Individual and dyadic network analyses of depressive symptoms in Chinese postpartum couples: A cross-sectional study

Social Support, Parenting Self-Efficacy, and Postpartum Depression Among Chinese Parents: The Actor-Partner Interdependence Mediation Model

INTRODUCTION

Postpartum depression affects both mothers and fathers. This study aimed to examine the relationships between social support, parenting self-efficacy, and postpartum depression in Chinese mothers and fathers and assess the mediating effect of parenting self-efficacy using a dyadic perspective.

METHODS

A cross-sectional study was implemented from December 2020 to July 2021 in Guangzhou, China, with 309 pairs of parents. The Edinburgh Postnatal Depression Scale, Social Support Rating Scale, Parenting Sense of Competence Scale-Efficacy subscale, and sociodemographic data sheet were completed by both parents. Dyadic analysis was conducted using the actor-partner interdependence mediation model. An actor effect is the relationship between variables within an individual, whereas a partner effect is the relationship between variables in the individual and the dyadic partner.

RESULTS

In total, 20.7% of mothers and 11.7% of fathers had elevated postpartum depressive symptoms at 6 weeks postpartum. The model revealed 6 actor effects: social support was positively associated with parenting self-efficacy for mothers (β, 0.39; 95% CI, 0.28-0.49) and fathers (β, 0.39; 95% CI, 0.30-0.48) and negatively associated with postpartum depression for mothers (β, -0.22; 95% CI, -0.32 to -0.12) and fathers (β, -0.37; 95% CI, -0.48 to -0.26). Parenting self-efficacy was negatively associated with postpartum depression in mothers (β, -0.41; 95% CI, -0.53 to -0.29) and fathers (β, -0.24; 95% CI, -0.37 to -0.12). Maternal social support had a partner effect on paternal parenting self-efficacy (β, 0.14; 95% CI, 0.04-0.24). Parenting self-efficacy mediated between social support and postpartum depression for both parents (mothers: β, -0.16; 95% CI, -0.23 to -0.10; fathers: β, -0.10; 95% CI, -0.16 to -0.05).

DISCUSSION

Postpartum depression was a dyadic phenomenon. Increasing mother-centered social support has the potential to improve the parenting self-efficacy of both parents and reduce the likelihood of postpartum depression.

Transmission of depressive symptoms in the nuclear family: a cross-sectional and cross-lagged network perspective

Children are more likely to develop depressive symptoms in families where parents have depressive symptoms. By conceptualizing the individual depressive symptom network of each family member as a whole, this study proposes a family symptom network model, and explored the mechanisms of transmission of depression within nuclear families at the symptom level. This study used four waves (2012, 2016, 2018, 2020) of data from the China Family Panel Studies (CFPS), which in wave one contained a representative sample of 1963 children (1038 boys; age = 12.60), 4763 mothers and 4614 fathers from China. Children with their parents completed the Center for Epidemiology Studies Depression Scale at each wave. Individual depressive symptom networks among children, fathers, and mothers were highly similar and stable across time. When considering depressive symptoms of all family members as a whole, there was a wide range of associations between child, father, and mother depressive symptom networks. The results of the cross-lagged network model suggest the bidirectional relationships between couples and parent-child depression. The current study provides preliminary validation of the family symptom network model. The model represents a further integration and extension of network theory of mental disorders and family systems theory, and points out the limitations of studying the intergenerational transmission of depression from a latent variable perspective. Thus, the family symptom network model proposed in this study could provide valuable new insights into understanding the intergenerational transmission of depression.

Fathers' subjective childbirth stress predicts depressive symptoms at six months postpartum

BACKGROUND

Childbirth is a seminal experience in parents' lives. However, little research has investigated the link between fathers' birth experiences and their postpartum mental health. We hypothesized that a more subjectively stressful birth will predict greater self-reported depressive symptoms in fathers at six months postpartum. We also investigated the association between mode of delivery and paternal subjective stress.

METHODS

Seventy-seven heterosexual fathers expecting their first child and cohabiting with their pregnant partners participated in the study. Depressive symptoms were assessed in pregnancy and again at six months postpartum. Subjective birth stress was measured within the first few days of the birth, and birth charts were collected to examine mode of delivery.

RESULTS

Fathers' ratings of subjective birth stress significantly predicted postpartum depressive symptoms at six months postpartum. Subjective birth stress ratings varied significantly for fathers whose partners delivered via emergency cesarean section compared to those whose partners gave birth via both medicated and the unmedicated vaginal delivery.

LIMITATIONS

The study was limited by its small community (non-clinical) sample, which was restricted to heterosexual, cohabitating couples. Additionally, births were mostly uncomplicated and only 14 mothers underwent emergency cesarean section.

CONCLUSION

These findings highlight that the days immediately following childbirth are a window of opportunity for early intervention in new fathers at risk for postpartum depression.