Posttraumatic stress, anxiety, and depression in mothers after preterm delivery and the associated psychological processes

Abstract Background: Empirical studies have shown traumatic, anxious, and depressive symptoms in mothers after preterm births. Many studies have focused on biological, social, and life circumstance factors to explain the emergence of these symptoms; their results are inconsistent. The ability of psychological processes to predict the emergence of psychopathology is now well documented in many clinical populations. However, the psychological processes underlying the onset of traumatic, anxious, and depressive symptoms in postpartum mothers of preterm infants had not yet been investigated. The aim of this study was to identify the most common symptoms experienced in the first few days after delivery and determine whether processes of anhedonia, brooding rumination, and worry are predictive of posttraumatic stress (PTS), anxiety, and depression symptoms. Methods: A sample of 106 mothers was screened for PTS, anxiety, and depression symptoms within the first 10 days after their preterm delivery. Anhedonia, brooding rumination, and worry were also assessed. Student’s t-tests were performed to identify the most severe manifestation reported. To explore the predictive effect of the psychological processes of anhedonia, brooding rumination, and worry, multiple linear regressions were performed. Results: Descriptive analysis shows that 75.5% of mothers reported a pathological symptom level for at least one of PTS, anxiety, or depression. Being alert and worrying are the predominant manifestations experienced in the first few days after preterm birth. Multiple linear regression showed that traumatic symptoms were predicted by worry and brooding rumination; anxiety symptoms were predicted by worry, reminiscence pleasure and a deficit in consummatory pleasure; and depressive symptoms were predicted by worry and a deficit in consummatory pleasure. Conclusions: Our findings support the process model and suggest that anhedonia, brooding rumination, and worry may be relevant targets for psychological interventions to treat PTS, anxiety, and depression symptoms. Behavioral activation could be an effective intervention to target these dysfunctional processes and thus improve maternal symptoms.