Role of Mediators in Reducing Antepartum Depressive Symptoms in Rural Low-Income Women Receiving a Culturally Tailored Cognitive Behavioral Intervention

Abstract

Although cognitive behavioral interventions (CBIs) have demonstrated effectiveness for reducing depressive symptoms in the general population, the mechanism for reducing antepartum depressive symptoms (APDS) in rural low-income and minority women is unknown. This study tested the hypothesis that reducing stress and negative thinking, enhancing self-esteem, and increasing social-support will mediate the effect of a CBI on reducing APDS in rural low-income and minority women. Our findings show that CBI may work through reducing stress and negative thinking and enhancing self-esteem, but not social support. The findings also suggest that mental health care providers should emphasize these activities to reduce antepartum depressive symptoms.

ACKNOWLEDGEMENTS

First, the authors wish to thank Ms. Elizabeth Tornquist (now deceased) for her editorial assistance in the preparation of this article. Finally, we thank John Morrow, MD, director of the local health department, the maternal and child nurses, and pregnancy care managers (PCM) for their collaboration on this project, as well as the women who participated in the primary study.

Funding

This work is supported by a grant from the National Institute of Mental Health (NIMH) (R34 MH086680-01A1); Clinical Trials ID: NCT 02144844.