Key Points
Rationale
Postpartum depression (PPD) affects an estimated 17-18% of mothers globally, with higher rates (33-53%) among low-income Hispanic mothers in the United States (Gress-Smith et al., 2012; Hahn-Holbrook et al., 2018).
PPD has significant implications for maternal well-being, caregiving behaviors, and long-term child outcomes (Netsi et al., 2018).
While previous research has examined mean levels of PPD symptoms at various time points, less is known about the intraindividual variability in symptom experience across the postpartum period.
Recent studies have highlighted the importance of capturing variability in maternal mood and its impact on child outcomes (Glynn et al., 2018, 2019).
However, little is known about factors contributing to intraindividual maternal mood variability, particularly in high-risk populations.
Understanding the dynamic nature of PPD symptoms and identifying factors that influence symptom patterns can inform more effective screening protocols, intervention strategies, and support systems for mothers during the postpartum period.
Method
The study used a dynamic structural equation modeling (DSEM) framework to examine intraindividual variability in PPD symptoms across the first year postpartum.
Procedure
Participants were assessed at multiple time points:
Sample
322 low-income Mexican-origin mothers (mean age = 27.79 years,SD= 6.48)
Measures
Statistical measures
Results
Hypothesis 1: Mothers will exhibit significant intraindividual variability in PPD symptoms across the first year postpartum.
Results: Confirmed.
Hypothesis 2:Prenatal cumulative risk, infant temperamental negativity, and prenatal depressive symptoms will predict higher equilibrium, greater carryover, and more volatility in PPD symptoms.
Results: Partially confirmed.
Hypothesis 3: Equilibrium, carryover, and volatility in PPD symptoms will be significantly correlated.
Insight
This study provides a novel characterization of the dynamic nature of PPD symptoms among low-income Mexican-origin mothers.
The findings reveal significant intraindividual variability in symptom experience, with mothers showing both persistence (carryover) and fluctuations (volatility) in their PPD symptoms across the first year postpartum.
Mothers with higher prenatal risk and infants with more negative temperament experienced higher overall levels of PPD symptoms and more pronounced fluctuations in symptoms over time.
This highlights the importance of considering both maternal and infant factors in understanding the course of PPD.
The study’s use of dynamic structural equation modeling offers a more nuanced perspective on PPD symptom patterns compared to traditional approaches that focus solely on mean levels.
This approach allows for the identification of different “phenotypes” of PPD symptom experience, which may have implications for targeted screening and intervention strategies.
Future research could explore:
Strengths
Limitations
These limitations suggest the need for future studies using multi-informant assessments, clinical interviews, and more diverse samples to corroborate and extend the current findings.
Clinical Implications
By recognizing the complex interplay of risk factors and symptom dynamics, healthcare providers and policymakers can develop more effective strategies to prevent and address PPD, ultimately promoting better outcomes for mothers, infants, and families.
References
Primary reference
Winstone-Weide, L. K., Somers, J. A., Curci, S. G., & Luecken, L. J. (2023). A dynamic perspective on depressive symptoms during the first year postpartum.Journal of Psychopathology and Clinical Science, 132(8), 949–960.https://doi.org/10.1037/abn0000878
Other references
Glynn, L. M., Howland, M. A., Sandman, C. A., Davis, E. P., Phelan, M., Baram, T. Z., & Stern, H. S. (2018). Prenatal maternal mood patterns predict child temperament and adolescent mental health.Journal of Affective Disorders, 228, 83-90.
Glynn, L. M., Stern, H. S., Howland, M. A., Risbrough, V. B., Baker, D. G., Nievergelt, C. M., Baram, T. Z., & Davis, E. P. (2019). Measuring novel antecedents of mental illness: The Questionnaire of Unpredictability in Childhood.Neuropsychopharmacology, 44(5), 876-882.
Gress-Smith, J. L., Luecken, L. J., Lemery-Chalfant, K., & Howe, R. (2012). Postpartum depression prevalence and impact on infant health, weight, and sleep in low-income and ethnic minority women and infants.Maternal and Child Health Journal, 16(4), 887-893.
Hahn-Holbrook, J., Cornwell-Hinrichs, T., & Anaya, I. (2018). Economic and health predictors of national postpartum depression prevalence: A systematic review, meta-analysis, and meta-regression of 291 studies from 56 countries.Frontiers in Psychiatry, 8, 248.
Netsi, E., Pearson, R. M., Murray, L., Cooper, P., Craske, M. G., & Stein, A. (2018). Association of persistent and severe postnatal depression with child outcomes.JAMA Psychiatry, 75(3), 247-253.
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Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
