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Hipwell AE, Tung I, Krafty RT, Leong AW, Spada M, Vaccaro H, Homitsky SC, Moses-Kolko E, Keenan K. A lifespan perspective on depression in the postpartum period in a racially and socioeconomically diverse sample of young mothers. Psychol Med 2023; 53:4415-4423. [PMID: 35513948 PMCID: PMC9637236 DOI: 10.1017/s0033291722001210] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 02/04/2022] [Accepted: 04/11/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Consistent evidence from retrospective reports and case registry studies indicates that a history of depression is a major risk factor for depression in the peripartum period. However, longitudinal studies with racially and socioeconomically diverse samples of young mothers are lacking, and little is known about developmental patterns of depression across the lifespan that can inform preventive interventions. METHODS Young primiparous mothers (n = 399, 13-25 years, 81% Black) were recruited from a population-based prospective study that began in childhood. Women reported on depression symptoms for at least 3 years prior to their pregnancy, during pregnancy, and at 4 months postpartum. Linear regression models were used to estimate change in pre-pregnancy depression severity and to evaluate associations between patterns of lifetime history and postpartum depression symptoms. RESULTS Results revealed high levels of continuity in depression from pregnancy to postpartum, and across multiple years pre-pregnancy to postpartum. Overall, depression severity leading up to pregnancy decreased over time, but patterns of worsening or improving symptoms were not associated with depression severity in the postpartum period. Instead, area under the pre-pregnancy trajectory curve, representing cumulative lifetime depression burden, was uniquely associated with postpartum depression after adjusting for prenatal depression severity. CONCLUSIONS Depression in the postpartum period should be considered within a lifespan perspective of risk that accumulates before conception. Clinical screening and early interventions are needed in adolescence and young adulthood to prevent the onset and persistence of depressive symptoms that could have long-term implications for peripartum health.
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Affiliation(s)
- Alison E. Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Irene Tung
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, California State University Dominguez Hills, Carson, CA, USA
| | - Robert T. Krafty
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Audrey W. Leong
- Department of Biological Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Meredith Spada
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Hope Vaccaro
- Department of Psychological Sciences, Case Western University, Cleveland, OH, USA
| | - Sarah C. Homitsky
- Women's Behavioral Health, Allegheny Health Network, Pittsburgh, PA, USA
| | - Eydie Moses-Kolko
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kate Keenan
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
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Personality traits as a risk factor for postpartum depression: A systematic review and meta-analysis. J Affect Disord 2022; 298:577-589. [PMID: 34763034 DOI: 10.1016/j.jad.2021.11.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 10/30/2021] [Accepted: 11/03/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Certain personality traits increase vulnerability to depression, but the evidence linking personality and postpartum depression (PPD) is less robust. This systematic review aimed to identify personality traits that increase the risk of PPD. METHODS We systematically reviewed studies retrieved from PubMed/Medline, PsycINFO, Scopus, CINAHL, and Cochrane, following the PRISMA guidelines for reporting. We carried out a meta-analysis on the association between neuroticism and PPD. RESULTS A total of 34 studies were analyzed. Of these, 31 considered at least one trait associated with PPD; 10 studies considered at least one trait not associated with PPD. The meta-analysis included 13 studies, concluding that neuroticism was associated with PPD (OR: 1.37; 95%CI: 1.22-1.53; p<0.001). LIMITATIONS Study design and approach to personality assessment influence results. Prospective longitudinal studies of persons with no prior history of mood disorder would provide stronger evidence about whether particular personality traits predict PPD. Most studies reviewed used self-report measures to assess personality. Study design and approach to personality assessment influence results, and indications of publication bias were found. CONCLUSIONS Neuroticism is the personality trait most widely studied in relation to PPD. Our meta-analysis found this trait is strongly related with PPD. Moreover, vulnerable personality style and trait anxiety are also associated with PPD. Screening for these traits might help identify women at risk, improving prevention, early detection, and possibly treatment.
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Hallford DJ, Rusanov D, Yeow JJE, Barry TJ. Overgeneral and specific autobiographical memory predict the course of depression: an updated meta-analysis. Psychol Med 2021; 51:909-926. [PMID: 33875023 DOI: 10.1017/s0033291721001343] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Impairments in retrieving event-level, specific autobiographical memories, termed overgeneral memory (OGM), are recognised as a feature of clinical depression. A previous meta-analytic review assessing how OGM predicts the course of subsequent depressive symptoms showed small effects for correlations and regression analyses when baseline depressive symptoms were controlled for. We aimed to update this study and examine whether their findings replicate given the decade of research that has been published since. A systematic literature review using the same eligibility criteria as the previous meta-analysis led to a doubling of eligible studies (32 v. 15). The results provided more precise estimates of effect sizes, and largely support the finding that OGM predicts the course of depressive symptoms. The effects were generally small, but significantly larger among clinical samples, compared to studies with non-clinical samples. There was some evidence that higher age was associated with stronger effects, and longer follow-up was associated with weaker effects. The findings on other moderating variables that were analysed were mixed. Continued research into this modifiable cognitive process may help to provide an avenue to better understand and treat highly prevalent and impactful depressive disorders.
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Affiliation(s)
- D J Hallford
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Victoria 3220, Melbourne, Australia
| | - D Rusanov
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Victoria 3220, Melbourne, Australia
| | - J J E Yeow
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Victoria 3220, Melbourne, Australia
| | - T J Barry
- Department of Psychology, University of Hong Kong, Pok Fu Lam, Hong Kong
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Prepartum mental time travelling: Investigating specificity and content of time travelling and their association with psychological distress. J Behav Ther Exp Psychiatry 2020; 69:101590. [PMID: 32603800 DOI: 10.1016/j.jbtep.2020.101590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 04/07/2020] [Accepted: 05/11/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES The current study compared mental time travelling in a group of first-time pregnant women with that in a group of non-pregnant women. We predicted that specificity of birth-related events would be negatively associated with psychological distress. METHODS Fifty-nine pregnant women and 59 controls were assessed twice. Pregnant women were assessed before (Time 1) and after (Time 2) childbirth, controls before and after an identical time period. Time travelling was evaluated under two different conditions, where participants generated memories and future predictions in response to neutral words. RESULTS No significant changes in psychological distress were observed over time. At Time 1, pregnant women were more likely to mentally travel to the future, and in general travelled further away from the present. Overall, they generated fewer specific events, which in turn was associated with less worry. The number of birth-related events was negatively associated with worry and positively with positive affect, whereas the number of specific birth-related events was negatively associated with positive affect, and positively associated with both symptoms of psychological distress, negative affect, and worry. LIMITATIONS The potential negative effect of specificity should be replicated in future studies, in longitudinal studies or experimentally, in order to address causal relations. CONCLUSIONS Pregnancy involves alterations in mental time travel, and specificity in events, recalled or imagined, was associated with more worry within the pregnant group, indicative of a detrimental effect. This goes counter to many previous studies assigning a positive role of specificity and warrants further exploration.
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Belcher J, Kangas M. Autobiographical memory specificity in response to emotion pictorial cues among non‐clinical participants. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/ajpy.12027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jessica Belcher
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia,
| | - Maria Kangas
- Department of Psychology, Centre for Emotional Health, Macquarie University, Sydney, New South Wales, Australia,
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Fonseca A, Canavarro MC. Cognitive correlates of women's postpartum depression risk and symptoms: the contribution of dysfunctional beliefs and negative thoughts. J Ment Health 2019; 29:614-622. [PMID: 30924704 DOI: 10.1080/09638237.2019.1581331] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Despite the extensive research on interpersonal and clinical risk factors for postpartum depression (PPD), there is a paucity of research on the potential role of cognitive variables (dysfunctional beliefs and negative thoughts) as correlates of PPD symptoms.Aims: This exploratory study aimed to understand the cognitive processes of women at a higher risk (i.e. presenting well-established interpersonal and clinical risk factors) for PPD by: (a) comparing women's dysfunctional motherhood-related beliefs and frequency of automatic thoughts, as a function of their levels of PPD risk and symptoms; (b) examining the cognitive correlates of PPD symptoms, controlling for the presence of well-established risk factors.Method: A cross-sectional internet survey comprising 441 postpartum women was conducted.Results: Women presenting high-risk for PPD showed more dysfunctional motherhood-related attitudes (p < 0.001), more frequent negative thoughts (p < 0.001) and less frequent positive thoughts (p < 0.001) than low-risk women. More dysfunctional beliefs related to maternal responsibility, more frequent negative thoughts related with personal maladjustment and with the metacognitive appraisal of the thoughts' content, and less frequent positive thoughts were found to be significantly associated with PPD symptoms.Conclusion: The inclusion of cognitive variables in risk assessment and preventive efforts for PPD may hold potential to increase its clinical efficacy.
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Affiliation(s)
- Ana Fonseca
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention (CINEICC) of the Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Maria Cristina Canavarro
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention (CINEICC) of the Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
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Denis A, Luminet O. Cognitive factors and post-partum depression: What is the influence of general personality traits, rumination, maternal self-esteem, and alexithymia? Clin Psychol Psychother 2017; 25:359-367. [PMID: 29282785 DOI: 10.1002/cpp.2168] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 11/22/2017] [Accepted: 11/24/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVES The objective was to assess the impact of cognitive factors on post-partum depression (PPD) symptoms. Because most of the literature data concern the immediate post-partum period or the first year post-partum, we notably sought to assess the longer term impact of cognitive factors on the symptoms of PPD. METHODS Two studies were performed. In a pilot study, 1-month post-partum, 63 women filled out a sociodemographic information sheet and completed the abbreviated, revised Eysenck Personality Questionnaire, the Ruminative Responses Scale, the Maternal Self-Report Inventory, and the Edinburgh Post-Natal Depression Scale. In the main study, 124 women additionally completed the Toronto Alexithymia Scale. The main study population was divided into 2 subgroups: women in the first year post-partum (n = 74) and those in the second year post-partum (n = 50). RESULTS In the pilot study performed 1-month post-partum, brooding rumination and low self-esteem were significant predictors of the PPD symptom intensity. Neuroticism, brooding rumination, and low maternal self-esteem were also significant predictors of the PPD symptoms reported in the first year post-partum. Lastly, ruminative thoughts and alexithymia were significant predictors of the PPD symptoms reported in the second year post-partum. CONCLUSIONS Our results suggest that alexithymia may be an important predictor of the incidence of this condition. The observation of differences in the PPD models as a function of the post-partum period may open up opportunities for developing novel PPD prevention/treatment programs.
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Affiliation(s)
- Anne Denis
- Université Grenoble Alpes, University Savoie Mont Blanc, LIP/PC2S, 38000, Grenoble, France
| | - Olivier Luminet
- Psychological Sciences Research Institute and Belgian Fund for Scientific Research (FRS-FNRS), Catholic University of Louvain, Louvain-la-Neuve, Belgium
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Van Daele T, Griffith JW, Van den Bergh O, Hermans D. Overgeneral autobiographical memory predicts changes in depression in a community sample. Cogn Emot 2014; 28:1303-12. [DOI: 10.1080/02699931.2013.879052] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Rapid habituation of ventral striatal response to reward receipt in postpartum depression. Biol Psychiatry 2011; 70:395-9. [PMID: 21507385 PMCID: PMC3454468 DOI: 10.1016/j.biopsych.2011.02.021] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Revised: 02/09/2011] [Accepted: 02/10/2011] [Indexed: 11/17/2022]
Abstract
BACKGROUND Little is known about neural mechanisms of postpartum depression (PPD). Previous research notes ventral striatal activity and dopamine release increases with maternal attachment but decreases in major depressive disorder. This study tests the hypothesis that striatal response to reward is altered in PPD. METHODS Subjects underwent functional magnetic resonance imaging blood oxygenation level-dependent acquisition during a fast event-related card-guessing, monetary reward task. Time series data from an independent sample of 10 healthy mothers were used to establish the ventral striatal region of interest (ROI). Repeated-measures analysis of variance of time series data in the established ROI was then conducted for a discrete group of healthy (n = 12) and depressed, unmedicated mothers (n = 12). RESULTS Data from the independent sample of 10 healthy mothers established an ROI in the left ventral striatum (-13, 12, -4, 477 mm(3)), with cluster significance p < .01, corrected. There was a significant quadratic interaction of time × group [F(1,22) = 5.22, p = .032] in this ROI in the healthy (n = 12) and depressed mothers (n = 12). This effect represents a nonlinear attenuation of ventral striatal response with time that was greater in depressed than healthy mothers. CONCLUSIONS Rapid attenuation of ventral striatal response to reward receipt in postpartum depression might represent an important neural mechanism of postpartum depression. Additional study with infant stimuli and in relationship to mother-infant behavior is needed.
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Sumner JA, Griffith JW, Mineka S. Overgeneral autobiographical memory as a predictor of the course of depression: a meta-analysis. Behav Res Ther 2010; 48:614-25. [PMID: 20399418 DOI: 10.1016/j.brat.2010.03.013] [Citation(s) in RCA: 231] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2009] [Revised: 03/09/2010] [Accepted: 03/15/2010] [Indexed: 10/19/2022]
Abstract
Overgeneral autobiographical memory (OGM) is a robust phenomenon in depression, but the extent to which OGM predicts the course of depression is not well-established. This meta-analysis synthesized data from 15 studies to examine the degree to which OGM 1) correlates with depressive symptoms at follow-up, and 2) predicts depressive symptoms at follow-up over and above initial depressive symptoms. Although the effects are small, specific and categoric/overgeneral memories generated during the Autobiographical Memory Test significantly predicted the course of depression. Fewer specific memories and more categoric/overgeneral memories were associated with higher follow-up depressive symptoms, and predicted higher follow-up symptoms over and above initial symptoms. Potential moderators were also examined. The age and clinical depression status of participants, as well as the length of follow-up between the two depressive symptom assessments, significantly moderated the predictive relationship between OGM and the course of depression. The predictive relationship between specific memories and follow-up depressive symptoms became greater with increasing age and a shorter length of follow-up, and the predictive relationship was stronger for participants with clinical depression diagnoses than for nonclinical participants. These findings highlight OGM as a predictor of the course of depression, and future studies should investigate the mechanisms underlying this relationship.
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Affiliation(s)
- Jennifer A Sumner
- Northwestern University, Department of Psychology, 2029 Sheridan Road, Suite 102, Evanston, IL 60208, USA.
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Overgeneral autobiographical memory predicts diagnostic status in depression. Behav Res Ther 2008; 46:668-77. [DOI: 10.1016/j.brat.2008.01.018] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2007] [Revised: 01/21/2008] [Accepted: 01/29/2008] [Indexed: 11/22/2022]
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Raes F, Hermans D, Williams JMG, Eelen P. A sentence completion procedure as an alternative to the Autobiographical Memory Test for assessing overgeneral memory in non-clinical populations. Memory 2008; 15:495-507. [PMID: 17613793 PMCID: PMC2796567 DOI: 10.1080/09658210701390982] [Citation(s) in RCA: 109] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Overgeneral memory (OGM) has been proposed as a vulnerability factor for depression (Williams et al., 2007) or depressive reactivity to stressful life-events (e.g., Gibbs & Rude, 2004). Traditionally, a cue word procedure known as the Autobiographical Memory Test (AMT; Williams & Broadbent, 1986) is used to assess OGM. Although frequently and validly used in clinical populations, there is evidence suggesting that the AMT is insufficiently sensitive to measure OGM in non-clinical groups. Study 1 evaluated the usefulness of a sentence completion method to assess OGM in non-clinical groups, as an alternative to the AMT. Participants were 197 students who completed the AMT, the Sentence Completion for Events from the Past Test (SCEPT), a depression measure, and visual analogue scales assessing ruminative thinking. Results showed that the mean proportion of overgeneral responses was markedly higher for the SCEPT than for the standard AMT. Also, overgeneral responding on the SCEPT was positively associated to depression scores and depressive rumination scores, whereas overgeneral responding on the AMT was not. Results suggest that the SCEPT, relative to the AMT, is a more sensitive instrument to measure OGM, at least in non-clinical populations. Study 2 further showed that this enhanced sensitivity is most likely due to the omission of the instruction to be specific rather than to the SCEPT's sentence completion format (as opposed to free recall to cue words).
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Affiliation(s)
- Filip Raes
- Department of Psychology, University of Leuven, Leuven, Belgium.
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