Depressive symptoms in the transition to parenthood: Patterns, processes and child outcomes
AbstractPostpartum depression has been recognized as a serious condition by clinicians and researchers for decades, yet our understanding of the complexities of depressive symptomatology during the perinatal period is still in its infancy. It is unlikely that any one factor or perspective can explain the multifaceted presentation and course of depressive symptoms in this period, and a more comprehensive understanding of meaningful distinctions within etiologies, symptom developments and prognosis is needed. Studies have traditionally focused on postpartum women. More recently, the pregnancy phase and fathers’ mental health has been included in research efforts, adding new perspectives. Furthermore, we know that depressive states in the transition to parenthood is not only detrimental to the mental health of parents, it can also have profound effects on the caretaking environment for the newborn child. Early parental depression adds to the child’s risk of developing a wide range of social, emotional and cognitive problems, however, there is a need for elucidating mechanisms for the transmission of risk, as well as factors that adds or buffers vulnerability for an adverse development. On this backdrop, the main goal of this thesis was to provide a more detailed understanding of how depressive symptoms unfold during the entire perinatal period for mothers and fathers, and how this relates to child outcomes. This included investigating the heterogeneity of perinatal depressive symptom courses among women; the dynamic transmission of depressive symptoms within parental couples throughout the perinatal events of pregnancy, childbirth and early parenthood; and how child outcomes are related to parental depressive symptoms while in the womb and the first 18 months of their lives. The data for this thesis are from the prospective, multisite study Little in Norway (LiN) and comprise nine data collection waves; four prenatal, birth records, and at six weeks, six months, 12 months and 18 months after the children were born. The 1,036 participating families were recruited at nine different well-baby clinics located at geographically diverse sites across Norway. Collected data includes surveys from both parents, birth records and psychological tests of the children. The papers presented in this thesis takes a detailed approach to depressive symptom development and expression in the transition to parenthood. By investigating heterogeneity of symptom courses, transmission of negative mood states within parental couples, and differential and mediating effects on child outcomes, findings provide important distinctions in our understanding of how depressive symptoms unfold during the specific events of pregnancy, childbirth and early parenthood. Findings have several clinical implications; the importance of including prevention, assessment and treatment efforts of depressive symptoms as early as the pregnancy phase; bringing the mental health of fathers into perinatal care; and direct resources to identify and accommodate the needs of those with a heightened risk for depressive symptomatology.
List of papers
|Paper I: Fredriksen, E., von Soest, T., Smith, L., & Moe, V. (2017). Patterns of pregnancy and postpartum depressive symptoms: Latent class trajectories and predictors. Journal of Abnormal Psychology, 126, 173-183. doi: 10.1037/abn0000246.The published versions is not available in DUO due to publisher restrictions. The accepted version is available in DUO: http://urn.nb.no/URN:NBN:no-66673|
|Fredriksen, E., von Soest, T., Smith, L., & Moe, V. (2019). Depressive symptom contagion in the transition to parenthood: Interparental processes and the role of partner-related attachment. Journal of Abnormal Psychology. DOI: 10.1037/abn0000429. The manuscript is included in the thesis. Published version is available at https://doi.org/10.1037/abn0000429|
|Paper III: Fredriksen, E., von Soest, T., Smith, L., & Moe, V. (2018). Parenting stress plays a mediating role in the prediction of early child development from both parents’ perinatal depressive symptoms. Journal of Abnormal Child Psychology, 1-16. doi: 10.1007/s10802-018-0428-4. The paper is included in the thesis. Also available at: https://doi.org/10.1007/s10802-018-0428-4|