Fatigue and Mindful Parenting in the Postpartum Period: The Role of Difficulties in Emotion Regulation and Anxious and Depressive Symptomatology

Abushaikha, L., Safadi, R., & Ahmad, M. (2018). Assessing the association between fatigue and functional status during postpartum. Sexual & Reproductive Healthcare, 18, 19–23. https://doi.org/10.1016/j.srhc.2018.08.005 Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2), 217–237. https://doi.org/10.1016/j.cpr.2009.11.004 American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596 Badr, H. A., & Zauszniewski, J. A. (2017). Meta-analysis of the predictive factors of postpartum fatigue. Applied Nursing Research, 36, 122–127. https://doi.org/10.1016/j.apnr.2017.06.010 Barlow, D.H., Farchione, T.J., Sauer-Zavala, S., Latin, H.M., Ellard, K.K., Bullis, J.R., Bentley, K.H., Boettcher, H.T., & Cassiello-Robbins, C. (2018). Unified protocol for transdiagnostic treatment of emotional disorders: Therapist guide (2nd ed.). Oxford University Press. https://doi.org/10.1093/med-psych/9780190685973.001.0001 Bögels, S. M., Hellemans, J., van Deursen, S., Römer, M., & van der Meulen, R. (2014). Mindful parenting in mental health care: Effects on parental and child psychopathology, parental stress, parenting, coparenting, and marital functioning. Mindfulness, 5(5), 536–551. https://doi.org/10.1007/s12671-013-0209-7 Bögels, S., & Restifo, K. (2014). Mindful parenting: A guide for mental health practitioners. Springer. https://doi.org/10.1007/978-1-4614-7406-7 Brown, S., & Lumley, J. (1998). Maternal health after childbirth: Results of an Australian population based survey. British Journal of Obstetrics and Gynaecology, 105(2), 156–161. https://doi.org/10.1111/j.1471-0528.1998.tb10045.x Caiado, B., Fernandes, D. V., Canavarro, M. C., & Moreira, H. (2020). The Interpersonal Mindfulness in Parenting Scale – Infant version: Psychometric properties and factor structure in a sample of Portuguese mothers in the postpartum period. Psychologica, 63(2), 139–157. https://doi.org/10.14195/1647-8606_63-2_7 Campbell-Sills, L., Barlow, D. H., Brown, T. A., & Hofmann, S. G. (2006). Effects of suppression and acceptance on emotional responses of individuals with anxiety and mood disorders. Behaviour Research and Therapy, 44(9), 1251–1263. https://doi.org/10.1016/j.brat.2005.10.001 Cisler, J. M., & Koster, E. H. W. (2010). Mechanisms of attentional biases towards threat in anxiety disorders: An integrative review. Clinical Psychology Review, 30(2), 203–216. https://doi.org/10.1016/j.cpr.2009.11.003 Coatsworth, J. D., Duncan, L. G., Greenberg, M. T., & Nix, R. L. (2010). Changing parent’s mindfulness, child management skills and relationship quality with their youth: Results from a randomized pilot intervention trial. Journal of Child and Family Studies, 19(2), 203–217. https://doi.org/10.1007/s10826-009-9304-8 Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates. Dix, T., Gershoff, E. T., Meunier, L. N., & Miller, P. C. (2004). The affective structure of supportive parenting: Depressive symptoms, immediate emotions, and child-oriented motivation. Developmental Psychology, 40(6), 1212–1227. https://doi.org/10.1037/0012-1649.40.6.1212 Duncan, L. G. (2007). Assessment of mindful parenting among parents of early adolescents: Development and validation of the Interpersonal Mindfulness in Parenting Scale [Unpublished doctoral dissertation]. The Pennsylvania State University. Duncan, L. G., Coatsworth, J. D., & Greenberg, M. T. (2009). A model of mindful parenting: Implications for parent–child relationships and prevention research. Clinical Child and Family Psychology Review, 12(3), 255–270. https://doi.org/10.1007/s10567-009-0046-3 Dunning, M., Seymour, M., Cooklin, A., & Giallo, R. (2013). Wide awake parenting: Study protocol for a randomised controlled trial of a parenting program for the management of post-partum fatigue. BMC Public Health, 13, 26. https://doi.org/10.1186/1471-2458-13-26 Fernandes, D. V., Canavarro, M. C., & Moreira, H. (2021a). The mediating role of parenting stress in the relationship between anxious and depressive symptomatology, mothers’ perception of infant temperament, and mindful parenting during the postpartum period. Mindfulness, 12(2), 275–290. https://doi.org/10.1007/s12671-020-01327-4 Fernandes, D. V., Canavarro, M. C., & Moreira, H. (2021b). Mindful parenting interventions for the postpartum period: Acceptance and preferences of mothers with and without depressive symptoms. Mindfulness, 12(2), 291–305. https://doi.org/10.1007/s12671-020-01430-6 Fonseca, A., Monteiro, F., & Canavarro, M. C. (2018). Dysfunctional beliefs towards motherhood and postpartum depressive and anxiety symptoms: Uncovering the role of experiential avoidance. Journal of Clinical Psychology, 74(12), 2134–2144. https://doi.org/10.1002/jclp.22649 Forman, D. R., O’Hara, M. W., Stuart, S., Gorman, L. L., Larsen, K. E., & Coy, K. C. (2007). Effective treatment for postpartum depression is not sufficient to improve the developing mother–child relationship. Development and Psychopathology, 19(2), 585–602. https://doi.org/10.1017/S0954579407070289 Giallo, R., Rose, N., & Vittorino, R. (2011a). Fatigue, wellbeing and parenting in mothers of infants and toddlers with sleep problems. Journal of Reproductive and Infant Psychology, 29(3), 236–249. https://doi.org/10.1080/02646838.2011.593030 Giallo, R., Seymour, M., Dunning, M., Cooklin, A., Loutzenhiser, L., & McAuslan, P. (2015). Factors associated with the course of maternal fatigue across the early postpartum period. Journal of Reproductive and Infant Psychology, 33(5), 528–544. https://doi.org/10.1080/02646838.2015.1021769 Giallo, R., Wade, C., Cooklin, A., & Rose, N. (2011b). Assessment of maternal fatigue and depression in the postpartum period: Support for two separate constructs. Journal of Reproductive and Infant Psychology, 29(1), 69–80. https://doi.org/10.1080/02646838.2010.513050 Gouveia, M. J. R., Canavarro, M. C. C. S. P., & Moreira, H. T. C. (2019). Linking mothers’ difficulties in emotion regulation to children/adolescents’ emotional eating in pediatric obesity: The mediating role of mindful parenting and children/adolescents’ depressive symptoms. Mindfulness, 10(5), 877–893. https://doi.org/10.1007/s12671-018-1055-4 Gouveia, M. J., Carona, C., Canavarro, M. C., & Moreira, H. (2016). Self-compassion and dispositional mindfulness are associated with parenting styles and parenting stress: The mediating role of mindful parenting. Mindfulness, 7(3), 700–712. https://doi.org/10.1007/s12671-016-0507-y Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2(3), 271–299. https://doi.org/10.1037/1089-2680.2.3.271 Haga, S. M., Ulleberg, P., Slinning, K., Kraft, P., Steen, T. B., & Staff, A. (2012). A longitudinal study of postpartum depressive symptoms: Multilevel growth curve analyses of emotion regulation strategies, breastfeeding self-efficacy, and social support. Archives of Women’s Mental Health, 15(3), 175–184. https://doi.org/10.1007/s00737-012-0274-2 Hayes, A. F. (2018). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach (2nd ed.). Guilford Press. Henderson, J., Alderdice, F., & Redshaw, M. (2019). Factors associated with maternal postpartum fatigue: An observational study. BMJ Open, 9(7), e025927. https://doi.org/10.1136/bmjopen-2018-025927 Hughes, E. K., & Gullone, E. (2010). Parent emotion socialisation practices and their associations with personality and emotion regulation. Personality and Individual Differences, 49(7), 694–699. https://doi.org/10.1016/j.paid.2010.05.042 Kabat-Zinn, M., & Kabat-Zinn, J. (1997). Everyday blessings: The inner work of mindful parenting. Hyperion Kaufman, E. A., Xia, M., Fosco, G., Yaptangco, M., Skidmore, C. R., & Crowell, S. E. (2016). The Difficulties in Emotion Regulation Scale Short Form (DERS-SF): Validation and replication in adolescent and adult samples. Journal of Psychopathology and Behavioral Assessment, 38(3), 443–455. https://doi.org/10.1007/s10862-015-9529-3 Kurth, E., Kennedy, H. P., Spichiger, E., Hösli, I., & Stutz, E. Z. (2011). Crying babies, tired mothers: What do we know? A Systematic Review. Midwifery, 27(2), 187–194. https://doi.org/10.1016/j.midw.2009.05.012 Lai, Y.-L., Hung, C.-H., Stocker, J., Chan, T.-F., & Liu, Y. (2015). Postpartum fatigue, baby-care activities, and maternal–infant attachment of vaginal and cesarean births following rooming-in. Applied Nursing Research, 28(2), 116–120. https://doi.org/10.1016/j.apnr.2014.08.002 Lorber, M. F. (2012). The role of maternal emotion regulation in overreactive and lax discipline. Journal of Family Psychology, 26(4), 642–647. https://doi.org/10.1037/a0029109 Lovejoy, M. C., Graczyk, P. A., O’Hare, E., & Neuman, G. (2000). Maternal depression and parenting behavior: A meta-analytic review. Clinical Psychology Review, 20(5), 561–592. https://doi.org/10.1016/S0272-7358(98)00100-7 MacDonald, E. E., & Hastings, R. P. (2010). Mindful parenting and care involvement of fathers of children with intellectual disabilities. Journal of Child and Family Studies, 19(2), 236–240. https://doi.org/10.1007/s10826-008-9243-9 Manning, K., Bakhshaie, J., Shepherd, J. M., Jones, J., Timpano, K. R., Viana, A. G., & Zvolensky, M. J. (2019). Fatigue severity and emotion dysregulation: Roles in mental health among trauma exposed college students. Fatigue: Biomedicine, Health & Behavior, 7(4), 181–195. https://doi.org/10.1080/21641846.2019.1661942 Manning, K., Garey, L., Mayorga, N. A., Shepherd, J. M., & Zvolensky, M. J. (2019). The relation between fatigue severity and anxious arousal, negative affect, and emotion dysregulation among adult e-cigarette users. Fatigue: Biomedicine, Health & Behavior, 7(2), 92–101. https://doi.org/10.1080/21641846.2019.1626059 Marques, R., Monteiro, F., Canavarro, M. C., & Fonseca, A. (2018). The role of emotion regulation difficulties in the relationship between attachment representations and depressive and anxiety symptoms in the postpartum period. Journal of Affective Disorders, 238, 39–46. https://doi.org/10.1016/j.jad.2018.05.013 Michielsen, H. J., De Vries, J., Van Heck, G. L., Van de Vijver, F. J. R., & Sijtsma, K. (2004). Examination of the dimensionality of fatigue: The construction of the Fatigue Assessment Scale (FAS). European Journal of Psychological Assessment, 20(1), 39–48. https://doi.org/10.1027/1015-5759.20.1.39 Moreira, H., & Canavarro, M. C. (2017). Psychometric properties of the Interpersonal Mindfulness in Parenting Scale in a sample of Portuguese mothers. Mindfulness, 8(3), 691–706. https://doi.org/10.1007/s12671-016-0647-0 Moreira, H., & Canavarro, M. C. (2018). Does the association between mindful parenting and adolescents’ dispositional mindfulness depend on the levels of anxiety and depression symptomatology in mothers? Journal of Adolescence, 68, 22–31. https://doi.org/10.1016/j.adolescence.2018.07.003 Moreira, H., Gouveia, M. J., & Canavarro, M. C. (2020). A bifactor analysis of the Difficulties in Emotion Regulation Scale - Short Form (DERS-SF) in a sample of adolescents and adults. Current Psychology. https://doi.org/10.1007/s12144-019-00602-5 Online Advance Publication. Nash, C., Morris, J., & Goodman, B. (2008). A study describing mothers’ opinions of the crying behaviour of infants under one year of age. Child Abuse Review, 17(3), 191–200. https://doi.org/10.1002/car.1017 Nazaré, B. (2018). Adaptação da Fatigue Assessment Scale em mães de bebés até dois anos. [Adaptation of the Fatigue Assessment Scale in mothers of babies aged up two years]. In I. Leal, S. von Humboldt, C. Ramos, A. Ferreira-Valente, & J. L. Pais Ribeiro (Eds.), Actas do 12º congresso nacional de psicologia da saúde (pp. 157–165). ISPA – Instituto Universitário Nelson, A. M. (2003). Transition to motherhood. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 32(4), 465–477. https://doi.org/10.1177/0884217503255199 Nicol-Harper, R., Harvey, A. G., & Stein, A. (2007). Interactions between mothers and infants: Impact of maternal anxiety. Infant Behavior and Development, 30(1), 161–167. https://doi.org/10.1016/j.infbeh.2006.08.005 Pais-Ribeiro, J., Silva, I., Ferreira, T., Martins, A., Meneses, R., & Baltar, M. (2007). Validation study of a Portuguese version of the Hospital Anxiety and Depression Scale. Psychology, Health & Medicine, 12(2), 225–237. https://doi.org/10.1080/13548500500524088 Palmer, C. A., & Alfano, C. A. (2017). Sleep and emotion regulation: An organizing, integrative review. Sleep Medicine Reviews, 31, 6–16. https://doi.org/10.1016/j.smrv.2015.12.006 Parent, J., McKee, L. G., Anton, M., Gonzalez, M., Jones, D. J., & Forehand, R. (2016). Mindfulness in Parenting and Coparenting. Mindfulness, 7(2), 504–513. https://doi.org/10.1007/s12671-015-0485-5 Potharst, E. S., Aktar, E., Rexwinkel, M., Rigterink, M., & Bögels, S. M. (2017). Mindful with your baby: Feasibility, acceptability, and effects of a mindful parenting group training for mothers and their babies in a mental health context. Mindfulness, 8(5), 1236–1250. https://doi.org/10.1007/s12671-017-0699-9 Rutherford, H. J. V., Wallace, N. S., Laurent, H. K., & Mayes, L. C. (2015). Emotion regulation in parenthood. Developmental Review, 36, 1–14. https://doi.org/10.1016/j.dr.2014.12.008 Sarıtaş, D., Grusec, J. E., & Gençöz, T. (2013). Warm and harsh parenting as mediators of the relation between maternal and adolescent emotion regulation. Journal of Adolescence, 36(6), 1093–1101. https://doi.org/10.1016/j.adolescence.2013.08.015 Sawyer, J. A. (2007). Mindful parenting, affective attunement, and maternal depression: A call for research. Graduate Student Journal of Psychology, 9, 3–9. Schultheis, A. M., Mayes, L. C., & Rutherford, H. J. V. (2019). Associations between emotion regulation and parental reflective functioning. Journal of Child and Family Studies, 28(4), 1094–1104. https://doi.org/10.1007/s10826-018-01326-z Shaffer, A., & Obradović, J. (2017). Unique contributions of emotion regulation and executive functions in predicting the quality of parent–child interaction behaviors. Journal of Family Psychology, 31(2), 150–159. https://doi.org/10.1037/fam0000269 Shen, J., Barbera, J., & Shapiro, C. M. (2006). Distinguishing sleepiness and fatigue: Focus on definition and measurement. Sleep Medicine Reviews, 10(1), 63–76. https://doi.org/10.1016/j.smrv.2005.05.004 Snaith, R. P. (2003). The Hospital Anxiety and Depression Scale. Health and Quality of Life Outcomes, 1, 29. https://doi.org/10.1186/1477-7525-1-29 Stein, A., Craske, M. G., Lehtonen, A., Harvey, A., Savage-McGlynn, E., Davies, B., Goodwin, J., Murray, L., Cortina-Borja, M., & Counsell, N. (2012). Maternal cognitions and mother–infant interaction in postnatal depression and generalized anxiety disorder. Journal of Abnormal Psychology, 121(4), 795–809. https://doi.org/10.1037/a0026847 Sutherland, J.-A. (2010). Mothering, guilt and shame. Sociology Compass, 4(5), 310–321. https://doi.org/10.1111/j.1751-9020.2010.00283.x Taylor, J., & Johnson, M. (2013). The role of anxiety and other factors in predicting postnatal fatigue: From birth to 6 months. Midwifery, 29(5), 526–534. https://doi.org/10.1016/j.midw.2012.04.011 Tibubos, A. N., Grammes, J., Beutel, M. E., Michal, M., Schmutzer, G., & Brähler, E. (2018). Emotion regulation strategies moderate the relationship of fatigue with depersonalization and derealization symptoms. Journal of Affective Disorders, 227, 571–579. https://doi.org/10.1016/j.jad.2017.11.079 Wade, C., Giallo, R., & Cooklin, A. (2012). Maternal fatigue and depression: Identifying vulnerability and relationship to early parenting practices. Advances in Mental Health, 10(3), 277–291. https://doi.org/10.5172/jamh.2012.10.3.277 Wilson, N., Wynter, K., Fisher, J., & Bei, B. (2018). Related but different: Distinguishing postpartum depression and fatigue among women seeking help for unsettled infant behaviours. BMC Psychiatry, 18, 309. https://doi.org/10.1186/s12888-018-1892-7 Xiao, S. X., Spinrad, T. L., & Carter, D. B. (2018). Parental emotion regulation and preschoolers’ prosocial behavior: The mediating roles of parental warmth and inductive discipline. The Journal of Genetic Psychology, 179(5), 246–255. https://doi.org/10.1080/00221325.2018.1495611 Yoo, S.-S., Gujar, N., Hu, P., Jolesz, F. A., & Walker, M. P. (2007). The human emotional brain without sleep — A prefrontal amygdala disconnect. Current Biology, 17(20), 877–878. https://doi.org/10.1016/j.cub.2007.08.007 Zeegers, M. A. J., Potharst, E. S., Veringa-Skiba, I. K., Aktar, E., Goris, M., Bögels, S. M., & Colonnesi, C. (2019). Evaluating mindful with your baby/toddler: Observational changes in maternal sensitivity, acceptance, mind-mindedness, and dyadic synchrony. Frontiers in Psychology, 10, 753. https://doi.org/10.3389/fpsyg.2019.00753 Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67(6), 361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x