Intolerance of Uncertainty as a Predictor of Depression Symptom Severity in the Perinatal Period.

다국어 초록 (Multilingual Abstract)

Mood symptoms are common during the perinatal period and, left untreated, are associated with negative outcomes for both mother and baby. Effective preventative interventions exist, but it is essential to identify those women at risk for developing perinatal depression who would benefit most from such interventions. Although a history of depression is currently one of the most well supported predictors of depression during the perinatal period, it is an incomplete predictor and it is important to examine additional predictors of depression. One potentially valuable predictor is intolerance of uncertainty (IU), a cognitive factor reflecting the tendency to view ambiguous events or unknown outcomes as unacceptably threatening. In this prospective longitudinal sample of women followed from early pregnancy through 6-months postpartum we examined the relationship between IU and depression symptoms, incorporating both self-report and behavioral measures of IU. We addressed three specific aims. First, we examined the extent to which women with a history of depression differed on IU from late pregnancy to 6-months postpartum, compared to women with no history of depression. Second, we tested the extent to which IU predicted change in depression symptom severity from late pregnancy through 6-months postpartum, above and beyond a history of depression. Finally, we tested whether the relationship between a stressful birth experience and symptoms of postpartum depression was moderated by IU.We found that women with a history of depression generally reported higher IU than women included in the comparison group, and that both groups generally reported higher IU in the postpartum period than during pregnancy. We found mixed evidence to support IU in late pregnancy as a predictor of change in depression symptom severity from late pregnancy through the postpartum period, and we found that, among women with high IU, a stressful birth experience that included loss of control was associated with symptoms of depression at 6-months postpartum.This study contributes to the evidence that IU appears to be a mechanism worth continued study during pregnancy and postpartum. Understanding the mechanisms of depression during pregnancy and postpartum is an important step in developing treatments that are more efficacious, effective, and efficient.