Fonseca Ana, Monteiro Fabiana, Alves Stephanie, Gorayeb Ricardo, Canavarro Maria Cristina
Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, University of Coimbra, Coimbra, Portugal.
Faculdade de Medicina de Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
Front Psychol. 2019 Feb 18;10:265. doi: 10.3389/fpsyg.2019.00265. eCollection 2019.
Be a Mom is a self-guided, web-based intervention to prevent persistent postpartum depression symptoms [PPD], targeting both at-risk postpartum women and/or women presenting early-onset postpartum depressive symptoms (selective/indicated preventive intervention). Be a Mom is grounded on the principles of Cognitive-Behavior Therapy and incorporates the recent contributions of acceptance and compassion-based approaches (third-wave approaches) applied to the perinatal context. This study aimed to explore the processes underlying therapeutic change in the Be a Mom intervention, by: (1) exploring whether participation in the Be a Mom promotes the enhancement of self-regulatory skills (emotion regulation abilities, psychological flexibility and self-compassion) in comparison with women who did not participate in the program; and (2) exploring whether changes in self-regulatory skills are associated with changes in depressive symptoms, among women who participated in the Be a Mom program. A pilot randomized, two-arm controlled trial was conducted. Eligible women (presenting PPD risk-factors and/or early-onset PPD symptoms) were enrolled in the study and were randomly assigned to the intervention group (Be a Mom, = 98) or to the waiting-list control group ( = 96). Participants in both groups completed baseline (T1) and post-intervention assessments (T2), including measures of depressive symptoms, emotion regulation abilities, psychological flexibility and self-compassion. From baseline to post-intervention assessment, women in the intervention group showed a significantly greater decrease in the levels of emotion regulation difficulties ( < 0.001) and a significant greater increase in the levels of self-compassion ( < 0.001) compared to the control group. No significant differences were found concerning psychological flexibility. Moreover, a greater decrease in difficulties in emotion regulation and greater increase in self-compassion levels were significantly associated with a greater decrease in depressive symptoms, among women in the intervention group. Be a Mom promotes the enhancement of women's emotion regulation abilities and self-compassion, and this seems to exert a protective effect in the presence of PPD risk factors (or early-onset symptoms) because it led to a reduction of depressive symptoms. By providing some insights into the processes that underlie treatment response to Be a Mom, this study highlights the important role of the targeted third-wave processes applied to the perinatal context.
“成为妈妈”是一项基于网络的自我引导式干预措施，旨在预防持续性产后抑郁症状（PPD），目标人群为有产后抑郁风险的女性和/或出现早发型产后抑郁症状的女性（选择性/针对性预防干预）。“成为妈妈”以认知行为疗法的原则为基础，并融入了近期应用于围产期的基于接纳和同情的方法（第三波方法）的成果。本研究旨在通过以下方式探索“成为妈妈”干预中治疗性改变的潜在过程：（1）与未参与该项目的女性相比，探讨参与“成为妈妈”项目是否能促进自我调节技能（情绪调节能力、心理灵活性和自我同情）的提升；（2）在参与“成为妈妈”项目的女性中，探讨自我调节技能的变化是否与抑郁症状的变化相关。开展了一项先导性随机双臂对照试验。符合条件的女性（存在产后抑郁风险因素和/或早发型产后抑郁症状）被纳入研究，并被随机分配到干预组（“成为妈妈”组，n = 98）或等待名单对照组（n = 96）。两组参与者均完成了基线（T1）和干预后评估（T2），包括抑郁症状、情绪调节能力、心理灵活性和自我同情的测量。从基线到干预后评估，与对照组相比，干预组女性的情绪调节困难水平显著降低（p < 0.001），自我同情水平显著提高（p < 0.001）。在心理灵活性方面未发现显著差异。此外，在干预组女性中，情绪调节困难的更大程度降低和自我同情水平的更大程度提高与抑郁症状的更大程度降低显著相关。“成为妈妈”促进了女性情绪调节能力和自我同情的提升，在存在产后抑郁风险因素（或早发型症状）的情况下，这似乎发挥了保护作用，因为它导致了抑郁症状的减轻。通过对“成为妈妈”治疗反应的潜在过程提供一些见解，本研究突出了应用于围产期的针对性第三波过程的重要作用。
