Exploring Trajectories and Predictors of Depressive Symptoms Among Young Couples During Their Transition to Parenthood.
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ABSTRACT:
SUBMITTER: Sipsma HL
PROVIDER: S-EPMC8728795 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Hearing loss is a prevalent chronic stressor among older adults and is associated with numerous adverse health outcomes. The life course principle of linked lives highlights that an individual's stressors can impact the health and well-being of others; however, there are limited large-scale studies examining hearing loss within marital dyads. Using 11 waves (1998-2018) of the Health and Retirement Study (n = 4881 couples), we estimate age-based mixed models to examine how 1) one's own hearing, 2) one's spouse's hearing, or 3) both spouses' hearing influence changes in depressive symptoms. For men, their wives' hearing loss, their own hearing loss, and both spouses having hearing loss are associated with increased depressive symptoms. For women, their own hearing loss and both spouses having hearing loss are associated with increased depressive symptoms, but their husbands' hearing loss is not. The connections between hearing loss and depressive symptoms within couples are a dynamic process that unfolds differently by gender over time.
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Project description:BackgroundNew mothers and fathers are at risk of developing postnatal depressive problems. To understand how postnatal depressive symptoms unfold over time, analyses at the within-person level are necessary. Inspecting postnatal depressive problems at the symptom level provides a novel perspective, ultimately offering insight into which symptoms contribute to the elevation of other symptoms over time.MethodsPanel graphical vector-autoregression (GVAR) models were applied to analyze the within-person temporal and contemporaneous relations between depressive symptoms across the postnatal period in new mothers and fathers (at T1; Nmothers = 869, Nfathers = 579). Depressive symptoms were assessed at 6-, 12-, and 18-months postpartum, using the Edinburgh Postnatal Depression Scale.ResultsThe results revealed that for mothers, sadness was a key symptom predicting symptom increases in multiple other depressive symptoms and itself (autoregressive effect) over time. Furthermore, anxiousness and feeling scared predicted each other across the postnatal period in mothers. For fathers, the most central predicting symptom in the overall network of symptoms was being anxious, while self-blame and being overwhelmed had strong self-maintaining roles in the fathers' symptomatology, indicating that these could be key features in fathers experiencing postnatal depressive problems. The pattern of symptoms that mothers and fathers experienced within the same time window (contemporaneous associations), shared many of the same characteristics compared to the temporal structure.ConclusionsThis study suggests that across the postnatal period, from 6- to 18-months postpartum, depressive symptoms in mothers and fathers contribute differently to the pattern of depressive problems, highlighting sadness as a key feature in maternal symptomatology and anxiousness components in paternal symptomatology.
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Project description:ObjectiveAlthough numerous studies address the relationships of depression with coping processes directed toward approaching or avoiding stressful experiences, the large majority are cross-sectional in design, assess coping processes at only one timepoint, or solely include prediction of the linear slope of depressive symptoms. In this research, coping processes were investigated as predictors of depressive symptoms, symptom trajectory classes (consistently high, recovery, consistently low), and major depressive episodes (MDEs) over 12 months in the cancer context.MethodWomen (N = 460) within 4 months of breast cancer diagnosis completed assessments of cancer-related coping processes, depressive symptoms, and MDEs at 7 points across 1 year.ResultsBeyond sociodemographic and medical variables, coping through cancer-related avoidance an average of 2 months after diagnosis was associated with likelihood of being in the high depressive symptom trajectory class and occurrence of a MDE during the year. Less decline in avoidant coping over time also predicted poor outcomes. In contrast, high initial engagement in approach-oriented coping, as well as increases in coping through emotional expression and acceptance, were associated with lower depressive symptoms across assessments and higher likelihood of being in the recovery or low trajectory class.ConclusionsGreater engagement in cancer-related avoidant coping was associated with all three indicators of depression, and greater approach-oriented coping was related to more favorable outcomes (except MDE). Sustained or increasing coping through emotional expression or acceptance predicted recovery from initially high depressive symptoms. Approach- and avoidance-oriented coping processes constitute malleable targets for preventive and ameliorative approaches. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Project description:Depressive syndrome and disorders increase substantially during adolescence. Little is known, however, about how individual symptoms of depression change over the course of this developmental period. The present study examined within-person changes in symptom severity of each individual symptom of depression, utilizing longitudinal data collected across 6 years of adolescence. Adolescent gender and family relationship variables were tested as predictors of the symptom trajectories (i.e., intercept and slope). Adolescents and their mothers (N = 240) were first evaluated when youth were in Grade 6 (M = 11.86 years old, SD = 0.56, 54% female) and then annually through Grade 12. Individual symptoms of depression were assessed by a clinical interviewer using the Children's Depression Rating Scale-Revised (CDRS-R). Mothers and youth also completed measures about their relationship on the Children's Report of Parent Behavior Inventory and the Family Environment Scale. Results showed that all depressive symptoms increased linearly over time except psychomotor disturbances and problems with concentration and decision making, which were best represented by a quadratic growth model. Sex differences were found such that significantly more rapid increases in worthlessness/guilt were found for girls than boys, and concentration/decision making problems significantly changed for boys, but not girls. Poor family relationship quality (mother-reported) predicted a significantly faster rate of increase in adolescents' symptoms of anhedonia, appetite/weight changes, and fatigue. High maternal psychological control (youth-reported) also predicted a faster rate of increase in anhedonia. Study limitations, future research directions, and clinical implications of the findings are discussed.
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Project description:Depression is a common mental illness and research has focused on late childhood and adolescence in an attempt to prevent or reduce later psychopathology and/or social impairments. It is important to establish and study population-averaged trajectories of depressive symptoms across adolescence as this could characterise specific changes in populations and help identify critical points to intervene with treatment. Multilevel growth-curve models were used to explore adolescent trajectories of depressive symptoms in 9301 individuals (57% female) from the Avon Longitudinal Study of Parents and Children, a UK based pregnancy cohort. Trajectories of depressive symptoms were constructed for males and females using the short mood and feelings questionnaire over 8 occasions, between 10 and 22 years old. Critical points of development such as age of peak velocity for depressive symptoms (the age at which depressive symptoms increase most rapidly) and the age of maximum depressive symptoms were also derived. The results suggested that from similar initial levels of depressive symptoms at age 11, females on average experienced steeper increases in depressive symptoms than males over their teenage and adolescent years until around the age of 20 when levels of depressive symptoms plateaued and started to decrease for both sexes. Females on average also had an earlier age of peak velocity of depressive symptoms that occurred at 13.5 years, compared to males who on average had an age of peak velocity at 16 years old. Evidence was less clear for a difference between the ages of maximum depressive symptoms which were on average 19.6 years for females and 20.4 for males. Identifying critical periods for different population subgroups may provide useful knowledge for treating and preventing depression and could be tailored to be time specific for certain groups. Possible explanations and recommendations are discussed.
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Project description:BackgroundThere are gaps in understanding longitudinal patterns and predictors of perinatal depressive symptoms in sub-Saharan Africa. This study aimed to explore trajectories of depressive symptoms and associated factors from pregnancy to 9 months post partum among Kenyan women.MethodsIn this prospective cohort study, we analysed data from the PrEP Implementation for Mothers in Antenatal Care (PrIMA) study in which HIV-negative women were enrolled in pregnancy and followed up to 9 months post partum in 20 public sector maternal-child health clinics in western Kenya. Pregnant women were eligible for enrolment if they were not infected with HIV, aged 15 years or older, and were able to provide consent. Eligible participants were screened and enrolled between Jan 15, 2018, and July 31, 2019, and followed up to 9 months post partum, with the last participant study visit conducted on Jan 15, 2021. Study nurses serially assessed depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CESD-10), intimate partner violence with the Hurt, Insult, Threaten, Scream scale, and social support with the Medical Outcomes Study scale. Generalised estimating equations were used to identify correlates of moderate-to-severe depressive symptoms (CESD-10 score ≥10) and group-based trajectory modelling identified discrete trajectories of perinatal depressive symptoms.FindingsAmong 4447 participants in the main PrIMA study, 3555 had complete depressive symptom data in pregnancy and depressive symptom data post partum and were included in the primary analysis. Median age was 24·0 years (IQR 21·0-28·7), 1330 (38%) participants had low social support, and 278 (8%) reported intimate partner violence in pregnancy. All participants (100%) were female and all (100%) were of African Kenyan ethnicity. Prevalence of moderate-to-severe depressive symptoms was higher in pregnancy than post partum (870 [24·5%; 95% CI 23·1-25·9] vs 597 [6·8%; 15·6-18·1]; p<0·0001). Five patterns of depressive symptoms were identified; persistent moderate-to-severe depressive symptoms in pregnancy and post partum (295 [8·3%]), moderate-to-severe depressive symptoms in pregnancy that resolved post partum (139 [3·9%]), moderate-to-severe depressive symptoms that emerged post partum (40 [1·1%]), chronically mild symptoms (2709 [76·2%]), and no depressive symptoms (372 [10·5%]). Emergent moderate-to-severe depressive symptoms were associated with older age. Emergent, persistent, and resolving moderate-to-severe depressive symptoms were associated with intimate partner violence during pregnancy; and persistent and resolving moderate-to-severe depressive symptoms were associated with low social support and high HIV risk (all p<0·05). Moderate-to-severe depressive symptom risk was significantly increased with intimate partner violence (adjusted odds ratio 2·07 [95% CI 1·81-2·31]; p<0·0001), low social support (1·74 [1·56-1·95]; p<0·0001), and partner HIV-positive status (1·48 [1·22-1·78]; p<0·0001). 23·34% (95% CI 18·77-27·65) of cases of perinatal moderate-to-severe depressive symptoms were attributable to low social support.InterpretationOne third of women had perinatal moderate-to-severe depressive symptoms; nearly half of these had higher severity phenotypes of resolving, persistent, and emerging moderate-to-severe depressive symptoms that might require tailored interventions. Perinatal women with comorbid psychosocial stressors such as intimate partner violence and previous pregnancy loss should be prioritised for mental health services that augment social support within routine maternal-child health care.FundingNational Institutes of Health.TranslationFor the Kiswahili translation of the abstract see Supplementary Materials section.
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Project description:Depression is a common comorbidity in cardiac patients. This study sought to document fluctuations of depressive symptoms in the 12 months after a first major cardiac event. In all, 310 patients completed a battery of psychosocial measures including the depression subscale of the Symptom Check List-90-Revised. A total of 252 of them also completed follow-up measures at 3 and 12 months. Trajectories of depressive symptoms were classified as none, worsening symptoms, sustained remission, and persistent symptoms. Although the prevalence of depressive symptoms was consistent at each assessment, there was considerable fluctuation between symptom classes. Regression analyses were performed to identify predictors of different trajectories.
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Project description:BackgroundThe aim of the study was to identify trajectories of perinatal depressive symptoms and their predictors among women living in a low-resource setting in South Africa, and who present with a risk of depression during pregnancy.MethodsThis is a secondary analysis of a randomised controlled trial among 384 women living in Khayelitsha, a low income setting in South Africa, recruited at their first antenatal visit if they scored 13 or above on the Edinburgh Postnatal Depression Scale, were at least 18 years of age, less than 29 weeks pregnant and spoke isiXhosa. Participants were followed up at 8 months gestation, 3 and 12 months postpartum. Latent trajectories of depressive symptoms were identified using growth mixture modelling, based on the Hamilton Depression Rating Scale (HDRS). There were no differences in HDRS scores between the control and intervention arms, so all participants were assessed together. Health, social and economic predictors of trajectories were investigated to identify high-risk groups with greater or more chronic depressive symptoms, using univariate logistic regression.ResultsTwo trajectories were identified: antenatal only (91.4%), with moderate to severe symptoms at baseline which later subside; and antenatal and postnatal (8.6%), with severe depressive symptoms during pregnancy and later in the postpartum period, which subside temporarily to moderate levels at 3 months postpartum. Predictors for the antenatal and postnatal trajectory include severe food insecurity, intimate partner violence, lower social support, greater functional impairment, problematic drinking and suicide risk.ConclusionsA small proportion of women who are at risk for depression antenatally remain at risk throughout the perinatal period, and can be differentiated from those who show a natural remission. Identification and referral strategies should be developed with these findings in mind, especially given the limited mental health resources in low-income settings.
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