Posttraumatic stress, anxiety, and depression in mothers after preterm delivery and the associated psychological processes

Abstract

BACKGROUND: Mothers of preterm infants report traumatic, anxious and depressive symptoms in the postpartum period. Many studies have focused on biological, social, and life circumstance factors to explain the emergence of these symptoms. The process model proposes to focus on psychological processes, which are mechanisms underlying mental disorders. However, the psychological processes underlying the onset of traumatic, anxious, and depressive symptoms in postpartum mothers of preterm infants had not yet been investigated. The aim of this study was to identify the most common symptoms experienced in the first few days after delivery and determine whether processes of anhedonia, brooding rumination, and worry are related to posttraumatic stress (PTS), anxiety, and depression symptoms. METHODS: A sample of 106 mothers was screened for PTS, anxiety, and depression symptoms within the first 10 days after their preterm delivery. Anhedonia, brooding rumination, and worry were also assessed as psychological processes. Student's t-tests were performed to identify the most severe manifestation reported. To explore the relationship between psychological processes and symptoms, multiple linear regressions were performed on each symptom. RESULTS: Descriptive analysis shows that 75.5% of mothers reported a pathological symptom level for at least one of PTS, anxiety, or depression. Being alert and worrying are the predominant manifestations experienced in the first few days after preterm birth. Multiple linear regression showed that PTS symptoms were associated with worry and brooding rumination; anxiety symptoms were associated with worry, reminiscence pleasure and a deficit in consummatory pleasure; and depressive symptoms were associated with worry and a deficit in consummatory pleasure. CONCLUSIONS: Our findings support the transdiagnostic nature of psychological processes and suggest that anhedonia, brooding rumination, and worry may be relevant targets for psychological interventions to concurrently treat PTS, anxiety, and depression symptoms. Behavioral activation could be an effective intervention to target these dysfunctional processes and thus improve maternal symptoms.