When a parent is born - Screening, prevention, and early treatment of psychological distress during the perinatal period

Abstract

Introduction: The perinatal period may represent a particularly challenging time. Studies have highlighted an association between several perinatal risk conditions (e.g., childhood maltreatment, poor social support, antenatal attachment, stress levels) and depressive symptoms. However, psychosocial risk conditions are rarely assessed in routine care settings, and consequently, early interventions are not implemented. Thus, this project aims at 1) detection of the psychosocial risk conditions that may favor the onset of perinatal depression; 2) identifying women at high-risk for perinatal depressive symptoms to realize early psychological interventions and evaluate their efficacy. The project follows a longitudinal approach, from pregnancy to 6 months after childbirth. Methods: Since October 2023 we have been carrying on the project “When a parent is born -Information, screening, prevention and early treatment of psychological distress in pregnancy and post-partum depression”, with the active involvement of the Obstetrics and Gynecology Unit of the Civic Hospital of Palermo. To date, more than 200 pregnant women have completed the screening protocol and responded to the following self-report instruments: CTQ-SF (childhood maltreatment); MSSS (maternal social support); MAAS (prenatal attachment); RF (reflective functioning); and EPDS and PAMA (perinatal psychological distress). Based on the above, we have implemented an exploratory study (participants 128 Italian pregnant women, Mage = 33.4; SD = 6.10) to examine how emotional abuse and neglect experiences may favor the occurrence of psychological distress in pregnant women, and whether prenatal attachment might explain this association. Results: Pearson correlations revealed a positive association between childhood neglect and perinatal psychological distress, as well as a negative association between childhood neglect and prenatal attachment scores. No significant correlations were found for emotional abuse. Perinatal psychological distress was negatively associated with prenatal attachment. Mediation analyses showed significant associations between childhood neglect and the dimensions of perinatal affectivity and prenatal maternal attachment. Prenatal maternal attachment mediated the relationship between neglect and perinatal psychological distress. Conclusions: The transition to motherhood is a sensitive period, particularly for women who have experienced abuse and neglect during childhood. These experiences may negatively impact the woman's disposition to emotionally and behaviorally engage in the formation of a bond with her unborn baby. These results may have important prevention and clinical implications and thus should warrant further exploration.