Postpartum distress in first-time parents: an actor-partner interdependence model approach Kristin D. Mickelson, school of social & behavioral sciences,

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Postpartum distress in first-time parents: an actor-partner interdependence model approach Kristin D. Mickelson, school of social & behavioral sciences, Arizona state university Alexandra chong, department of psychology, kent state university Susanne Biehle, department of psychology, DePauw university Brian don, department of psychology, California Lutheran university Alynn Gordon, department of psychology, kent state university

Gender & the transition to parenthood

Transition to parenthood and distress Many first-time parents report that they feel unprepared for the transition to parenthood (Vanzetti & Duck, 1996) Between 8% and 15% of women who give birth experience some form of clinical postpartum mood disorder (NIH, 2009) Less research on paternal postpartum distress Prevalence rates of paternal postpartum depression in community samples range widely from 1.2% to 25.5% (Goodman, 2004) Researchers have found some men experience depression both during pregnancy and in the postpartum period (e.g. Morse, Buist, & Durkin, 2000; Raskin, Richman, & Gaines, 1990) Anxiety is highest for men during pregnancy and then declines after the birth – suggesting that increased anxiety for men may be a result of concerns about the transition to parenthood (e.g. Glazer, 1980; Teixeira, Figueiredo, Conde, Pacheco, & Costa, 2009)

Gaps in research on transition to parenthood Many stressors occur in the context of relationships but are still studied individually What impact do partners have on each other? Actor-Partner Interdependence Model (APIM) (Kenny, Kashy & Cook, 2006) Attitudes and outcomes of those in intimate relationships are fundamentally interconnected Thus, it is impossible to truly understand the association between stress-social support-health in an individual without also examining his/her partner’s influence

Three perspectives in transition to parenthood (Cowan, Cowan, Heming, et al., 1985) HERS: an expansive literature on PPD in mothers Numerous predictors of postpartum depression, including biological, mental, social, psychological factors – both self and spouse Very few studies on other aspects of maternal postpartum distress HIS: fewer studies on paternal PPD Strongest predictor of paternal PPD is maternal PPD Intrapersonal factors during pregnancy more predictive of postpartum depression for fathers than spousal factors during pregnancy (Matthey et al., 2000; Morse et al., 2000) Very few studies on other aspects of paternal postpartum distress THEIRS: In past several years, more studies taking an APIM approach to the transition to parenthood and relationship satisfaction and PPD (e.g., Kohn et al., 2012) However, as with Hers and His – no systematic studies of other aspects of postpartum distress MORSE ET AL - Specifically, men’s negative affect, anxiety, and depression during pregnancy, as well as their being in a relationship less than 2 years, and feeling controlled in the relationship were all predictive of paternal postpartum distress. Men’s postpartum distress scores were not predicted by any of their spouse’s variables measured during pregnancy. MATTHEY ET AL. - similarly found that men’s own personal factors, such as perceptions of their parents during childhood and personality variables like neuroticism, were more predictive of their PPD than shared factors with their spouse.

Postpartum distress Adjustment to parenthood encompasses symptoms of not only postpartum depression, but also anxiety and positive affect. Green (1998) argued “as research psychologists, our interests should be broader than those extremes of mood that qualify for psychiatric labels. If we are actually interested in the full range of normal experiences, as well as the abnormal, then we should abandon dichotomies and use continuous measures…This [also] begs the question of the measurement of positive feelings.” Even though Green made this argument almost 2 decades ago, research continues to primarily focus on postpartum depression, with only a small handful of studies examining maternal anxiety (e.g., Matthey et al., 2003; Miller, et al., 2006) and even fewer examining maternal positive or negative affect (e.g., Morse et al., 2000, who only examined affect as a predictor of PPD).

Study aims/hypotheses Primary aim: To understand how both actor and partner intrapersonal and interpersonal factors influence postpartum distress (i.e., depression, anxiety, lack of positive affect) in a non-clinical, low-risk sample of couples experiencing the transition to parenthood Hypothesis 1: Maternal postpartum distress will be associated with a prior history of maternal and paternal depression, concurrent partner distress, intrapersonal and relationship factors Hypothesis 2: Paternal postpartum distress will be associated with a prior history of paternal (but not maternal) depression, concurrent partner distress, intrapersonal and relationship factors but not household labor factors Hypothesis 3: With regards to partner effects, maternal postpartum distress will be influenced by both actor and partner effects, whereas paternal postpartum distress will be primarily influenced by actor effects Research Question: Due to the lack of research on postpartum anxiety and positive affect, we do not have specific predictions about whether the risk factors for these outcomes will be similar or different from postpartum depression

Baby T.I.M.E. Study Couples were interviewed during 3rd trimester, 1-month, 4-months postpartum, & 9-months postpartum Sample: 104 married/cohabiting couples expecting their first child (i.e., primiparous) Retention rate over 4 waves = 80% 91.3% married and 8.7% cohabiting; married/cohabiting for 3.29 years on average Men were slightly older (M = 29.99 yrs.) on average than women (M = 28.06 yrs.) Mostly White (88%), college educated (75%), and average household income between $60K-$80K

measures Postpartum Distress – Depression (PDSS; Beck & Gable, 2000), Anxiety (SCL-90R; Derogatis, 1992), Positive Affect (POMS; McNair, Lorr & Droppleman, 1981) Prenatal Depression – CES-D (Radloff, 1977) Intrapersonal Factors – Parenting Efficacy (Self-Efficacy for Parenting Tasks; Coleman & Karraker, 2003) and Daily Stress (Bolger, DeLongis, Kessler, & Schilling,1989) Household Labor Factors – Amount of Housework (hours per week), Amount of Childcare (hours per week), Perceived Fairness of Housework, Perceived Fairness of Childcare Relationship Factors – Perceived Emotional Spousal Support, Perceived Negative Spousal Interactions, Relationship Satisfaction (RAS; Hendrick, 1988)

Apim multi-level modeling analyses Dual intercept model approach in the Level-1 equations in accord with Barnett, Marshall, Raudenbush, and Brennan (1993) Maternal Postpartum Depression and Positive Affect and Paternal Postpartum Depression: study wave and concurrent partner distress (Level 1) and actor prenatal depression (grand- mean centered) (Level 2) Maternal Anxiety: study wave (Level 1) and actor prenatal depression (grand-mean centered) (Level 2) for mothers; Paternal Anxiety: study wave (Level 1) and actor prenatal depression (grand-mean centered), years married and employment status (Level 2.) Paternal Positive Affect: concurrent partner distress (Level 1) and actor prenatal depression (grand- mean centered at Level 2).

Maternal results Postpartum Depression Postpartum Anxiety Postpartum Positive Affect Interpersonal Factors Daily Stress (Actor b= 1.40* ; Partner b =1.32*) Parenting Efficacy (Partner b =-4.27***) Household Factors Perceived Fairness Childcare (Actor b= -1.25*) Relationship Factors Emotional Spousal Support (Partner b =-1.90**) Negative Spousal Interactions (Actor b= 2.80***) Relationship Satisfaction (Actor b=-2.32**) Interpersonal Factors Daily Stress (Actor b= 0.83***) Parenting Efficacy (Partner b = -0.76*) Household Factors (nothing) Relationship Factors Emotional Spousal Support (Actor b=0.86*) Negative Spousal Interactions (Partner b = 0.84**) Relationship Satisfaction (ns) Interpersonal Factors Daily Stress (Actor b= -1.29**) Parenting Efficacy (Partner b = 1.47**) Household Factors Perceived Fairness Childcare (Actor b= 1.05*) Relationship Factors Emotional Spousal Support (Actor b= 1.38*) Negative Spousal Interactions (Actor b= -1.36**) Relationship Satisfaction (Actor b= 1.698***) *p < .05 **p < .01 ***p < .001

Paternal results Postpartum Depression Postpartum Anxiety Postpartum Positive Affect Interpersonal Factors Daily Stress (ns) Parenting Efficacy (Partner b = -2.22***) Household Factors (nothing) Relationship Factors Emotional Spousal Support (Actor b = -1.20*) Negative Spousal Interactions (Actor b= 1.25*) Relationship Satisfaction (Actor b= -1.25*) Interpersonal Factors Daily Stress (Actor b= 0.79**; Partner b = 0.63*) Parenting Efficacy (Partner b = -0.88**) Household Factors Childcare Hours (Partner b = 0.01*) Relationship Factors (nothing) Interpersonal Factors Daily Stress (Actor b= -1.32***) Parenting Efficacy (Partner b = 1.05*) Household Factors Perceived Fairness Housework (Actor b= 1.08*) Childcare Hours (Partner b = 0.02*) Relationship Factors Emotional Spousal Support (Actor b= 2.61***) Negative Spousal Interactions (Actor b= -1.96***) Relationship Satisfaction (Actor b= 1.88***) *p < .05 **p < .01 ***p < .001

Conclusions: hers Maternal postpartum distress was predicted by a combination of actor and partner effects Mothers may be particularly attuned to not only the daily stress she is going through, but also what her partner is going through during the transition in terms of daily stress and/or parenting efficacy Contrary to predictions, the majority of associations for relationship and household predictors were actor effects Suggests what mothers get out of the relationship may be more important to their adjustment to parenthood than what their partner is getting out of the relationship

Conclusions: his More actor than partner effects for paternal postpartum distress (with the exception of paternal anxiety) Contrary to our predictions and prior research, actor daily stress was the only significant intrapersonal predictor of paternal postpartum distress Majority of significant predictors of paternal postpartum distress were relationship-oriented Similar to mothers, it appears that paternal adjustment to the transition to parenthood is more focused on what fathers are getting out of their relationship with their partner – as opposed to what their partner is getting out the relationship.

Conclusions: Theirs No significant partner effects for sociodemographic predictors or prenatal depression on maternal or paternal postpartum distress Concurrent (but not prenatal) partner distress was a significant predictor of both parents’ postpartum distress Another similarity between mothers and fathers is the relative lack of results for household labor predictors Partner parenting efficacy was the only other significant partner effect across all three outcomes for both mothers and fathers Why partner parenting efficacy?

Future directions Examine potential explanatory mechanisms for the unique relationship between partner parenting efficacy and an individual’s postpartum distress. Examine whether these associations hold over the course of parenthood or are unique to this early stage of the transition. Examine the causal associations between predictors and postpartum distress Examine in higher risk and more diverse couples transitioning to parenthoood

THANK YOU! QUESTIONS?