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JAD:澳大利亚研究发现COVID-19大流行带来的产前压力可预测心理因素对产后焦虑的调节作用

2022-08-02 影像小生 MedSci原创

孕期客观困难和主观痛苦水平越高,产后两个月焦虑水平就越高,弹性、不确定性容忍度和认知评估可以缓冲流行病压力对产后焦虑的影响。

产后焦虑很常见,15%的产后妇女报告有明显的焦虑症状。产后焦虑与婴儿过度担忧、恐慌发作、呼吸困难、育儿和亲密关系困难、母乳喂养减少和性情困难有关)。产后焦虑的风险因素包括较低的社会经济地位、初产、既往心理健康问题史和“怀孕和分娩期间的不利环境”。怀孕期间的主要压力源,如朋友或家人的死亡/疾病、经济问题或与亲人的冲突,可增加妇女产后焦虑的风险。然而,许多生活压力事件在人群中并不是随机分布的;例如,对抑郁症的双胞胎研究表明,经历不良生活事件的倾向可能是遗传性状的功能,受到基因的影响。基因混淆的可能性使得很难区分这些事件的客观困难(即暴露于外部应激源的水平)和主观痛苦的相对影响;了解它们对产妇产后焦虑发展的各自作用可以指导预防和干预工作。

Amber-Lee Di Paolo等探索了适应力、对不确定性的容忍度和对大流行后果的认知评估在多大程度上缓和了大流行对产后2个月焦虑的产前客观困难和主观痛苦的影响。

该研究测量了居住在澳大利亚的419名孕妇以及产后两个月的客观困难和主观痛苦、心理健康和潜在的心理调节因素。采用分层多元回归分析。

结果如下

产后两个月焦虑在不同弹性、不确定性容忍度和认知评价水平上对客观困难或主观痛苦的影响。

1.   客观困难和主观苦恼可独立预测产后焦虑。三种心理因素都能调节客观困难对焦虑的影响。对于韧性低/中性、对不确定性的容忍度低/中等或认知评价消极的女性,更大的客观困难预示着更高的产后焦虑

2.   相反,对于心理弹性高、对不确定性容忍度高、认知评价中性/积极的女性,则没有关联。

3.   只有中性/积极的认知评价显著缓冲了主观痛苦对焦虑的影响。

综上所述,该研究发现,孕期客观困难和主观痛苦水平越高,产后两个月焦虑水平就越高,弹性、不确定性容忍度和认知评估可以缓冲流行病压力对产后焦虑的影响。这些发现有助于我们更好地了解在压力时期对弱势妇女进行干预和评估的选择,以及怀孕期间与COVID-19相关的压力导致产后焦虑的机制。

文献出处

Prenatal stress from the COVID-19 pandemic predicts maternal postpartum anxiety as moderated by psychological factors: The Australian BITTOC Study

https://www.sciencedirect.com/science/article/pii/S0165032722007169

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    2022-08-02 zwddoctor

    产后焦虑很常见,15%的产后妇女报告有明显的焦虑症状。产后焦虑与婴儿过度担忧、恐慌发作、呼吸困难、育儿和亲密关系困难、母乳喂养减少和性情困难有关)。

    0

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    2022-08-01 qilu_qi
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