%0 Journal Article %J Depress Anxiety %D 2012 %T Impact of childhood trauma on the outcomes of a perinatal depression trial. %A Grote, Nancy K %A Spieker, Susan J %A Lohr, Mary Jane %A Geibel, Sharon L %A Swartz, Holly A %A Frank, Ellen %A Houck, Patricia R %A Katon, Wayne %K Adult %K Adult Survivors of Child Abuse %K Depressive Disorder %K Female %K Humans %K Poverty %K Pregnancy %K Pregnancy Complications %K Psychotherapy, Brief %K Risk Factors %K Treatment Outcome %X

BACKGROUND: Childhood abuse and neglect have been linked with increased risks of adverse mental health outcomes in adulthood and may moderate or predict response to depression treatment. In a small randomized controlled trial treating depression in a diverse sample of nontreatment-seeking, pregnant, low-income women, we hypothesized that childhood trauma exposure would moderate changes in symptoms and functioning over time for women assigned to usual care (UC), but not to brief interpersonal psychotherapy (IPT-B) followed by maintenance IPT. Second, we predicted that trauma exposure would be negatively associated with treatment response over time and at the two follow-up time points for women within UC, but not for those within IPT-B who were expected to show remission in depression severity and other outcomes, regardless of trauma exposure.

METHODS: Fifty-three pregnant low-income women were randomly assigned to IPT-B (n = 25) or UC (n = 28). Inclusion criteria included ≥ 18 years, >12 on the Edinburgh Postnatal Depression Scale, 10-32 weeks gestation, English speaking, and access to a phone. Participants were evaluated for childhood trauma, depressive symptoms/diagnoses, anxiety symptoms, social functioning, and interpersonal problems.

RESULTS: Regression and mixed effects repeated measures analyses revealed that trauma exposure did not moderate changes in symptoms and functioning over time for women in UC versus IPT-B. Analyses of covariance showed that within the IPT-B group, women with more versus less trauma exposure had greater depression severity and poorer outcomes at 3-month postbaseline. At 6-month postpartum, they had outcomes indicating remission in depression and functioning, but also had more residual depressive symptoms than those with less trauma exposure.

CONCLUSIONS: Childhood trauma did not predict poorer outcomes in the IPT-B group at 6-month postpartum, as it did at 3-month postbaseline, suggesting that IPT including maintenance sessions is a reasonable approach to treating depression in this population. Since women with more trauma exposure had more residual depressive symptoms at 6-month postpartum, they might require longer maintenance treatment to prevent depressive relapse.

%B Depress Anxiety %V 29 %P 563-73 %8 2012 Jul %G eng %N 7 %R 10.1002/da.21929 %0 Journal Article %J Women Health %D 2011 %T The prevalence and correlates of depressive symptoms among adolescent mothers: results from a 17-year longitudinal study. %A Gavin, Amelia R %A Lindhorst, Taryn %A Lohr, Mary Jane %K Adolescent %K Adult %K Cohort Studies %K Depression %K Female %K Humans %K Logistic Models %K Longitudinal Studies %K Male %K Marital Status %K Mothers %K Parity %K Pregnancy %K Pregnancy in Adolescence %K Prevalence %K Public Health %K Sexual Partners %K Smoking %K Social Welfare %K Spouse Abuse %K Young Adult %X

The objective of the authors in this study was to examine the prevalence and correlates of elevated depressive symptoms in a 17-year cohort study of 173 women who were unmarried, pregnant adolescents between June 1988 and January 1990. Multiple logistic regression was used to estimate the associations between correlates and elevated depressive symptoms during five distinct developmental periods of the life course. Depressive symptoms were measured by the Brief Symptom Inventory depression subscale. The prevalence of elevated depressive symptoms in adolescent mothers significantly increased over the 17 years of the study from 19.8% to 35.2%. In adjusted analyses, antenatal depressive symptoms were positively and significantly associated with elevated depressive symptoms at every developmental period. Intimate partner violence was positively and significantly associated with elevated depressive symptoms during all but one developmental period. Other significant correlates of elevated depressive symptoms included welfare receipt, smoking, and parity, all of which were significant at some, but not other, developmental periods. Antenatal depressive symptoms and intimate partner violence were positively and significantly associated with elevated depressive symptoms. Given the public health consequences associated with maternal depression, clinical and community-based interventions should be developed to identify and to treat adolescent mothers at-risk for antenatal depression and intimate partner violence.

%B Women Health %V 51 %P 525-45 %8 2011 Aug 31 %G eng %N 6 %R 10.1080/03630242.2011.606355 %0 Journal Article %J Psychol Health %D 2010 %T Young mothers' decisions to use marijuana: a test of an expanded Theory of Planned Behaviour. %A Morrison, Diane M %A Lohr, Mary Jane %A Beadnell, Blair A %A Gillmore, Mary Rogers %A Lewis, Steven %A Gilchrist, Lewayne %K Adolescent %K Decision Making %K Female %K Follow-Up Studies %K Humans %K Marijuana Smoking %K Marital Status %K Mothers %K Motivation %K Pregnancy %K Psychological Theory %K Self Efficacy %K Social Environment %X

The current study examines the Theory of Planned Behaviour's (TPB) ability to predict marijuana use among young women who experienced a premarital pregnancy before the age of 18 years, using longitudinal data. The validity of the TPB assumption that all other variables work through TPB constructs is also tested. Indicators of four constructs that have been shown in the literature to be predictive of marijuana use-persistent environmental adversity, emotional distress, adolescent marijuana use and drug use in the social network-were tested as predictors of attitudes, norms and self-efficacy, in a structural equation modelling framework. All paths from distal predictors were through the mediating TPB constructs, in accordance with the tenets of the model. Implications of these findings for the TPB model and for understanding factors that lead to marijuana use are discussed.

%B Psychol Health %V 25 %P 569-87 %8 2010 Jun %G eng %N 5 %R 10.1080/08870440902777554