رابطه آلکسیتیمیا و علائم افسردگی پری ناتال

Objective The purpose of this study was to examine the relationship between alexithymia and perinatal depressive symptoms and the stability of the alexithymia construct in a sample of low-income, predominantly Latina women during pregnancy and the early postpartum period. Methods Seventy-seven pregnant women completed self-report questionnaires and were classified as “high risk” or “low risk” for developing a major depressive episode based on a history of depression and/or current high depressive symptom scores. Measures included the Toronto Alexithymia Scale, the Center for Epidemiological Studies Depression Scale, and the Maternal Mood Screener, and were completed during pregnancy and at postpartum month 2. Results Alexithymia was positively associated with depressive symptoms during pregnancy and early postpartum. Women at high risk for depression had significantly higher alexithymia levels than low-risk women during pregnancy but not during postpartum. Alexithymia and depressive symptoms were independently and strongly correlated across the ante- and postpartum periods. Hierarchical regression analyses indicate that alexithymia scores at postpartum were predicted by alexithymia scores during pregnancy, above and beyond the variance explained by the depressive symptom scores during pregnancy and postpartum. Conclusion Alexithymia is positively correlated with depressive symptoms during the perinatal period and is a stable phenomenon.

Alexithymia is a multidimensional personality construct characterized by three core features: (a) difficulty identifying emotions and distinguishing between emotions and bodily sensations, (b) difficulty describing or communicating emotions to others, and (c) an externally oriented style of thinking [1], [2] and [3]. Multiple etiologies, from biological to psychological, have been proposed for the development of alexithymia [3], [4] and [5]. Recent research supports a social learning model of alexithymia in which parents who have difficulties regulating their own emotions (i.e., high levels of alexithymia) also have more difficulty attending to and interpreting their children's emotions, thus not being able to teach their children how to regulate their own emotions [6], [7] and [8]. Another area of research has documented that mothers who are depressed, at either the subsyndromal or clinical level, also have difficulty regulating their children's emotions [9], [10] and [11]. However, to date, minimal research has focused on the relationship between depression and alexithymia in mothers, who are the primary caregivers in most families. This is surprising given that alexithymia and depression have been found to be positively and strongly associated in various psychiatric [12] and nonpsychiatric populations [13] and [14]. In examining this association, there is an ongoing debate as to whether alexithymia is a trait (i.e., a stable personality factor) or state (i.e., changes in alexithymia depend on the course or onset of other disorders). Researchers [5], [15] and [16] have advocated for an examination of the absolute and relative stability of alexithymia over time to address this issue. Luminet et al. [15] reported that although alexithymia scores changed pre- to post-treatment for major depression, there was also evidence for its relative stability because alexithymia scores correlated significantly with changes in depression scores; the authors concluded that alexithymia is relatively stable and best conceptualized as a stable personality trait. Saarijärvi et al. [16] recently conducted a study examining the relationship between alexithymia and depression in a sample of outpatients with major depression over a 5-year period and found that alexithymia was both a stable personality trait and a state. In particular, there were differences in the three factors of alexithymia: difficulty identifying and communicating emotions were state dependent (i.e., associated with decreased depressive symptoms), whereas externally oriented thinking showed absolute stability over time. Ten to fifteen percent of new mothers experience postpartum depression [17]. Yet only one study, conducted in Finland, has examined the relationship between alexithymia and perinatal depression [18]. It examined the relationship between women's social conditions during pregnancy and their children's level of alexithymia 31 years later. Results from this study indicate that pregnant women who had an unwanted pregnancy, a child born into a family with four or more children, and/or lived in rural areas were more likely to have children who reported having higher levels of alexithymia. In addition, depression during pregnancy was associated with higher levels of alexithymia in children of urban-dwelling women. Depression was reported as a dichotomous variable (“normal/depressed” or “very depressed”), which was derived from mothers' mood (normal, depressed, or very depressed). However, this definition does not differentiate between “depression” defined as scores on symptom scales and “depression” meeting current diagnostic criteria for major depressive episodes (MDEs). In addition, no study to date has examined the relationship between alexithymia and depression in the early postpartum period (i.e., within the first 6 months). This period is important because the effect of maternal depression can be observed in infants as young as 3 months [19] and [20] and because it is critical in the formation of mother–infant attachment relationships [21]. Therefore, the perinatal period (from pregnancy to the early postpartum) provides a particularly important time to examine the relationship between alexithymia and depressive symptoms. The present study examined the relationship between perinatal depressive symptomatology and alexithymia in a sample of low-income, urban, predominantly Latina pregnant women. We tested three hypotheses: first, whether alexithymia would be positively associated with depressive symptoms during pregnancy and the early postpartum period; second, whether women at high risk for MDEs had higher levels of alexithymia than women at low risk for MDEs; and third, whether alexithymia would be stable across time in this population.