Scientific Abstract
Background: Over 50% of postpartum women experience unwanted intrusive thoughts about their newborn. These thoughts are highly distressing given that they often are associated with the safety of their baby. Women with postpartum depression, anxiety, and OCD are more likely to experience these thoughts. However, psychological processes that contribute to intrusive thoughts are understudied. A better understanding of these processes can inform targeted treatment. The purpose of this study was to examine whether certain psychological risk factors and resiliency factors were associated with intrusive thoughts during the postpartum period.
Methods: Postpartum women (N = 266) completed measures of psychological inflexibility, cognitive fusion, mindfulness, anxiety and depression symptoms, and demographics.
Results: We conducted hierarchical regression analyses to determine which risk and resiliency factors explained variance in intrusive thoughts. When controlling for history of PMADs, women who endorsed more cognitive fusion (b = .270 , p= .019) and emotional distress (b = .140 , p = .050) experienced more intrusive thoughts. When controlling for demographics and these risk factors, women who endorsed more awareness of internal experiences (b = .129 , p = .025) and less acceptance (b = -.239 , p = .005) experienced more intrusive thoughts.
Conclusions: Consistent with the literature, women who were diagnosed with PMADS and endorsed more emotional distress reported more intrusive thoughts. Further, women who endorsed more cognitive fusion experienced more intrusive thoughts—suggesting that women may benefit from cognitive defusion techniques. Surprisingly, women who reported more internal awareness and less acceptance experienced more intrusive thoughts. This finding may be because women with more intrusive thoughts may be more aware of their internal experiences. However, it highlights that how women relate to thoughts is key for their distress. Teaching women how to cope with intrusive thoughts (e.g., acceptance), rather than only being more aware, could be a promising target of intervention.