Be a Mom, a Web-Based Intervention to Prevent Postpartum Depression: The Enhancement of Self-Regulatory Skills and Its Association With Postpartum Depressive Symptoms.

Maria Cristina Canavarro,Stephanie Alves,Fabiana Monteiro,Ana Fonseca,Ricardo Gorayeb

doi:10.3389/fpsyg.2019.00265

Maria Cristina Canavarro, Stephanie Alves + Show 3 more

Open Access

https://doi.org/10.3389/fpsyg.2019.00265

Copy DOI

Abstract

Aim: Be a Mom is a self-guided, web-based intervention to prevent persistent postpartum depression symptoms [PPD], targeting both at-risk postpartum women and/or women presenting early-onset postpartum depressive symptoms (selective/indicated preventive intervention). Be a Mom is grounded on the principles of Cognitive-Behavior Therapy and incorporates the recent contributions of acceptance and compassion-based approaches (third-wave approaches) applied to the perinatal context. This study aimed to explore the processes underlying therapeutic change in the Be a Mom intervention, by: (1) exploring whether participation in the Be a Mom promotes the enhancement of self-regulatory skills (emotion regulation abilities, psychological flexibility and self-compassion) in comparison with women who did not participate in the program; and (2) exploring whether changes in self-regulatory skills are associated with changes in depressive symptoms, among women who participated in the Be a Mom program.Methods: A pilot randomized, two-arm controlled trial was conducted. Eligible women (presenting PPD risk-factors and/or early-onset PPD symptoms) were enrolled in the study and were randomly assigned to the intervention group (Be a Mom, n = 98) or to the waiting-list control group (n = 96). Participants in both groups completed baseline (T1) and post-intervention assessments (T2), including measures of depressive symptoms, emotion regulation abilities, psychological flexibility and self-compassion.Results: From baseline to post-intervention assessment, women in the intervention group showed a significantly greater decrease in the levels of emotion regulation difficulties (p < 0.001) and a significant greater increase in the levels of self-compassion (p < 0.001) compared to the control group. No significant differences were found concerning psychological flexibility. Moreover, a greater decrease in difficulties in emotion regulation and greater increase in self-compassion levels were significantly associated with a greater decrease in depressive symptoms, among women in the intervention group.Discussion: Be a Mom promotes the enhancement of women’s emotion regulation abilities and self-compassion, and this seems to exert a protective effect in the presence of PPD risk factors (or early-onset symptoms) because it led to a reduction of depressive symptoms. By providing some insights into the processes that underlie treatment response to Be a Mom, this study highlights the important role of the targeted third-wave processes applied to the perinatal context.

Highlights

Postpartum depression (PPD) represents a significant public health problem
This study aims to: (1) explore whether the participation in the Be a Mom program promotes the enhancement of self-regulatory skills by examining changes in self-regulatory skills among women who participated and those who did not participate in the program; and (2) examine whether changes in each of the self-regulatory skills are associated with changes in the outcome, among women who participated in the Be a Mom program
Be a Mom was developed to target the enhancement of self-regulatory skills such as emotion regulation abilities, psychological flexibility and self-compassion (Fonseca et al, 2018c), further evidence was needed to establish whether these self-regulatory skills are effectively promoted within the program and whether they result in a significant reduction in the levels of depressive symptoms

Summary

Introduction

Postpartum depression (PPD) represents a significant public health problem. Women who meet criteria for PPD often display comorbid anxiety symptoms (Falah-Hassani et al, 2016) and are at an increased risk for prolonged depression (Netsi et al, 2018). The effects of PPD may be far-reaching and long-lasting, to the mother’s health (Woolhouse et al, 2014), and to the motherchild interaction (Tronick and Reck, 2009) and to the child’s development (Kingston et al, 2012; Stein et al, 2014). Given the significant number of maternal-infant dyads affected by PPD (Drury et al, 2016), there have been increased efforts to implement effective prevention and treatment approaches to target this clinical condition

Objectives

Methods

Results

Conclusion