Mediating Effect of Resilience During Pregnancy on the Association Between Maternal Trait Anger and Postnatal Depression

Objective: The association between anger and postnatal depression has been reported in previous studies. However, whether this association is mediated by resilience is unknown. Resilience is a dynamic process of individuals' positive adaptation to stress and adversity. This study investigated the mediating effect of resilience during pregnancy on the association between trait anger during pregnancy and postnatal depression at one-month.

Methods: A longitudinal study from the third trimester to one-month postnatal using online self-report questionnaires was conducted in two maternity clinics in Tokyo. Trait anger and resilience during pregnancy and postnatal depression at one-month were measured by the State-Trait Anger Expression Inventory, resilience test, and the Edinburgh Postnatal Depression Scale. To test the hypothesis, Structural Equation Modeling was used.

Results: Data of 531 participants were analyzed. The final Structural Equation Modeling model demonstrated that resilience during pregnancy had a partial mediating effect on the association between trait anger during pregnancy and postnatal depression at one-month. Trait anger was significantly associated with resilience during pregnancy (β = -0.28) and postnatal depression (β = 0.24). Resilience during pregnancy was significantly associated with postnatal depression (β = -0.20).

Conclusions: This study demonstrated that resilience during pregnancy had a partial mediating effect on the association between trait anger during pregnancy and postnatal depression at one-month. The findings highlight the importance of identifying pregnant women with high trait anger and providing interventions to enhance their resilience to decrease the risk of postnatal depression.