- Research article
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An investigation of dispositional mindfulness and mood during pregnancy
BMC Pregnancy and Childbirth volumeĀ 19, ArticleĀ number:Ā 273 (2019)
Abstract
Background
Mindfulness courses are being offered to numerous groups and while a large body of research has investigated links between dispositional mindfulness and mood, few studies have reported this relationship during pregnancy. The aim of this study was to investigate this relationship in pregnant women to offer insight into whether an intervention which may plausibly increase dispositional mindfulness would be beneficial for this population.
Methods
A cross-sectional analysis was conducted to explore potential relationships between measures of mindfulness and general and pregnancy-specific mood. A sample of pregnant women (nā=ā363) was recruited using online advertising and community-based recruitment and asked to complete a number of questionnaires online.
Results
Overall, higher levels of mindfulness were associated with improved levels of general and pregnancy-related mood in pregnant women. Controlling for general stress and anxiety, higher scores for mindfulness in (psychologically) healthy women were associated with lower levels of pregnancy-related depression, distress and labour worry but this relationship was not apparent in those with current mental health problems. In participants without children, higher mindfulness levels were related to lower levels of pregnancy-related distress.
Conclusions
These results suggest a promising relationship between dispositional mindfulness and mood though it varies depending on background and current problems. More research is needed, but this paper represents a first step in examining the potential of mindfulness courses for pregnant women. Increasing mindfulness, and therefore completing mindfulness-based courses, is potentially beneficial for improvements in mood during pregnancy.
Background
Existing research evaluating mindfulness and pregnancy has explored the utility of mindfulness courses during pregnancy but the mechanism of change is unclear. Exploration of how mindfulness relates to mood during pregnancy should be conducted to expand the literature and support studies examining the change which takes place during and after mindfulness-based courses but very few studies have examined the relationship between dispositional mindfulness and mood in non-intervention samples. One study found that higher dispositional mindfulness was associated with lower anxiety during pregnancy and less self-regulation problems and negative affect in the 10āmonth old infant [1]. A further small study [2] found that higher āact awareā dispositional mindfulness (a subscale on the FFMQ [3]) during pregnancy was related to lower postnatal depression and anxiety scores and that as prenatal mindfulness decreased over time, postnatal depression and anxiety scores increased. A recent study found a similar relationship with dispositional mindfulness during pregnancy such that higher levels of mindfulness were related to lower levels of depression and distress [4].
Pregnancy-specific and general anxiety and stress likely reflect different emotional constructs [5,6,7,8]. However, research to date has not examined the association between dispositional mindfulness and pregnancy specific measures.
This study aimed to extend previous work by examining the association of dispositional mindfulness with general and pregnancy specific measures in a large sample of pregnant women. The results were examined to evaluate whether increasing dispositional mindfulness during pregnancy may be beneficial, something which mindfulness courses are purported to do [9]. It appears important to elucidate the relationship between dispositional mindfulness and mood during pregnancy to better understand whether, and how, courses offered during this time may be helpful. Individual difference variables such as dispositional mindfulness may have a greater impact on variables such as worry about labour in those who have no prior experiences of childbirth to pattern their beliefs, fears and expectations. Therefore we divided and analysed the sample for those with and without children. In individuals with pre-existing mental health problems, anxiety about pregnancy and labour may reflect underlying psychopathology in addition to situation specific concerns. As such individual differences in mindfulness may play a different, perhaps lesser role in determining distress in these participants. Therefore we divided and analysed the sample in two groups as a function of their pre-existing mental health problems.
Methods
Participants
Data was drawn from three samples of expectant mothers: a cross-sectional survey sample investigating various aspects of mindfulness and mood during pregnancy (nā=ā157) and baseline data from two studies exploring the potential of an online mindfulness course for use during pregnancy (nā=ā207). The sample was non-clinical; responses to the questionnaires were expected to vary within the normal range. The minimum age was 18āyears. Only participants who completed all questionnaires were included; the data collection website was configured to prevent incomplete pages from being submitted.
Procedure
Participants were recruited using online advertising, including Facebook, Twitter, motherhood forums and through distribution of information about the project to local community buildings. Participants were directed to a study website where the participant information was displayed and if they wanted to take part, they were directed to sign consent (on the website, by ticking boxes to agree to the consent form statements and entering their name and date) and complete questionnaires using the Online Survey website [10], see AdditionalĀ fileĀ 1 for the Checklist for Reporting Results of Internet E-Surveys [11]. Informed consent was obtained from all individual participants included in the study.
Measures
A demographic questionnaire included questions about familial and occupational status and the birth (Additional file 2). The following measures were then presented:
Dispositional mindfulness
The Five-Facet Mindfulness Questionnaire-15 (FFMQ [3, 12]) measures dispositional mindfulness ranging from 15 to 75. The scale incorporates mindfulness facet subscales: observe; describe; non-judgement; non-reactivity; awareness. FFMQ mindfulness has shown to increase following mindfulness courses [12]. Cronbachās Ī± for the present studyā=ā.75.
Perceived stress
The Perceived Stress Scale (PSS [13]) was included in this study to measure general stress and measures how uncontrollable and overwhelming past month events are perceived to have been, ranging from 0 to 40. Cronbachās Ī±ā=ā.78.
General anxiety
The General Anxiety Disorder Scale (GAD-7 [14]), measures general anxiety for two preceding weeks and has decreased in a highly anxious pregnant sample following mindfulness courses [15]. Scores range from 0 to 21. Cut-offs are 5, 10 and 15 for mild, moderate and severe anxiety. Cronbachās Ī±ā=ā.90.
Perinatal depression
The Edinburgh Postnatal Depression Scale (EPDS [16]) measures levels of depression over the previous week and ranges from 0 to 30. The measure is designed to assess levels of depression during pregnancy and does not include items that might be confounded by physical aspects of pregnancy (e.g. fatigue, sleep disturbance). A score of 9/10 indicates possible depression; 12/13 likely depression. It has been used during the prenatal and postnatal phases [17, 18]. Cronbachās Ī±ā=ā.76.
Pregnancy distress
The Tilburg Pregnancy Distress Scale (TPDS [19]) measures pregnancy-related distress for the preceding 7ādays and ranges from 0 to 48. A score of more than 17 indicates ādistressedā. High TPDS distress has been associated with lower levels of dispositional mindfulness in pregnant samples [4]. Cronbachās Ī±ā=ā.82.
Worries about labour
Labour worry is said to differ from anxiety and, at a certain level, is a normal part of pregnancy. The Oxford Worries about Labour scale (OWLS [6]) scale has a range of 10ā40 with 10 being the highest worry. The scale was created as a retrospective measure of labour worry using common worries from qualitative data and has not previously been used in a sample of pregnant women. The mean labour worry score in a non-clinical sample of new mothers was 25.15 (SD 6.72 [6]). Cronbachās Ī±ā=ā.84.
The following measures were completed by the survey study and pilot study samples (nā=ā178).
Prenatal distress
The Revised Prenatal Distress Questionnaire (PDQ [7]; PDQ-R [8]) measures pregnancy-related distress ranging from 0 to 34, with questions added at the second and third trimesters. Scores are calculated by dividing the sum by the number of items; normative non-clinical scores are 0.77 overall (SD 0.435 [20]) and 0.72 (SD 0.35), 0.59 (SD 0.32) and 0.55 (0.30) for the three trimesters [8]. Cronbachās Ī±ā=ā.85.
Pregnancy-related discomforts
The scale for Pregnancy-Related Discomforts (PRD [21]), asks about the previous week. The ranges are 0ā75, 0ā65 and 0ā65 for the three trimesters respectively. Normative scores for the three trimesters are 36.9, 26.0 and 29.2 [21]. Cronbachās Ī±ā=ā.90 for first trimester discomforts (nā=ā30) and .86 for second trimester discomforts (nā=ā126).
Pregnancy experience
The Pregnancy Experience Scale (PES-Brief [22]) has 10 questions for positive and negative experiences (uplifts, hassles) of pregnancy, rated from 0 to 3. Frequency scores are calculated by totalling endorsed questions for uplifts and hassles; previous mean scores are 9.5 for uplifts and 6.5ā7.5 for hassles. Intensity scores are calculated by summing the scores for hassles or uplifts and dividing them by the frequency; previous means are 2.4 for uplifts and 1.4 for hassles [22, 23]. Cronbachās Ī±ā=ā.88 for uplifts and .81 for hassles.
Statistical analysis
A series of Pearsonās correlations were run on mood and mindfulness data to investigate relationships. When exploring pregnancy-specific experience, partial correlations were used to control for general stress (PSS data) and anxiety (GAD-7 data). T-tests were conducted to explore any differences between participants who were currently well and those experiencing mental health difficulties.
Results
Data checks
One participant was removed (the first answer was always given), leaving 363 completers. PES hassles showed positive kurtosis (4.609) and the Shapiro Wilkās test was significant for uplifts and hassles with first and third trimester subsamples (sample split into trimesters for analysis (first nā=ā27, second nā=ā116, third nā=ā13), indicating that trimester analyses conducted using this measure should be non-parametric or bootstrapped.
Sample characteristics
Approximately half of the sample (56.5%, nā=ā205) had children. Most participants were in their second trimester of pregnancy with 76.6% (nā=ā278) in their second, 12.9% (nā=ā47) in their first and 10.5% (nā=ā38) in their third. Demographic data is shown in TableĀ 1. Most participants were located in the UK, educated to degree level or higher, married or cohabiting and employed.
Sample means
Mean scores are presented in TableĀ 2. Sample means were typically above population norms with higher scores for stress, anxiety, TPDS distress (meeting the threshold of 17 for ādistressedā [19]) and depression. The smaller sample (made up of survey and pilot samples, nā=ā178) showed moderate pregnancy distress (PDQr [20]), and discomforts [21]. Mean mindfulness was 46.88 (SD 9.57), similar to that found with non-clinical pregnant samples previously (48.10, SD 7.01) [12].
Dispositional mindfulness and general mood
Correlations examining the relationship with dispositional mindfulness and general measures of stress, anxiety and depression showed a negative relationship with PSS stress (rā=āā.622, pā<ā.001), GAD-7 anxiety (rā=āā.551, pā<ā.001) and EPDS Depression, (rā=āā.660, pā<ā.001).
Dispositional mindfulness and pregnancy-related distress
To examine the hypothesis that higher dispositional mindfulness would be associated with lower levels of pregnancy-related distress, correlations were computed between the FFMQ-15, the TPDS (pregnancy distress) and the OWLS (labour worry). There were significant correlations between mindfulness TPDS distress (rā=āā.501, pā<ā.001) and OWLS labour worry (rā=ā.180, pā<Ā .005).
Mindfulness and other aspects of pregnancy experience
Participants from the survey and pilot study samples, nā=ā178, completed several additional measures. These showed that mindfulness was significantly negatively correlated with PDQr distress (rā=āā.430, pā<ā.001), first trimester discomfort (rā=āā.447, pā<ā.05, nā=ā30), second trimester discomfort (rā=āā.373, pā<ā.001, nā=ā147) and the frequency (bootstrapped based on 1000 samples rā=āā.360, pā<ā.001, 95% CIsāāā.469, ā.227) and intensity (bootstrapped based on 1000 samples rā=āā.432, pā<ā.001, 95% CIsāāā.550, ā.296) of negative pregnancy experiences. There was no correlation between mindfulness and the frequency (bootstrapped rā=ā.111, pā=Ā .139, 95% CIsāāā.057, .266) or intensity (bootstrapped rā=ā.118, p .117, 95% CIsāāā.026, .278) of positive pregnancy experiences.
Mindfulness and pregnancy experiences
Controlling for general mood; the PSS for perceived stress and GAD-7 for anxiety, partial correlations were re-run with FFMQ mindfulness and pregnancy-related measures (nā=ā363). Mindfulness was still correlated with EPDS depression (rPSS,GAD-7ā=āā.325, pā<ā.001) and TPDS distress (rPSS,GAD-7ā=āā.233, pā<ā.001) but not to OWLS labour worry (rPSS,GAD-7ā=ā.026, pā=Ā .623).
With the smaller sample (nā=ā178), mindfulness was correlated with PDQr distress (rPSS,GAD-7ā=āā.185, pā<ā.05) and negative pregnancy experiences, both in frequency (bootstrapped based on 1000 samples rPSS,GAD-7ā=āā.235, pā<ā.005, 95% CIsāāā.360, ā.094) and intensity (bootstrapped based on 1000 samples rPSS,GAD-7ā=āā.176, pā<ā.05, 95% CIsāāā.315, ā.016). There was no relationship with first trimester (rPSS,GAD-7ā=āā.165, pā=Ā .400, nā=ā30) or second trimester (rPSS,GAD-7ā=āā.067, pā=Ā .423, nā=ā147) discomforts.
Dispositional mindfulness and pregnancy-specific mood by parity
See TableĀ 3 for the difference in measures by parity.
Partial correlations, controlling for general PSS stress and GAD-7 anxiety were run to examine any difference in those who already had children (nā=ā205) and those who did not (nā=ā158), see TableĀ 4.
In those who had previous children, mindfulness was correlated with EPDS depression (rPSS,GAD-7ā=āā.443, pā<Ā .001) and TPDS distress (rPSS,GAD-7ā=āā.204, pā<Ā .005). OWLS labour worry was not correlated with mindfulness in those with (rPSS,GAD-7ā=ā.011, pā=Ā .880) children.
Examining the measures completed by fewer participants (nā=ā178), comparing those with (nā=ā90) and without children (nā=ā88), mindfulness was not correlated with PDQr distress in those with children (rPSS,GAD-7ā=āā.074, pā=Ā .495).
Correlations with mindfulness and pregnancy experience showed that there was still a relationship with the frequency of negative pregnancy experiences and mindfulness in those who already had children (bootstrapped based on 1000 samples rPSS,GAD-7ā=āā.297, pā=Ā .005, 95% CIsāāā.482, ā.116).There was a trend for the intensity of negative pregnancy experiences in those with children (bootstrapped based on 1000 samples rPSS,GAD-7ā=āā.207, pā=Ā .053, 95% CIsāāā.401, .025). Examining second trimester discomforts, mindfulness was not correlated in those who had children (rPSS,GAD-7ā=āā.035, pā=Ā .773, nā=ā71).
In those without children, EPDS depression was no longer correlated with mindfulness (rPSS,GAD-7ā=āā.147, pā=Ā .067) and was still correlated with TPDS distress (rPSS,GAD-7ā=āā.305, pā<Ā .001). OWLS labour worry was not correlated with mindfulness in those without children (rPSS,GAD-7ā=ā.084, pā=Ā .299).
Examining the measures completed by fewer participants (nā=ā178), comparing those with (nā=ā90) and without children (nā=ā88), mindfulness was correlated with PDQr distress (rPSS,GAD-7ā=āā.357, pā=Ā .001) in those who had no previous children.
In those without prior children, there was no longer a relationship between negative pregnancy experience and mindfulness, either frequency (bootstrapped based on 1000 samples rPSS,GAD-7ā=āā.145, pā=Ā .182, 95% CIsāāā.309, .017) or intensity (bootstrapped based on 1000 samples rPSS,GAD-7ā=āā.158, pā=Ā .147, 95% CIsāāā.321, .019). Examining second trimester discomforts, mindfulness was not correlated in those who did not have children (rPSS,GAD-7ā=āā.194, pā=Ā .097, nā=ā76).
Mindfulness, general mood and current mental health problems
Participants were asked whether or not they had current mental health problems and if so, what they were. Of those who did have mental health problems (nā=ā52) a variety of problems were stated including depression (nā=ā22), anxiety (nā=ā15), bipolar depression (nā=ā1) or a mixture of two or more co-morbidities (nā=ā14) including issues such as depression, anxiety, obsessive compulsive disorder, borderline personality disorder, bipolar depression and post-traumatic stress disorder.. A conservative effect size of 0.25 (f) [27] was used to determine the t-test power with a sample of 52 compared with 311 healthy participants, using G*Power software [28]. The estimated power for such a test was 80% (df 361).
Compared with currently well participants (nā=ā311), participants with mental health issues (nā=ā52) had significantly higher perceived stress, t (361)ā=ā5.52, pā<ā.001 and anxiety t (361)ā=ā6.21, pā<ā.001. Dispositional mindfulness was also significantly lower for participants experiencing mental health problems, t (361)ā=āāā5.30, pā<ā.001. See TableĀ 5.
Correlations examining the relationship with mindfulness and mood in participants with (nā=ā52) and without (nā=ā311) current mental health problems showed that perceived stress was correlated with mindfulness in the two groups, rā=āā.455, pā<ā.005 and rā=āā.612, pā<ā.001 respectively and so was anxiety, rā=āā.355, pā<ā.05 and rā=āā.536, pā<ā.001.
Mindfulness, pregnancy-related mood and current mental health problems
Participants with mental health issues (nā=ā52) had significantly higher EPDS pregnancy-related depression, t (361)ā=ā5.52, pā<ā.001 and pregnancy-related TPDS distress t (361)ā=ā1.97, pā=ā.05 compared with their currently healthy counterparts (nā=ā311).
Correlations split by current mental health problems (nā=ā52) or not (nā=ā311) showed that, in those without problems, mindfulness was correlated with pregnancy-related depression, rā=āā.665, pā<ā.001, distress, rā=āā.57, pā<ā.001 and labour worry, rā=ā.244, pā<ā.001. For participants with current problems, mindfulness was correlated with pregnancy-related depression, rā=āā.433, pā<ā.005 but not correlated with distress, rā=āā.78, pā=ā.58, nor labour worry, rā=āā.140, pā=ā.32.
Partial correlations in those with no current mental health problems (nā=ā311), controlling for general mood (PSS stress, & GAD-7 anxiety) showed that mindfulness was correlated with pregnancy-related depression, r (PSS, GAD-7)ā=āā.359, pā<Ā .001 and distress, r (PSS, GAD-7)ā=āā.333, pā<Ā .001 and not with labour worry, r (PSS, GAD-7)ā=ā.078, pā=Ā .17. Examining participants with current problems (nā=ā52), mindfulness was not correlated with pregnancy-related depression, r (PSS, GAD-7)ā=āā.133, pā=ā.36, distress, r (PSS, GAD-7)ā=ā.136, pā=ā.35, nor labour worry, r (PSS, GAD-7)ā=āā.192, pā=ā.18.
Discussion and conclusions
The intention of this study was to evaluate the relationship between mood and mindfulness in a cross-sectional analysis of pregnant women to further limited research.
The level of dispositional mindfulness had a significant association with mood such that higher mindfulness scores were related to lower scores of general stress and anxiety and controlling for general mood, pregnancy-related depression, distress and rates of negative pregnancy experiences.
For participants who had children, when accounting for levels of general stress and anxiety, higher mindfulness scores were associated with lower scores of pregnancy-related depression, distress and negative pregnancy experiences. In those without children, higher mindfulness was associated with lower pregnancy-related distress.
Higher levels of mindfulness were related to lower levels of general stress and anxiety whether or not participants had current mental health problems. In those without current problems, when controlling for general stress and anxiety, higher mindfulness scores were associated with lower levels of pregnancy-related depression and distress but for participants who had current mental health problems, there was no relationship.
The current findings show that, in a sample with higher scores of negative mood overall, higher levels of dispositional mindfulness are associated with lower levels of general and pregnancy-related negative mood, but that the background of the participants should be taken into account. The current analysis, being correlational in nature, can only show a relationship and not causality, i.e. it is unclear whether lower levels of mindfulness incur higher levels of stress etc. or that higher levels of stress incur lower levels of mindfulness. While the current findings suggest that offering a mindfulness-based stress reduction course to women during pregnancy may be beneficial, more research should be conducted to investigate the relationship and potential benefits in more detail. This paper presents an initial exploration of how mood and mindfulness relate to each other during pregnancy and is a precursor to future studies investigating mindfulness interventions for pregnant populations.
Research has found that higher dispositional mindfulness during pregnancy was associated with improved mood during and after pregnancy if it was maintained or increased [2]. Potentially, sustaining levels of mindfulness over pregnancy could be beneficial for low mood. Offering a course with mindfulness-based elements, specifically aimed at alleviating low mood during pregnancy, may be most beneficial.
This study has limitations. First, the study is cross-sectional with no follow-up data so it is difficult to posit how these women would have felt later in pregnancy. While splitting the sample by trimester gives an indication of mood during different times, it would be more informative to investigate how mood changes during pregnancy. Second, measures of pregnancy-specific anxiety and stress were not included to limit participant burden; while pregnancy-specific and general anxiety and stress may reflect different emotional constructs, potential differences cannot be currently evaluated because of this omission and it may be helpful to include them in future studies.
This is one of the first studies to explore mood and dispositional mindfulness during pregnancy and as such, is a good precursor to future studies. Proceeding studies should investigate whether mindfulness mediates mood improvement and use this work to improve the rationale and research surrounding the utility of mindfulness courses for use in this population.
Availability of data and materials
The datasets used during the current study are not publicly available but are available from the corresponding author on reasonable request.
References
van den Heuvel MI, Johannes MA, Henrichs J, Van den Bergh BRH. Maternal mindfulness during pregnancy and infant socio-emotional development and temperament: The mediating role of maternal anxiety. Early Hum Dev. 2015;91(2):103ā8. https://doi.org/10.1016/j.earlhumdev.2014.12.003.
Zoeterman SE. In the moment: prenatal mindful awareness and its relationship to depression, anxiety, and birth experience. (Doctoral dissertation, Teachers College, Columbia University). 2013.
Baer RA, Smith GT, Hopkins J, Krietemeyer J, Toney L. Using self-report assessment methods to explore facets of mindfulness. Assessment. 2006;13(1):27ā45. https://doi.org/10.1177/1073191105283504.
Truijens SEM, NyklĆÄek I, van Son J, Pop VJM. Validation of a short form Three Facet Mindfulness Questionnaire (TFMQ-SF) in pregnant women. Pers Individ Dif. 2015. https://doi.org/10.1016/j.paid.2015.06.037.
Roesch SC, Schetter CD, Woo G, Hobel CJ. Modeling the types and timing of stress in pregnancy. Anxiety Stress Coping. 2004;17(1):87ā102.
Redshaw M, Martin C, Rowe R, Hockley C. The Oxford worries about labour scale: Women's experience and measurement characteristics of a measure of maternal concern about labour and birth. Psychol Health Med. 2009;14(3):354ā66. https://doi.org/10.1080/13548500802707159.
Yali AM, Lobel M. Coping and distress in pregnancy: an investigation of medically high risk women. J Psychosom Obstet Gynecol. 1999;20(1):39ā52.
Lobel M, Cannella DL, Graham JE, DeVincent C, Schneider J, Meyer BA. Pregnancy-specific stress, prenatal health behaviors, and birth outcomes. Health Psychol. 2008;27(5):604.
Carmody J, Baer RA. Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. J Behav Med. 2008;31(1):11.
Online surveys. https://www.onlinesurveys.ac.uk/. Accessed 18 July 2019.
Eysenbach G. Improving the quality of Web surveys: the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). J Med Internet Res. 2004;6(3):e34.
Baer RA, Carmody J, Hunsinger M. Weekly change in mindfulness and perceived stress in a mindfulness-based stress reduction program. J Clin Psychol. 2012;68(7):755ā65. https://doi.org/10.1002/jclp.21865.
Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385ā96 doi:citeulike-article-id:2078058.
Spitzer RL, Kroenke K, Williams JBW, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092ā7. https://doi.org/10.1001/archinte.166.10.1092.
Goodman J, Guarino A, Chenausky K, Klein L, Prager J, Petersen R, et al. CALM pregnancy: results of a pilot study of mindfulness-based cognitive therapy for perinatal anxiety. Arch Womenās Ment Health. 2014;17(5):373ā87. https://doi.org/10.1007/s00737-013-0402-7.
Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatry. 1987;150(6):782ā6. https://doi.org/10.1192/bjp.150.6.782.
Pearson RM, Evans J, Kounali D, Lewis G, Heron J, Ramchandani PG, et al. Maternal depression during pregnancy and the postnatal period: risks and possible mechanisms for offspring depression at age 18 years. JAMA Psychiatry. 2013;70(12):1312ā9. https://doi.org/10.1001/jamapsychiatry.2013.2163.
Edmondson OJ, Psychogiou L, Vlachos H, Netsi E, Ramchandani PG. Depression in fathers in the postnatal period: assessment of the Edinburgh postnatal depression scale as a screening measure. J Affect Disord. 2010;125(1):365ā8.
Pop V, Pommer A, Pop-Purceleanu M, Wijnen H, Bergink V, Pouwer F. Development of the Tilburg pregnancy distress scale: the TPDS. BMC Pregnancy Childbirth. 2011;11(1):80.
Coussons-Read ME, Lobel M, Carey JC, Kreither MO, DāAnna K, Argys L, et al. The occurrence of preterm delivery is linked to pregnancy-specific distress and elevated inflammatory markers across gestation. Brain Behav Immun. 2012;26(4):650ā9.
Shinkawa H, Shimada M, Hirokane K, Hayase M, Inui T. Development of a scale for pregnancy-related discomforts. J Obstet Gynaecol Res. 2012;38(1):316ā23. https://doi.org/10.1111/j.1447-0756.2011.01676.x.
DiPietro JA, Christensen A, Costigan K. The pregnancy experience scale ā brief version. J Psychosom Obstet Gynaecol. 2008;29(4):262ā7.
DiPietro JA, Costigan K, Hawkins M. Measuring the ups and downs of pregnancy stress. J Psychosom Obstet Gynaecol. 2004;25(3ā4):189ā201.
Cohen S, Williamson G. Perceived stress in a probability sample of the United States. In: Spacapan S, Oskamp S, editors. The social psychology of health: Claremont Symposium on applied social psychology; 1988. p. 31ā67.
Lƶwe B, Decker O, MĆ¼ller S, BrƤhler E, Schellberg D, et al. Validation and standardization of the generalized anxiety disorder screener (GAD-7) in the general population. Med Care. 2008;46(3):266ā74. https://doi.org/10.1097/MLR.0b013e318160d093.
Cox JL, Murray D, Chapman G. A controlled study of the onset, duration and prevalence of postnatal depression. Br J Psychiatry. 1993;163(1):27ā31. https://doi.org/10.1192/bjp.163.1.27.
Cohen S. A power primer. Psychol Bull. 1992;112(1):155ā9.
Erdfelder E, Faul F, Buchner A. GPOWER: a general power analysis program. Behav Res Methods Instrum Comput. 1996;28(1):1ā11.
Acknowledgements
This work was supported by a studentship from the Mental Health Foundation with additional financial support from the Oxford Mindfulness Centre. The authors would like to thank all of the women who participated in this study.
Funding
This work was funded by a studentship from the Mental Health Foundation with additional financial support from the Oxford Mindfulness Centre. The funding bodies had no input into the study and were updated annually on the progress of the DPhil.
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AK, CC and MD were involved in study conception and design. AK collected and managed the data. AK completed statistical analysis and all authors contributed to statistical interpretation. AK prepared the manuscript and completed revisions. CC and MD provided critical feedback on all manuscript drafts. All authors approved the manuscript. AK is the guarantor.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee, the Central University Research Ethics Committee (CUREC; MSD-IDREC- C1ā2013-016) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors. Informed consent was obtained from all individual participants included in the study via the secure Online Surveys website [10], by ticking boxes to agree to the consent form statements and entering their name and date.
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Participants consented to the use of their anonymous data to be use in publications.
Competing interests
Adele Krusche completed this work as part of her DPhil in Psychiatry. Catherine Crane is based at the Oxford Mindfulness Centre and funded by the Wellcome Trust, GR 104908/Z/14/Z. She has no competing interests to declare. Dr. Maret Dymond is a partner within The New Forest Mindfulness and Therapeutic Centre. She has no competing interests to declare.
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Checklist for Reporting Results of Internet E-Surveys (CHERRIES). (DOCX 15 kb)
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Sociodemographic Questionnaire. (DOCX 20 kb)
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Krusche, A., Crane, C. & Dymond, M. An investigation of dispositional mindfulness and mood during pregnancy. BMC Pregnancy Childbirth 19, 273 (2019). https://doi.org/10.1186/s12884-019-2416-2
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DOI: https://doi.org/10.1186/s12884-019-2416-2