The question about the risk factors associated to the development of postnatal distress has not only been addressed from a biological point of view, but from a psychosocial approach as well.
This perspective inquires about the relevance of a number of demographic, obstetric, and psychological factors that may underlie this phenomenon. The extensive discussion offered by current literature about these factors has led to the development of a well validated model that considers the six most significant risk factors for the onset of postnatal distress, namely
- Antenatal depression
- Antenatal anxiety
- Social support (being support from the partner specially significant)
- Negative life events
- Low self-esteem
- Previous history of depression
(Beck, 1996, 2001; O’Hara, 1991; O’Hara & Swain, 1996; Robertson et al, 2004).
Other variables have been suggested as contributing factors, such as an increased level of daily hassles, socioeconomic variables, parity, and psychological aspects (such as specific personality traits). Nevertheless, current research supports the notion that the above listed factors play a major role in the onset and maintenance of postnatal distress.
These findings have been used to design - and promote the use of - procedures to identify women who may be at risk for developing postnatal depression, and who may need special care, assistance, and/or treatment.
Showing posts with label Risk factors. Show all posts
Showing posts with label Risk factors. Show all posts
Wednesday, 4 August 2010
Biological factors for postnatal distress
Since both anxiety and depressive symptoms – the most characteristic signs of distress - have been found to have a negative effect on the mother’s wellbeing and the newborn’s development (Beck, 1998), a large body of research from different perspectives has focused on building explanatory models and describing risk factors that may explain the development of this phenomenon.
From a biochemical perspective, the intense physiological and hormonal changes observed across pregnancy and the postpartum period have been pointed out as a possible cause for the onset of postnatal distress. This hypothesis is based on the findings about the interaction between ovarian hormones - such as progesterone and estrogen – and central nervous system neurotransmitters related to mood disorders (i.e. serotonin and GABA).
Studies have usually focused on hormones such as progesteron, estrogene, cortisol, and prolactine. During pregnancy these hormones increase their levels progressively to reach levels that are hundred times higher than those found in non-pregnant women. This high concentration decreases intensively after delivery and the withdrawal of the placenta - with the exception of prolactine, which remains high in lactating women - therefore it has been hypothesized that depressed mood in the early postpartum period might be related to the sudden drop of hormonal levels (Harris, 2010).
Several studies have been conducted on this topic, and although hormonal fluctuation has provided a suitable explanation for the aetiology of PPD in some cases, it has failed to do so in many others; which raise questions about individual differences in the responses to both increase and reduction of hormonal levels. In effect several authors (Bloch, 2000; Harris et al, 2010, Kammerer et al, 2009; Klier et al, 2007) have suggested that women who develop postnatal depression may have certain vulnerability and/or high responsiveness to hormonal changes, which would put them at higher risk for developing mood disorders.
The mixed and inconclusive nature of current findings on this topic highlights the complex dynamics within the endocrine system and its intricate relation to the neural structures involved in mood regulation and mood disorders; and raises the question about the role of other factors - such as psychosocial aspects - that may play a role in this phenomenon.
From a biochemical perspective, the intense physiological and hormonal changes observed across pregnancy and the postpartum period have been pointed out as a possible cause for the onset of postnatal distress. This hypothesis is based on the findings about the interaction between ovarian hormones - such as progesterone and estrogen – and central nervous system neurotransmitters related to mood disorders (i.e. serotonin and GABA).
Studies have usually focused on hormones such as progesteron, estrogene, cortisol, and prolactine. During pregnancy these hormones increase their levels progressively to reach levels that are hundred times higher than those found in non-pregnant women. This high concentration decreases intensively after delivery and the withdrawal of the placenta - with the exception of prolactine, which remains high in lactating women - therefore it has been hypothesized that depressed mood in the early postpartum period might be related to the sudden drop of hormonal levels (Harris, 2010).
Several studies have been conducted on this topic, and although hormonal fluctuation has provided a suitable explanation for the aetiology of PPD in some cases, it has failed to do so in many others; which raise questions about individual differences in the responses to both increase and reduction of hormonal levels. In effect several authors (Bloch, 2000; Harris et al, 2010, Kammerer et al, 2009; Klier et al, 2007) have suggested that women who develop postnatal depression may have certain vulnerability and/or high responsiveness to hormonal changes, which would put them at higher risk for developing mood disorders.
The mixed and inconclusive nature of current findings on this topic highlights the complex dynamics within the endocrine system and its intricate relation to the neural structures involved in mood regulation and mood disorders; and raises the question about the role of other factors - such as psychosocial aspects - that may play a role in this phenomenon.
Subscribe to:
Posts (Atom)