Application of a stress and coping model to antenatal depressive symptomatology.
ABSTRACT This study examined the utility of a stress/coping model of antenatal depressive symptomatology. The direct and moderating effects of appraisal, coping resources and coping strategies on depression were explored. A total of 242 primiparous women completed questionnaires during the third trimester of pregnancy. Predictors included life events, coping resources (social support, quality of women's earlier relationships with parents), appraisal (threat, self-efficacy) and coping strategies (wishful thinking, positive reappraisal, problem solving, emotional approach). Results of regression analyses indicated that higher depression was related to higher stressful life events, threat appraisal and wishful thinking coping, and lower positive reappraisal coping. The expected stress exacerbation effects of wishful thinking on depression were supported. There was no support for the expected stress buffering effects of coping resources and coping strategies on depression. Findings provide preliminary support for the use of a stress/coping model to guide future research into psychosocial predictors of antenatal depression.
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ABSTRACT: Extensive evidence documents that prenatal maternal stress predicts a variety of adverse physical and psychological health outcomes for the mother and baby. However, the importance of the ways that women cope with stress during pregnancy is less clear. We conducted a systematic review of the English-language literature on coping behaviors and coping styles in pregnancy using PsycInfo and PubMed to identify 45 cross-sectional and longitudinal studies involving 16,060 participants published between January 1990 and June 2012. Although results were often inconsistent across studies, the literature provides some evidence that avoidant coping behaviors or styles and poor coping skills in general are associated with postpartum depression, preterm birth, and infant development. Variability in study methods including differences in sample characteristics, timing of assessments, outcome variables, and measures of coping styles or behaviors may explain the lack of consistent associations. In order to advance the scientific study of coping in pregnancy, we call attention to the need for a priori hypotheses and greater use of pregnancy-specific, daily process, and skills-based approaches. There is promise in continuing this area of research, particularly in the possible translation of consistent findings to effective interventions, but only if the conceptual basis and methodological quality of research improve.Health Psychology Review 01/2014; 8(1):70-94. DOI:10.1080/17437199.2012.752659 · 6.75 Impact Factor
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ABSTRACT: A range of psychosocial, medical, and demographic variables may influence pregnant women's psychological status. However the association between coping strategies, anxiety, worries, and depression during pregnancy is a relatively neglected area of research. Therefore, the aim of this study was to examine the relationship between coping strategies, antenatal anxiety, pregnancy worries, and depressive symptomatology after controlling for the effects of background variables. The study sample consisted of 163 pregnant women, with gestational age ranging from 11 to 26 weeks, attending antenatal screening at a Greek public hospital. Coping strategies were measured with Brief COPE, pregnancy worries were measured with Cambridge Worry Scale (CWS), anxiety was assessed using State-Trait Anxiety Inventory (STAI-X version), and depression was measured with Center for Epidemiologic Studies-Depression scale (CES-D). Pearson's correlation coefficients were calculated among all study variables, followed by hierarchical multiple linear regression. In the univariate analysis, low annual income, unemployment, conception after an IVF treatment, and a previous history of miscarriage were associated with anxiety, depression, and worries. Additionally, almost all coping strategies (denial, behavioral disengagement, self-blame, self-distraction, substance use, acceptance, positive reframing, active coping, and seeking emotional support) were significantly associated with antenatal anxiety, worries, and depression. Linear regression analysis showed that only previous history of miscarriage, conception after IVF, as well as denial, behavioral disengagement and acceptance coping strategies were significantly related to anxiety, worries and depressive symptomatology. The risk factors found in this study could help clinicians target anxiety and depression screening to high-risk populations of pregnant women. Provision of adequate training for obstetricians and midwives in the detection and management of anxiety and depression among pregnant women should help to decrease the psychological burden during pregnancy.Archives of Women s Mental Health 04/2013; 16(5). DOI:10.1007/s00737-013-0338-y · 1.96 Impact Factor
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ABSTRACT: Self-efficacy can be conceptualised as a person's perception of their own ability to produce a desired outcome. Low self-efficacy has been reported to be a mediating variable in developing depression. The Self-Efficacy Questionnaire for Depressed Adolescents (SEQ-DA) is a 12-item inventory, designed to measure self-perceived ability of the young person to cope with depressive symptoms. This paper presents further information on the psychometric properties of the SEQ-DA in a clinical sample of depressed adolescents. The SEQ-DA was administered to a clinical sample of 130 adolescents with a depressive disorder at baseline, at the end of 3 months of therapy and 6 months following therapy. A diagnosis of depression was made using the Schedule for Affective Disorders and Schizophrenia for School Aged Children. The ability of the SEQ-DA to identify those adolescents who had a diagnosis of major depressive disorder at baseline, following treatment and at 6-month follow-up was evaluated. Receiver operating characteristic (ROC) analysis of the SEQ-DA in this clinical sample of depressed adolescents was undertaken to establish cut-off scores of the SEQ-DA. The SEQ-DA score at baseline of < 36 and following treatment of < 43 were predictive of a depressive disorder. The SEQ-DA is a very simple self-report measure that can be used to predict which adolescents treated for depression are likely to remain depressed, thus prompting more intensive treatment and follow-up.Australian and New Zealand Journal of Psychiatry 01/2012; 46(1):47-54. DOI:10.1177/0004867411428390 · 3.77 Impact Factor