A Dynamic Perspective on PPD Symptoms: Effects of Infant Temperament and Psychosocial Risk

• In Event: Child Temperament: Implications for Parents and Parenting

Abstract

The current study used novel methodology to characterize intra-individual variability in the experience of dynamic, within-person changes (e.g., carryover and volatility around one’s own equilibrium) in postpartum depressive (PPD) symptoms across the first year postpartum. This study moves beyond an examination of mean levels to characterize intraindividual dynamics across the developmentally important postpartum period and evaluates the impact of infant temperamental negativity and maternal cumulative risk on a mother’s fluctuations in depressive symptoms. Caring for infants with more negative temperaments may render mothers more vulnerable to “random shocks” in their PPD symptoms (e.g., greater volatility in symptoms) and also lead to more rigid, stable symptoms that carryover from one time point to the next. Further, low-income and ethnic minority women in the U.S. are likely to experience multiple psychosocial risk factors, making it important to understand the additive effect that stressors can have on the dynamics of PPD symptoms across the postpartum period.

Methods: With a sample of 322 low-income Mexican-origin mothers (Mage = 27.79; SD = 6.48), this study evaluated multilevel location scale analyses in a dynamic structural equation modeling (DSEM; Asparouhov et al., 2018) framework to identify intra-individual equilibrium, carryover, and volatility in maternal PPD symptoms. PPD symptoms were assessed at 11 time points from 3 weeks to 1 year postpartum (EPDS; Cox & Holden, 2003). A prenatal cumulative risk index was calculated from individual psychosocial risk factors (economic hardship, intimate partner violence during pregnancy, negative life events, perceived stress, family negativity, cultural stress, and neighborhood concentrated disadvantage). Infant temperamental negativity was assessed via maternal report at infant age 6 weeks (IBQ; Putnam et al., 2014). Covariates included prenatal depressive symptoms, assessed during the third trimester of pregnancy.

Results: Results of the within-level model indicated that, on average, there was non-null carryover and volatility in maternal PPD symptoms. Maternal PPD symptoms at temporally adjacent time points were more similar to each other, such that change in depressive symptoms at one time point were found to carry over to the next time point. Non-null volatility in PPD symptoms reflected substantial ebbs and flows in PPD symptoms over the first year postpartum. Results of the between-level model demonstrated that mothers differed from each other in the carryover and volatility of their PPD symptoms, such that some mothers showed stronger carryover in PPD symptoms and some mothers exhibited more volatility in their PPD symptoms. Mothers who reported higher prenatal depressive symptoms had a higher equilibrium and more volatility and carryover in PPD symptoms. Mothers with more negative infants and those with higher cumulative risk exhibited a higher equilibrium of PPD symptoms and more volatility in symptoms but did not differ in their carryover of PPD symptoms.

Conclusions: Maternal fluctuations in PPD symptoms are not uniform across all Mexican-origin mothers in the current sample. Infant characteristics and cumulative risk may exacerbate or reduce these dynamic, within-person changes over time.

Authors

• Laura K. Winstone-Weide, University of Texas at Austin
  Presenting Author

• Jennifer Anne Somers, University of California - Los Angeles

• Sarah Gianna Curci, Arizona State University

• Linda J. Luecken, Arizona State University