Experiential avoidance as a mediator of risk factors for higher order internalizing psychopathology in the perinatal period

IF 2.5 3区心理学 Q2 PSYCHOLOGY, CLINICAL

Journal of Clinical Psychology Pub Date : 2024-01-24 DOI:10.1002/jclp.23644

Michelle L. Miller, Lily J. Jiang, Michael W. O'Hara

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Abstract

Objectives

Perinatal psychopathology can be damaging. This study examined the strength of the associations between risk factors and all perinatal mood and anxiety disorder symptoms while assessing the mediating effect of experiential avoidance.

Method

Participants (N = 246) completed assessments during pregnancy (28–32 weeks) and the postpartum (6–8 weeks). Structural equation modeling (SEM) was used to examine associations between risk factors and latent factors: distress (composed of depression, generalized anxiety, irritability, and panic symptoms); fear (social anxiety, agoraphobia, specific phobia, and obsessive-compulsive); and bipolar (mania and obsessive-compulsive).

Results

During pregnancy, past psychiatric history, anxiety sensitivity, maladaptive coping, and age were significant risk factors. In the postpartum, negative maternal attitudes and past psychiatric history were only risk factors for symptoms that composed distress. Experiential avoidance mediated the relation between maladaptive coping and symptoms that composed fear.

Conclusion

It is important to assess for psychological risk factors starting in pregnancy. This study identified critical risk factors that are associated with the underlying commonality among perinatal mood and anxiety symptoms. Some of the risk factors as well as the mediator are malleable (negative maternal attitudes, experiential avoidance), creating new possibilities for prevention and treatment of perinatal mood and anxiety disorder symptoms.

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体验性回避是围产期高阶内在化精神病理学风险因素的中介。

目的：围产期精神病理学可能会造成伤害。本研究考察了风险因素与所有围产期情绪和焦虑障碍症状之间的关联强度，同时评估了体验性回避的中介效应：方法：参与者（N = 246）在孕期（28-32 周）和产后（6-8 周）完成评估。采用结构方程建模（SEM）来研究风险因素与潜在因素之间的关联：痛苦（包括抑郁、广泛性焦虑、易怒和恐慌症状）；恐惧（社交焦虑、广场恐惧症、特殊恐惧症和强迫症）；双相情感障碍（躁狂症和强迫症）：怀孕期间，既往精神病史、焦虑敏感性、适应不良的应对方式和年龄是重要的风险因素。在产后，产妇的消极态度和既往精神病史只是构成痛苦症状的风险因素。体验性回避在适应不良的应对方式和恐惧症状之间起到了中介作用：从孕期开始评估心理风险因素非常重要。本研究发现了与围产期情绪和焦虑症状潜在共性相关的关键风险因素。其中一些风险因素和中介因素具有可塑性（消极的母性态度、经验性回避），为围产期情绪和焦虑障碍症状的预防和治疗提供了新的可能性。

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来源期刊

Journal of Clinical Psychology PSYCHOLOGY, CLINICAL-

CiteScore

5.40

自引率

3.30%

发文量

177

期刊介绍： Founded in 1945, the Journal of Clinical Psychology is a peer-reviewed forum devoted to research, assessment, and practice. Published eight times a year, the Journal includes research studies; articles on contemporary professional issues, single case research; brief reports (including dissertations in brief); notes from the field; and news and notes. In addition to papers on psychopathology, psychodiagnostics, and the psychotherapeutic process, the journal welcomes articles focusing on psychotherapy effectiveness research, psychological assessment and treatment matching, clinical outcomes, clinical health psychology, and behavioral medicine.