Mental Health Service (116c), VA Ann Arbor Healthcare System, Ann Arbor, MI, United States of America; Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America.
Department of Human Development and Family Sciences, Texas Tech University, Lubbock, TX, United States of America.
J Affect Disord. 2024 Sep 15;361:1-9. doi: 10.1016/j.jad.2024.06.010. Epub 2024 Jun 4.
Mothers with a history of childhood maltreatment (CM) are particularly vulnerable to postpartum mental health changes. Variability in mental health trajectories is present over the first 18-months postpartum. Little is known about the potentially unique impacts of post-traumatic change or resilience on later postpartum mental health.
Participants (N = 97) completed questionnaires over the first 18-months postpartum measuring demographic risk, mental health symptoms, traumatic experiences, and resilience. Mothers also completed an interview measure coded for post-traumatic changes at 6-months postpartum. Multinomial logistic regression models examined post-traumatic change and resilience factors as predictors of mothers' longitudinal latent mental health trajectory.
Three classes of latent postpartum mental health emerged: low-symptom, vulnerable, and chronic high-risk. Mothers reporting stronger positive post-traumatic changes were more likely to be in the low-symptom class than the chronic high-risk class (B = -1.082, p = .01). Mothers reporting stronger negative post-traumatic changes were more likely to be in the vulnerable class (B = 0.778, p = .006) or chronic high-risk class (B = 0.906, p = .046) than the low-symptom class. Resilience was not predictive of mental health class.
Findings are correlational, and causal effects between post-traumatic growth and mental health symptoms cannot be assumed. Mothers who consented to the interview may not be fully representative of all women who have experienced CM, limiting generalizability of findings.
Positive post-traumatic change is associated with reduced psychopathology. These findings may assist in identification of mothers at greater risk of adverse postpartum outcomes and futher inform interventions focused on enhancing positive changes in post-traumatic cognitions.
有儿童期虐待史的母亲特别容易受到产后心理健康变化的影响。产后头 18 个月的心理健康轨迹存在差异。对于创伤后变化或适应力对后期产后心理健康的潜在独特影响知之甚少。
97 名参与者在产后头 18 个月内完成了调查问卷，内容包括人口统计学风险、心理健康症状、创伤经历和适应力。母亲们还在产后 6 个月完成了一个访谈，对创伤后变化进行了编码。多项逻辑回归模型检验了创伤后变化和适应力因素对母亲纵向潜在心理健康轨迹的预测作用。
出现了三种潜在的产后心理健康轨迹：低症状、脆弱和慢性高风险。报告积极创伤后变化较强的母亲更有可能处于低症状类，而不是慢性高风险类（B=-1.082，p=.01）。报告消极创伤后变化较强的母亲更有可能处于脆弱类（B=0.778，p=.006）或慢性高风险类（B=0.906，p=.046），而不是低症状类。适应力不能预测心理健康类别。
研究结果是相关的，不能假定创伤后成长和心理健康症状之间存在因果关系。同意接受访谈的母亲可能不能完全代表所有经历过儿童期虐待的女性，这限制了研究结果的普遍性。
积极的创伤后变化与减少精神病理学有关。这些发现可能有助于识别有不良产后结局风险较高的母亲，并进一步为关注增强创伤后认知积极变化的干预措施提供信息。
