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Gattamelata A, Coccia ME, Fioravanti G, Zurkirch VP, Moyano N. Factor Structure and Psychometric Properties of the Italian Version of the Childbearing Motivations Scale. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2025; 22:186. [PMID: 40003412 PMCID: PMC11855479 DOI: 10.3390/ijerph22020186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/28/2024] [Revised: 01/24/2025] [Accepted: 01/26/2025] [Indexed: 02/27/2025]
Abstract
The Childbearing Motivations Scale (CMS) is a multidimensional self-report measure of positive and negative motivations influencing the decision to become a parent. This study aimed to validate the Italian version of the CMS. A sample of 522 participants (27% men and 73% women) aged from 18 to 55 years was recruited. The four-factor model for the positive subscale and the five-factor model for the negative subscale of the CMS demonstrated a good fit. Reliability values ranged from 0.70 to 0.91. Both factors had evidence for convergent validity with sex, age, and relationship duration: women reported lower in some of the negative motivations to become a mother in contrast to men. Moreover, the greater the age, the lower the negative motivations for becoming a parent. Those in a longer relationship indicated lower negative motivations. No significant correlations were found for the positive motivations subscale. Significant differences were found for income levels (low vs. medium/high) regarding personal fulfillment, financial problems, and body-image concerns, as well as in cultural levels (medium vs. high) concerning economic constraints, intergenerational continuity, immaturity, and physical suffering. These findings suggest that individuals with lower economic resources scored higher across all these areas on the Negative Childbearing Motivations subscale. Our findings indicate that the CMS can be used to reliably assess the motivations for parenthood among Italian men and women.
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Affiliation(s)
- Antonio Gattamelata
- Escuela de Doctorado en Psicología, Universidad de Jaén, Campus Las Lagunillas s/n, 23071 Jaén, Spain;
- Department of Psychology, Universidad de Jaén, Campus Las Lagunillas s/n, Ed.C5, 23071 Jaén, Spain
| | - Maria Elisabetta Coccia
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy;
| | - Giulia Fioravanti
- Department of Health Sciences (DSS), University of Florence, 50135 Florence, Italy;
| | - Vanessa Prisca Zurkirch
- Maternal and Child Department, Regional Reference Center on Relational Criticalities (RCRC), Careggi University Hospital, 50134 Florence, Italy;
| | - Nieves Moyano
- Escuela de Doctorado en Psicología, Universidad de Jaén, Campus Las Lagunillas s/n, 23071 Jaén, Spain;
- Department of Psychology, Universidad de Jaén, Campus Las Lagunillas s/n, Ed.C5, 23071 Jaén, Spain
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Međedović J. Consistency and Variation in Natural Selection on Personality Across 17 Countries. EVOLUTIONARY PSYCHOLOGY 2025; 23:14747049251324908. [PMID: 40094705 PMCID: PMC11915285 DOI: 10.1177/14747049251324908] [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: 03/19/2025] Open
Abstract
The effects of natural selection on personality traits are still understudied, which is in contrast with their importance for analyzing the evolution of personality. In the present research, we analyzed natural selection on the Big Five personality traits by estimating the relations between personality characteristics and evolutionary fitness (reproductive success: i.e., number of children) using the World Values Survey wave 6 data (N = 22,636; 17 countries). Using multilevel Poisson regression models with random slopes, we obtained a positive linear association between conscientiousness and reproductive success. We also detected a nonlinear association between openness and the criterion measure: additional graphical and ANOVA analyses showed that nonlinearity emerged from the fact that only individuals with above average openness had lower reproductive success. The effect sizes of the associations between personality traits and reproductive success were low. Finally, we detected variation in selection gradients (i.e., differences in fixed model coefficients) across the countries-coefficients with both positive and negative signs are estimated for extraversion, neuroticism, and openness. This variation is in accordance with the state-dependent models of personality evolution, where environment is viewed as an external state-the environment's moderating effect on the personality-fitness link may preserve inter-individual variation in behavior within and between the populations.
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Affiliation(s)
- Janko Međedović
- Institute of Criminological and Sociological Research, Belgrade, Serbia
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Haehner P, Schaefer B, Brickau D, Kaiser T, Luhmann M. The perception of major life events across the life course. PLoS One 2024; 19:e0314011. [PMID: 39630640 PMCID: PMC11616814 DOI: 10.1371/journal.pone.0314011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 11/04/2024] [Indexed: 12/07/2024] Open
Abstract
To better understand the effects of life events, research interest recently turned to the question of how life events are perceived (e.g., as positive, predictable, or controllable). However, research on this topic primarily focused on young adulthood, leaving it unclear whether and how the perception of life events varies across the life course. In this study, we examined the relationship between age and different perceived event characteristics using nationally representative data from the German Socioeconomic Panel Innovation Sample (N = 1,044). We found that people reported different event types across among age groups. Furthermore, the perception of life events varied across age and depending on whether an event was experienced at a normative age or not. These findings underline the necessity to take on a life-course perspective when examining life events and support theoretical claims on the relevance of age norms in life-event research.
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Affiliation(s)
- Peter Haehner
- Department of Psychology, Ruhr University Bochum, Bochum, Germany
- Department of Psychology, University of Zurich, Zürich, Switzerland
| | - Bernd Schaefer
- Department of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Debora Brickau
- Department of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Till Kaiser
- Department of Psychology, Ruhr University Bochum, Bochum, Germany
- Institute of Educational Science, University of Osnabrueck, Osnabrück, Germany
| | - Maike Luhmann
- Department of Psychology, Ruhr University Bochum, Bochum, Germany
- German Center for Mental Health (DZPG), Bochum/Marburg, Germany
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Hetzel-Riggin MD, James S, Willmes A, Berner M, Buczek TJ. The Role of Personality, Just World Beliefs, and Rape Myth Acceptance on Sexual Violence Bystander Intentions. JOURNAL OF CHILD SEXUAL ABUSE 2024:1-17. [PMID: 39291870 DOI: 10.1080/10538712.2024.2404000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 08/01/2024] [Accepted: 08/19/2024] [Indexed: 09/19/2024]
Abstract
Socioecological models of bystander intervention suggest that a complex decision-making process is required for a prosocial bystander to intervene, starting with intrapersonal variables of cognition and personality. This study investigates how rape myth acceptance, personality, and just world beliefs impact the frequency of positive bystander intention. The study's sample size consisted of 139 college students. Participants completed an online survey in which they read a vignette and indicated whether they would intervene as a bystander at 25 different instances throughout the vignette. Correlational analyses showed that agreeableness and openness were positively associated with prosocial bystander behavioral intention. A multiple regression analysis found only the belief that the world was a safe and good place was predictive of prosocial bystander behavioral intention. The results suggest that bystander intervention education programs should be revised to address just world beliefs.
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Asselmann E, Garthus-Niegel S, Martini J. How research on personality development can improve our understanding of perinatal adjustment. J Reprod Infant Psychol 2023; 41:485-487. [PMID: 37783226 DOI: 10.1080/02646838.2023.2242148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Affiliation(s)
- Eva Asselmann
- Department of Psychology, Institute for Mental Health and Behavioral Medicine, HMU Health and Medical University, Potsdam, Germany
| | - Susan Garthus-Niegel
- Institute for Systems Medicine (ISM) and Faculty of Medicine, Medical School Hamburg, Hamburg, Germany
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Childhood and Families, Norwegian Institute of Public Health, Oslo, Norway
| | - Julia Martini
- Department of Psychiatry & Psychotherapy, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden
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Asselmann E, Holst E, Specht J. Longitudinal bidirectional associations between personality and becoming a leader. J Pers 2023; 91:285-298. [PMID: 35428997 DOI: 10.1111/jopy.12719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 03/21/2022] [Accepted: 04/04/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Leaders differ in their personalities from non-leaders. However, when do these differences emerge? Are leaders "born to be leaders" or does their personality change in preparation for a leadership role and due to increasing leadership experience? METHOD Using data from the German Socio-Economic Panel Study, we examined personality differences between leaders (N = 2683 leaders, women: n = 967; 36.04%) and non-leaders (N = 33,663) as well as personality changes before and after becoming a leader. RESULTS Already in the years before starting a leadership position, leaders-to-be were more extraverted, open, emotionally stable, conscientious, and willing to take risks, felt to have greater control, and trusted others more than non-leaders. Moreover, personality changed in emergent leaders: While approaching a leadership position, leaders-to-be (especially men) became gradually more extraverted, open, and willing to take risks and felt to have more control over their life. After becoming a leader, they became less extraverted, less willing to take risks, and less conscientious but gained self-esteem. CONCLUSIONS Our findings suggest that people are not simply "born to be leaders" but that their personalities change considerably in preparation for a leadership role and due to leadership experience. Some changes are transient, but others last for a long time.
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Affiliation(s)
- Eva Asselmann
- Department of Psychology, HMU Health and Medical University, Potsdam, Germany
| | - Elke Holst
- German Institute for Economic Research (DIW Berlin), Berlin, Germany
| | - Jule Specht
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
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Asselmann E, Specht J. Personality growth after relationship losses: Changes of perceived control in the years around separation, divorce, and the death of a partner. PLoS One 2022; 17:e0268598. [PMID: 35921259 PMCID: PMC9348722 DOI: 10.1371/journal.pone.0268598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/02/2022] [Indexed: 11/30/2022] Open
Abstract
Background Previous research suggests that romantic relationships play a crucial role for perceived control. However, we know surprisingly little about changes in perceived control before and after the end of romantic relationships. Methods Based on data from the Socio-Economic Panel Study (SOEP), a nationally representative household panel study from Germany, we examined changes of perceived control in the years around separation from a partner (N = 1,235), divorce (N = 423), and the death of a partner (N = 437). Results Multilevel analyses revealed that external control beliefs were higher in but not beyond the first year after separation from a partner. Internal and total control beliefs increased gradually in the years after separation. Moreover, internal control beliefs were higher in and especially beyond the first year after the death of a partner compared to the years before. No evidence was found that perceived control already changed in the years before relationship losses or in the years around a divorce. Conclusion Taken together, these findings point toward stress-related growth of perceived control after some relationship losses–especially separation and the death of a partner.
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Affiliation(s)
- Eva Asselmann
- Faculty of Health, HMU Health and Medical University, Potsdam, Germany
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jule Specht
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
- * E-mail:
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Asselmann E, Specht J. Dramatic effects but fast adaptation: Changes in life satisfaction and different facets of affective well-being around the death of a partner and death of a child. Appl Psychol Health Well Being 2022; 15:451-465. [PMID: 35895084 DOI: 10.1111/aphw.12388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 06/28/2022] [Indexed: 11/30/2022]
Abstract
Although everyone would agree that bereavement is extremely stressful, surprisingly little is known about changes in different facets of affective well-being in the years surrounding the death of a loved one. On the basis of the Socio-Economic Panel Study, we examined changes in cognitive well-being (life satisfaction) and different facets of affective well-being (happiness, sadness, anxiety, and anger) in the years around the death of a partner (N = 989) and child (N = 276). Data on the death of a partner and child as well as cognitive and affective well-being were assessed yearly since 2007. Multilevel analyses revealed that both events were associated with very large well-being impairments (>1 SD) that were most pronounced for sadness, happiness, and life satisfaction in the first year of bereavement. Afterwards, bereaved individuals managed to recover impressively well: Levels of life satisfaction, happiness, and sadness were on average similar 5 years after losing a partner or child compared with 5 years before the respective loss. Our findings suggest (a) that many individuals tend to be capable to even cope with highly stressful loss experiences and (b) that Set-Point Theory not only applies to life satisfaction but also different facets of affective well-being around the death of a loved one.
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Affiliation(s)
- Eva Asselmann
- Faculty of Health, HMU Health and Medical University, Potsdam, Germany
| | - Jule Specht
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
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Leikas S, Lahti-Pulkkinen M, Räikkönen K. Facet-level changes in mothers’ neuroticism and extraversion from early pregnancy to 6 months post-partum. EUROPEAN JOURNAL OF PERSONALITY 2022. [DOI: 10.1177/08902070221098908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Becoming a parent could be expected to affect personality development, but the existing results on parenthood-personality change connection are mixed. The present study investigated 2445 primi- and multiparous mothers’ facet- and domain-level changes in Neuroticism and Extraversion from early pregnancy to 6 months post-partum, using latent difference score models. The results showed that Excitability and the affective facets of Neuroticism decreased, and the Neuroticism facets Impulsivity and Self-Consciousness increased during the follow-up. Furthermore, mother-perceived child difficult temperament attenuated desirable personality change and amplified the increases in Impulsivity. The results suggested that considering facet-level changes in personality development across significant life events is informative, and that mother-perceived child temperament may represent an important moderator of short-term personality change across the transition to parenthood.
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Affiliation(s)
- Sointu Leikas
- Swedish School of Social Science, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Marius Lahti-Pulkkinen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Katri Räikkönen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Asselmann E, Garthus-Niegel S, Knappe S, Martini J. Physical and mental health changes in the five years before and five years after childbirth: A population-based panel study in first-time mothers and fathers from Germany. J Affect Disord 2022; 301:138-144. [PMID: 35032504 DOI: 10.1016/j.jad.2022.01.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 01/04/2022] [Accepted: 01/10/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND The transition to parenthood is characterized by far-reaching changes in life. However, little prospective-longitudinal evidence from general population samples exists on changes of general physical and mental health in the years around the birth of a child among mothers and fathers. METHODS Using data from the German Socio-Economic Panel Study (SOEP), this study examined continuous and discontinuous short- and long-term changes of general physical and mental health from five years before until five years after the birth of the first child in women (N = 1,912) and men (N = 1,742). Whether a child was born was assessed annually throughout the study. Physical and mental health was assessed biannually from 2002 to 2018 with the SF-12v2. RESULTS Multilevel analyses revealed that women experienced a considerable decrease of physical health during pregnancy, which remitted after delivery. On average, women's mental health increased in the last year before and first year after delivery. These mental health improvements were stronger in older vs. younger mothers and remained largely stable in the years after childbirth. In contrast, little evidence for changes of general physical or mental health in (expectant) fathers was found. LIMITATIONS Physical and mental health was assessed with a short questionnaire only (SF-12v2). CONCLUSIONS On average, women's mental health tends to improve before and after the birth of the first child. Men seem to be much less affected by the birth of a child than many previous studies suggest.
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Affiliation(s)
- Eva Asselmann
- Department of Psychology, HMU Health and Medical University, Olympischer Weg 1, Potsdam, Germany.
| | - Susan Garthus-Niegel
- Department of Medicine, Faculty of Medicine, Medical School Hamburg, Hamburg, Germany; Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Susanne Knappe
- Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany; Evangelische Hochschule Dresden (ehs), University of Applied Sciences for Social Work, Education and Nursing, Dresden Germany
| | - Julia Martini
- Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany; Department of Psychiatry and Psychotherapy, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
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Stavrova O, Reitz AK, Evans AM. Temporal Dynamics of Interpersonal Trust During the Transition to Parenthood. JOURNAL OF RESEARCH IN PERSONALITY 2022. [DOI: 10.1016/j.jrp.2022.104188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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12
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Wundrack R, Asselmann E, Specht J. Personality development in disruptive times: The impact of personal versus collective life events. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2021. [DOI: 10.1111/spc3.12635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Richard Wundrack
- Department of Psychology Humboldt‐Universität zu Berlin Berlin Germany
| | - Eva Asselmann
- Department of Psychology Humboldt‐Universität zu Berlin Berlin Germany
| | - Jule Specht
- Department of Psychology Humboldt‐Universität zu Berlin Berlin Germany
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Asselmann E, Specht J. Personality maturation and personality relaxation: Differences of the Big Five personality traits in the years around the beginning and ending of working life. J Pers 2021; 89:1126-1142. [PMID: 33872401 DOI: 10.1111/jopy.12640] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 02/28/2021] [Accepted: 04/13/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE At work, people are confronted with clear behavioral expectations. In line with the Social Investment Principle, the beginning and ending of working life might thus promote changes in personality traits that are relevant at work (e.g., Conscientiousness). METHOD Based on the data from the Socio-Economic Panel Study (SOEP), we examined nuanced differences of the Big Five personality traits in the years around the beginning and ending of working life. Whether participants had started working or retired in the past year was assessed yearly. The Big Five personality traits were assessed in four waves between 2005 and 2017. RESULTS In people who started working, multilevel analyses revealed that Conscientiousness was higher in the first year of working life versus all other years. Extraversion was higher in and after the first year of working life versus before, and Agreeableness increased gradually in the three years after people had started working. In people who retired, Conscientiousness was lower in and after the first year of retirement versus before. No other traits differed around the start of retirement. CONCLUSIONS Our findings suggest that the start of working life might promote personality maturation and that retirement might promote personality "relaxation."
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Affiliation(s)
- Eva Asselmann
- Faculty of Life Sciences, Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jule Specht
- Faculty of Life Sciences, Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
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Asselmann E, Garthus-Niegel S, Martini J. Personality and Peripartum Changes in Perceived Social Support: Findings From Two Prospective-Longitudinal Studies in (Expectant) Mothers and Fathers. Front Psychiatry 2021; 12:814152. [PMID: 35126214 PMCID: PMC8811288 DOI: 10.3389/fpsyt.2021.814152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 12/09/2021] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The aim of this study was to examine changes in perceived social support from early pregnancy to 2 years postpartum and to test whether these changes (a) differ between mothers and fathers or (b) vary as a function of the Big Five personality traits. BACKGROUND Higher peripartum social support in (expectant) mothers and fathers has been associated with fewer complications during pregnancy and delivery as well as better parental and offspring health. METHODS Prospective-longitudinal data from two regional-epidemiological samples from Germany were used: MARI (N = 396, including n = 293 mothers and n = 103 fathers) and DREAM (N = 2,819, including n = 1,689 mothers and n = 1,130 fathers). The Big Five personality traits were assessed during pregnancy in MARI as well as 8 weeks after the anticipated birth date in DREAM with short forms of the Big Five Inventory. Perceived social support was assessed during pregnancy, 4 months postpartum, and 16 months postpartum in MARI as well as during pregnancy, 14 months postpartum, and 2 years postpartum in DREAM using the short version of the Social Support Questionnaire. RESULTS Multilevel analyses revealed that perceived social support decreased across the peripartum period, and this decrease did not differ between mothers and fathers. More extraverted, emotionally stable, agreeable, conscientious, and open parents perceived higher levels of social support across the peripartum period. The peripartum decrease of perceived social support was smaller in parents who were more extraverted. CONCLUSION Our findings suggest that especially extraversion plays an important role for high and stable levels of perceived social support across the peripartum period. IMPLICATIONS Particularly highly introverted parents might profit from targeted social support interventions.
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Affiliation(s)
- Eva Asselmann
- Faculty of Health, HMU Health and Medical University, Potsdam, Germany
| | - Susan Garthus-Niegel
- Faculty of Medicine, Medical School Hamburg, Institute for Systems Medicine (ISM), Hamburg, Germany.,Faculty of Medicine, Institute and Policlinic of Occupational and Social Medicine, Technische Universität Dresden, Dresden, Germany.,Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Julia Martini
- Faculty of Psychology, School of Science, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Faculty of Medicine, Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
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