A Transdiagnostic Approach to Measuring and Conceptualizing Perinatal Depression Symptoms Restricted; Files Only
Pingeton, Blaire (Summer 2023)
Abstract
Introduction. Depression is difficult to measure and conceptualize, particularly among pregnant and postpartum people. Accurate measurement of perinatal depression is vital; perinatal depression is common and associated with long-term adverse outcomes for parents and families. This dissertation is comprised of two studies that attempted to (Study 1) reconceptualize symptoms of perinatal depression and related disorders using a transdiagnostic framework, and (Study 2) apply this new conceptual model to increase our understanding of the relationship between childhood maltreatment and perinatal depression symptoms.
Method. In Study 1, we conducted secondary analyses from two samples of women at risk of perinatal depression. Data were derived from items from seven commonly used measures. We compared fit indices from our original factor model—one general and six specific factors derived from the Research Domain Criteria (Loss, Potential Threat, Frustrative Nonreward, and Sleep-Wakefulness) and depression literatures (Somatic and Coping)—to our novel factor model (adding a Positive Affect factor). In Study 2, we used a mixture model to categorize individuals by their factor scores across the perinatal period. We then tested whether childhood maltreatment was associated with a specific pattern of symptoms.
Results. In Study 1, we found that the addition of a PA factor improved model fit. At least partial metric invariance was found between perinatal periods, with the exception of trimester 3 – postpartum period 1. In Study 2, we found that our person-centered approach identified three classes of symptoms, with one class having more clinically advantageous outcomes, one class having mean outcomes, and one class having more clinically disadvantageous outcomes. Childhood maltreatment was associated with an increased likelihood of being classified into the clinically disadvantageous class.
Conclusions. Clinicians and researchers are encouraged to consider these findings as a template for understanding profiles of symptoms of depression in perinatal patients, which can be used to guide treatment planning and the development of more effective screening, prevention, and intervention tools to prevent deleterious outcomes.
Table of Contents
General Introduction………………………………………………….…page 1
Study 1…………………………………………………………….……page 7
Table 1….page 25
Table 2….page 26
Table 3….page 27
Table 4….page 28
Table 5….page 29
Table 6….page 30
Supplemental Table 1….page 32
Supplemental Table 2….page 33
Supplemental Table 3….page 34
Supplemental Table 4….page 35
Supplemental Table 5….page 37
Study 2……………………………………………………….……....page 38
Table 1….page 57
Table 2a….page 58
Table 2b….page 59
Figures 1a-b….page 60
Figure 2….page 61
Figure 3….page 62
Figure 4a-b….page 63
Figure 5….page 64
Supplemental Table 1….65
Supplemental Table 2….66
Supplemental Table 3….67
Supplemental Table 4….68
Supplemental Table 5….69
General Discussion………………………………………….…….page 70
References………………………………………………....………page 75
About this Dissertation
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File download under embargo until 16 August 2029 | 2023-06-23 12:48:17 -0400 | File download under embargo until 16 August 2029 |
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