Skip to main content
Top
Published in: Archives of Women's Mental Health 3/2012

01-06-2012 | Original Article

A longitudinal study of postpartum depressive symptoms: multilevel growth curve analyses of emotion regulation strategies, breastfeeding self-efficacy, and social support

Authors: Silje M. Haga, Pål Ulleberg, Kari Slinning, Pål Kraft, Thorbjørn B. Steen, Annetine Staff

Published in: Archives of Women's Mental Health | Issue 3/2012

Login to get access

Abstract

Postpartum depression is a serious health issue affecting as many as 10–15 % of postpartum women. This longitudinal study aimed to explore how psychological variables such as cognitive emotion regulation strategies, breastfeeding self-efficacy (BSE), and dimensions of social support predicted postpartum depressive symptoms (Edinburgh Postnatal Depression Scale). The data were collected with web-based survey questionnaires between May 2008 and December 2009, in a sample of 737 new mothers. The same questionnaire was surveyed at three points in time: 6 weeks, 3 months, and 6 months postpartum. Data were analyzed using multilevel modeling (level 1, time points; level 2, person). Results showed that BSE, certain cognitive emotion regulation strategies, perceived available support, and need for support predicted the rate of postpartum depressive symptoms. Only breastfeeding self-efficacy predicted change in postpartum depressive symptoms. This study illustrates the importance of psychological variables with regard to postpartum depressive symptoms. Implications for preventative efforts are discussed.
Literature
go back to reference Aldao A, Nolen-Hoeksema S (2010) Specificity of cognitive emotion regulation strategies: a transdiagnostic examination. Behav Res Ther 48:974–983PubMedCrossRef Aldao A, Nolen-Hoeksema S (2010) Specificity of cognitive emotion regulation strategies: a transdiagnostic examination. Behav Res Ther 48:974–983PubMedCrossRef
go back to reference Bandura A (1977) Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev 84(2):191–215PubMedCrossRef Bandura A (1977) Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev 84(2):191–215PubMedCrossRef
go back to reference Bandura A (1994) Self-efficacy. In: Ramachaudran VS (ed) Encyclopedia of human behavior, vol 4. Academic Press, New York, pp 71–81, Reprinted in H. Friedman (ed). Encyclopedia of mental health. Academic Press, San Diego, 1998 Bandura A (1994) Self-efficacy. In: Ramachaudran VS (ed) Encyclopedia of human behavior, vol 4. Academic Press, New York, pp 71–81, Reprinted in H. Friedman (ed). Encyclopedia of mental health. Academic Press, San Diego, 1998
go back to reference Berle JØ, Aarre TF, Mykletun A, Dahl AA, Holsten F (2003) Screening for postnatal depression: validation of the Norwegian version of the Edinburgh postnatal depression scale, and assessment of risk factors for postnatal depression. J Affect Disord 76:151–156PubMedCrossRef Berle JØ, Aarre TF, Mykletun A, Dahl AA, Holsten F (2003) Screening for postnatal depression: validation of the Norwegian version of the Edinburgh postnatal depression scale, and assessment of risk factors for postnatal depression. J Affect Disord 76:151–156PubMedCrossRef
go back to reference Bloch M, Rotenberg N, Koren D, Klein E (2005) Risk factors associated with the development of postpartum mood disorders. J Affect Disord 88(1):9–18PubMedCrossRef Bloch M, Rotenberg N, Koren D, Klein E (2005) Risk factors associated with the development of postpartum mood disorders. J Affect Disord 88(1):9–18PubMedCrossRef
go back to reference Blyth R, Creedy DK, Dennis C-L, Moyle W, Pratt J, Vries SMD (2002) Effects of maternal confidence on breastfeeding duration: an application of breastfeeding self-efficacy theory. Birth 29(4):278–284PubMedCrossRef Blyth R, Creedy DK, Dennis C-L, Moyle W, Pratt J, Vries SMD (2002) Effects of maternal confidence on breastfeeding duration: an application of breastfeeding self-efficacy theory. Birth 29(4):278–284PubMedCrossRef
go back to reference Bonari L, Bennett H, Einarson A, Koren G (2004) Risks of untreated depression during pregnancy. Can Fam Physician 50:37–39PubMed Bonari L, Bennett H, Einarson A, Koren G (2004) Risks of untreated depression during pregnancy. Can Fam Physician 50:37–39PubMed
go back to reference Boyd RC, Le HN, Somberg R (2005) Review of screening instruments for postpartum depression. Arch Wom Ment Health 8:141–153CrossRef Boyd RC, Le HN, Somberg R (2005) Review of screening instruments for postpartum depression. Arch Wom Ment Health 8:141–153CrossRef
go back to reference Callen J, Pinelli J (2004) Incidence and duration of breastfeeding for term infants in Canada, United States, Europe and Australia. Birth 31(4):285–292PubMedCrossRef Callen J, Pinelli J (2004) Incidence and duration of breastfeeding for term infants in Canada, United States, Europe and Australia. Birth 31(4):285–292PubMedCrossRef
go back to reference Campbell-Sills L, Barlow DH (2007) Incorporating emotion regulation into conceptualizations and treatments of anxiety and mood disorders. In: Gross J (ed) Handbook of emotion regulation. The Guilford Press, New York Campbell-Sills L, Barlow DH (2007) Incorporating emotion regulation into conceptualizations and treatments of anxiety and mood disorders. In: Gross J (ed) Handbook of emotion regulation. The Guilford Press, New York
go back to reference Coleman PK, Karraker KH (1997) Self-efficacy and parenting quality: findings and future applications. Dev Rev 18:47–85CrossRef Coleman PK, Karraker KH (1997) Self-efficacy and parenting quality: findings and future applications. Dev Rev 18:47–85CrossRef
go back to reference Collins NL, Dunkel-Schetter C, Lobel M, Scrimshaw SCM (1993) Social support in pregnancy: psychological correlates of birth outcomes and postpartum depression. J Pers Soc Psychol 65(6):1243–1258PubMedCrossRef Collins NL, Dunkel-Schetter C, Lobel M, Scrimshaw SCM (1993) Social support in pregnancy: psychological correlates of birth outcomes and postpartum depression. J Pers Soc Psychol 65(6):1243–1258PubMedCrossRef
go back to reference Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatr 150:782–786CrossRef Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatr 150:782–786CrossRef
go back to reference Cutrona CE, Troutman BR (1986) Social support, infant temperament and parenting self-efficacy: a mediational model of postpartum depression. Child Dev 57:1507–1518PubMedCrossRef Cutrona CE, Troutman BR (1986) Social support, infant temperament and parenting self-efficacy: a mediational model of postpartum depression. Child Dev 57:1507–1518PubMedCrossRef
go back to reference Dai X, Dennis CL (2003) Translation and validation of the Breastfeeding Self-Efficacy Scale into Chinese. J Midwifery Wom Health 48(5):350–356CrossRef Dai X, Dennis CL (2003) Translation and validation of the Breastfeeding Self-Efficacy Scale into Chinese. J Midwifery Wom Health 48(5):350–356CrossRef
go back to reference Dennis C-L (2002) Breastfeeding initiation and duration: a 1990–2000 literature review. JOGN Nursing 31(1):12–32 Dennis C-L (2002) Breastfeeding initiation and duration: a 1990–2000 literature review. JOGN Nursing 31(1):12–32
go back to reference Dennis C-L (2003) The breastfeeding self-efficacy scale: psychometric assessment of the short form. JOGN Nursing 32(6):734–744 Dennis C-L (2003) The breastfeeding self-efficacy scale: psychometric assessment of the short form. JOGN Nursing 32(6):734–744
go back to reference Dennis C-L, Faux S (1999) Development and psychometric testing of the breastfeeding self-efficacy scale. Res Nurs Health 22:399–409PubMedCrossRef Dennis C-L, Faux S (1999) Development and psychometric testing of the breastfeeding self-efficacy scale. Res Nurs Health 22:399–409PubMedCrossRef
go back to reference Dunkel-Schetter C, Bennett TL (1990) Differentiating the cognitive and behavioral aspects of social support. In: Sarason BR, Sarason IG, Pierce GR (eds) Social support: an interational view. Wiley, New York Dunkel-Schetter C, Bennett TL (1990) Differentiating the cognitive and behavioral aspects of social support. In: Sarason BR, Sarason IG, Pierce GR (eds) Social support: an interational view. Wiley, New York
go back to reference Eberhard-Gran M, Eskild A, Tambs K, Schei B, Opjordsmoen S (2001) The Edinburgh Postnatal Depression Scale: validation in a Norwegian community sample. Nord J Psychiatr 55:113–117CrossRef Eberhard-Gran M, Eskild A, Tambs K, Schei B, Opjordsmoen S (2001) The Edinburgh Postnatal Depression Scale: validation in a Norwegian community sample. Nord J Psychiatr 55:113–117CrossRef
go back to reference Eberhard-Gran M, Slinning K (2007) Nedstemthet og depresjon i forbindelse med fødsel. Folkehelseinstituttet Eberhard-Gran M, Slinning K (2007) Nedstemthet og depresjon i forbindelse med fødsel. Folkehelseinstituttet
go back to reference Eberhard-Gran M, Garthus-Niegel S, Garthus-Niegel K, Eskild A (2010) Postnatal care: a cross-cultural and historical perspective. Arch Womens Ment Health 13(6):459–466PubMedCrossRef Eberhard-Gran M, Garthus-Niegel S, Garthus-Niegel K, Eskild A (2010) Postnatal care: a cross-cultural and historical perspective. Arch Womens Ment Health 13(6):459–466PubMedCrossRef
go back to reference Garnefski N, Kraaij V (2006) Cognitive emotion regulation questionnaire: development of a short 18-item version (CERQ-short). Pers Indiv Differ 41:1045–1053CrossRef Garnefski N, Kraaij V (2006) Cognitive emotion regulation questionnaire: development of a short 18-item version (CERQ-short). Pers Indiv Differ 41:1045–1053CrossRef
go back to reference Garnefski N, Kraaij V, Spinhoven PH (2001) Negative life events, cognitive emotion regulation and depression. Pers Indiv Differ 30:1311–1327CrossRef Garnefski N, Kraaij V, Spinhoven PH (2001) Negative life events, cognitive emotion regulation and depression. Pers Indiv Differ 30:1311–1327CrossRef
go back to reference Goodman SH, Brogan D, Lynch ME, Shielding B (1993) Social and emotional competence in children of depressed mothers. Child Dev 64:516–531PubMedCrossRef Goodman SH, Brogan D, Lynch ME, Shielding B (1993) Social and emotional competence in children of depressed mothers. Child Dev 64:516–531PubMedCrossRef
go back to reference Gross JJ, Richards JM, John OP (2006) Emotion regulation in everyday life. In: Snyder DK, Simpson J, Hughes JN (eds) Emotion regulation in couples and families: pathways to dysfunction and health. American Psychological Association, Washington, DC, pp 13–35CrossRef Gross JJ, Richards JM, John OP (2006) Emotion regulation in everyday life. In: Snyder DK, Simpson J, Hughes JN (eds) Emotion regulation in couples and families: pathways to dysfunction and health. American Psychological Association, Washington, DC, pp 13–35CrossRef
go back to reference Haggkvist AP, Brantsaeter AL, Grjibovski AM, Helsing E, Meltzer HM, Haugen M (2010) Prevalence of breast-feeding in the Norwegian Mother and Child Cohort Study and health service-related correlates of cessation of full breast-feeding. Public Health Nutr. doi:10.1017/S1368980010001771 Haggkvist AP, Brantsaeter AL, Grjibovski AM, Helsing E, Meltzer HM, Haugen M (2010) Prevalence of breast-feeding in the Norwegian Mother and Child Cohort Study and health service-related correlates of cessation of full breast-feeding. Public Health Nutr. doi:10.​1017/​S136898001000177​1
go back to reference Harris B, Huckle P, Thomas R, Johns S, Fung H (1989) The use of rating scales to identify post-natal depression. Br J Psychiatr 154:813–817CrossRef Harris B, Huckle P, Thomas R, Johns S, Fung H (1989) The use of rating scales to identify post-natal depression. Br J Psychiatr 154:813–817CrossRef
go back to reference Haslam DM, Pakenham KI, Smith A (2006) Social support and postpartum depressive symptomatology: the mediating role of maternal self-efficacy. Infant Mental Health J 27(3):276–291CrossRef Haslam DM, Pakenham KI, Smith A (2006) Social support and postpartum depressive symptomatology: the mediating role of maternal self-efficacy. Infant Mental Health J 27(3):276–291CrossRef
go back to reference Horowitz JA, Goodman JH (2005) Identifying and treating postpartum depression. JOGNN Clin Issues 34:264–273 Horowitz JA, Goodman JH (2005) Identifying and treating postpartum depression. JOGNN Clin Issues 34:264–273
go back to reference Howell EA, Mora P, DiBonaventura MD, Leventhal H (2009) Modifiable factors associated with changes in postpartum depressive symptoms. Arch Wom Ment Health 12:113–120CrossRef Howell EA, Mora P, DiBonaventura MD, Leventhal H (2009) Modifiable factors associated with changes in postpartum depressive symptoms. Arch Wom Ment Health 12:113–120CrossRef
go back to reference Howell EA, Mora P, Leventhal H (2006) Correlates of early postpartum depressive symptoms. Matern Child Health J 10(2):149–157PubMedCrossRef Howell EA, Mora P, Leventhal H (2006) Correlates of early postpartum depressive symptoms. Matern Child Health J 10(2):149–157PubMedCrossRef
go back to reference Hox JJ (2010) Multilevel analysis: techniques and applications, 2nd edn. Routledge, New York Hox JJ (2010) Multilevel analysis: techniques and applications, 2nd edn. Routledge, New York
go back to reference Lakey B, Drew JB (1997) A social–cognitive perspective on social support. In: Pierce GR, Lakey B, Sarason IG, Sarason BR (eds) Sourcebook of social support and personality. Plenum Press, New York Lakey B, Drew JB (1997) A social–cognitive perspective on social support. In: Pierce GR, Lakey B, Sarason IG, Sarason BR (eds) Sourcebook of social support and personality. Plenum Press, New York
go back to reference Larsen RJ, Prizmic Z (2004) Affect regulation. In: Baumeister RF, Vohs KD (eds) Handbook of self-regulation. Research, theory, and application. Guilford Press, New York Larsen RJ, Prizmic Z (2004) Affect regulation. In: Baumeister RF, Vohs KD (eds) Handbook of self-regulation. Research, theory, and application. Guilford Press, New York
go back to reference Lovestone S, Kumar R (1993) Postnatal psychiatric illness: the impact on partners. Br J Psychiatr 163:210–216CrossRef Lovestone S, Kumar R (1993) Postnatal psychiatric illness: the impact on partners. Br J Psychiatr 163:210–216CrossRef
go back to reference Mennin DS, Holoway RM, Fresco DM, Moore MT, Heimberg RG (2007) Delineating components of emotion and its dysregulation in anxiety and mood psychopathology. Behav Ther 38:284–302PubMedCrossRef Mennin DS, Holoway RM, Fresco DM, Moore MT, Heimberg RG (2007) Delineating components of emotion and its dysregulation in anxiety and mood psychopathology. Behav Ther 38:284–302PubMedCrossRef
go back to reference Misri S, Sinclair SA, Kuan AJ (1997) Breast-feeding and postpartum depression: is there a relationship? Can J Psychiatr 42:1061–1065 Misri S, Sinclair SA, Kuan AJ (1997) Breast-feeding and postpartum depression: is there a relationship? Can J Psychiatr 42:1061–1065
go back to reference Munk-Olsen T, Munk Laursen T, Bøcker Pedersen C, Mors O, Bo Mortensen P (2006) New parents and mental disorders: a population-based register study. J Am Med Assoc 296(21):2582–2589CrossRef Munk-Olsen T, Munk Laursen T, Bøcker Pedersen C, Mors O, Bo Mortensen P (2006) New parents and mental disorders: a population-based register study. J Am Med Assoc 296(21):2582–2589CrossRef
go back to reference Nolen-Hoeksema S, Stice E, Wade E, Bohon C (2007) Reciprocal relations between rumination and bulimic, substance abuse, and depressive symptoms in female adolescents. J Abnorm Psych 116:198–207CrossRef Nolen-Hoeksema S, Stice E, Wade E, Bohon C (2007) Reciprocal relations between rumination and bulimic, substance abuse, and depressive symptoms in female adolescents. J Abnorm Psych 116:198–207CrossRef
go back to reference Nolen-Hoeksema S, Wisco BE, Lyubomirsky S (2008) Rethinking rumination. Perspect Psychol Sci 3:400–424CrossRef Nolen-Hoeksema S, Wisco BE, Lyubomirsky S (2008) Rethinking rumination. Perspect Psychol Sci 3:400–424CrossRef
go back to reference O’Hara MW, Swain AM (1996) Rates and risk of postpartum depression—a meta-analysis. Int Rev Psychiatr 8:37–54CrossRef O’Hara MW, Swain AM (1996) Rates and risk of postpartum depression—a meta-analysis. Int Rev Psychiatr 8:37–54CrossRef
go back to reference Pippins JR, Brawarsky P, Jackson RA, Fuentes-Afflick E, Haas JS (2006) Association of breastfeeding with maternal depressive symptoms. J Wom Health 15(6):754–762CrossRef Pippins JR, Brawarsky P, Jackson RA, Fuentes-Afflick E, Haas JS (2006) Association of breastfeeding with maternal depressive symptoms. J Wom Health 15(6):754–762CrossRef
go back to reference Ramchandani P, Stein A, Evans J, O’Connor TG (2005) Paternal depression in the postnatal period and child development: a prospective population study. Lancet 365(9478):2201–2205PubMedCrossRef Ramchandani P, Stein A, Evans J, O’Connor TG (2005) Paternal depression in the postnatal period and child development: a prospective population study. Lancet 365(9478):2201–2205PubMedCrossRef
go back to reference Robertson E, Grace S, Wallington T, Stewart DE (2004) Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatr 26:289–295CrossRef Robertson E, Grace S, Wallington T, Stewart DE (2004) Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatr 26:289–295CrossRef
go back to reference Schaefer C, Coyne JC, Lazarus RS (1981) The health-related functions of social support. J Behav Med 4:381–406PubMedCrossRef Schaefer C, Coyne JC, Lazarus RS (1981) The health-related functions of social support. J Behav Med 4:381–406PubMedCrossRef
go back to reference Schwarzer R, Knoll N (2007) Functional roles of social support within the stress and coping process, a theoretical and empirical overview. Int J Psych 42(4):243–252CrossRef Schwarzer R, Knoll N (2007) Functional roles of social support within the stress and coping process, a theoretical and empirical overview. Int J Psych 42(4):243–252CrossRef
go back to reference Schwarzer R, Leppin A (1991) Social support and health: a theoretical and empirical overview. J Soc Pers Relat 8:99–127CrossRef Schwarzer R, Leppin A (1991) Social support and health: a theoretical and empirical overview. J Soc Pers Relat 8:99–127CrossRef
go back to reference Singer J, Willett J (2003) Applied longitudinal data analysis: modelling change and event occurrence. Oxford University Press, New York Singer J, Willett J (2003) Applied longitudinal data analysis: modelling change and event occurrence. Oxford University Press, New York
go back to reference Stern DN (1998) The motherhood constellation: a unified view of parent–infant psychotherapy. Karnac Books, London Stern DN (1998) The motherhood constellation: a unified view of parent–infant psychotherapy. Karnac Books, London
go back to reference World Health Organization (2001) The optimal duration of exclusive breastfeeding. WHO, Geneva World Health Organization (2001) The optimal duration of exclusive breastfeeding. WHO, Geneva
go back to reference Ystrøm E, Niegel S, Klepp K-I, Vollrath ME (2008) The impact of maternal negative affectivity and general self-efficacy on breastfeeding: the Norwegian mother and child cohort study. J Pediatr 152:68–72PubMedCrossRef Ystrøm E, Niegel S, Klepp K-I, Vollrath ME (2008) The impact of maternal negative affectivity and general self-efficacy on breastfeeding: the Norwegian mother and child cohort study. J Pediatr 152:68–72PubMedCrossRef
Metadata
Title
A longitudinal study of postpartum depressive symptoms: multilevel growth curve analyses of emotion regulation strategies, breastfeeding self-efficacy, and social support
Authors
Silje M. Haga
Pål Ulleberg
Kari Slinning
Pål Kraft
Thorbjørn B. Steen
Annetine Staff
Publication date
01-06-2012
Publisher
Springer Vienna
Published in
Archives of Women's Mental Health / Issue 3/2012
Print ISSN: 1434-1816
Electronic ISSN: 1435-1102
DOI
https://doi.org/10.1007/s00737-012-0274-2

Other articles of this Issue 3/2012

Archives of Women's Mental Health 3/2012 Go to the issue