An assessment of depression, psychosocial factors, and resilience among women seeking prenatal care at an urban community health center.

OBJECTIVE: To describe the relationship between resilience and mental health and psychosocial characteristics in the prenatal period. METHODS: A prospective cohort pilot study was conducted among English-speaking women aged 18 years or older with singleton pregnancies of at least 20 weeks' duration who received prenatal care at an urban community health center in the USA between March and October 2014. Surveys were administered and a retrospective chart review was conducted. Resilience and depression were measured using validated scales and anxiety was self-reported. Univariate and bivariate analyses were performed. RESULTS: Thirty women participated. The median resilience score was 82.0 (interquartile range [IQR] 74.0-92.0). Median resilience scores were significantly lower among women with a history of depression (73.0 [IQR 66.0-81.0]) than among those without a history (85.0 [IQR 79.0-92.0]; P=0.007). A history of using medication for anxiety, depression, or insomnia before pregnancy was also associated with lower resilience (median 74.0 [IQR 64.5-80.0] vs 83.5 [IQR 79.0-92.0]; P=0.029). Neither anxiety nor substance use was associated with resilience. Higher resilience was associated with religious affiliation and having adequate financial resources (both P<0.05). CONCLUSION: Depression history, prior medication use, religious affiliation, and financial security affect resilience in pregnancy. These data inform a strengths-based approach to prenatal care and future research endeavors.

Can survival processing enhance story memory? Testing the generalizability of the adaptive memory framework.

Research from the adaptive memory framework shows that thinking about words in terms of their survival value in an incidental learning task enhances their free recall relative to other semantic encoding strategies and intentional learning (Nairne, Pandeirada, & Thompson, 2008). We found similar results. When participants used incidental survival encoding for a list of words (e.g., "Will this object enhance my survival if I were stranded in the grasslands of a foreign land?"), they produced better free recall on a surprise test than did participants who intentionally tried to remember those words (Experiment 1). We also found this survival processing advantage when the words were presented within the context of a survival or neutral story (Experiment 2). However, this advantage did not extent to memory for a story's factual content, regardless of whether the participants were tested by cued recall (Experiment 3) or free recall (Experiments 4-5). Listening to a story for understanding under intentional or incidental learning conditions was just as good as survival processing for remembering story content. The functionalist approach to thinking about memory as an evolutionary adaptation designed to solve reproductive fitness problems provides a different theoretical framework for research, but it is not yet clear if survival processing has general applicability or is effective only for processing discrete stimuli in terms of fitness-relevant scenarios from our past.