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Hornor G. Child Sexual Abuse Victimization and Parenting. J Pediatr Health Care 2024; 38:438-449. [PMID: 38697699 DOI: 10.1016/j.pedhc.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/07/2023] [Accepted: 09/21/2023] [Indexed: 05/05/2024]
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Huizink AC, Lammassaari D, Nolvi S, Korja R, Karlsson L, Karlsson H, Kataja EL. Antecedents of maternal pregnancy-related anxiety trajectories: The FinnBrain birth cohort study. Acta Psychiatr Scand 2024. [PMID: 38369812 DOI: 10.1111/acps.13671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVE Little is known about the normative courses of pregnancy-related anxiety throughout pregnancy and their antecedents. We examined in a large scale pregnancy cohort which potentially distinct trajectories of pregnancy-related anxiety across pregnancy can be identified, and which factors predict these trajectories. METHODS A general sample of pregnant women (n = 2928) from the FinnBrain Birth Cohort participated in this study. Several questionnaires were filled in at 14, 24, and 34 weeks of gestation, including the pregnancy-related anxiety questionnaire-revised as main outcome. Latent Growth Mixture Modeling was applied to identify the trajectories of pregnancy-related anxiety across pregnancy, and t-tests and chi-quare tests were conducted to find antecedents of these trajectories. RESULTS Two distinct trajectories were identified: (1) a low symptoms group, N = 2594 (88.6%), with lower and slightly increasing levels of pregnancy-related anxiety (2) a moderately-high symptoms group, N = 334 (11.4%) reported higher and slightly decreasing levels of anxiety. Correlates of the moderately-high anxious group included a lower monthly income, drinking alcohol or smoking in early pregnancy, more daily hassles and less joy, more early life adversities, younger age, primiparity, single parenthood, using depression medication, and having higher scores on depression and general anxiety. CONCLUSIONS Although the majority of pregnant women fall within a low risk trajectory of pregnancy-related anxiety, another group with consistently higher levels of pregnancy anxiety throughout pregnancy may need more clinical attention, as their high pregnancy-related anxiety scores may indicate a risk profile that includes a variety of general and more pregnancy-specific risk factors, which together can negatively affect fetal and infant development and behavior.
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Affiliation(s)
- Anja C Huizink
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Dora Lammassaari
- Department of Psychology and Speech Pathology, University of Turku, Turku, Finland
| | - Saara Nolvi
- Department of Psychology and Speech Pathology, University of Turku, Turku, Finland
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - Riikka Korja
- Department of Psychology and Speech Pathology, University of Turku, Turku, Finland
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - Linnea Karlsson
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
- Department of Clinical Medicine, Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Hasse Karlsson
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
- Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - Eeva Leena Kataja
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
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Li M, O'Donnell KJ, Caron J, Meaney MJ, Kobor M, D'Arcy C, Su Y, Liu A, Meng X. To what extent do social support and coping strategies mediate the relation between childhood maltreatment and major depressive disorder: A longitudinal community-based cohort. Dev Psychopathol 2024; 36:50-61. [PMID: 36102218 DOI: 10.1017/s0954579422000918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study aimed to articulate the roles of social support and coping strategies in the relation between childhood maltreatment (CM) and subsequent major depressive disorder (MDD) with a comprehensive exploration of potential factors in a longitudinal community-based cohort. Parallel and serial mediation analyses were applied to estimate the direct effect (DE) (from CM to MDD) and indirect effects (from CM to MDD through social support and coping strategies, simultaneously and sequentially). Sociodemographic characteristics and genetic predispositions of MDD were considered in the modeling process. A total of 902 participants were included in the analyses. CM was significantly associated with MDD (DE coefficient (β) = 0.015, 95% confidence interval (CI) = 0.002∼0.028). This relation was partially mediated by social support (indirect β = 0.004, 95% CI = 0.0001∼0.008) and negative coping (indirect β = 0.013, 95% CI = 0.008∼0.020), respectively. Social support, positive coping, and negative coping also influenced each other and collectively mediated the association between CM and MDD. This study provides robust evidence that although CM has a detrimental effect on later-on MDD, social support and coping strategies could be viable solutions to minimize the risk of MDD. Intervention and prevention programs should primarily focus on weakening negative coping strategies, then strengthening social support and positive coping strategies.
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Affiliation(s)
- Muzi Li
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Douglas Research Centre, Montreal, Quebec, Canada
| | - Kieran J O'Donnell
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Douglas Research Centre, Montreal, Quebec, Canada
- Yale Child Study Center, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, Yale University, New Haven, CT, USA
- Child & Brain Development Program, CIFAR, Toronto, Ontario, Canada
| | - Jean Caron
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Douglas Research Centre, Montreal, Quebec, Canada
| | - Michael J Meaney
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Douglas Research Centre, Montreal, Quebec, Canada
| | - Michael Kobor
- Centre for Molecular Medicine and Therapeutics, BC Children's Hospital Research Institute (BCCHR), Vancouver, British Columbia, Canada
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Carl D'Arcy
- Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Yingying Su
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Douglas Research Centre, Montreal, Quebec, Canada
| | - Aihua Liu
- Douglas Research Centre, Montreal, Quebec, Canada
| | - Xiangfei Meng
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Douglas Research Centre, Montreal, Quebec, Canada
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Sun S, Luo C, Zeng X, Wu Q. The relationship between pregnancy stress and mental health of the pregnant women: the bidirectional chain mediation roles of mindfulness and peace of mind. Front Psychol 2024; 14:1295242. [PMID: 38259564 PMCID: PMC10800386 DOI: 10.3389/fpsyg.2023.1295242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/15/2023] [Indexed: 01/24/2024] Open
Abstract
Objective This study aimed to investigate the relationship between pregnancy stress and mental health of the pregnant women, employing a positive psychology perspective. Specifically, the study sought to explore how the two positive psychological qualities of mindfulness and peace of mind may serve as potential mediators in the association between pregnancy stress and mental health of the pregnant women. Methods Seven hundreds and thirteen pregnant women seeking care at the First Affiliated Hospital of Sun Yat-Sen University were included in this study. The participants completed a self-report demographic questionnaire, as well as several validated scales including the Pregnancy Pressure Scale (PPS), Mindful Attention Awareness Scale (MAAS), Peace of Mind Scale (PoMS), and Chinese Health Questionnaire (CHQ). The Amos 23.0 system was utilized to construct structural equation models. Results A total of 713 participants had an average age of 29.46 ± 4.81 years and an average gestational age of 24.26 ± 22.66 weeks. Out of the pregnant women, 163 (22.9%) experienced moderate or higher levels of pregnancy stress (PPS > 1), while 212 (29.7%) exhibited mental distress (CHQ > 3). Pregnancy stress exhibited a positive association with mental distress, while displaying negative associations with mindfulness and peace of mind. Mindfulness and peace of mind were negatively associated with mental distress. By employing structural equation modeling, the analysis revealed that mindfulness and peace of mind acted as partial mediators in the relationship between pregnancy stress and mental health. Furthermore, the identified models exhibited bidirectional sequential mediating pathways, suggesting that the pathways of mindfulness ↔ peace of mind mitigated the harmful influence of pregnancy stress on the mental health of pregnant women. Conclusion This study adds to the current body of knowledge by investigating the relationships among mindfulness, peace of mind, pregnancy stress, and mental health in pregnant women. From a positive psychology framework, it provides valuable understanding of the intricate dynamics between pregnancy stress and protective factors of mental health. Consequently, interventions aimed at bolstering positive psychological qualities in pregnant women should prioritize the cultivation of mindfulness to foster peace of mind, or alternatively, the cultivation of peace of mind to enhance mindfulness, ultimately leading to improved mental health outcomes.
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Affiliation(s)
- Shasha Sun
- College of Humanities and Social Sciences, Zhongkai University of Agriculture and Engineering, Guangzhou, China
| | - Chunqi Luo
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xun Zeng
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Qichang Wu
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Fares-Otero NE, O J, Spies G, Womersley JS, Gonzalez C, Ayas G, Mossie TB, Carranza-Neira J, Estrada-Lorenzo JM, Vieta E, Schalinski I, Schnyder U, Seedat S. Child maltreatment and resilience in adulthood: a protocol for a systematic review and meta-analysis. Eur J Psychotraumatol 2023; 14:2282826. [PMID: 38010898 PMCID: PMC10993816 DOI: 10.1080/20008066.2023.2282826] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/05/2023] [Indexed: 11/29/2023] Open
Abstract
Background: Although child maltreatment (CM) has been linked to health problems and poor psychosocial functioning, not all individuals exposed to CM develop or experience negative consequences later in life. This suggests that some individuals show resilience after being exposed to CM. However, conclusions have been limited by inconsistent findings across different CM subtypes and resilience domains.Objective: To develop a protocol for conducting a systematic review and meta-analysis to quantify associations between CM (overall and its subtypes) and resilience (global and its multiple domains) in adulthood, and to examine moderators and mediators of these associations.Method: PubMed, PsycINFO, Embase, Scopus, and Web of Science will be searched to identify relevant studies on the association between CM (exposure) and resilience (outcome) in adults (≥ 18 years). Data will be screened and extracted by at least two independent reviewers. The methodological quality of the included studies will be independently assessed with a modified version of the Newcastle-Ottawa Scale (NOS). If deemed viable, a meta-analysis will be conducted using a random effects model. Heterogeneity of evidence will be estimated with the I2 statistic, and publication bias will be assessed. The effects of potential moderators (e.g. timing and severity of CM, age, sex, family cohesion, socio-economic status, country/region) will be analysed using meta-regression and subgroup analyses, and meta-analytical structural equation modelling will be employed to synthesise indirect mediation effects. Candidate moderators and mediators (e.g. genetic factors, brain functioning, attachment style, personality traits, physical activity, and social support) will be also examined qualitatively.Conclusions: This protocol will facilitate a systematic review and meta-analysis that has the potential to enhance our knowledge about the association between CM exposure in early life and resilience in adulthood. Understanding associations and underlying mechanisms between CM and resilience is potentially important in informing prevention and interventions to sustain health and improve outcomes among adults with a history of CM.PROSPERO registration: CRD42023394120.
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Affiliation(s)
- Natalia E. Fares-Otero
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (UBNeuro), Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Spain
- Fundació Clínic per a la Recerca Biomèdica (FCRB), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Spain
| | - Jiaqing O
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Georgina Spies
- South African PTSD Research Programme of Excellence, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Genomics of Brain Disorders Research Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Jacqueline S. Womersley
- South African PTSD Research Programme of Excellence, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Genomics of Brain Disorders Research Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Carolina Gonzalez
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, Australia
| | - Görkem Ayas
- Graduate School of Health Sciences, Koç Üniversitesi, Istanbul, Turkey
| | - Tilahun Belete Mossie
- Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Julia Carranza-Neira
- Faculty of Health Sciences, School of Medicine, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
| | | | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic, Institute of Neurosciences (UBNeuro), Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona (UB), Barcelona, Spain
- Fundació Clínic per a la Recerca Biomèdica (FCRB), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Network Centre for Biomedical Research in Mental Health (CIBERSAM), Health Institute Carlos III (ISCIII), Barcelona, Spain
| | - Inga Schalinski
- Universität der Bundeswehr München, Department of Human Sciences, Munich, Germany
| | | | - Soraya Seedat
- South African PTSD Research Programme of Excellence, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Genomics of Brain Disorders Research Unit, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
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Foti TR, Watson C, Adams SR, Rios N, Staunton M, Wei J, Sterling SA, Ridout KK, Young-Wolff KC. Associations between Adverse Childhood Experiences (ACEs) and Prenatal Mental Health and Substance Use. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6289. [PMID: 37444136 PMCID: PMC10341286 DOI: 10.3390/ijerph20136289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023]
Abstract
Adverse childhood experiences (ACEs) are common and increase the risk of poor health outcomes. Resilience may offer protection against the impacts of ACEs. This study examined the association between maternal ACEs and mental/behavioral health outcomes during pregnancy overall and by resilience. The sample comprised pregnant patients in two pilot studies screened for eight ACEs and resilience during standard prenatal care in Kaiser Permanente Northern California from 1 March 2016 to 30 July 2016 (Study 1, medical centers A, B) and from 1 April 2018 to 31 March 2019 (Study 2, medical centers A, C). Early pregnancy outcomes included anxiety and depressive disorders, depression symptoms, intimate partner violence (IPV), and substance use. Multivariable logistic regression was used in this cross-sectional study to examine associations between maternal ACEs (0, 1-2, ≥3) and mental/behavioral health outcomes overall and among those with low and high resilience. Patients (n = 1084) averaged 30.8 years (SD 5.1); 41.7% were non-Hispanic White; 41.7% experienced ≥1 ACE, and 40.3% had low resilience. Patients with 1-2 ACEs or ≥3 ACEs (versus 0 ACEs) had higher odds of anxiety and depressive disorders, depressive symptoms, IPV, and any prenatal substance use (OR 1.44-4.40, p < 0.05). Each individual ACE was associated with ≥2 mental/behavioral health outcomes. In stratified analyses, having ≥1 ACE (vs. 0) was associated with a greater number of mental/behavioral health outcomes among patients with low versus high resilience. ACEs were associated with prenatal mental/behavioral health conditions, particularly in the context of low resilience, highlighting the importance of trauma-informed prenatal care and the need to study resilience-building interventions during pregnancy.
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Affiliation(s)
- Tara R. Foti
- College of Public Health, University of South Florida, Tampa, FL 33612, USA
| | - Carey Watson
- Obstetrics and Gynecology, Kaiser Permanente, Antioch Medical Center, Antioch, CA 94531, USA
| | - Sara R. Adams
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA (K.C.Y.-W.)
| | - Normelena Rios
- Obstetrics and Gynecology, Kaiser Permanente, Dublin Medical Center, Dublin, CA 94568, USA
| | - Mary Staunton
- Department of Psychiatry, Kaiser Permanente, Walnut Creek Medical Center, Walnut Creek, CA 94596, USA
| | - Julia Wei
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA (K.C.Y.-W.)
| | - Stacy A. Sterling
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA (K.C.Y.-W.)
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Kathryn K. Ridout
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA (K.C.Y.-W.)
- Department of Psychiatry, Kaiser Permanente, Santa Rosa Medical Center, Santa Rosa, CA 95403, USA
| | - Kelly C. Young-Wolff
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA (K.C.Y.-W.)
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
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Brunton R, Dryer R. Alcohol consumption after pregnancy awareness and the additive effect of pregnancy-related anxiety and child abuse. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04387-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
AbstractThis study examined whether pregnant women alter their alcohol consumption upon pregnancy awareness and any additive effect of a maternal history of child abuse and pregnancy-related anxiety in predicting antenatal alcohol consumption. Pregnant women (N = 548, M = 31.44, SD = 4.58) completed an online survey consisting of the Pregnancy-related Anxiety Scale, Adverse Childhood Experience Questionnaire, questions on alcohol consumption and demographics. The Wilcoxon test examined difference scores between pre-pregnancy awareness and post-awareness drinking. More women reduced or ceased drinking after pregnancy awareness (M = 0.15, SD = 1.03) than before pregnancy recognition (M = 3.12, SD = 3.91). Only two women increased their alcohol consumption, with 140 reporting no change. In the hierarchical regression analysis, child abuse was not significant in the model, whereas pregnancy-related anxiety predicted alcohol consumption, with pre-pregnancy drinking the strongest predictor. There was no significant interaction effect between pregnancy-related anxiety and child abuse. While limited by a cross-sectional design and single questions to assess alcohol intake, our findings are consistent with extant literature. Findings related to child abuse were not significant, and likely due to low prevalence in the sample, Despite this, we further established that pregnancy-related anxiety remains a significant predictor of antenatal drinking regardless of how much alcohol a woman may consume pre-pregnancy. This relationship may be explained by drinking used to cope with pregnancy-related anxieties. While current guidelines recommend alcohol screening, many women may not accurately report their alcohol intake screening for pregnancy-related anxiety may provide an avenue to identify women more at risk of drinking during pregnancy.
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Tuxunjiang X, Wumaier G, Zhang W, Sailike B, Wang X, Jiang T. The relationship between positive psychological qualities and prenatal negative emotion in pregnant women: A path analysis. Front Psychol 2023; 13:1067757. [PMID: 36687899 PMCID: PMC9849688 DOI: 10.3389/fpsyg.2022.1067757] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/29/2022] [Indexed: 01/06/2023] Open
Abstract
Objective The objective of this study was to investigate the relationship between positive psychological qualities and negative emotions of pregnant women. Methods We surveyed 774 pregnant women in a tertiary hospital in Urumqi using the following measures: a self-report general demographic data questionnaire, Generalized Anxiety Disorder scale (GAD-7), Patients Health Questionnaire depression scale (PHQ-9), Pregnancy Pressure Scale (stocktickerPPS), Perceived Social Support Scale (PSSS), General Self-Efficacy Scale (GSES), and Connor-Davidson Resilience scale (CD-RISC). We used the Amos2.03 system to build a structural equation model. Results A total of 774 subjects had an average age of 30 years and an average gestational age of 23 weeks. Among the 774 respondents, 122 (15.8%) had moderate or above pregnancy stress (stocktickerPPS > 1), 376 (48.6%) had mild or above anxiety symptoms (GAD-7 ≥ 5), 456 (58.9%) had mild or above depression symptoms (PHQ-9 ≥ 5), 740 (95.6%) had moderate or above social support scores (PSSS ≥ 37), and 124 (16.0%) had good or above psychological resilience scores (CD-RISC ≥ 60). Notably, 372 (48.1%) people had a self-efficacy score above the overall average (GSES ≥ 2.6). Pregnancy stress had positive correlations with anxiety and depression (β = 0.57, 0.30, P < 0.01) and negative correlations with self-efficacy (β = -0.19, P < 0.01). Anxiety had positive correlations with depression (β = 0.54, P < 0.01) and negative correlations with social support (β = -0.45, P < 0.01). Social support had positive correlations with self-efficacy and resilience (β = 0.37, 0.47, P < 0.01). Resilience had negative correlations with anxiety (β = -0.09, P < 0.01), and self-efficacy had positive correlations with resilience (β = 0.41, P < 0.01). Conclusion Identification of pregnancy stress should be emphasized in pregnant women with negative emotions. Efforts to strengthen the positive psychological qualities of pregnant women should focus on cultivating psychological resilience to reduce the occurrence of anxiety, and improving social support should be a priority because it can enhance psychological resilience and self-efficacy. We provide a reason to intervene in the negative emotions of pregnant women from the perspective of the positive psychology of pregnant women.
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Affiliation(s)
| | - Gulijianati Wumaier
- Xinjiang Production and Construction Corps 13th Division Red Star Hospital, Hami, China
| | - Wei Zhang
- Department of Public Health, Xinjiang Medical University, Ürümqi, China
| | - Bahedana Sailike
- Department of Public Health, Xinjiang Medical University, Ürümqi, China
| | - Xiaoting Wang
- Department of Public Health, Xinjiang Medical University, Ürümqi, China
| | - Ting Jiang
- Department of Public Health, Xinjiang Medical University, Ürümqi, China
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Huang J, Xu L, Xu Z, Luo Y, Liao B, Li Y, Shi Y. The relationship among pregnancy-related anxiety, perceived social support, family function and resilience in Chinese pregnant women: a structural equation modeling analysis. BMC Womens Health 2022; 22:546. [PMID: 36572883 PMCID: PMC9791157 DOI: 10.1186/s12905-022-02145-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/23/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Accumulating evidence suggests that pregnancy-related anxiety (PRA) has adverse impacts on maternity health and infant development. A substantial body of literature has documented the important influence of family function, perceived social support and resilience on PRA. However, research identifying the mediating mechanisms underlying this relationship in China are still lacking. Therefore, the current study aimed to investigate the prevalence of PRA under the three-child policy in China, and also explore the interrelationships among perceived social support, family function, resilience, and PRA. METHODS In this cross-sectional study, a convenient sampling method was used to select 579 pregnant women who underwent prenatal examination at the maternity outpatient departments of the First Affiliated Hospital of Chongqing Medical University in China from December 2021 to April 2022. Participants were required to complete the following questionnaires: the demographic form, the Chinese Pregnancy-related Anxiety scale, the 10-item Connor-Davidson Resilience Scale, the APGAR Family Care Index Scale, and Multidimensional Scale of Perceived Social Support. Pearson correlation analysis was utilized to examine the rudimentary relationship among the study variables. Bootstrapping analyses in the structural equation modeling were applied to identify the significance of indirect effects. RESULTS There were 41.4% of pregnant Chinese women indicating PRA. Correlational analyses indicated that perceived social support, family function and resilience were negatively associated with PRA (r = - 0.47, P < 0.01; r = - 0.43, P < 0.01; r = - 0.37, P < 0.01, respectively). The results of bootstrapping analyses demonstrated significant indirect effects of perceived social support (β = - 0.098, 95% CI [- 0.184, - 0.021]) and family function (β = - 0.049, 95% CI [- 0.103, - 0.011]) on PRA via resilience. CONCLUSIONS Chinese pregnant women are suffering from high levels of PRA. Better family function and perceived social support might reduce the occurrence of PRA, as well as by the mediating effects of resilience. Healthcare providers must be concerned about PRA and perform corresponding actions to reduce it. By strengthening social support and improving family function, antenatal care providers could effectively reduce or prevent PRA. And more importantly, implementing resilience-promoting measures are also essential to relieve anxiety and support mental health in pregnant women.
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Affiliation(s)
- Jingui Huang
- grid.190737.b0000 0001 0154 0904Department of Medical Oncology, Chongqing University Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
| | - Lingli Xu
- grid.190737.b0000 0001 0154 0904Department of Human Resources, Chongqing University Cancer Hospital, Chongqing, 400030 China
| | - Zhen Xu
- grid.190737.b0000 0001 0154 0904Department of Medical Oncology, Chongqing University Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
| | - Yexin Luo
- grid.190737.b0000 0001 0154 0904Department of Medical Oncology, Chongqing University Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
| | - Bizhen Liao
- grid.452206.70000 0004 1758 417XDepartment of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 China
| | - Yan Li
- grid.452206.70000 0004 1758 417XDepartment of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016 China
| | - Yumei Shi
- grid.190737.b0000 0001 0154 0904Department of Medical Oncology, Chongqing University Cancer Hospital, No.181 Hanyu Road, Shapingba District, Chongqing, 400030 China
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Tuxunjiang X, Li L, Wumaier G, Zhang W, Sailike B, Jiang T. The mediating effect of resilience on pregnancy stress and prenatal anxiety in pregnant women. Front Psychiatry 2022; 13:961689. [PMID: 36311519 PMCID: PMC9614225 DOI: 10.3389/fpsyt.2022.961689] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 09/16/2022] [Indexed: 11/20/2022] Open
Abstract
Objective To investigate the relationship between pregnancy stress and prenatal anxiety in pregnant women in Urumqi, Xinjiang, and the mediating effect of mental resilience level on the relationship between pregnancy stress and prenatal anxiety. Method The investigation involved 750 pregnant women at a tertiary hospital in Urumqi, and included a questionnaire eliciting general demographic information, a pregnancy stress scale (Pregnancy Pressure Scale, PPS), generalized anxiety disorder scale (Generalized Anxiety Disorder-7, GAD-7), and a mental resilience scale (Connor-Davidson resilience scale, CD-RISC). The Bootstrap mediation effect test was used to test the effect relationship between variables, and Amos was used to establish the structural equation model. Results Among the 750 participants, 122 (16.2%) had moderate or greater pregnancy stress (PPS > 1), 372 (49.6%) had mild or greater anxiety symptoms (GAD-7 > 5), and 241 (32.1%) had good or higher mental resilience score. Pregnancy stress negatively affected resilience (β = -0.37, p < 0.01), and resilience also negatively affected prenatal anxiety (β = -0.12, p < 0.01). The mediating effect value of resilience was 8.3%. Conclusion Pregnancy stress, mental resilience, and prenatal anxiety were significantly correlated, and mental resilience played a partial mediating role in the influence of pregnancy stress on prenatal anxiety. It is recommended that pregnant women exercise their mental resilience to reduce the incidence of prenatal anxiety and promote physical and mental health.
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Affiliation(s)
| | - Ling Li
- Obstetrics Department, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | | | - Wei Zhang
- Department of Public Health, Xinjiang Medical University, Urumqi, China
| | - Bahedana Sailike
- Department of Public Health, Xinjiang Medical University, Urumqi, China
| | - Ting Jiang
- Department of Public Health, Xinjiang Medical University, Urumqi, China
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Dryer R, Brunton R, Krägeloh C, Medvedev O. Screening for Pregnancy-Related Anxiety: Evaluation of the Pregnancy-Related Anxiety Scale-Screener Using Rasch Methodology. Assessment 2022:10731911221103309. [PMID: 35713016 DOI: 10.1177/10731911221103309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Pregnancy-related anxiety has been linked to many maternal and child-related negative outcomes. However, there is an absence of free, well-validated screeners for this condition. The Pregnancy-related Anxiety Scale-Screener (PrAS-Screener) was evaluated using robust Rasch methodology. This study also aimed to develop a shorter version to meet the need of settings governed by professional guidelines stipulating the use of brief instruments. Data from 400 pregnant women (Mage = 27.82, SD = 5.38) were subjected to Rasch analyses and the resulting Rasch models confirmed in a second sample (N = 400, Mage = 26.29, SD = 4.95). After minor modifications, the original 15-item PrAS-Screener demonstrated good fit, unidimensionality, excellent targeting, invariance, and internal consistency. After removal of items with content overlap, an 11-item version was developed, with this version showing good fit, unidimensionality, reasonable targeting, and sound internal consistency. The PrAS-Screeners show promise as psychometrically sound clinical scales for screening pregnancy-related anxiety.
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Affiliation(s)
- Rachel Dryer
- Australian Catholic University, Strathfield, New South Wales, Australia
| | - Robyn Brunton
- Charles Sturt University, Bathurst, New South Wales, Australia
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12
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Yang W, Hou Y, Chen Y, Liu W, Fang F, Xiao J, Wang J. Personality Characteristics and Emotional Distress Among Chinese Pregnant Women: A Moderated Mediation Model. Front Psychiatry 2021; 12:645391. [PMID: 34867496 PMCID: PMC8636932 DOI: 10.3389/fpsyt.2021.645391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 10/15/2021] [Indexed: 11/13/2022] Open
Abstract
Previous studies have suggested that certain personality characteristics are associated with emotional distress during pregnancy. However, the underlying mechanism of this association is rarely understood. The current study investigated the links between personality and pregnant women's emotional distress (depressive and anxiety symptoms), tested the chain mediating effects of two resilience factors-social support and positive coping, and explored whether socioeconomic status (SES) could moderate the effects (including direct and/or indirect effects) of personality on their emotional distress. Results of a relatively large sample of pregnant women in China (N = 1157) showed positive associations for psychoticism and neuroticism with depressive and anxiety symptoms as well as negative associations for extraversion with depression and anxiety. After controlling for four important variables (the first pregnancy or not, having adverse pregnancy experience or not, being pregnant as planned or not, and number of weeks of pregnancy), social support and positive coping acted as chain mediators on the associations of personality with depressive symptoms as well as of personality with anxiety. Overall, the association of personality and depressive symptoms demonstrated invariance across socioeconomic status (SES). However, SES moderated the relationship between personality and anxiety. Specifically, the negative association of positive coping with anxiety symptoms was weaker for low SES women than for high SES ones. Results highlight the importance of social support and positive coping to decrease personality-related depressive and anxiety symptom among pregnant women. Furthermore, identifying other resilience factors that alleviate anxiety in women with low SES is urgently called for.
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Affiliation(s)
| | | | - Yu Chen
- School of Nursing, Southern Medical University, Guangzhou, China
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13
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Brunton R, Dryer R. Child Sexual Abuse and Pregnancy: A Systematic Review of the Literature. CHILD ABUSE & NEGLECT 2021; 111:104802. [PMID: 33218712 DOI: 10.1016/j.chiabu.2020.104802] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 09/07/2020] [Accepted: 11/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Child sexual abuse is related to many negative outcomes but less known is the effect on pregnancy and childbirth. OBJECTIVE This review critically examined the literature on the occurrence of child sexual abuse and outcomes associated with this abuse during pregnancy and childbirth. METHODS Five databases were searched over 50 years using an iterative approach and the terms pregnancy, sexual abuse/assault, childbirth/labour, identifying 49 studies. RESULTS The prevalence of child sexual abuse in pregnant women ranged from 2.63% to 37.25 with certain characteristics more common with a higher (e.g., specific questions, low income) or lower (broad questions, higher education) prevalence. Compared to women with no history of abuse, child sexual abuse survivors may have more concerns with their care, greater health complaints, fear childbirth and have difficulties with delivery. They also had a higher likelihood of PTSD symptomology and anxiety, consumed more harmful substances (e.g., alcohol, cigarettes, and drugs) and had greater concerns with their appearance, poorer health, sleep and may also have a higher risk of re-victimisation. CONCLUSIONS The balance of evidence suggests that compared to non-abused women, women with a child abuse history have more adverse experiences with pregnancy, childbirth, and care, with their abuse history, likely contributes to harmful behaviours and psychopathology. However, variability in operationalisation and measurement of abuse may contribute to these findings so tentative conclusions are drawn. Future research should examine the generalisability of the findings (relating to scale limitations) and recommendations for screening (e.g., sensitive items, scoring). Clinical implications of the findings point to the need for early identification of women with a child abuse history as such women require trauma-sensitive care and consideration. A useful tool is the Pregnancy-related Anxiety Scale which provides insights into specific areas of concern.
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Affiliation(s)
- Robyn Brunton
- Charles Sturt University, School of Psychology, Bathurst, NSW 2795, Australia.
| | - Rachel Dryer
- Australian Catholic University, Strathfield, NSW 2135, Australia
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