Douglas Institute Research Centre, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada.
Douglas Institute Research Centre, 6875 Boulevard LaSalle, Verdun, QC H4H 1R3, Canada; Department of Psychiatry, McGill University, 1033 Avenue des Pins, Montreal, QC H3A 1A1, Canada.
J Affect Disord. 2022 Oct 1;314:68-77. doi: 10.1016/j.jad.2022.06.055. Epub 2022 Jun 24.
While there have been reports of increased perinatal anxiety during the COVID-19 pandemic (Stepowicz et al., 2020), there has been a lack of research on the relative importance of objective hardship and subjective distress. In this study, we explored the extent to which resilience, tolerance of uncertainty, and cognitive appraisal of the pandemic's consequences moderate the effect of prenatal objective hardship and subjective distress due to the pandemic on 2-month postpartum anxiety.
Data were collected as part of the Birth in the Time of COVID (BITTOC) study. We measured objective hardship and subjective distress, mental health, and potential psychological moderators in 419 pregnant women residing in Australia, and at two months postpartum. Hierarchical multiple regressions were used.
Objective hardship and subjective distress independently predicted postpartum anxiety. All three psychological factors moderated the effect of objective hardship on anxiety. For women with low/neutral resilience, or low/moderate tolerance of uncertainty, or a negative cognitive appraisal, greater objective hardship predicted higher postpartum anxiety. Conversely, for women with high resilience, or high tolerance of uncertainty, or neutral/positive cognitive appraisal, there was no association. Only a neutral/positive cognitive appraisal significantly buffered the effect of subjective distress on anxiety.
Participants self-selected themselves into the study. The generalizability of our results could be restricted to women of higher socio-economic status.
These findings help us better understand options for intervention and assessment of vulnerable women during times of stress, along with the mechanisms by which COVID-related stress during pregnancy contributes to postpartum anxiety.
虽然有报道称 COVID-19 大流行期间围产期焦虑增加（Stepowicz 等人，2020 年），但对于客观困难和主观困扰的相对重要性的研究较少。在这项研究中，我们探讨了韧性、对不确定性的容忍度以及对大流行后果的认知评估在多大程度上调节了由于大流行导致的产前客观困难和主观困扰对 2 个月产后焦虑的影响。
数据是作为 COVID 期间分娩研究（Birth in the Time of COVID，BITTOC）的一部分收集的。我们在澳大利亚的 419 名孕妇中测量了客观困难和主观困扰、心理健康以及潜在的心理调节因素，并在产后两个月进行了测量。采用分层多元回归分析。
客观困难和主观困扰独立预测产后焦虑。所有三个心理因素都调节了客观困难对焦虑的影响。对于韧性低/中等或不确定性容忍度低/中等或认知评估负面的女性，较大的客观困难预示着产后焦虑更高。相反，对于韧性高或不确定性容忍度高或认知评估中性/积极的女性，两者之间没有关联。只有中性/积极的认知评估显著缓冲了主观困扰对焦虑的影响。
参与者自行选择参加研究。我们研究结果的普遍性可能仅限于社会经济地位较高的女性。
这些发现有助于我们更好地了解在压力时期对脆弱女性进行干预和评估的选择，以及怀孕期间与 COVID 相关的压力导致产后焦虑的机制。
