A longitudinal study of perinatal depression and the risk role of cognitive fusion and perceived stress on postpartum depression.

AIMS AND OBJECTIVES: To explore fluctuations in perinatal depression based on physiological, psychological and interpersonal dimensions to analyse risk factors across three time points: in the third trimester and at weeks 1 and 6 postpartum. BACKGROUND: Pregnant women experience depression at multiple time points and require screening. Studies have shown protective and negative factors related to postpartum depression. Cognitive fusion refers to an individual's emotions and behaviours that are regulated and influenced by that individual's own cognitive overregulation, especially when facing stress. This is an important psychological factor related to depression, but little is known about it in pregnant women. DESIGN: A longitudinal study was conducted from June 2019-July 2020, and the findings are reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. METHODS: Pregnant women (n = 207) were recruited, and a questionnaire survey was performed at 32-34 weeks of pregnancy and at weeks 1 and 6 postpartum. Repeated-measures analysis of variance was performed to analyse the changes in depression over time. Regression analysis and linear mixed modelling were used to identify risk factors. Pearson's correlation analysis was performed to analyse the relationships between variables. RESULTS: Of the pregnant women, 36.70% experienced antenatal depression and prolonged depression with the onset of postpartum depression (12.21%). Some depressive moods disappeared spontaneously after delivery (47.37%). Perceived stress was the highest risk predictor of postpartum depression (ß = 0.332), followed by cognitive fusion (ß = 0.178), which remained stable over time and might have been positively related to having a vulnerable personality (0.2 < r < 0.4). Social support plays a positive role in lowering postpartum depression (ß = -0.027). CONCLUSIONS: Changes in depression were influenced by multiple factors with stability and predictability across time. Psychological dimensions, such as perceived stress and cognitive fusion, are risk factors for developing postpartum depression and antenatal depression. RELEVANCE TO CLINICAL PRACTICE: Pregnant women can be divided into depressive cohorts according to screening at different time points to provide targeted interventions.

The relationship between personality traits, caring characteristics and abuse tendency among professional caregivers of older people with dementia in long-term care facilities.

AIMS AND OBJECTIVES: To explore the relationship between personality traits, caring characteristics and abuse tendency among professional caregivers of older people with dementia in long-term care facilities in China. BACKGROUND: Elder abuse is a serious global health problem and human right violation with high incidence among older people with dementia. There are many investigations about impact factors of risk of abuse among family caregivers of older people with dementia. However, in long-term care facilities, the situation of abuse tendency needs further investigation. DESIGN: Cross-sectional study. METHODS: An observational survey was conducted according to the STROBE checklist. We investigated 156 professional caregivers of older people with dementia in three long-term care facilities in Guangzhou, China. Participants completed a demographic questionnaire, the Caregiver Abuse Screen (CASE) and the Neuroticism Extraversion Openness Five-Factor Inventory (NEO-FFI). Data were analysed using Mann-Whitney U tests, Kruskal-Wallis tests, Spearman's rank correlation and logistic regression analyses. RESULTS: Over half of the participants (51.9%) reported abuse tendency to the older people with dementia. There was a significant negative correlation between the caregivers' agreeableness scores of NEO-FFI and their CASE scores. Multivariate logistic regression analyses highlighted that protective factors of abuse tendency were caregivers' agreeableness, care recipients' source of finances and their duration of dementia while higher care difficulty and presence of older people's behavioural and psychological symptoms of dementia (BPSD) were the risk factors. CONCLUSION: Caregivers' agreeableness personality trait and the caring characteristics of older people with dementia may be relevant to abuse tendency in long-term care facilities. Further study with a larger sample size is needed to validate such a correlation. RELEVANCE TO CLINICAL PRACTICE: Older people with dementia are at high risk for abuse. Prospective caregivers could pay more attention to developing their own agreeableness. The managers might establish monitoring system for reducing the abuse.