Experiential Avoidance as a Mediator of Risk Factors for Higher Order
Internalizing Psychopathology in the Perinatal Period
Abstract
Objectives: Perinatal psychopathology can be damaging. This
study examined the strength of the associations between risk factors and
all perinatal mood and anxiety disorder symptoms while assessing the
mediating effect of experiential avoidance. Method:
Participants ( N =246) completed assessments during pregnancy
(28-32 weeks) and the postpartum (6-8 weeks). Structural equation
modeling (SEM) was used to examine associations between risk factors and
latent factors: Distress (composed of depression, generalized anxiety,
irritability, and panic symptoms); Fear (social anxiety, agoraphobia,
specific phobia, and obsessive-compulsive); and Bipolar (mania and
obsessive-compulsive). Results: During pregnancy, past
psychiatric history, anxiety sensitivity, maladaptive coping, and age
were significant risk factors. In the postpartum, negative maternal
attitudes and past psychiatric history were only risk factors for
symptoms that composed Distress. Experiential avoidance mediated the
relation between maladaptive coping and symptoms that composed Fear.
Conclusion: It is important to assess for psychological risk
factors starting in pregnancy. This study identified critical risk
factors that are associated with the underlying commonality among
perinatal mood and anxiety symptoms. Some of the risk factors as well as
the mediator are malleable (negative maternal attitudes, experiential
avoidance), creating new possibilities for prevention and treatment of
perinatal mood and anxiety disorder symptoms.