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功能失调性完美主义和回避型人格风格对产后精神障碍的纵向影响:通过产前抑郁和焦虑的途径。

Longitudinal effects of dysfunctional perfectionism and avoidant personality style on postpartum mental disorders: Pathways through antepartum depression and anxiety.

作者信息

Oddo-Sommerfeld Silvia, Hain Sarah, Louwen Frank, Schermelleh-Engel Karin

机构信息

University Hospital of Frankfurt Division of Obstetrics and Fetomaternal Medicine Theodor-Stern-Kai, 7, 60590 Frankfurt, Germany.

University Hospital of Frankfurt Division of Obstetrics and Fetomaternal Medicine Theodor-Stern-Kai, 7, 60590 Frankfurt, Germany; University of Frankfurt Institute of Psychology PEG, Theodor-W.-Adorno-Platz, 6, 60629 Frankfurt am Main, Germany.

出版信息

J Affect Disord. 2016 Feb;191:280-8. doi: 10.1016/j.jad.2015.11.040. Epub 2015 Nov 28.

Abstract

BACKGROUND

There is first evidence that some personality characteristics raise the risk of postpartum depression (PPD). The present longitudinal study investigates whether dysfunctional perfectionism and avoidant personality style predict PPD, postpartum anxiety (PPA) and bonding impairment (BI) directly or indirectly through antepartum anxiety (APA) and antepartum depression (APD).

METHODS

Pregnant women were recruited in two obstetric departments in Germany. The assessment occurred at two measurement time points: In the third trimester of pregnancy (N=297) and twelve weeks postpartum (N=266). Six questionnaires were administered during pregnancy: perfectionism, personality styles, anxiety, and depression. Postpartum, data on PPA, PPD and BI were collected. We conducted two path analyses in order to examine direct and indirect effects of the two personality characteristics on postpartum disorders.

RESULTS

Testing for direct effects of dysfunctional perfectionism and avoidant personality style on PPD, PPA, and BI did not yield significant results. Instead, significant indirect effects were found: PPD, PPA, and BI were influenced indirectly by dysfunctional perfectionism and avoidant personality style via APD and APA. This model explained high portions of the variance of PPD, PPA, and impaired bonding. Each of the two personality characteristics explained a unique part of the outcome measures. The influence on BI was mediated by PPD. APD affected PPD and PPA more strongly than APA.

LIMITATION

Path models with manifest (observed) variables may lead to measurement errors. Self-rating questionnaires may raise the problem of social desirability.

CONCLUSION

Dysfunctional perfectionism and avoidant personality style are significant risk factors for PPD, PPA, and BI. Screenings of both variables, as well as of APA and APD, which mediated the effect of personality traits on postpartum syndromes, are necessary.

摘要

背景

有初步证据表明某些人格特征会增加产后抑郁症(PPD)的风险。本纵向研究调查功能失调性完美主义和回避型人格风格是否直接或通过产前焦虑(APA)和产前抑郁(APD)间接预测产后抑郁症、产后焦虑(PPA)和母婴联结障碍(BI)。

方法

在德国的两个产科部门招募孕妇。评估在两个测量时间点进行:妊娠晚期(N = 297)和产后12周(N = 266)。在孕期发放了六份问卷:完美主义、人格风格、焦虑和抑郁问卷。产后收集有关产后焦虑、产后抑郁症和母婴联结障碍的数据。我们进行了两项路径分析,以检验这两种人格特征对产后疾病的直接和间接影响。

结果

功能失调性完美主义和回避型人格风格对产后抑郁症、产后焦虑和母婴联结障碍的直接影响检验未得出显著结果。相反,发现了显著的间接影响:功能失调性完美主义和回避型人格风格通过产前抑郁和产前焦虑对产后抑郁症、产后焦虑和母婴联结障碍产生间接影响。该模型解释了产后抑郁症、产后焦虑和母婴联结受损变异的很大一部分。这两种人格特征各自解释了结果测量的一个独特部分。对母婴联结障碍的影响由产后抑郁症介导。产前抑郁对产后抑郁症和产后焦虑的影响比产前焦虑更强。

局限性

具有显性(观察到的)变量的路径模型可能会导致测量误差。自评问卷可能会引发社会期望问题。

结论

功能失调性完美主义和回避型人格风格是产后抑郁症、产后焦虑和母婴联结障碍的重要风险因素。对这两个变量以及介导人格特质对产后综合征影响的产前焦虑和产前抑郁进行筛查是必要的。

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