Resilience resources, life stressors, and postpartum depressive symptoms in a community sample of low and middle-income Black, Latina, and White mothers.

Resilience resources refer to factors that protect against the physical and mental health effects of stress exposure. This study used a cross-sectional design to test whether three individual-level resilience resources-mastery, self-esteem, and perceived social support-moderated associations between prenatal major life stressors and postpartum depressive symptoms at approximately 8 weeks postpartum. Participants were 2510 low- and middle-income women enrolled after the birth of a baby in a multi-site study of five communities in the United States. At approximately 8 weeks postpartum, participants were interviewed in their homes to assess the three resilience resources, symptoms of depression, and major life stressors that had occurred during the pregnancy. The results of path analyses revealed that mastery and self-esteem moderated the positive association between prenatal life stressors and postpartum depressive symptoms adjusting for race/ethnicity, partner status, years of education, and household income. Perceived social support was associated with fewer postpartum depressive symptoms but did not moderate the association between life stressors and depressive symptoms. Higher levels of two personal resilience resources, mastery and self-esteem, attenuated the association between prenatal life stressors and early postpartum depressive symptoms in a large, predominantly low-income multi-site community sample. These findings highlight the protective nature of individual-level resilience resources in the early postpartum period when maternal adjustment shapes parent and child health outcomes.

Anxiety in pregnancy and length of gestation: Findings from the healthy babies before birth study.

OBJECTIVES: Anxiety is prevalent in pregnancy and predicts risk of adverse birth outcomes. Many instruments measure anxiety in pregnancy, some of which assess pregnancy anxiety defined as maternal concerns about a current pregnancy (e.g., baby, childbirth). The present study examined covariance among four anxiety or distress measures at two times in pregnancy and tested joint and individual effects on gestational length. We hypothesized that the common variance of the measures in each trimester would predict earlier delivery. METHOD: Research staff interviewed 196 women in first and third trimester utilizing a clinical screener of anxiety severity/impairment, two instruments measuring pregnancy anxiety, and one on prenatal distress. Birth outcomes and medical risk factors were obtained from medical records after birth. Structural equation modeling fit latent factors for each trimester from the four measures. Subsequent models tested whether the latent factors predicted gestational length, and unique effects of each measure. RESULTS: The third-trimester pregnancy anxiety latent factor predicted shorter gestational length adjusting for mother's age, education, parity, and obstetric risk. Scores on a four-item pregnancy-specific anxiety measure (PSAS) in third trimester added uniquely to prediction of gestational length. In first trimester, scores on the clinical screener (OASIS) uniquely predicted shorter gestational length whereas the latent factor did not. CONCLUSION: These results support existing evidence indicating that pregnancy anxiety is a reliable risk factor for earlier birth. Findings point to possible screening for clinically significant anxiety symptoms in the first trimester, and pregnancy-specific anxiety thereafter to advance efforts to prevent earlier delivery. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Resilience Resources Scale: A brief resilience measure validated with undergraduate students.

Objective: This paper presents a theory-based brief resilience scale, the Resilience Resources Scale (RRS), and evidence for its factor structure, reliability, and validity in two studies of undergraduate students. Participants: Study 1 sampled 295 students and Study 2 sampled 244 students. Methods: Study 1 participants completed the RRS and other measures online at one of two time points eight weeks apart (n = 193), or at both time points (n = 102). Study 2 participants completed the RRS and other measures online on a single occasion. Results: Factor analyses provided evidence for a one-factor model. Results indicated high internal consistency and strong test-retest reliability. Evidence of concurrent and predictive validity is presented. Conclusions: The RRS measures resilience resources known to be protective of physical and mental health. This brief scale has sound psychometric properties in these initial studies of undergraduate students. We offer possible directions for use of the RRS in this and other populations.

"The Mental Health Piece is Huge": perspectives on developing a prenatal maternal psychological intervention for congenital heart disease.

OBJECTIVES: Women carrying a fetus diagnosed with congenital heart disease often experience significant distress because of their medical diagnosis. Given the well-documented impact associated with elevated prenatal stress and critical importance of developing targeted interventions, this study aims to examine stressors, coping and resilience resources, and mental health treatment preferences in pregnant women receiving a congenital heart disease diagnosis to inform the development of a psychological intervention to reduce maternal distress prenatally. METHODS: Three groups of participants were included consisting of two pregnant women carrying a fetus with congenital heart disease, five women of children (4-16 months) with congenital heart disease, and five paediatric cardiology medical providers. Responses were gathered via semi-structured interviews and analysed using qualitative thematic analysis. RESULTS: Information regarding four broad areas were analysed of emotional distress during pregnancy; experience of initial diagnosis; coping and resilience; and perspectives on a mental health intervention in pregnancy. Anxiety regarding baby's future, guilt following diagnosis, and various coping strategies emerged as primary themes among the participant sample. Medical staff corroborated mothers' heightened anxiety and viewed a psychotherapeutic intervention during the prenatal period as essential and complimentary to standard of care. CONCLUSION: We identified salient themes and preferred components for a future psychological intervention delivered prenatally. PRACTICE IMPLICATIONS: Patients' and providers' perspectives regarding the nature of maternal distress, resilience and treatment preferences can inform the development of interventions to support the emotional well-being of pregnant women carrying a fetus with congenital heart disease to optimise care and potentially improve outcomes for fetal brain development.

The moderating role of resilience resources in the association between stressful life events and symptoms of postpartum depression.

BACKGROUND: One in seven women experience postpartum depression, posing a serious public health concern. One of the most robust predictors of elevated postpartum depressive symptoms is major stressful life events that occur during pregnancy. Having greater resilience resources that promote successful adaptation to stressful demands may be protective in the face of stress during pregnancy. The current study tested whether three resilience resources- mastery, dispositional optimism, and spirituality- each predicted early symptoms of postpartum depression and moderated the hypothesized association between experiencing stressful life events during pregnancy and symptoms of postpartum depression. METHODS: The sample included 233 women who participated in a prospective longitudinal study from pregnancy through postpartum. Depressive symptoms were assessed at approximately 4 to 8 weeks after birth, whereas resilience resources and stressful life events were measured in pregnancy. Multiple linear regressions were used to test hypotheses. RESULTS: Stressful life events predicted greater symptoms of depression postpartum. Mastery and optimism predicted fewer symptoms of depression postpartum. Mastery moderated the association between stressful life events and symptoms of depression when controlling for previous psychiatric history, t(231) = -1.97, p=.0497. LIMITATIONS: There was some attrition among study participants across timepoints, which was accounted for in analyses with multiple imputation. CONCLUSIONS: These findings point to the protective nature of a mother's sense of mastery in the face of major life stressors during pregnancy and suggest this is an important construct to target in interventions addressing postpartum depression.