indirectly relate to postpartum depression by decreasing exposure to positive reinforcers. In addition, having a history of psychiatric illness increases the effect of rumination on postpartum depression. These findings suggest that psychological interventions are needed to reduce rumination and increase contact with positive reinforcements to reduce postpartum depression, especially for high-risk groups.

Psychometric properties of an Arabic translation of the Big Three Perfectionism Scale-Short Form (BTPS-SF) in a community sample of adults

BACKGROUND

Despite the high clinical relevance of the perfectionism construct as a transdiagnostic contributor to different mental health symptoms, and the recent burgeoning of research in this area across cultures in the past two decades, the Arab region was one of the cultural settings experiencing the slowest progress in this line of research. This study aimed to make a meaningful contribution to the literature by validating an Arabic-language version of the 16-item Big Three Perfectionism Scale-Short Form (BTPS-SF). In particular, we sought to examine structure and concurrent validity, internal consistency, and measurement invariance across gender groups.

METHOD

A web-based, convenience sampling method was adopted to collect a sample of Arabic-speaking adults from the general population of Lebanon (N = 515; aged 27.55 ± 10.92 years; 69.9% females). The forward-backward method was applied in translating the Arabic version of the BTPS-SF.

RESULTS

The examination of the internal structure, using Confirmatory Factor Analysis (CFA), demonstrated that the three-factor model (i.e., rigid, self-critical, and narcissistic perfectionism) fitted well to the data. All three factors of the Arabic 16-item BTPS-SF yielded excellent reliability estimates, with both Cronbach's alpha and McDonald's omega ranging from 0.83 to 0.86. Multi-group CFA revealed that fit indices showed no significant difference in model fit at the configural, metric, and scalar levels, thus suggesting that the factor loadings, pattern structure, and item intercepts are invariant across gender groups. Finally, BTPS-SF subscales scores correlated positively with psychological distress (i.e., depression, stress and anxiety), and inversely with subjective well-being, indicating an acceptable concurrent validity.

CONCLUSION

The present findings allow us to conclude that the Arabic BTPS-SF permits to capture reliably and validly three main factors of perfectionism. We hope that providing this psychometrically sound scale will encourage its large use not only in empirical research, but also in clinical applications, including psychological screening and treatment monitoring.

Examining the Relationship Between Maladaptive Perfectionism and Social Anxiety: The Mediating Role of Self-Compassion

Previous studies have indicated a relationship between perfectionism and social anxiety symptoms, but the mechanisms between these concepts are not well-defined yet. This study focused on the mediator role of self-compassion in the relationship between maladaptive perfectionism and social anxiety symptoms controlling self-esteem. It is hypothesized that maladaptive perfectionism would be related to lower levels of self-compassion and lower levels of self-compassion related to greater social anxiety symptoms controlling self-esteem. The sample consisted of 389 university students who completed a battery of instruments, including measures of The Liebowitz Social Anxiety Scale (LSAS), The Big Three Perfectionism Scale (BTPS), The Self-Compassion Scale (SCS), and The Rosenberg Self-Esteem Scale (RSES). Simple mediation analyses with bootstrapping demonstrated that self-compassion has a significant mediator role in the relationship between maladaptive perfectionism and social anxiety when self-esteem is not included in the model. However, results also revealed that the indirect effect of self-compassion is no longer significant when self-esteem is included in the model as a covariate. Findings suggest that self-compassion has no mediator role independent from self-esteem in the context of perfectionism and social anxiety.

A Conceptual Analysis of Mental Health Maladaptation in Postpartum

Aim: This concept analysis aims to explore how the concept of maladaptation applies to mental health changes among postpartum women. Background: The concept of maladaptation is utilized throughout various disciplines but minimally in women's health, including a limited focus on maladaptive body dissatisfaction and perfectionistic beliefs of women in the postpartum period. Methods: The Walker and Avant eight-phase model was used to guide this analysis. Data Source: A search for maladaptation articles through Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, ProQuest, and PubMed databases, as well as Google Scholar, was conducted. Results: A review of the literature concerning maladaptation in postpartum mental health resulted in defining two key attributes, including conforming to cultural norms of body image and pressure of perfection. In understanding maladaptation and its attributes, childbirth educators and health-care professionals will be able to better determine more contributing factors for postpartum depression (PPD) and formulate a plan that includes early intervention and support. Conclusion: This concept analysis is intended to improve maternal and neonatal health outcomes by understanding mental health maladaptations related to PPD.

Current Resources for Evidence-Based Practice, May 2022

An extensive review of new resources to support the provision of evidence-based care for women and infants. The current column includes a discussion of the roles of researchers and clinicians in fostering evidence-based practice, diagnostic test accuracy in suspected preeclampsia, and the effectiveness of decision-making tools in patients with pre-pregnancy morbidities.