Abstract
Despite many prevailing societal beliefs, parents often experience mood and anxiety symptoms during the postpartum period, often referred to as postpartum distress (PPD). The aim of this study was to explicate whether aspects of role functioning during the postpartum period are associated with PPD, and whether this association may be partially explained by relationship adjustment. Seventy-three couples and an additional nine women who were 4–12 weeks postpartum participated in this study. Results indicate that men’s experience of role unacceptability predicted their own greater PPD symptoms which were partially mediated by their own poorer relationship adjustment, as well as women’s poorer relationship adjustment. Additionally, women’s work-family strain predicted their own greater PPD symptoms as well as men’s greater relationship adjustment. These results serve to highlight several key aspects of men’s and women’s postpartum role functioning and the associations that they share with postpartum distress symptoms. Implications for research and clinical work are discussed.
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References
Abramowitz, J. S., Meltzer-Brody, S., Leserman, J., Killenberg, S., Rinaldi, K., Mahaffey, B. L., & Pedersen, C. (2010). Obsessional thoughts and compulsive behaviors in a sample of women with postpartum mood symptoms. Archives of Women's Mental Health, 13(6), 523–530. https://doi.org/10.1007/s00737-010-0172-4.
Banti, S., Borri, C., Camilleri, V., Cortopassi, C., Montagnani, M. S., Ramacciotti, D., & Mauri, M. (2009). Perinatal mood and anxiety disorders. Clinical assessment and management. A review of current literature. Giornale Italiano Di Psicopatologia/ Italian Journal of Psychopathology, 15(4), 351–366.
Bartlett, E. E. (2004). The effects of fatherhood on the health of men: A review of the literature. Journal of Men's Health & Gender, 1(2–3), 159–169. https://doi.org/10.1016/j.jmhg.2004.06.004.
Baucom, D. H., Whisman, M. A., & Paprocki, C. (2012). Couple‐based interventions for psychopathology. Journal of Family Therapy, 34(3), 250–270.
Beach, S. R. H., & Gupta, M. (2003). Depression. In M. A. Whisman (Ed.), Treating difficult couples: Helping clients with coexisting mental and relationship disorders (pp. 88–113). New York, NY: Guilford Press.
Beck, C. T. (2001). Predictors of postpartum depression: An update. Nursing Research, 50(5), 275–285. https://doi.org/10.1097/00006199-200109000-00004.
Bielawska-Batorowicz, E., & Kossakowska-Petrycka, K. (2006). Depressive mood in men after the birth of their offspring in relation to a partner's depression, social support, fathers' personality and prenatal expectations. Journal of Reproductive and Infant Psychology, 24(1), 21–29. https://doi.org/10.1080/02646830500475179.
Bradley, R., & Slade, P. (2011). A review of mental health problems in fathers following the birth of a child. Journal of Reproductive and Infant Psychology, 29(1), 19–42. https://doi.org/10.1080/02646838.2010.513047.
Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological bulletin, 98(2), 310.
Cowan, C. P., & Cowan, P. A. (1988). Who does what when partners become parents: Implications for men, women, and marriage. Marriage & Family Review, 12(3–4), 105–131. https://doi.org/10.1300/J002v12n03_07.
Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782–786. https://doi.org/10.1192/bjp.150.6.782.
Doss, B. D., Rhoades, G. K., Stanley, S. M., & Markman, H. J. (2009). The effect of the transition to parenthood on relationship quality: An 8-year prospective study. Journal of Personality and Social Psychology, 96(3), 601–619. https://doi.org/10.1037/a0013969.
Epstein, N. B., & Baucom, D. H. (2002). Enhanced cognitive-behavioral therapy for couples: A contextual approach. Washington, DC: American Psychological Association. https://doi.org/10.1037/10481-000.
Flynn, H. A., Sexton, M., Ratliff, S., Porter, K., & Zivin, K. (2011). Comparative performance of the edinburgh postnatal depression scale and the patient health questionnaire-9 in pregnant and postpartum women seeking psychiatric services. Psychiatry Research, 187(1–2), 130–134. https://doi.org/10.1016/j.psychres.2010.10.022.
Fritz, M. S., & MacKinnon, D. P. (2007). Required sample size to detect the mediated effect. Psychological Science, 18(3), 233–239. https://doi.org/10.1111/j.1467-9280.2007.01882.x.
Funk, J. L., & Rogge, R. D. (2007). Testing the ruler with item response theory: Increasing precision of measurement for relationship satisfaction with the couples satisfaction index. Journal of Family Psychology, 21(4), 572–583. https://doi.org/10.1037/0893-3200.21.4.572.
Gavin, N. I., Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S., Gartlehner, G., & Swinson, T. (2005). Perinatal depression: A systematic review of prevalence and incidence. Obstetrics and Gynecology, 106(5 Pt 1), 1071–1083. https://doi.org/10.1097/01.AOG.0000183597.31630.db.
Glade, A. C., Bean, R. A., & Vira, R. (2005). A prime time for Marital/Relational intervention: A review of the transition to parenthood literature with treatment recommendations. American Journal of Family Therapy, 33(4), 319–336. https://doi.org/10.1080/01926180590962138.
Goldberg, A. E., & Perry-Jenkins, M. (2004). Division of labor and working-class women's well-being across the transition to parenthood. Journal of Family Psychology, 18(1), 225–236. https://doi.org/10.1037/0893-3200.18.1.225.
Hall, W. A. (1993). Development and early testing of the Role Enactment Questionnaire. Canadian Journal of Nursing Research Archive, 25(4), 57–65.
Hall, W. A., & Long, B. C. (2007). Relations among prenatal role quality, life satisfaction, and dual-earner parents' postnatal depression. Journal of Prenatal & Perinatal Psychology & Health, 21(3), 231–248 Retrieved from http://birthpsychology.com/journals.
Hanusa, B. H., Scholle, S. H., Haskett, R. F., Spadaro, K., & Wisner, K. L. (2008). Screening for depression in the postpartum period: A comparison of three instruments. Journal of Women's Health, 17(4), 585–596. https://doi.org/10.1089/jwh.2006.0248.
Hill, M. A. (1997). SPSS Missing Value Analysis 7.5 [Computer program manual]. Chicago: SPSS Inc..
Hock, E., Schirtzinger, M. B., Lutz, M. B., & Widaman, K. (1995). Maternal depressive symptomatology over the transition to parenthood: Assessing the influence of marital satisfaction and marital sex role traditionalism. Journal of Family Psychology, 9(1), 79–88. https://doi.org/10.1037/0893-3200.9.1.79.
Johnson, D. R., & Young, R. (2011). Toward best practices in analyzing datasets with missing data: Comparisons and recommendations. Journal of Marriage and Family, 73(5), 926–945. https://doi.org/10.1111/j.1741-3737.2011.00861.x.
Langer, S. L., Brown, J. D., & Syrjala, K. L. (2009). Intrapersonal and interpersonal consequences of protective buffering among cancer patients and caregivers. Cancer, 115(S18), 4311–4325.
Lawrence, E., Rothman, A. D., Cobb, R. J., & Bradbury, T. N. (2010). Marital satisfaction across the transition to parenthood: Three eras of research. In R. D. Parke (Ed.), Strengthening couple relationships for optimal child development: Lessons from research and intervention (pp. 97–114). Washington, DC: American Psychological Association. https://doi.org/10.1037/12058-007.
Mamun, A. A., Clavarino, A. M., Najman, J. M., Williams, G. M., O'Callaghan, M. J., & Bor, W. (2009). Maternal depression and the quality of marital relationship: A 14-year prospective study. Journal of Women's Health (2002), 18(12), 2023–2031. https://doi.org/10.1089/jwh.2008.1050.
Marshall, N. L., & Barnett, R. C. (1993). Work-family strains and gains among two-earner couples. Journal of Community Psychology, 21(1), 64–78. https://doi.org/10.1002/1520-6629(199301)21:1<64::AID-JCOP2290210108>3.0.CO;2-P.
Matthey, S., Barnett, B., Kavanagh, D. J., & Howie, P. (2001). Validation of the edinburgh postnatal depression scale for men, and comparison of item endorsement with their partners. Journal of Affective Disorders, 64(2–3), 175–184. https://doi.org/10.1016/S0165-0327(00)00236-6.
McMahon, C., Barnett, B., Kowalenko, N., & Tennant, C. (2005). Psychological factors associated with persistent postnatal depression: Past and current relationships, defence styles and the mediating role of insecure attachment style. Journal of Affective Disorders, 84(1), 15–24. https://doi.org/10.1016/j.jad.2004.05.005.
Muthén, L.K. and Muthén, B.O. (1998-2010). Mplus User’s Guide. Sixth Edition. Los Angeles: Muthén & Muthén
O'Hara, M. W. (2009). Postpartum depression: What we know. Journal of Clinical Psychology, 65(12), 1258–1269. https://doi.org/10.1002/jclp.20644.
O'Hara, M. W., & Swain, A. M. (1996). Rates and risk of postpartum depression-A meta-analysis. International Review of Psychiatry, 8(1), 37–54. https://doi.org/10.3109/09540269609037816.
Paulson, J. F., & Bazemore, S. D. (2010). Prenatal and postpartum depression in fathers and its association with maternal depression: A meta-analysis. JAMA: The Journal of the American Medical Association, 303(19), 1961–1969. https://doi.org/10.1001/jama.2010.605.
Perry-Jenkins, M., Goldberg, A. E., Pierce, C. P., & Sayer, A. G. (2007). Shift work, role overload, and the transition to parenthood. Journal of Marriage and Family, 69(1), 123–138.
Roberts, S. L., Bushnell, J. A., Collings, S. C., & Purdie, G. L. (2006). Psychological health of men with partners who have post-partum depression. Australian and New Zealand Journal of Psychiatry, 40(8), 704–711. https://doi.org/10.1111/j.1440-1614.2006.01871.x.
Trice-Black, S. (2010). Perceptions of women’s sexuality within the context of motherhood. The Family Journal, 18(2), 154–162.
Whisman, M. A., & Bruce, M. L. (1999). Marital dissatisfaction and incidence of major depressive episode in a community sample. Journal of Abnormal Psychology, 108(4), 674–678. https://doi.org/10.1037/0021-843X.108.4.674.
Acknowledgements
We gratefully acknowledge Wendy A. Hall, RN, PhD, and Bonita C. Long for the use of their Role Enactment Questionnaire.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Boeding, S.E., Baucom, D.H., Cohen, M.J. et al. Roles and postpartum distress: The mediating role of relationship adjustment. Curr Psychol 38, 1679–1691 (2019). https://doi.org/10.1007/s12144-017-9728-z
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DOI: https://doi.org/10.1007/s12144-017-9728-z