(PS10-87) Longitudinal Study on the Relationship between Emotion Regulation and Perinatal Mental Health in Japanese Women

In Japan, the prevalence of perinatal depression ranges from 10% to 15%, which is lower than global rates. However, a previous study reported that Japanese perinatal women who attempted suicide suffered from depression and other psychiatric disorders, with a mortality rate more than twice that of maternal mortality due to obstetric abnormalities. Therefore, it is necessary to identify psychological factors contributing to perinatal depression and anxiety and provide appropriate interventions for Japanese perinatal women.

This study aimed to investigate the relationship between emotion regulation (ER) strategies and depression, anxiety, and stress in Japanese perinatal women. The research involved an online survey of 300 mothers at two time points: during the third trimester of pregnancy (Time 1) and 12 weeks postpartum (Time 2). The study assessed depression, anxiety, stress, and emotion regulation strategies. These included the Edinburgh Postnatal Depression Scale (EPDS), Depression Anxiety Stress Scale (DASS-21), Perceive Prenatal Maternal Stress Scale (PPMSS), Parenting Stress Index Short Form (PSI-SF), Emotion Regulation Questionnaire (ERQ), Ruminative Responses Scale (RRS), Acceptance and Action Questionnaire-II (AAQ-II), Mindfulness Attention Awareness Scale (MAAS), Cognitive Avoidance Questionnaire (CAQ), and Problem Solving Inventory (PSI).

Results showed a positive correlation between ERQ reappraisal and suppression at both time points, consistent with Japanese cultural norms. Psychological flexibility and mindfulness negatively correlated with prenatal and parenting stress. The results of mediation analysis revealed that, at Time 1, brooding and reflection on the rumination, as well as psychological flexibility mediate the relationship between stress and depression/anxiety during pregnancy. Similarly, at Time 2, significant mediating effects of the relationship between postpartum stress and depression/anxiety were observed for brooding, reflection, and psychological flexibility. The results of hierarchical multiple regression showed that the interaction between parenting stress and mindfulness, as well as cognitive avoidance, predicted changes in depression (p < .10). Additionally, the interaction between parenting stress and rumination significantly predicted changes in depression and anxiety (p< .01).

These findings suggest that psychological flexibility, mindfulness, and control over rumination may play important roles in mediating the relationship between pregnancy/parenting stressors and depression or anxiety in Japanese perinatal women. Consequently, it may be necessary to develop Cognitive Behavioral Therapy (CBT) interventions that focus on enhancing psychological flexibility and mindfulness while managing rumination to reduce depression and anxiety in Japanese perinatal women.

This study has several limitations, including potential inconsistencies in the data due to postpartum surveys being conducted at varying intervals between 3 to 6 months after childbirth. Additionally, caution is needed to interpret results using the Japanese version of the DASS due to sample limitations and structure differences from the original version.