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Wheeler JM, LaManna J, Esparza L, Khalil D, Davis JW, Xie R, Misra DP, Giurgescu C, Kavanaugh K. A Mixed Methods Approach to Understand Mother-Father Relationship and Perceived Stress Among Black Pregnant Women. J Perinat Neonatal Nurs 2024; 38:256-270. [PMID: 39074324 DOI: 10.1097/jpn.0000000000000838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
BACKGROUND Black women in the United States report moderate to high levels of perceived stress during pregnancy. Though lower levels of involvement and support from father of the baby (FOB) and higher levels of conflict have been associated with higher levels of maternal perceived stress, it is not clear how Black pregnant women experience the mother-father relationship and its influence on perceived stress. PURPOSE To examine and describe the mother-father relationship and its role in experiences of perceived stress from the perspective of Black pregnant women. METHODS Using a convergent, mixed methods approach with ideal-type analysis, we conducted a secondary analysis of data among 60 Black pregnant women enrolled in the Biosocial Impact on Black Births study. Women completed online self-report questionnaires and participated in a semi-structured interview by telephone. RESULTS Participants who reported more conflict with FOB also reported higher levels of perceived stress (ρ(47) = .431, P= .002). Themes (importance, communication, support, conflict, satisfaction, and stress) emerged from the data. Five distinct mother-father relationship typologies were identified following an ideal-type analysis of the combined dataset: Cared For; Managing Expectations; Just Friends, For the Kids; It's Complicated; and Can't be Bothered. CONCLUSIONS These findings are an innovative exemplar of ideal-type analysis and provide a deeper understanding of the nuance and dynamics within the mother-father relationship and how it influences perceived stress among Black pregnant women. IMPLICATIONS Clinicians must recognize the significance of the mother-father relationship and, when appropriate, encourage paternal involvement or intervene if there is conflict during pregnancy.
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Affiliation(s)
- Jenna M Wheeler
- Author Affiliations: College of Nursing, University of Central Florida, Orlando, Florida (Drs Wheeler, LaManna, Davis, Xie, and Giurgescu); Department of Epidemiology and Biostatistics, Michigan State University, East Lansing (Ms Esparza and Dr Misra); College of Nursing, Wayne State University, Detroit, Michigan (Dr Khalil); Department of Statistics and Data Science, University of Central Florida, Orlando, Florida (Dr Xie); and Department of Nursing Research and Evidence Based Practice, Children's Wisconsin, Milwaukee, Wisconsin (Dr Kavanaugh)
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Chang CY, Liu SR, Glynn LM. One size doesn't fit all: Attitudes towards work modify the relation between parental leave length and postpartum depression. Arch Womens Ment Health 2023:10.1007/s00737-023-01374-5. [PMID: 37737880 DOI: 10.1007/s00737-023-01374-5] [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: 05/08/2023] [Accepted: 09/12/2023] [Indexed: 09/23/2023]
Abstract
The present study aimed to investigate the relationship between parental leave length and maternal depressive symptoms at six- and twelve-months postpartum and whether this relation was influenced by women's attitudes towards leave, whether leave was paid or unpaid, and the reason they returned to work. The sample included 115 working women recruited during pregnancy as part of a larger longitudinal study. Analyses revealed that maternal attitudes toward leave influenced the association between leave length and depressive symptoms. Specifically, longer leaves were associated with increased depressive symptoms for women who missed their previous activities at work. Furthermore, women who missed work and had leave for 16 weeks or more, exhibited higher depressive symptoms at six- and twelve-months. Last, results also indicated that women who returned to work solely for monetary reasons exhibited more depressive symptoms at six-months postpartum than those who returned to work for other reasons. This study is among the first to show that women's attitudes towards parental leave and their individual reasons for returning to work are important factors to consider that may have potential implications for parental leave policies.
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Affiliation(s)
| | - Sabrina R Liu
- Department of Human Development, California State University, San Marcos, San Marcos, CA, USA
| | - Laura M Glynn
- Department of Psychology, Chapman University, Orange, CA, USA
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Mashayekh-Amiri S, Jafarabadi MA, Montazeri M, Fallon V, Silverio SA, Mirghafourvand M. Validation of the Iranian version of the Postpartum Specific Anxiety Scale 12-item research short-form for use during global crises (PSAS-IR-RSF-C). BMC Psychiatry 2023; 23:511. [PMID: 37452292 PMCID: PMC10347867 DOI: 10.1186/s12888-023-04998-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 07/04/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Due to its high pervasiveness and adversarial consequences, postpartum anxiety has been one of the most worrying public health concerns in the last decade. According to previous research, the occurrence of mental disorders among women in the postpartum period upsurges significantly in the course of universal disasters. The Postpartum Specific Anxiety Scale - Research Short Form - for use in global Crises [PSAS-IR-RSF-C] has not been used in Iran for postpartum women during a health system shock. Consequently, this study was conducted to determine the validity and reliability of the Persian version (PSAS-IR-RSF-C) during the COVID-19 pandemic. METHODS This cross-sectional study was performed with 180 women who were between six weeks and six months after delivery, by random sampling method from December 2021 to June 2022. The validity of the PSAS-RSF-C in terms of face, content, was analyzed, and the construct validity was assessed using exploratory and confirmatory factor analyses. Internal consistency and test-retest reliability of the questionnaire were measured using (Cronbach's alpha, McDonald's ω) and intraclass correlation coefficient (ICC), respectively. RESULTS The content validity index and content validity ratio of the Persian version of the PSAS-IR-RSF-C were 0.96 and 0.98, respectively. A three-factor structure was extracted during the exploratory factor analysis process, and model validity was confirmed by the values of fit indices. Cronbach's alpha coefficient, McDonald's ω and intra-cluster correlation coefficient (95% confidence interval) were 0.74, 0.92 (0.78 to 0.93) and 0.97 (0.93 to 0.98), respectively. CONCLUSIONS For the specific assessment of postpartum anxiety among Iranian women during crises, the Persian version of the PSAS-IR-RSF-C is a valid and reliable tool.
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Affiliation(s)
- Sepideh Mashayekh-Amiri
- Students Research Committee, Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Cabrini Research, Cabrini Health, Melbourne, VIC 3144 Australia
- School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3004 Australia
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Montazeri
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Victoria Fallon
- Department of Women and Children’s Health, School of Life Course and Population Sciences, King’s College London, London, UK
| | - Sergio A. Silverio
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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J Henshaw E, Cooper M, Wood T, N Doan S, Krishna S, Lockhart M. Psychosocial predictors of early postpartum depressive and anxious symptoms in primiparous women and their partners. BMC Pregnancy Childbirth 2023; 23:209. [PMID: 36973695 PMCID: PMC10041514 DOI: 10.1186/s12884-023-05506-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 03/07/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND While the majority of research on postpartum depressive and anxious symptoms has focused on mothers, a growing body of research suggests a need to understand the role of the partner's health and relationship quality as predictors of postpartum maternal depression, while also better understanding correlates of partner or paternal depression in the postpartum period. The purpose of the current study is to evaluate mother and partner stress, anxiety, mood, infant care support, and relationship quality as predictors of perinatal depressive and anxious symptoms in first time mothers and partners during the postpartum hospital stay. METHODS First time parent couples (n = 116) completed a survey during the two-day postpartum stay in a Midwest hospital. Depressive (EPDS) and anxiety symptoms (DASS-21-Anxiety) were assessed in both mothers and partners. Hierarchical linear regression was used to evaluate relationship satisfaction, partner infant care support, stress, and co-parent mood as predictors of mood in mothers and partners separately. RESULTS Stress was a predictor of anxiety and depression symptoms in both mothers and partners. Additionally, co-parent anxiety significantly predicted anxiety in both mothers and partners. Maternal relationship satisfaction was a predictor of the partner's depressive symptoms, and maternal perceptions of partner infant support predicted maternal depressive symptoms. CONCLUSIONS Together, these results suggest that stress, relationship satisfaction, and co-parent mood are related to depressive and anxious symptoms in mothers and partner, underscoring the need to continue exploring mother and partner mental health in a dyadic framework.
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Affiliation(s)
- Erin J Henshaw
- Department of Psychology, Denison University, 100 W. College St, Granville, OH, 43023, USA.
| | - Marie Cooper
- Riverside Methodist Hospital, OhioHealth, 3535 Olentangy River Rd., Columbus, OH, 43214, USA
| | - Teresa Wood
- Nursing Operations, OhioHealth, Columbus, USA
| | - Stacey N Doan
- Claremont McKenna College, 888 N. Columbia Ave, Claremont, CA, 91711, USA
| | - Sanchita Krishna
- OhioHealth Research Institute, 3535 Olentangy River Rd, Columbus, OH, 43214, USA
| | - Marie Lockhart
- OhioHealth Research Institute, 3535 Olentangy River Rd, Columbus, OH, 43214, USA
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Bánovčinová Ľ, Škodová Z. The effect of perceived stress and postpartum partner support on postpartum depression. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2022. [DOI: 10.15452/cejnm.2022.13.0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Effects of family relationship and social support on the mental health of Chinese postpartum women. BMC Pregnancy Childbirth 2022; 22:65. [PMID: 35078423 PMCID: PMC8787939 DOI: 10.1186/s12884-022-04392-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 01/11/2022] [Indexed: 12/19/2022] Open
Abstract
Abstract
Background
Numerous studies suggest that interpersonal relationships and social support influence the development of postpartum depression and sleep quality for women. However, the effect of support from the husband or the mother-in-law has not been thoroughly validated. The current study examined the relative contribution of marital satisfaction, perceived caring of the mother-in-law, and social support on postpartum depression and sleep quality simultaneously in a path model.
Methods
A cross-sectional study was conducted from March to June 2017 in Hebei, China, using a self-report questionnaire. A total of 817 women participated at 6 weeks postpartum. Sociodemographics and information about marital satisfaction, perceived caring of the mother-in-law, social support, postpartum depression, and sleep were collected. Path analysis was used to analyze the cross-sectional data.
Results
The final model had a highly satisfactory fit. Marital satisfaction and perceived caring of mother-in-law had both direct and indirect effects on postpartum depression through social support, but these two variables had only an indirect effect on sleep quality through social support and postpartum depression. Sleep quality is a consequence of postpartum depression at 6 weeks after delivery. The prevalence of minor and major postpartum depressive symptoms at 6 weeks postpartum was 41.49 and 23.13%, respectively. A total of 371 (45.41%) women experienced sleep disturbance at 6 weeks postpartum.
Conclusions
These findings suggest that interpersonal relationships with family members play important roles in postpartum depression and sleep quality through social support in Chinese women. Improving the relationship between new mothers and their husbands or mothers-in-law and then enhancing social support might reduce postpartum depression and sleep disturbance.
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Li X, Laplante DP, Paquin V, Lafortune S, Elgbeili G, King S. Effectiveness of cognitive behavioral therapy for perinatal maternal depression, anxiety and stress: A systematic review and meta-analysis of randomized controlled trials. Clin Psychol Rev 2022; 92:102129. [DOI: 10.1016/j.cpr.2022.102129] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 12/20/2021] [Accepted: 01/20/2022] [Indexed: 12/20/2022]
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Eslahi Z, Bahrami N, Allen KA, Alimoradi Z. Spouse's social support in the postpartum period, predictors and its relationship with postpartum depression in a sample of Iranian primiparous women. Int J Gynaecol Obstet 2020; 154:24-30. [PMID: 33222169 DOI: 10.1002/ijgo.13488] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/22/2020] [Accepted: 11/18/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To investigate the predictive factors of receiving spousal support in the postpartum period and its relationship with postpartum depression (PPD). METHODS This cross-sectional study was conducted between January and May 2019 in 250 primiparous women to determine the predictors of spousal social support in the postpartum period. Three scales were used to collect data: The Demographic and Obstetric Checklist, the Postpartum Partner Support Scale, and the Edinburgh Postpartum Depression Scale. RESULTS Multivariate regression showed that the employment status of the spouse and life satisfaction variables were predictive of whether social support was received from a spouse in the postpartum period. In total, the variables examined in this model explained 19% of the variance for a mother receiving spousal social support in the postpartum period. PPD and spousal social support had a moderately inverse and significant correlation (β = -0.39). CONCLUSION Life satisfaction and employment of the spouse are important predictive variables for receiving social support of the spouse in the postpartum period. There is also a significant inverse relationship between PPD and spousal social support.
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Affiliation(s)
- Zahra Eslahi
- Students' Research Committee, School of Nursing & Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Nasim Bahrami
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Kelly-Ann Allen
- Faculty of Education, Monash University, Clayton, Vic, Australia
| | - Zainab Alimoradi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
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Yadav T, Shams R, Khan AF, Azam H, Anwar M, Anwar T, Siddiqui C, Abbas K, Sukaina M, Ghazanfar S. Postpartum Depression: Prevalence and Associated Risk Factors Among Women in Sindh, Pakistan. Cureus 2020; 12:e12216. [PMID: 33489623 PMCID: PMC7815271 DOI: 10.7759/cureus.12216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Introduction Postpartum depression (PPD) is defined as the onset of depressive symptoms within six weeks of childbirth. PPD is more common in resource-constrained countries as compared to developed countries. The study aimed to evaluate the factors associated with PPD among women in Sindh, Pakistan. Methods A multi-centre, cross-sectional study was conducted at three major tertiary care setups in Sindh, Pakistan. All women presenting to the outpatient department within six weeks of giving live birth were eligible to participate. All women who had stillbirths, abortions, or were treated for a past psychiatric illness or neurological disease were excluded from the study. The Edinburgh postpartum depression scale (EPDS) was used as a screening tool. All socio-demographic factors were documented in a predefined pro forma. The data was analyzed using Statistical Package for Social Sciences (SPSS, Version 26, IBM, Chicago, IL). Results According to the Edinburgh postpartum depression scale (EPDS), the incidence of postpartum depression in the current study population was 19.3%. Of these, 12 (3.3%) women had persistently thought about self-harming. Over 100 women did not receive any formal education, constituting the majority of the study population. Formula milk feeding of the newborn was significantly associated with an increased frequency of postpartum depression (p= 0.0001). Conclusion The current study highlights the significant burden of postpartum depression in Pakistan. However, the present study failed to find any significant risk factors associated with postpartum depression. Only formula milk feeding was significantly associated with a higher frequency of PPD among study patients.
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Affiliation(s)
- Tularam Yadav
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Rija Shams
- Internal Medicine, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Amir F Khan
- General Surgery, Lady Reading Hospital MTI, Peshawar, PAK
| | - Hadiya Azam
- Internal Medicine, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Masroor Anwar
- Internal Medicine, Hayatabad Medical Complex, Peshawar, PAK.,Surgery, Lady Reading Hospital MTI, Peshawar, PAK
| | - Tooba Anwar
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | | | - Kiran Abbas
- Internal Medicine, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Mahnoor Sukaina
- Internal Medicine, Karachi Medical and Dental College, Karachi, PAK
| | - Shamas Ghazanfar
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
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Çankaya S, Alan Dikmen H. Effects of depression, anxiety, stress, and partner relationship satisfaction on sexual dysfunction in women in the postpartum period. SEXUAL AND RELATIONSHIP THERAPY 2020. [DOI: 10.1080/14681994.2020.1851026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Seyhan Çankaya
- Department of Midwifery, Health Sciences Faculty of Selcuk University, Konya, Turkey
| | - Hacer Alan Dikmen
- Department of Midwifery, Health Sciences Faculty of Selcuk University, Konya, Turkey
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Cortés-García L, Takkouche B, Rodriguez-Cano R, Senra C. Mediational mechanisms involved in the relation between attachment insecurity and depression: A meta-analysis. J Affect Disord 2020; 277:706-726. [PMID: 32911221 DOI: 10.1016/j.jad.2020.08.082] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/12/2020] [Accepted: 08/25/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Several studies have investigated the intermediate variables or mediators through which attachment insecurity influence the development of depression. However, there has not been a systematic synthesis of this literature to date. The current meta-analytic review aimed at identifying such mediators and quantifying their effect size. METHODS We systematically searched Medline, Pubmed, Psycinfo, Embase, Proceedings Web of Science and ProQuest Dissertations & Theses Global up until May 2019. 108 studies met inclusion criteria (i.e., investigated intermediate variables that explain the effect of attachment insecurity [exposure] on depressive symptoms [outcome]). Standardized regression coefficients of the indirect and total paths of mediation models of 80 studies were pooled using the inverse of their variance as a weight. Studies were coded and ranked for quality. RESULTS Dysfunctional attitudes (β = 0.10, 95% CI = 0.01 to 0.20), self-criticism (β = 0.17, 95% CI = 0.04 to 0.28), low self-compassion (β = 0.16, 95% CI = 0.02 to 0.29), and cognitive hyperactivating regulation strategies (β = 0.13, 95% CI = 0.05 to 0.20), such as repetitive thinking (β = 0.17, 95% CI = 0.07 to 0.28), and particularly, brooding rumination β = 0.20, 95% CI = 0.07 to 0.32), mediated the association between insecure attachment and depressive symptoms. Indirect effects were only significant among adult populations. LIMITATIONS The methodological quality of studies was mostly moderate to low and analyses revealed considerable heterogeneity. CONCLUSION Our findings support the direct targeting of cognitive-emotional psychological mechanisms in prevention programs and treatment of depression. More longitudinal studies are needed to clarify the interplay of such mediators along with other interpersonal factors between insecure attachment and depression.
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Affiliation(s)
- Laura Cortés-García
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Spain.
| | - Bahi Takkouche
- Department of Preventive Medicine, University of Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBER-ESP), Madrid, Spain
| | - Ruben Rodriguez-Cano
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Carmen Senra
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Spain
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deMontigny F, Gervais C, Pierce T, Lavigne G. Perceived Paternal Involvement, Relationship Satisfaction, Mothers' Mental Health and Parenting Stress: A Multi-Sample Path Analysis. Front Psychiatry 2020; 11:578682. [PMID: 33240130 PMCID: PMC7667046 DOI: 10.3389/fpsyt.2020.578682] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/28/2020] [Indexed: 12/21/2022] Open
Abstract
Research has demonstrated the short- and long-term impacts of maternal mental health and well-being on children's emotional and behavioral outcomes. It is thus important to better understand the antecedents of maternal depression and stress. The aim of this study was to determine whether the contribution of perceived paternal involvement to account for mothers' depression and parental stress was mediated by relationship factors such as parenting alliance and dyadic adjustment. A second aim was to determine whether these relationships hold equally true in mothers of infants and young toddlers (0-24 months) and mothers of older children (25 months and older). Cross-sectional data were collected from 447 mothers. Mothers reported on their perceptions of paternal involvement with childcare responsibilities, dyadic adjustment, parenting alliance, parenting stress, and depression. Multi-sample path modeling analyses were conducted. Results revealed that perceived paternal involvement was positively related to both dyadic adjustment and parental alliance, that parenting alliance was negatively related to all three subscales of parenting stress and mothers' depression but that dyadic adjustment was negatively related to parenting distress (one subscale of parenting stress) and mothers' depression. Results from the multi-sample analyses indicated that the pattern of relationships was the same in the two groups, but that the model was not invariant. The most notable difference was that parenting alliance did not significantly account for depression in the mothers of younger children. Correlates of maternal mental health and well-being identified in this study could be useful when designing psychological interventions for mothers and fathers.
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Affiliation(s)
- Francine deMontigny
- Laboratory at the Heart of Families, Department of Nursing Science, Center of Research and Studies in Family Intervention, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Christine Gervais
- Laboratory at the Heart of Families, Department of Nursing Science, Center of Research and Studies in Family Intervention, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Tamarha Pierce
- Department of Psychology, Université Laval, Québec City, QC, Canada
| | - Geneviève Lavigne
- Center of Research and Studies in Family Intervention, Université du Québec en Outaouais, Gatineau, QC, Canada
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Bergeron S, Brassard A, Mondor J, Péloquin K. Under, Over, or Optimal Commitment? Attachment Insecurities and Commitment Issues in Relationally Distressed Couples. JOURNAL OF SEX & MARITAL THERAPY 2019; 46:246-259. [PMID: 31684844 DOI: 10.1080/0092623x.2019.1683664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Using a new multidimensional model of relationship commitment, this study examined the association among attachment insecurities (avoidance and anxiety) and commitment (optimal, over, and under) in 159 relationally distressed, monogamous and mainly heterosexual couples. Dyadic analyses revealed that avoidant individuals reported less optimal and less over-commitment, as well as more under-commitment. Their partners also reported less over-commitment. Moreover, whereas anxious individuals reported more over-commitment, their partners reported less optimal commitment and more under-commitment. Moderation analyses showed that anxious individuals reported more optimal commitment when their partners reported very high levels of avoidance. The findings suggest nuanced implications for couple therapy.
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Affiliation(s)
- Sabryna Bergeron
- Department of Psychology, Université de Montréal, Québec, Canada
| | - Audrey Brassard
- Department of Psychology, Université de Sherbrooke, Québec, Canada
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A systematic mixed-studies review on mindfulness-based childbirth education programs and maternal outcomes. Nurs Outlook 2019; 67:696-706. [DOI: 10.1016/j.outlook.2019.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/29/2019] [Accepted: 05/15/2019] [Indexed: 11/18/2022]
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15
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Prelog PR, Makovec MR, Šimic MV, Sršen TP, Perat M. Individual and Contextual Factors of Nulliparas' Levels of Depression, Anxiety and Fear of Childbirth in the Last Trimester of Pregnancy: Intimate Partner Attachment a Key Factor? Zdr Varst 2019; 58:112-119. [PMID: 31275438 PMCID: PMC6598389 DOI: 10.2478/sjph-2019-0015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 05/21/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Depression, anxiety and fear of childbirth have numerous consequences for women and their developing offspring. Insecure attachment in close adult relationships is considered to be a risk factor for depressive symptoms. This study aims to gain further insight into the risk factors for depressive and anxiety symptoms in nulliparous women during the third trimester of pregnancy regarding the main contextual relations, with an emphasis on partner attachment. METHODS A group of 325 nulliparas in the third trimester of pregnancy was enrolled in a childbirth preparation program. The following instruments were applied: Experiences in Close Relationships-Revised, the Edinburgh Depression Scale, the Zung Anxiety Scale, and a questionnaire regarding fear of childbirth. Three separate multiple linear regression models were built to explore the associations between demographic, social and attachment variables and mental health functioning. RESULTS Highly educated nulliparas and those with a higher level of co-workers' emotional support experienced a lower level of anxiety when other predictors in the model were held constant. Of all the predictors in the model, only attachment anxiety and co-workers' support were statistically significantly associated with the level of depression. Attachment anxiety was significantly associated with all three mental health indicators (level of depression, anxiety and fear of childbirth). CONCLUSIONS The results suggest that intimate attachment anxiety could be a key contextual factor for mood and anxiety mental health functioning during the third trimester of pregnancy, accessible to change. Our results could facilitate the formulation of interventions for reducing antenatal depressive symptoms.
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Affiliation(s)
- Polona Rus Prelog
- University Psychiatric Clinic Ljubljana, Studenec 48, 1000Ljubljana, Slovenia
- University of Ljubljana, Faculty of Medicine, Vrazov trg 2, 1000Ljubljana, Slovenia
| | - Maja Rus Makovec
- University Psychiatric Clinic Ljubljana, Studenec 48, 1000Ljubljana, Slovenia
| | - Marijana Vidmar Šimic
- University Medical Centre Ljubljana, Division of Gynaecology and Obstetrics, Zaloška 7, 1000Ljubljana, Slovenia
| | - Tanja Premru Sršen
- University Medical Centre Ljubljana, Division of Gynaecology and Obstetrics, Zaloška 7, 1000Ljubljana, Slovenia
| | - Mitja Perat
- Institute of Human Resources Development, 1000Ljubljana, Slovenia
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Fentz HN, Simonsen M, Trillingsgaard T. General, Interpersonal, and Gender Role Specific Risk Factors of Postpartum Depressive Symptoms in Fathers. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2019. [DOI: 10.1521/jscp.2019.38.7.545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction: Paternal postnatal depression has significant negative consequences for the family and child. Still, only little attention has been paid to potential unique risk factors of depression in fathers and the theoretical grounding of such research is sparse. Method: This study examined prenatal risk factors derived from three theoretical models: the cognitive vulnerability-stress model, the interpersonal model, and the gender role risk model of paternal postnatal depression. The sample consisted of 211 expectant fathers, of whom 5.7% scored above the clinical cut-off on the Edinburgh Postnatal Depression Scale, and 235 mothers were included as a reference group. Participants filled in questionnaires during pregnancy and four months postpartum. Results: The study results suggest that prenatal depressive score is the strongest risk factor for both paternal and maternal postnatal depressive symptoms. In addition, childhood separation from parents, unemployment, financial strain, and doubts about having the child were unique risk factors for paternal depressive symptoms, while lower marital satisfaction was a unique risk factor for maternal depression. Discussion: These findings highlight that beyond the strong role of prenatal depressive symptoms for both genders, specific risk factors for father depression exist. This may be informative to health care professionals in increasing the reach and prevention of depression in new fathers.
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Chen J, Cross WM, Plummer V, Lam L, Sun M, Qin C, Tang S. The risk factors of antenatal depression: A cross-sectional survey. J Clin Nurs 2019; 28:3599-3609. [PMID: 31165522 DOI: 10.1111/jocn.14955] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 04/14/2019] [Accepted: 05/26/2019] [Indexed: 12/14/2022]
Abstract
AIMS AND OBJECTIVES To investigate the prevalence of depression in the third trimester of pregnancy and identify the related demographic risk factors. BACKGROUND Antenatal depression as a disabling and treatable disease has a wide-ranging impact on perinatal women and has received extensive attention from researchers. DESIGN A cross-sectional survey was conducted at three public hospitals. METHODS Demographic questionnaire was developed from the literature review, and depression was assessed using the Edinburgh Postnatal Depression Scale. A binary logistic regression model was used to assess the association between depression and demographic predictors. STROBE checklist for cross-sectional studies was applied in this paper (see Appendix S1). RESULT A total of 773 pregnant women participated in the study. 29.6% of participants scored more than 9 points on Edinburgh Postnatal Depression Scale. In the final logistic model, living in rural area, marital satisfaction, assisted reproductive technology, lacking of prenatal health knowledge and life events were strongly significantly associated with antenatal depression. Moreover, living in an extended family, without Medicare insurance, unemployed, working as civil servants or healthcare workers, and lower household income also predicted antenatal depression. However, education level, smoking or drinking before pregnancy was found not to be associated with antenatal depression. CONCLUSION Our findings suggest that the prevalence of antenatal depression was high. Satisfied with the current marital status, pregnancy without assisted reproductive technology, knowledge of perinatal care and no life events recently were considered as the protective factors for antenatal depression. RELEVANCE TO CLINICAL PRACTICE Antenatal psychological interventions should focus on how to improve the marital satisfaction and the relationship with their family members. More attentions should be paid to the women who have had some life events recently or received assisted reproductive technology for pregnancy.
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Affiliation(s)
- Jiarui Chen
- Xiangya Nursing School, Central South University, Changsha, China
| | - Wendy M Cross
- School of Nursing, Midwifery and Healthcare, Federation University Australia, Melbourne, Victoria, Australia
| | - Virginia Plummer
- School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia.,Peninsula Health, Frankston, Victoria, Australia
| | - Louisa Lam
- School of Nursing, Midwifery and Healthcare, Federation University Australia, Melbourne, Victoria, Australia.,School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
| | - Mei Sun
- Xiangya Nursing School, Central South University, Changsha, China
| | - Chunxiang Qin
- Xiangya Nursing School, Central South University, Changsha, China.,Obstetrical Department, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Siyuan Tang
- Xiangya Nursing School, Central South University, Changsha, China
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Sun M, Tang S, Chen J, Li Y, Bai W, Plummer V, Lam L, Qin C, Cross WM. A study protocol of mobile phone app-based cognitive behaviour training for the prevention of postpartum depression among high-risk mothers. BMC Public Health 2019; 19:710. [PMID: 31174494 PMCID: PMC6555984 DOI: 10.1186/s12889-019-6941-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 05/07/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The changes in China's family planning policy in recent years have led to changes in the age structure of pregnant women, and the prevalence of postpartum depression (PPD) is also on the rise. Cognitive Behaviour Training (CBT) as an effective intervention is widely used for postpartum depression. However, the shortage and health disparities of mental health resources, the stigma of postpartum depression in postpartum women and the need for postpartum recovery and child care prevent postpartum women from seeking traditional face-to-face CBT. Therefore, the purpose of this proposed study is to examine the effect of mobile phone applications (App) based CBT on postpartum depression, anxiety, pressure and parenting sense of competence. METHODS A double blind, randomized controlled trial will be used in this study to examine the effectiveness of App-based CBT in reducing the prevalence of postpartum depression compared with usual postpartum care in China. A total of 120 participants will be recruited in this study. The intervention consists of a weekly theme module app for continuous six weeks, each module including learning content and assignments. The control group received usual postpartum care content through the App. Outcome measures include postpartum depression, anxiety, pressure and parenting sense of competence at 0-, 3- and 6-month after the intervention. DISCUSSION If our intervention is effective, it will provide a time-friendly and unrestricted intervention for the psychological care of perinatal women, which can effectively solve the shortage and unevenness of mental health resources. TRIAL REGISTRATION Chinese Clinical Trial Registry, ChiCTR1900020735 . Registered 15 January 2019.
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Affiliation(s)
- Mei Sun
- Xiangya Nursing School, Central South University, 172 Tongzipo Road Yuelu district, Changsha, 410013, Hunan, China
| | - Siyuan Tang
- Xiangya Nursing School, Central South University, 172 Tongzipo Road Yuelu district, Changsha, 410013, Hunan, China
| | - Jiarui Chen
- Xiangya Nursing School, Central South University, 172 Tongzipo Road Yuelu district, Changsha, 410013, Hunan, China.
| | - Ying Li
- Xiangya Nursing School, Central South University, 172 Tongzipo Road Yuelu district, Changsha, 410013, Hunan, China
| | - Wenhui Bai
- Henan Provincial People's Hospital, Zhengzhou, 450000, China
| | - Virginia Plummer
- School of Nursing and Midwifery, Monash University, Melbourne, VIC, 3800, Australia.,Peninsula Health, Frankston, VIC, 3199, Australia.,School of Nursing and Healthcare Professions, Federation University, Melbourne, VIC, 3806, Australia
| | - Louisa Lam
- School of Nursing and Midwifery, Monash University, Melbourne, VIC, 3800, Australia.,School of Nursing and Healthcare Professions, Federation University, Melbourne, VIC, 3806, Australia
| | - Chunxiang Qin
- Xiangya Nursing School, Central South University, 172 Tongzipo Road Yuelu district, Changsha, 410013, Hunan, China.,Obstetrical Department, The Third Xiangya Hospital, Central South University, Changsha, 410013, China
| | - Wendy M Cross
- School of Nursing and Healthcare Professions, Federation University, Melbourne, VIC, 3806, Australia
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Kleinman C, Reizer A. Negative caregiving representations and postpartum depression: The mediating roles of parenting efficacy and relationship satisfaction. Health Care Women Int 2017; 39:79-94. [DOI: 10.1080/07399332.2017.1369080] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
| | - Abira Reizer
- School of Social Work, Ariel University, Ariel, Israel
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Lau Y, Htun TP, Wong SN, Tam WSW, Klainin-Yobas P. Therapist-Supported Internet-Based Cognitive Behavior Therapy for Stress, Anxiety, and Depressive Symptoms Among Postpartum Women: A Systematic Review and Meta-Analysis. J Med Internet Res 2017; 19:e138. [PMID: 28455276 PMCID: PMC5429436 DOI: 10.2196/jmir.6712] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 01/26/2017] [Accepted: 02/13/2017] [Indexed: 12/12/2022] Open
Abstract
Background A growing number of meta-analyses have supported the application of therapist-supported Internet-based cognitive behavior therapy (iCBT) for psychological disorders across different populations, but relatively few meta-analyses have concentrated on postpartum women. Objective This meta-analysis evaluated the efficacy of therapist-supported iCBT in improving stress, anxiety, and depressive symptoms among postpartum women. Methods A total of 10 electronic databases were used to search for published and unpublished trials. Cochrane Collaboration tool for assessing risk of bias was utilized to measure methodological quality. Meta-analysis was performed using the RevMan software (Review Manager version 5.3 for Windows from the Nordic Cochrane Centre, the Cochrane Collaboration, 2014). Among the 789 studies identified, 8 randomized controlled trials were selected, involving 1523 participants across 6 countries. Results More than half (65%) of the eligible studies had a low risk of bias with no heterogeneity. Results revealed that therapist-supported iCBT significantly improved stress (d=0.84, n=5), anxiety (d=0.36, n=6), and depressive symptoms (d=0.63, n=8) of the intervention group compared with those of the control group at post-intervention. Conclusions This review revealed that therapist-supported iCBT significantly improves stress, anxiety, and depressive symptoms among postpartum women with small to large effects. Future effectiveness studies should establish the essential components, format, and approach of iCBT with optimal levels of human support to maximize a long-term effect.
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Affiliation(s)
- Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tha Pyai Htun
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Suei Nee Wong
- Medical Resource Team, National University of Singapore Libraries, Singapore, Singapore
| | - Wai San Wilson Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Piyanee Klainin-Yobas
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Tissot H, Favez N, Frascarolo F, Despland JN. Coparenting Behaviors as Mediators between Postpartum Parental Depressive Symptoms and Toddler's Symptoms. Front Psychol 2016; 7:1912. [PMID: 28018259 PMCID: PMC5152153 DOI: 10.3389/fpsyg.2016.01912] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 11/22/2016] [Indexed: 11/23/2022] Open
Abstract
Postpartum parental depression, even of mild intensity and short duration, has negative consequences on child development, including increased externalizing and internalizing symptoms. Studies revealed that the links between parental depression and child development are mediated by parenting difficulties. On the other hand, the mediating role of problematic family-level relationships, such as low coparenting support and high conflict between the parents, has rarely been considered, although coparenting difficulties have been linked with both increased depressive symptoms in parents and increased symptoms in toddlers. In the present study, we proposed testing a comprehensive mediation model linking parental depression, coparenting, and child symptoms. At 3 months postpartum, a convenience sample of 69 parental couples completed the Edinburgh Postnatal Depression Scale. In addition, we assessed levels of coparenting support and conflict during a mother–father–infant play situation, the Lausanne Trilogue Play. At 18 months postpartum, both parents assessed child symptoms with the Symptom Checklist Questionnaire. The results showed that coparenting support mediated the links between parental depressive symptoms and child symptoms, but only for mothers: Maternal depressive symptoms were linked with lower coparenting support, which in turn predicted increased psychofunctional symptoms and behavior problems assessed by mothers. Although coparenting conflict behaviors were not predicted by parents’ depressive symptoms, higher conflict was unexpectedly linked with fewer behavior problems assessed by both parents. The present study allowed us to unveil complex pathways between mild parental mood disturbances, family-level relationships, and child development in the first months of the child’s life.
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Affiliation(s)
- Hervé Tissot
- Faculty of Psychology and Educational Sciences, University of Geneva Geneva, Switzerland
| | - Nicolas Favez
- Faculty of Psychology and Educational Sciences, University of GenevaGeneva, Switzerland; Center for Family Studies, Department of Psychiatry, Lausanne University Hospital, University of LausanneLausanne, Switzerland
| | - France Frascarolo
- Center for Family Studies, Department of Psychiatry, Lausanne University Hospital, University of Lausanne Lausanne, Switzerland
| | - Jean-Nicolas Despland
- Center for Family Studies, Department of Psychiatry, Lausanne University Hospital, University of Lausanne Lausanne, Switzerland
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