| The purpose of the present study was to test several depression models including Beck's cognitive model, Rehm's self-control model, Seligman's learned helplessness model, and Lewinsohn's behavioral model in a prospective study of postpartum depression. A sample of 170 women were followed from the second trimester of their preganancy until, on the average, 11 weeks postpartum. The sample could be characterized as follows: mean age, 26.6; marital status, 85.3% married; race, 84.1% white; religion, 50.6% Catholic, and 26% Protestant. In terms of socioeconomic status they represented all levels with a bias toward the middle to upper middle class. The subjects were representative of women who had delivered at the large womens hospital where the study was conducted.;At the time of the initial contact subjects completed a series of questionnaires that tapped constructs related to each model of depression as well as the Beck Depression Inventory. In addition, extensive sociodemographic data were collected including information about the size and make-up of the subjects' social networks. Within a month of delivery a rating of delivery stress was made on the basis of each subject's birth record at the hospital. Approximately six to fourteen weeks following delivery subjects were reassessed on the depression inventory. Also, an assessment of the occurrence of stressful life events since the beginning of pregnancy was completed.;Subjects whose postpartum Beck Depression Inventory score was greater than 12 (N = 19) and a control group who scored less than 10 on the Beck (N = 23) participated in an interview assessment to determine if they met Research Diagnostic Criteria for Major Affective Disorder.;Predictor variables and prepartum depression level were entered into a stepwise multiple regression on postpartum depression level. The following variables accounted for significant (at leastp < .05) independent variance in postpartum depression level: prepartum depression level; measures derived from the depression models of Rehm, Seligman, and Lewinsohn; weighted frequency of life events since the beginning of pregnancy; stressfulness of delivery; and whether or not the subject was divorced. Altogether, these variables accounted for 42% of the variance in postpartum depression level. However, the prepartum depression level alone accounted for 26% of the variance with the rest of the variables accounting for 16%.;On the basis of the interview assessments an estimate of a 22% prevalence rate for at least mild depression during the first three months postpartum was made. This estimate was interpreted cautiously given many difficulties in assessing postpartum depression.;The results of the study were interpreted as providing modest support for the cognitive-behavioral theories that were tested. It was also clear from the study that predicting depression is a complex process and that many factors play roles in determining the onset of a depressive episode. It was concluded that additional research is needed to clarify the etiological significance of cognitive dysfunctions and behavioral deficits in the depressive disorders. |
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