Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-23T12:57:48.642Z Has data issue: false hasContentIssue false

Coping Style and Depressive Symptomatology during Pregnancy in a Private Setting Sample

Published online by Cambridge University Press:  10 January 2013

Alexandre Faisal-Cury*
Affiliation:
Universidade do São Paulo (Brazil)
Mariangela Gentil Savoia
Affiliation:
Universidade do São Paulo (Brazil)
Paulo Rossi Menezes
Affiliation:
Universidade do São Paulo (Brazil)
*
Correspondence concerning this article should be addressed to Alexandre Faisal-Cury. Rua Mário Ferraz, 135/32, J. Europa, São Paulo (Brazil) 01453-010. Phone/Fax: +055 011 36838196. E-mail: [email protected]

Abstract

Aim:

to evaluate the association of antenatal depressive symptomatology (AD) with life events and coping styles, the hypothesis was that certain coping strategies are associated to depressive symptomatology.

Methods:

we performed a cross sectional study of 312 women attending a private clinic in the city of Osasco, São Paulo from 27/05/1998 to 13/05/2002. The following instruments were used: Beck Depression Inventory (BDI), Holmes and Rahe Schedule of Recent Events (SSRS), Folkman and Lazarus Ways of Coping Questionnaire and questionnaire with social-demographic and obstetric data. Inclusion criteria: women with no past history of depression, psychiatric treatment, alcohol or drug abuse and no clinical-obstetrical complications. Odds ratios and 95% CI were used to examine the association between AD (according to BDI) and exposures variables. Hypothesis testing was done with X2 tests and a p value < .05.

Results:

AD occurred in 21.1% of pregnant women. By the univariate analyses, education, number of pregnancies, previous abortion, husband income, situation of marriage and score of SSRS were associated with AD. All coping styles were associated with AD, except seeking support and positive reappraisal. By the multivariate analyses, four coping styles were kept in the final model: confront (p = .039), accepting responsibility (p < .001), escape-avoidance (p = .002), problem-solving (p = .005).

Conclusions:

AD was highly prevalent and was associated with maladaptive coping styles.

Objetivo:

evaluar la asociación de la sintomatología depresiva antenatal (AD), con acontecimientos de la vida y estilos de afrontamiento, la hipótesis era que ciertas estrategias de afrontamiento se asocian a síntomas depresivos.

Método:

Se realizó un estudio transversal con 312 mujeres que asistían a una clínica privada en la ciudad de Osasco, São Paulo desde 27/05/1998 a 13/05/2002. Los instrumentos utilizados fueron: el Inventario de Depresión de Beck (BDI), la escala de reajuste social de Holmes y Rahe (SRRS), la escala de estrategias de afrontamiento (ways of Coping)de Folkman y Lazarus y un cuestionario de datos socio-demográficos y obstétricos. Criterios de inclusión: mujeres sin antecedentes de depresión, tratamiento psiquiátrico, o de abuso de drogas o alcohol y sin complicaciones clínico-obstétricas. Se utilizaron Odds ratios y IC del 95% para examinar la asociación entre AD (según BDI) y las variables de exposición. La prueba de hipótesis se llevó a cabo con tests de ⊠2 y un valor de p < ,05.

Resultados:

AD se produjo en el 21,1% de las mujeres embarazadas. Con el análisis univariado, la educación, el número de embarazos, abortos anteriores, los ingresos del marido, la situación del matrimonio y la puntuación de SRRS se relacionan con AD. Todos los estilos de afrontamiento se asocian con AD, con excepción de la búsqueda de apoyo y la reevaluación positiva. Utilizando el análisis multivariado, cuatro estilos de afrontamiento se mantuvieron en el modelo final: enfrentamiento (p = ,039), aceptar responsabilidad (p < ,001), huida-evitación (p = ,002), y resolución de problemas (p = ,005).

Conclusiones:

La AD fue altamente prevalente y se asocia con conductas de afrontamiento mal adaptadas.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aldwin, C. M., & Revenson, T. A. (1987). Does coping help?. Reexamination of the relation between coping and mental health. Journal of Personality and Social Psychology, 53, 337348. http://dx.doi.org/10.1037//0022-3514.53.2.337CrossRefGoogle ScholarPubMed
Anderson, L., Sundstrom-Poromma, I., Wuff, M., Astrom, M., & Bixo, M. (2004). Implications of antenatal depression and anxiety for obstetric outcomes. Obstetrics & Gyecology, 104, 467476. http://dx.doi.org/10.1097/01.AOG.0000135277.04565.e9CrossRefGoogle Scholar
Andrade, L., Gorenstein, C., Vieira Filho, A. H., Tung, T. C., & Artes, R. (2001). Psychometric properties of the Portuguese version of the state-trait anxiety inventory applied to college students: Factor analysis and relation to the Beck Depression Inventory. Brazilian Journal of Medical and Biological Research, 34, 367374. http://dx.doi.org/10.1590/S0100-879X2001000300011Google Scholar
Areias, M. E. G., Kumar, R., Barros, H., & Figueiredo, E. (1996). Correlates of postnatal depression in mothers and fathers. British Journal of Psychiatry, 169, 3641. http://dx.doi.org/10.1192/bjp.169.1.36CrossRefGoogle ScholarPubMed
Arizmendi, T. G., & Affonso, D. D. (1987). Stressful events related to pregnancy and postpartum. Journal of Psychosomatic Research, 31, 743756. http://dx.doi.org/10.1016/0022-3999(87)90023-7CrossRefGoogle ScholarPubMed
Beck, A. T., Ward, C. H., & Mendelson, M. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561571. http://dx.doi.org/10.1001/archpsyc.1961.01710120031004Google Scholar
Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychological Review, 8, 77100. http://dx.doi.org/10.1016/0272-7358(88)90050-5CrossRefGoogle Scholar
Belsky, J., & Rovine, M. (1984). Social network contact, family support and the transition to parenthood. Journal of Marriage and Family, 46, 455462. http://dx.doi.org/10.2307/352477Google Scholar
Bennett, H. A., Einarson, A., Taddio, A., Koren, G., & Einarson, T. R. (2004). Prevalence of depression during pregnancy: Systematic review. Obstetrics & Gynecology, 103, 698709. http://dx.doi.org/10.1097/01.AOG.0000116689.75396.5fCrossRefGoogle ScholarPubMed
Bjorck, J. P., Cuthbertson, W., Thurman, J. W., & Lee, Y. S. (2001). Ethnicity, coping, and distress among Korean Americans, Filipino Americans, and Caucasian. Americans. Journal of Social Psychology, 141, 421442. http://dx.doi.org/10.1080/00224540109600563CrossRefGoogle ScholarPubMed
Chung, T. K. H., Lau, T. K., Yip, A. S. K., Chiu, H. F., & Lee, D. T. (2001). Antepartum depressive symptomatology is associated with adverse obstetric and neonatal outcomes. Psychosomatic Medicine, 63, 830834.CrossRefGoogle ScholarPubMed
De Tychey, C., Spitz, E., & Briançon, S. (2004). Prévalence de la dépression prénatale et stratégies de coping [Prevalence of perintal depresión and coping strategies]. Neuropsychiatrie de l'enfance et de l'adolescence, 52, 261265. http://dx.doi.org/10.1016/j.neurenf.2004.02.006CrossRefGoogle Scholar
Demyttenaere, K., Maes, A., Nijs, P., Odendael, H., & Van Assche, F. A. (1995). Coping style and preterm labor. Journal of Psychosomatic Obstetrics and Gynecology, 16, 109115. http://dx.doi.org/10.3109/01674829509042786CrossRefGoogle ScholarPubMed
Faisal-Cury, A., Tedesco, J. J. A., Kahhale, S., Menezes, P. R., & Zugaib, M. (2004). Postpartum depression: In relation to life events and patterns of coping. Archives of Women's Mental Health, 7, 123131. http://dx.doi.org/10.1007/s00737-003-0038-0Google Scholar
Faisal-Cury, A., & Menezes, P. R. (2007). Prevalence of anxiety and depression during pregnancy in a private setting sample. Archives of Women's Mental Health, 10, 2532. http://dx.doi.org/10.1007/s00737-006-0164-6CrossRefGoogle Scholar
Faisal-Cury, A., Menezes, P., Araya, R., & Zugaib, M. (2009). Common mental disorders during pregnancy: Prevalence and associated factors among low-income women in São Paulo, Brazil. Depression and anxiety during pregnancy. Archives of Women's Mental Health, 12, 335343. http://dx.doi.org/10.1007/s00737-009-0081-6CrossRefGoogle Scholar
Fatove, F. O., Adeveni, A. B., & Oladimeji, B. Y. (2004). Emotional distress and its correlates among Nigerian women in late pregnancy. Journal of Obstetrics & Gynaecology, 24, 504509. http://dx.doi.org/10.1080/01443610410001722518CrossRefGoogle Scholar
Felton, B., & Revenson, T. (1984). Coping with chronic illness: A study of illness controllability and the influence of coping strategies on psychological adjustment. Journal of Consulting and Clinical Psychology, 52, 343353. http://dx.doi.org/10.1037//0022-006X.52.3.343CrossRefGoogle ScholarPubMed
Ferri, C. P., Mitsuhiro, S. S., Barros, M. C., Chalem, E., Guinsburg, R., Patel, V., … Laranjeira, R. (2007). The impact of maternal experience of violence and common mental disorders on neonatal outcomes: A survey of adolescent mothers in Sao Paulo, Brazil. BMC Public Health, 7, 209218. http://dx.doi.org/10.1186/1471-2458-7-209CrossRefGoogle ScholarPubMed
Folkman, S., & Lazarus, R. S. (1980). An analysis of coping in a middle-age community sample. Journal of Health and Social Behavior, 21, 219239. http://dx.doi.org/10.2307/2136617CrossRefGoogle Scholar
Folkman, S., & Lazarus, R., (1985). If changes it must be a process: Study of emotion and coping during three stages of a college examination. Journal of Personality and Social Psychology, 48, 150170. http://dx.doi.org/10.1037//0022-3514.48.1.150CrossRefGoogle ScholarPubMed
Folkman, S., Lazarus, R. S., Dunkel-Schetter, C., DeLongis, A., & Gruen, R. J. (1986). The dynamics of a stressful encounter: Cognitive, appraisal, coping, and encounter outcomes. Journal of Personality and Social Psychology, 50, 9921003. http://dx.doi.org/10.1037//0022-3514.50.5.992Google Scholar
Folkman, S., & Lazarus, R. S. (1986). Stress processes and depressive symptomatology. Journal of Abnormal Psychology, 95, 107113. http://dx.doi.org/10.1037//0021-843X.95.2.107Google Scholar
Folkman, S., Lazarus, R. S., Pimley, S., & Novacek, J. (1987) Age differences in stress and coping processes. Psychology & Aging, 2, 171184. http://dx.doi.org/10.1037//0882-7974.2.2.171CrossRefGoogle ScholarPubMed
Folkman, S., & Lazarus, R. S. (1988). Manual for the ways of coping questionnaire. Palo Alto, CA: Consulting Psychologist Press.Google Scholar
Folkman, S., & Lazarus, R. (1988b). Coping as a mediator of emotion. Journal of Personality and Social Psychology, 54, 466475. http://dx.doi.org/10.1037//0022-3514.54.3.466Google Scholar
Gorenstein, C., & Andrade, L. (1996). Validation of Portuguese version of the Beck Depression Inventory and the State-Trait Anxiety Inventory in Brazilian subjects. Brazilian Journal of Medical and Biological Research, 29, 453457.Google ScholarPubMed
Gorenstein, C., Andrade, L., Vieira Filho, A. H. G., Tung, T. C., & Artes, R. (1999). Psychometric properties of the Portuguese version of the Beck Depression Inventory on Brazilian college students. Journal of Clinical Psychology, 55, 553562. http://dx.doi.org/10.1002/(SICI)1097-4679(199905)55:5<553::AIDJCLP3>3.3.CO;2-43.0.CO;2-D>CrossRefGoogle ScholarPubMed
Gramling, L. F., Lambert, V. A., & Pursley-Crotteau, S. (1998). Coping in young women: Theoretical retroduction. Journal of Advanced Nursing, 28, 10821091. http://dx.doi.org/10.1046/j.1365-2648.1998.00821.xCrossRefGoogle ScholarPubMed
Hatton, C., Knussen, C., Slopper, P., & Turner, S., (1995). The stability of the ways of coping (Revised) Questionnaire over time in parents of children with Down's syndrome: A research note. Psychological Medicine, 25, 419422. http://dx.doi.org/10.1017/S003329170003631XCrossRefGoogle ScholarPubMed
Heron, J., O'Connor, T. G., Evans, J., Golding, J., Glover, V., & The ALSPAC Study Team (2004). The course of anxiety and depression through pregnancy and the postpartum in a community sample. Journal of Affective Disorders 80, 6573. http://dx.doi.org/10.1016/j.jad.2003.08.004CrossRefGoogle Scholar
Holcomb, W. L., Stone, L. S., Lustman, P. J., Gavard, J. A., & Mostello, D. J. (1996). Screening for depression in pregnancy: Characteristics of the Beck Depression Inventory. Obstetrics & Gynecology, 88, 10211025. http://dx.doi.org/10.1016/S0029-7844(96)00329-8Google ScholarPubMed
Holmes, T. H., & Rahe, R. H. (1967). The social readjustment rating scale. Journal of Psychosomatic Research, 11, 213218. http://dx.doi.org/10.1016/0022-999(67)90010-4CrossRefGoogle ScholarPubMed
Huizink, A. C., de Medina, P. G., Mulder, E. J., Visser, G. H., & Buitelaar, J. K. (2002). Coping in normal pregnancy. Annals of Behavioural Medicine, 24, 132140. http://dx.doi.org/10.1207/S15324796ABM2402_10CrossRefGoogle ScholarPubMed
Huizink, A. C., Robles de Medina, P. G., Mulder, E. J., Visser, G. H., & Buitelaar, J. K. (2003). Stress during pregnancy is associated with developmental outcome in infancy. Journal of Child and Psychological Psychiatric, 44, 810818. http://dx.doi.org/10.1111/1469-7610.00166CrossRefGoogle ScholarPubMed
Levy-Shiff, R., Dimitrovsky, L., Shulman, S., & Har-Even, D. (1998). Cognitive appraisals, coping strategies, and support resources as a correlates of parenting and infant development. Developmental Psychology, 34, 14171427. http://dx.doi.org/10.1037//0012-1649.34.6.1417Google Scholar
Lovisi, G. M., López, J. R. A., Coutinho, E. S. F., & Patel, V. (2005). Poverty, violence and depression during pregnancy: A survey of mothers attending a public hospital in Brazil. Psychological Medicine, 35, 14851492. http://dx.doi.org/10.1017/S0033291705005362CrossRefGoogle ScholarPubMed
Manolache, L., Petrescu-Seceleanu, D., & Benea, V. (2010). Life events involvement in psoriasis onset/recurrence. International Journal of Dermatology, 49, 636641. http://dx.doi.org/10.1111/j.1365-4632.2009.04367.xCrossRefGoogle ScholarPubMed
Morling, B., Kitayama, S., & Miyamoto, A. (2003). American and Japanese women use different coping strategies during normal pregnancy. Personality and Social Psychology Bulletin, 29, 15331546. http://dx.doi.org/10.1177/0146167203256878Google Scholar
O'Hara, M. W., Neunaber, D. J., & Zekoski, E. M. (1984). Prospective study of postpartum depression: Prevalence, course and predictive factors. Journal of Abnormal Psychology, 93, 158171. http://dx.doi.org/10.1037//0021-843X.93.2.158Google Scholar
O'Hara, M.W., & Swain, A. M. (1996). Rates and risk of postpartum depression: AMeta analysis. International Review of Psychiatry, 8, 3754. http://dx.doi.org/10.3109/09540269609037816Google Scholar
Pakenham, K. I., Smith, A., & Rattan, S. L. (2007). Application of a stress and coping model to antenatal depressive symptomatology. Psychology, Health & Medicine, 12, 266277. http://dx.doi.org/10.1080/13548500600871702Google Scholar
Patel, V., Rodrigues, M., & DeSouza, N. (2002) Gender, poverty, and postnatal depression: A study of mothers in Goa, India. American Journal of Psychiatry, 159, 4347. http://dx.doi.org/10.1176/appi.ajp.159.1.43Google Scholar
Patel, V., & Prince, M. (2006). Maternal psychological morbidity and low birth weight in India. British Journal of Psychiatry, 188, 284285. http://dx.doi.org/10.1192/bjp.bp.105.012096Google Scholar
Rahman, A., Bunn, J., Lovel, H., & Creed, F. (2007). Association between antenatal depression and low birthweight in a developing country. Acta Psychiatrica Scandinavia, 115, 481486. http://dx.doi.org/10.1111/j.1600-0447.2006.00950.xCrossRefGoogle ScholarPubMed
Rey, E., Moreno Ortega, M., Garcia Alonso, M. O., & Diaz-Rubio, M. (2009). Constructive thinking, rational intelligence and irritable bowel syndrome. World Journal of Gastroenterology, 15, 31063111.Google Scholar
Roesch, S. C., Schetter, C. D., Woo, G., & Hobel, C. J. (2004). Modeling the types and timing of stress in pregnancy. Anxiety, Stress & Coping, 17, 87102. http://dx.doi.org/10.1080/1061580031000123667Google Scholar
Rudnicki, S. R., Graham, J. L., Habboushe, D. F., & Ross, R. D. (2001). Social support and avoidant coping: Correlates of depressed mood during pregnancy in minority women. Women Health, 34, 1934. http://dx.doi.org/10.1300/J013v34n03_02CrossRefGoogle ScholarPubMed
Salamero, M., Marcos, T., Gutierrez, F., & Rebull, B. (1994). Factorial study of the BDI in pregnant women. Psychological Medicine, 24, 10311035. http://dx.doi.org/10.1017/S0033291700029111CrossRefGoogle ScholarPubMed
Savoia, M. G., Santana, P. R., & Mejias, N. P. (1996). Adaptação do Inventário de Estratégias de Folkman e Lazarus para o português. [Adaptation of the Folkman and Lazarus Inventory to Portuguese]. Revista de Psicologia da USP, 7, 83201.Google Scholar
Srivastava, S., & Boyer, J. L. (2010). Psychological stress is associated with relapse in type 1 autoimmune hepatitis. Liver International, 30, 14391447. http://dx.doi.org/10.1111/j.1478-3231.2010.02333.xGoogle Scholar
STATA (2005). Stata Statistical software. Texas, TX: Stata Corporation.Google Scholar
Steiner, M., & Yonkers, K. (1998). Depression in women. London, England: Martin Dunitz.Google Scholar
Teissedre, .F., & Chabrol, H. (2004). A study of the Edinburgh Postnatal Depression Scale (EPDS) on 859 mothers: Detection of mothers at risk for postpartum depression. Encephale, 30, 376381. http://dx.doi.org/10.1016/S0013-7006(04)95451-6Google Scholar
Vaaler, A. E., Morken, G., Iversen, V. C., Kondziella, D., & Linaker, O. M. (2010). Acute Unstable Depressive Syndrome (AUDS) is associated more frequently with epilepsy than major depression. BMC Neurology, 10, 6775. http://dx.doi.org/10.1186/1471-2377-10-67CrossRefGoogle ScholarPubMed
Wenzel, A., Haugen, E. N., Jackson, L. C., & Robinson, K. (2003). Prevalence of generalized anxiety at eight weeks postpartum. Archives of Women's Mental Health, 6, 4349. http://dx.doi.org/10.1007/s00737-002-0154-2CrossRefGoogle ScholarPubMed
Wilson, L. M., Reid, A. J., Midmer, D. K., Biringer, A., Carroll, J. C., & Stewart, D. E. (1996). Antenatal psychosocial risk factors associated with adverse outcomes. Canadian Medical Association Journal, 154, 785799.Google Scholar