Browsing by Author "Grekin, Rebecca"

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    Examining psychological inflexibility as a mediator of postpartum depressive symptoms: A longitudinal observational study of perinatal depression
    (Elsevier, 2023) Thomas, Emily B. K.; Miller, Michelle L.; Grekin, Rebecca; O’Hara, Michael W.; Psychiatry, School of Medicine
    Background: Depression is a common, serious complication during the postpartum period. Predictors of postpartum depression characterize who is at-risk for persistent symptoms. This study explored how psychological inflexibility affects depressive symptoms at 4 and 12 weeks postpartum. Methods: Participants receiving prenatal care at a medical center were recruited during the second trimester. Participants (n = 180) completed online assessments and diagnostic interviews during the third trimester (≥ 28 weeks gestation), and at 4-, 8-, and 12-weeks postpartum. Online assessments measured psychological inflexibility (PI) and depressive symptoms, while diagnostic interviews measured lifetime history of depression. Results: Mediation analysis examined pathways between 4-weeks postpartum depression, 8-weeks postpartum PI, and 12-weeks postpartum depression. Depressive symptoms at 4-weeks postpartum predicted PI at 8-weeks postpartum (β = 0.31, SE = 0.06, t(177) = 6.06, p < .001). Depressive symptoms at 4-weeks postpartum (β = 0.42, SE = 0.06, t(176) = 7.12, p < .001) and PI at 8-weeks postpartum (β = 0.32, SE = .08, t(176) = 4.09, p < .001) predicted depressive symptoms at 12-weeks postpartum. Depressive symptoms at 4-weeks, 8-week PI, and lifetime history of depression accounted for 42% of the variance in 12-week depressive symptoms (R2 = 0.42). The confidence interval of the indirect effect (0.04, 0.18) did not include zero, indicating significant mediation by PI. Conclusions: PI mediated the relation between 4- and 12-weeks postpartum depressive symptoms when controlling for lifetime history of depression. Psychological inflexibility is a transdiagnostic target for future prevention and intervention research during the postpartum period.
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    The role of prenatal posttraumatic stress symptoms among trauma exposed women in predicting postpartum depression
    (Wiley, 2022) Grekin, Rebecca; Thomas, Emily B.K.; Miller, Michelle L.; O’Hara, Michael W.; Psychiatry, School of Medicine
    Research suggests that a history of trauma and prenatal posttraumatic stress symptoms (PTSS) are predictive of postpartum depression (PPD). Pregnant women at risk for PPD are often identified through depression symptom measures, while PTSS also may help to identify those at increased risk. Women who do not endorse depressive symptoms, though experience PTSS, may be missed when screening is exclusively based on depressive symptoms. The current study aimed to determine if prenatal PTSS were associated with PPD at 4- and 12-week postpartum in trauma-exposed women. Pregnant women (N = 230) in their third trimester were assessed for depression and PTSS at pregnancy, 4 and 12 weeks postpartum. Traumatic life events were assessed during pregnancy. Hierarchical regression analyses examined predictors of PPD, including history of depression, number of past traumas, and symptoms from the posttraumatic stress disorder (PTSD) Checklist short-form (PCL-6). At 4 and 12 weeks postpartum, history of trauma and depression did not predict depressive symptoms, however, irritability and unwanted intrusive memories of trauma were predictive of increased depressive symptoms. Prenatal irritability and unwanted memories may be predictive of elevated PPD symptoms. Future research should examine whether these symptoms represent increased risk of postpartum depressive symptoms to improve screening, prevention, and treatment efforts.