Franck Erik, Vanderhasselt Marie-Anne, Goubert Liesbet, Loeys Tom, Temmerman Marleen, De Raedt Rudi
University of Antwerp, Antwerp, Belgium; Karel de Grote University College, Antwerp, Belgium.
Ghent University, Ghent, Belgium.
J Behav Ther Exp Psychiatry. 2016 Mar;50:15-22. doi: 10.1016/j.jbtep.2015.04.010. Epub 2015 May 1.
Understanding vulnerability factors involved in the development of postnatal depression has important implications for theory and practice. In this prospective study, we investigated whether self-esteem instability during pregnancy would better predict postnatal depressive symptomatology than level of self-esteem. In addition, going beyond former studies, we tested the possible origin of this instability, examining whether day-to-day fluctuations in self-esteem could be explained by fluctuations in mood state, and whether this day-to-day self-esteem reactivity would predict postnatal depressive symptoms.
114 healthy never-depressed women were tested during the late second or third trimester of their gestation (Time 1) and at 12 weeks after delivery (Time 2). Day-to-day levels of self-esteem and depressed mood state were assessed at Time 1. At Time 2, postnatal depressive symptoms were assessed.
The results show that, after controlling for initial depressive symptomatology, age and socio-economic status, postnatal depressive symptomatology at 12 weeks after childbirth could be predicted by self-esteem instability and not level of self-esteem. In addition, multi-level analyses demonstrated that these changes in day-to-day levels of self-esteem are associated with changes in day-to-day levels of depressed mood state and that those subjects with greater prenatal self-esteem reactivity upon depressed mood report higher levels of depressive symptoms post-partum.
We used paper and pencil day-to-day measures of state self-esteem, which can be subject to bias.
These results provide evidence for a diathesis-stress account of postnatal depression, highlighting the importance of a multi-dimensional view of self-esteem and the predictive role of self-esteem instability.
了解产后抑郁症发展过程中的脆弱因素对理论和实践具有重要意义。在这项前瞻性研究中，我们调查了孕期自尊稳定性是否比自尊水平能更好地预测产后抑郁症状。此外，超越以往研究，我们测试了这种不稳定性的可能来源，研究自尊的日常波动是否可以用情绪状态的波动来解释，以及这种日常自尊反应性是否能预测产后抑郁症状。
114名从未患过抑郁症的健康女性在妊娠晚期第二或第三个月（时间1）和分娩后12周（时间2）接受测试。在时间1评估自尊和抑郁情绪状态的日常水平。在时间2评估产后抑郁症状。
结果表明，在控制了初始抑郁症状、年龄和社会经济地位后，产后12周的抑郁症状可以由自尊不稳定性而非自尊水平预测。此外，多层次分析表明，自尊日常水平的这些变化与抑郁情绪状态的日常水平变化相关，并且那些在情绪低落时产前自尊反应性较高的受试者产后抑郁症状水平较高。
我们使用纸笔形式的日常状态自尊测量方法，可能存在偏差。
这些结果为产后抑郁症的素质-应激模型提供了证据，强调了自尊多维视角的重要性以及自尊不稳定性的预测作用。
