Perceived Social Support Partially Mediates the Impact of Temperament and Character on Postpartum Depression.

Yukako Nakamura,Nagahide Takahashi,Norio Ozaki,Mako Morikawa,Aya Yamauchi,Takashi Okada

doi:10.3389/fpsyt.2021.816342

Abstract

IntroductionTemperament and character of pregnant women, especially harm avoidance (HA) and self-directedness (SD) have been identified as risk factors for postpartum depression, in addition to poor social support. However, the relationship between these personality traits and social support for depressive symptoms after delivery has not been examined.MethodsData were extracted from a prospective cohort survey on pregnant women conducted in Nagoya, Japan that included the Temperament and Character Inventory (TCI), the Social Support Questionnaire (J-SSQ), and the Edinburgh Postnatal Depression Scale (EPDS) at approximately week 25 and 1 month postpartum. A mediation analysis using structural equation modeling (SEM) was used to test if social support in pregnancy is a mediator between personality traits and postpartum depressive symptoms.ResultsThousand five hundred and fifty-nine women were included in the analysis. Both harm avoidance and SD were significantly associated with depressive symptoms (total effect: β [SE], 0.298 [0.041], P < 0.001 for harm avoidance; total effect: β [SE], −0.265 [0.067], P < 0.001 for SD). Mediation analysis showed that the effect of harm avoidance on depressive symptoms was partially mediated by low social support (direct effect: β [SE], 0.193 [0.004], P < 0.001; indirect effect: β [SE], 0.082 [0.034], P = 0.015). Self-directedness on depressive symptoms was not found to be mediated by low social support.ConclusionResults indicate that poor social support worsens depressive symptoms in women with high HA during pregnancy. Limitations include a possible selection bias due to the limited target facilities; most variables being evaluated based on self-report questionnaires, and different number of samples available for analysis between harm avoidance and SD.

Highlights

Temperament and character of pregnant women, especially harm avoidance (HA) and self-directedness (SD) have been identified as risk factors for postpartum depression, in addition to poor social support
The Edinburgh Postnatal Depression Scale (EPDS) score at 1 month after delivery was positively correlated with Harm Avoidance (HA) (r = 0.259, p < 0.01) and negatively correlated with SD (r = −0.344, p < 0.01), Japanese version of Social Support Questionnaire (J-SSQ) Number (r = −0.111, p < 0.01), and Satisfaction (r = −0.097, p < 0.01)
Mediation analysis showed that the effect of HA on depressive symptoms was partially mediated by low social support, indicating that 29.8% of the total effect of HA on EPDS scores was mediated through low social support

Summary

Introduction

Temperament and character of pregnant women, especially harm avoidance (HA) and self-directedness (SD) have been identified as risk factors for postpartum depression, in addition to poor social support. Identification of the risk for postpartum depression, and protective factors against its development, is critical [10, 11]. It has been pointed out that the involvement of temperament and personality in the development of depression using various questionnaires or inventories [12,13,14]. The four dimensions of temperament are Novelty Seeking (NS), Harm Avoidance (HA), Reward Dependence (RD), and persistence (P), and the three dimensions of personality are, self-directedness (SD), Cooperativeness (C), and Self-Transcendence (ST) [20]. Subsequent research confirmed the state-dependence of temperament [23, 24], and recently the distinction between the constructs of temperament and personality has been called into question [25]

Methods

Results

Discussion

Conclusion