Raes Filip, Smets Jorien, Wessel Ineke, Van Den Eede Filip, Nelis Sabine, Franck Erik, Jacquemyn Yves, Hanssens Myriam
Faculty of Psychology and Educational Sciences, University of Leuven, Belgium.
Faculty of Psychology and Educational Sciences, University of Leuven, Belgium; Department of Applied Psychology, Thomas More University College, Antwerp, Belgium.
J Psychosom Res. 2014 Jul;77(1):64-9. doi: 10.1016/j.jpsychores.2014.04.003. Epub 2014 Apr 24.
Maladaptive response styles to negative affect have been shown to be associated with prospective (postpartum) depression. Whether maladaptive styles to positive affect are also critically involved is understudied, even though anhedonia (a correlate of low positive affectivity) is a cardinal symptom of depression. The present study is the first to investigate the predictive value of cognitive response styles to both negative (depressive rumination) and positive affect (dampening) for postpartum depressive symptoms.
During the third trimester of pregnancy, 210 women completed self-report instruments assessing depression (symptom severity and current and/or past episodes) and scales gauging the presence of depressive rumination and dampening. Of these women, 187 were retained for postpartum follow-up, with depressive symptoms being reassessed at 12 (n=171) and 24 (n=176) weeks after delivery.
Regression analyses showed that higher levels of dampening of positive affect during pregnancy predicted higher levels of depressive symptoms at 12 and 24 weeks postpartum, irrespective of initial symptom severity, past history of depression and levels of rumination to negative affect. Prepartum trait levels of rumination, however, did not predict postpartum symptomatology when controlled for baseline symptoms and history of major depressive episode(s).
The results of this investigation suggest that the way women cognitively respond to positive affect contributes perhaps even more to the development of postpartum depression than maladaptive response styles to negative affect.
对消极情绪的适应不良反应方式已被证明与产后抑郁症相关。尽管快感缺失（低积极情感的一个相关因素）是抑郁症的主要症状，但对积极情绪的适应不良方式是否也起着关键作用却未得到充分研究。本研究首次调查了对消极情绪（抑郁性沉思）和积极情绪（情绪低落）的认知反应方式对产后抑郁症状的预测价值。
在妊娠晚期，210名女性完成了自我报告工具，评估抑郁症（症状严重程度以及当前和/或过去的发作情况）以及测量抑郁性沉思和情绪低落存在情况的量表。在这些女性中，187名被保留进行产后随访，在分娩后12周（n = 171）和24周（n = 176）重新评估抑郁症状。
回归分析表明，孕期积极情绪低落程度较高预示着产后12周和24周时抑郁症状水平较高，无论初始症状严重程度、既往抑郁病史以及对消极情绪的沉思程度如何。然而，在控制基线症状和重度抑郁发作史后，产前沉思特质水平并不能预测产后症状。
本调查结果表明，女性对积极情绪的认知反应方式对产后抑郁症发展的影响可能甚至比消极情绪的适应不良反应方式更大。
