A Pilot Study Assessing the Relationship Between Child Harming Thoughts and Postpartum Depression

This pilot study explored relationships between postpartum mood and child harming thoughts. Fifty mothers from an outpatient pediatric office completed the Edinburgh Postnatal Depression Scale (EPDS), Postpartum Depression Predictors Inventory-Revised (PDPI-R), and Beck Anxiety Inventory (BAI). Participants also completed the Child Thoughts Inventory (CTI), a modified version of the Yale-Brown Obsessive-Compulsive Inventory (Y-BOCS) and Florida Obsessive-Compulsive Inventory (FOCI). Results indicated significant positive correlations between postpartum depression and anxiety and frequency and intensity of child harming thoughts. In addition, having a poor self-view was significantly correlated with intensity of child harming thoughts and previous anxiety was correlated with both frequency and intensity of child harming thoughts. Despite the fact that mothers experiencing postpartum mood disturbances rarely harm their infants the findings of this pilot study suggest that these women may have frequent and intense ego-dystonic thoughts about harming their children. Results also suggest that postpartum depression and anxiety may share similar cognitive processes.     

Mother's prenatal and postpartum depression symptoms and infant's sleep problems at 6 months

Mother's prenatal and postpartum depression have been associated with infant's sleep problems. This study aimed to analyze (a) the effects of mother's prenatal and postpartum depression symptoms, including the effects of prenatal and postpartum anxiety and depression scores of the Edinburgh Postnatal Depression Scale (EPDS), on infant's sleep problems at 6 months, and (b) the interaction effect between mother's prenatal and postpartum depression symptoms and infant's sex on infant's sleep problems at 6 months. The sample was comprised of 164 mother–infant dyads whose mothers completed measures of depression at the third trimester of pregnancy, 2 weeks, 3 and 6 months postpartum and a measure of infant's sleep problems at 6 months (CSHQ-I). Mother's prenatal depression symptoms, specifically depression scores of the EPDS, predicted more infant's sleep anxiety and daytime sleepiness, while mother's depression symptoms at 2 weeks postpartum, specifically anxiety scores of the EPDS, predicted more bedtime resistance and CSHQ-I total scores at 6 months. Boys of mothers with more prenatal depression symptoms presented more sleep anxiety at 6 months. Both mother's prenatal and early postpartum depression symptoms have a negative effect on the emergence of infant's sleep problems. Additionally, boys seem more vulnerable to mother's prenatal depression symptoms.     

Symptoms of depression in Swedish fathers in the postnatal period and development of a screening tool

Methods for detecting depression in fathers after the birth of their child are scarce. The Edinburgh Postnatal Depression Scale (EPDS), used to screen mothers for postpartum depression (PPD), lacks somatization and externalizing items. This potentially decreases its sensitivity in detecting depression in fathers, as many men actually express depression with somatization or externalizing symptoms. The present study assessed depressive symptoms in fathers of children 0–18 months old, and evaluated whether addressing both typical depression and externalizing, so‐called “depressive equivalent” symptoms, might be more suitable for such assessment. The Beck Depression Inventory‐II (BDI‐II), EPDS, and Gotland Male Depression Scale (GMDS) were responded to by 447 Swedish fathers online. Among participants, 27% reported depressive symptoms above the BDI‐II cut‐off suggestive of depression. Most fathers reported both traditional and depressive equivalent symptoms and a subgroup expressed exclusively depressive equivalent symptoms. Consistently, a scale combining items from the EPDS and GMDS showed higher sensitivity than the EPDS alone in identifying fathers with elevated depressive symptoms, at equal levels of specificity. Our findings suggest that a combination of EPDS and depressive equivalent symptom items results in a more suitable instrument for screening for depression in fathers during the postnatal period.     

Antenatal depressive symptoms are strongly predicted by the severity of pre-menstrual syndrome: results of partial least squares analysis

Background/Objective: Antenatal depression (AD) is the commonest morbidity during pregnancy. There is evidence that premenstrual syndrome (PMS) and AD share common immune-inflammatory and sex hormonal pathways. This study aims to evaluate the association between the severity of depressive PMS and AD in early and late pregnancy. Method: Participants were followed from early (<=16 weeks) to late pregnancy (>=20 weeks). The Premenstrual Symptoms Screening Tool (PSST) was used to assess PMS and AD symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Results: Up to 57.6% of the variance in the early EPDS score was explained by the regression on the first factor extracted from 10 depression and anxiety PSST items (dubbed the DepAnx PSST), insomnia PSST, relation dissatisfaction, and partner abuse. There were specific indirect effects of DepAnx PSST (p < 0.001), insomnia PSST (p = 0.041), relation dissatisfaction (p = 0.023) and partner abuse (p = 0.007) on the late EPDS which were mediated by the early EPDS score. Conclusion: The affective, but not psychosomatic, symptoms of PMS strongly predict AD symptoms suggesting that the pathophysiology of affective PMS symptoms overlap with those of AD.     

Intolerance of Uncertainty and Perfectionistic Beliefs About Parenting as Cognitive Mechanisms of Symptom Change During Cognitive Behavior Therapy for Perinatal Anxiety

ObjectiveA recent randomized controlled trial of group cognitive behavior therapy (CBGT) for perinatal anxiety showed that CBGT is effective in reducing anxiety and depression in pregnant and postpartum women. In secondary analyses, the role of potential mechanisms of symptom change was examined, including intolerance of uncertainty (IU), self-oriented parenting perfectionism (SOPP) and societal-prescribed parenting perfectionism (SPPP).MethodThe sample included 75 women (M_age = 31.99, SD = 3.57; 37.3% pregnant, 62.7% postpartum) who sought treatment for anxiety and completed the 6-week CBGT or 6-week waitlist within the larger trial. Measures of anxiety (State-Trait Inventory for Cognitive and Somatic Anxiety; STICSA), depression (Edinburgh Postnatal Depression Scale; EPDS), and the proposed mediators (IU, SOPP, SPPP) were completed at baseline and 6-weeks post-baseline.ResultsTwo moderated mediation models were evaluated to identify potential mediators of the effect of condition (CBGT, waitlist) on anxiety (STICSA; Model 1) or depressive symptoms (EPDS; Model 2). In Model 1, changes in IU partially mediated the effect of condition on anxiety (STICSA) for both pregnant and postpartum women. Changes in SOPP and SPPP were partial mediators for postpartum women only. Change in depression (EPDS) was also a partial mediator for pregnant women in this model. In Model 2, none of the cognitive variables mediated the effect of condition on depressive symptoms (EPDS). However, change in anxiety (STICSA) was a significant mediator of the effect of condition on depression (EPDS) and only among pregnant women.ConclusionsThe results provide support for IU, SOPP and SPPP as mechanisms of change during CBGT and identify differences in important mechanisms among pregnant and postpartum women.     

Associations Between Maternal Mental Health and Child Emotional and Behavioral Problems: Does Prenatal Mental Health Matter?

This study examined associations between elevated symptoms of prenatal depression or anxiety and offspring emotional and behavioral problems during mid to late childhood taking into account the impact of later maternal mental health symptoms. The sample consisted of 2,891 women and their children (49 % male) from a prospective, community-based study, the Avon Longitudinal Study of Parents and Children. Women completed measures of depressive (Edinburgh Postnatal Depression Scale) and anxious (Crown Crisp Experiential Index) symptoms at regular intervals beginning in pregnancy. Mothers and teachers assessed offspring emotional and behavioral problems using the Strengths and Difficulties Questionnaire when children were 10–11 years old. Multivariable regression models were fit to address study hypotheses. Exposure to elevated symptoms of maternal depression during pregnancy was associated with increased total offspring emotional and behavioral problems, even after controlling for later maternal mental health problems and a range of sociodemographic and psychosocial characteristics, according to mothers’ but not teachers’ reports. Similarly, children exposed to elevated symptoms of maternal anxiety during pregnancy were reported to have increased total emotional and behavioral problems by mothers but not by teachers. We found support for modest associations between elevated symptoms of maternal depression and anxiety during the prenatal period and certain domains of offspring emotional and behavioral problems in mid to late childhood above and beyond the impact of later maternal mental health problems. These findings highlight the need for additional clinical and research attention to the prenatal period and to both maternal depression and anxiety.     

The interface of mental and emotional health and pregnancy in urban indigenous women: Research in progress

Research among indigenous women in Australia has shown that a number of lifestyle factors are associated with poor obstetric outcomes; however, little evidence appears in the literature about the role of social stressors and mental health among indigenous women. The not‐for‐profit organization beyondblue established a “Depression Initiative” in Australia. As part of this they provided funding to the Townsville Aboriginal and Torres Strait Islander Health Service in the “Mums and Babies” clinic. The aim of this was to establish a project to (a) describe the mental health and level of social stressors among antenatal indigenous women and (b) assess the impact of social stressors and mental health on perinatal outcome. A purposive sample of 92 indigenous women was carried out. Culturally appropriate research instruments were developed through consultations with indigenous women's reference groups. The participants reported a range of psychosocial stressors during the pregnancy or within the last 12 months. Significant, positive correlations emerged between the participants' Edinburgh Postnatal Depression Scale (EPDS; J. Cox, J. Holden, & R. Sagovsky, 1987) score and the mothers' history of child abuse and a history of exposure to domestic violence. A more conservative cutoff point for the EPDS (>9 vs. >12) led to 28 versus 17% of women being identified as “at risk” for depression. Maternal depression and stress during pregnancy and early parenthood are now recognized as having multiple negative sequelae for the fetus and infant, especially in early brain development and self‐regulation of stress and emotions. Because of the cumulative cultural losses experienced by Australian indigenous women, there is a reduced buffer to psychosocial stressors during pregnancy; thus, it is important for health professionals to monitor the women's emotional and mental well‐being.     

Postnatal depression among mothers in the United Arab Emirates: socio-cultural and physical factors

Postnatal depression (PND) has been found to affect women in cultures around the world. This study sought to further identify the prevalence and related socio-cultural and physical factors in Arab women from the United Arab Emirates (UAE). The study involved a sample of Emirati women recruited in a government maternity hospital in Abu Dhabi who completed demographic questionnaires soon after giving birth (n=125) and the Edinburgh Postnatal Depression Scale (EPDS) at 3 months (n=86) and 6 months postpartum (n=56). Data are presented in three categories of: No Depression (scores of 0-9), Borderline Depression (scores of 10-12) and Depression (scores of 13+). It was found that at 3 months, this sample had 22% of mothers falling into the Depression category and another 22% falling in the Borderline Depression category. At 6 months, this fell to 12.5% Depression category and 19.6% Borderline Depression category. Relationships between higher depression scores and risk factors included; not breastfeeding, giving birth to the first child, poor self body image and view of weight, poor relationship with mother-in-law, and an older age at marriage. Results are discussed in relation to UAE and Islamic culture.     

The association between depressive symptoms and smoking in pregnant adolescents

There have been no studies that have specifically examined the relationship between smoking and depressive symptoms in Australian pregnant adolescents. Eighty one pregnant adolescents completed an adapted version of Lawson's (1994) Smoking Questionnaire and the Edinburgh Postnatal Depression Scale. Smoking status (smokers vs. non-smokers) and depressive symptoms remained stable during pregnancy. However, comparisons of depressive symptoms across smoking categories revealed that pregnant adolescent smokers were more likely to be depressed than pregnant adolescent lifetime non-smokers, particularly in the later stages of pregnancy. There was a weak association between the number of cigarettes smoked and depressive symptoms, but only in the third trimester. Recommendations include further examination of the association between depression or depressive symptoms and smoking, and investigation of how change in smoking status during pregnancy may effect depression.     

Affective facial expression in sub-clinically depressed and non-depressed mothers during contingent and non-contingent face-to-face interactions with their infants

BackgroundDepression in the postpartum period involves feelings of sadness, anxiety and irritability, and attenuated feelings of pleasure and comfort with the infant. Even mild- to- moderate symptoms of depression seem to have an impact on caregivers affective availability and contingent responsiveness. The aim of the present study was to investigate non-depressed and sub-clinically depressed mothers interest and affective expression during contingent and non-contingent face-to-face interaction with their infant.MethodsThe study utilized a double video (DV) set-up. The mother and the infant were presented with live real-time video sequences, which allowed for mutually responsive interaction between the mother and the infant (Live contingent sequences), or replay sequences where the interaction was set out of phase (Replay non-contingent sequences). The DV set-up consisted of five sequences: Live1-Replay1-Live2-Replay2-Live3. Based on their scores on the Edinburgh Postnatal Depression Scale (EPDS), the mothers were divided into a non-depressed and a sub-clinically depressed group (EPDS score ≥ 6).ResultsA three-way split-plot ANOVA showed that the sub-clinically depressed mothers displayed the same amount of positive and negative facial affect independent of the quality of the interaction with the infants. The non-depressed mothers displayed more positive facial affect during the non-contingent than the contingent interaction sequences, while there was no such effect for negative facial affect.ConclusionsThe results indicate that sub-clinically level depressive symptoms influence the mothers’ affective facial expression during early face-to-face interaction with their infants. One of the clinical implications is to consider even sub-clinical depressive symptoms as a risk factor for mother-infant relationship disturbances.     

Maternal romantic attachment,and antenatal and postnatal mother–infant attachment in a sample of Polish women

In this exploratory study, we evaluated the relationship between a woman's self-reported romantic attachment style (as measured with The Attachment Styles Questionnaire), her experience of pregnancy, antenatal (The Maternal–Fetal Attachment Scale) and postnatal (Postpartum Bonding Questionnaire) attachment with her baby, and depressive symptomatology (The Edinburgh Postnatal Depression Scale). In the first stage of the study 162 pregnant females participated; of these, 64 were followed up in the second stage. The maternal romantic attachment style predicted attachment with the baby in the antenatal, but not in the postpartum period. The anxious-ambivalent romantic attachment style predicted more interaction with and attributing more characteristics to the foetus, secure attachment style was positively correlated with role taking, and avoidant—with attributing more characteristics to the foetus. In the postpartum period, the correlation between antenatal and postnatal attachment was only moderate; role taking during pregnancy correlated with anxiety about care for an infant. However, our study shows the association of the profile of anxious-ambivalent romantic attachment with postpartum depression, which heightens the risk of postnatal mother–infant bonding impairments.     

Precursors of social emotional functioning among full-term and preterm infants at 12 months: Early infant withdrawal behavior and symptoms of maternal depression

This study forms part of a longitudinal investigation of early infant social withdrawal, maternal symptoms of depression and later child social emotional functioning. The sample consisted of a group of full-term infants (N = 238) and their mothers, and a group of moderately premature infants (N = 64) and their mothers. At 3 months, the infants were observed with the Alarm Distress Baby Scale (ADBB) and the mothers completed the Edinburgh Postnatal Depression Scale (EPDS). At 12 months, the mothers filled out questionnaires about the infants’ social emotional functioning (Infant Toddler Social Emotional Assessment and the Ages and Stages Questionnaire-Social Emotional). At 3 months, as we have previously shown, the premature infants had exhibited more withdrawal behavior and their mothers reported elevated maternal depressive symptoms as compared with the full-born group. At 12 months the mothers of the premature infants reported more child internalizing behavior. These data suggest that infant withdrawal behavior as well as maternal depressive mood may serve as sensitive indices of early risk status. Further, the results suggest that early maternal depressive symptoms are a salient predictor of later child social emotional functioning. However, neither early infant withdrawal behavior, nor gestational age, did significantly predict social emotional outcome at 12 months. It should be noted that the differences in strength of the relations between ADBB and EPDS, respectively, to the outcome at 12 months was modest. An implication of the study is that clinicians should be aware of the complex interplay between early infant withdrawal and signs of maternal postpartum depression in planning ports of entry for early intervention.     

Socioeconomic and psychological correlates of postpartum depression at 6 months in Dhaka,Bangladesh

To current study aimed to estimate the point prevalence and identify correlates of postpartum depression (PPD) in a sample of mothers in Dhaka. A total of 235 participants from low- and middle-SES neighbourhoods in Dhaka completed the Edinburgh Postnatal Depression Scale (EPDS) and other assessments of socioeconomic and psychological factors at 24 weeks postpartum. Regression models were fit to explore potential correlates of PPD. The estimated prevalence of high PPD risk in the current sample is 24.3%. In multivariable linear regression models, recent life events, perceived stress and household resources (e.g., access to cooking gas, telephone, furniture, electricity, television, etc.) were significantly associated with PPD. The association of social support with PPD when controlling for other variables was sensitive to the choice of social support measure, highlighting an important methodological issue. The point prevalence of PPD among poor, urban mothers in Bangladesh ranges from 12.3 to 28.5%, with psychological risk factors and household resources as strong correlates.     

Low-end specificity of childhood measures of emotional distress: consistent effects for anxiety and depressive symptoms in a nonclinical population

Previous research regarding the low-end specificity of self-report measures of affective distress in children suggests that defensiveness acts differentially to lower scores on self-report measures of depressive symptoms, but not on self-report measures of anxiety. This investigation examined this issue in a nonclinical sample of 442 children, ages 7 to 16. Participants completed measures of depressive symptoms (Children's Depression Inventory), anxiety symptoms (State-Trait Anxiety Inventory for Children) and defensiveness (Children's Social Desirability Scale). In contrast to previous research, the results in this study indicated similar effects of defensiveness on measures of depressive symptoms and anxiety. Low-end depression participants obtained significantly higher defensiveness scores, as did low-end anxious participants. In an attempt to circumvent the effects of defensiveness, we measured anhedonia (Pleasure Scale for Children, or PSC) as a proxy of depressive symptoms. We also found the PSC to be subject to the effects of defensiveness at approximately the same magnitude as the measures of anxiety and depressive symptoms.     

A measure of parental stress in mothers with small children: dimensionality, stability and validity

Self-reported parental stress was investigated in three samples of mothers with small children, using a Swedish version of the Parenting Stress Index (PSI). Dimensionality in experienced stress using items from six PSI Parent Domain subscales and eight new items was examined in factor analyses of data from a nationwide representative sample. Cross-validation proved the chosen factor pattern to be stable. Based on an oblique 5-factor solution new subscales were constructed. A second order factor analysis indicated influence from a higher order factor, seen as a general parental stress construct. High alpha coefficients revealed that homogeneous subscales had been formed. Test-retest correlations indicated good stability over a mean time period of 30 days. Influences from maternal background variables were found, but no relation to child age or gender. Global estimates of parental stress, reported child problems, mothers' scoring on the Edinburgh Postnatal Depression Scale and two measures of social support all correlated significantly with overall parental stress, and with some subscales. The justification of the subscale approach to parental stress was discussed. It was concluded that the PSI in its present form could be used as a reliable and valid instrument for measuring experienced parental stress in mothers of young children.     

Influence of obstetrical events on satisfaction and anxiety during childbirth: a prospective longitudinal study

The aim of this study was to investigate the feelings of anxiety and satisfaction among 79 primiparas who had uncomplicated pregnancies, at the time of hospital admission and after birth, considering the mode of delivery, analgesia, and pain levels. Questionnaires were completed at admission to the hospital and two months after delivery, using the State-Trait Anxiety Inventory (STAI) state scale and the Labour Agentry Scale. The mean (SD) STAI state score was higher at admission (36.7 (10.7)) than 4 months after childbirth (32.1 (9.7)) (paired Student’s t-test, t = 2.93; df = 78; p = .004). However, the postnatal anxiety was not associated with the mode of delivery, epidural or pain. Regarding the satisfaction with the expectations of control during childbirth, the mean (SD) score was higher before childbirth (166.0 (21.8)) than after (157.5 (33.5)) (paired Student’s t-test, t = ?2.28; df = 77; p = .03). The satisfaction with the childbirth experience was significantly associated with the expectations of childbirth and the mode of delivery, but not with analgesia or pain. The postnatal anxiety was associated with physical health, pain and the Edinburgh Postnatal Depression Scale score during the postpartum period. It is important to consider the temporality of perinatal anxiety in order to understand its causes. Our results indicate that the experience of childbirth was predicted in this sample by the antenatal expectations and delivery outcomes.     

Postnatal Depression and Infant Health Practices Among High-Risk Women

Women’s postnatal depressive symptoms have been associated with many adverse outcomes for children. The current study examined the frequency association with relative risk between postnatal depressive symptoms and mothers’ use of preventative infant health practices. The study used the Edinburgh Postnatal Depression Scale (EPDS) and Parental Health and Depression Questionnaire (PHDQ) to identify women’s depressive symptoms in a prospective longitudinal sample of 134 high-risk non-white mothers receiving well-baby health services. Unadjusted frequency comparisons examined the effect of women’s postnatal depressive symptoms on infant outcomes. Results found that compared to 60 women without postnatal depressive symptoms, 74 women with symptoms engaged in significantly fewer well-child health-visits, were less likely to use home safety devices or place their infants in the preferred back-to-sleep position, and did not complete immunizations. Depressed women were also more likely to lack knowledge of nurturing and sensitive parenting, use corporal punishment and inappropriate foods, and to show poor parenting practices. These findings provide additional supportive evidence that more efforts are needed to identify and assess women’s depressive symptoms to promote health and safety of young children. Methodological limitations and recommendations for future research are addressed.     

Do early parental postnatal depression,attachment style and perceived social support affect neurodevelopmental outcomes of premature infants?

BackgroundThe birth of a premature infant is both a stressful event for both parents and associated with an increased rate of postnatal depression (PND). Additionally some mothers may have delayed feelings of attachment to their babies because of the medical procedures or possible medical complications. Social support is known as an important factor for well-being in the postnatal period. However there is scarce data about these factors for fathers. We aimed to identify the impact of parental PND, attachment style and social support on premature infant development considering the prematurity degree and risk groups.MethodsThis prospective study was conducted by including 96 infants who were born preterm. Mothers and fathers were given Edinburgh Postnatal Depression Scale (EPDS), Adult Attachment Style Scale (AASS), and Multidimensional Scale of Perceived Social Support (MSPSS) to fill out when their infants’ corrected age was 3 months. The developmental evaluation was conducted with Bayley III at the corrected 6 months and 18 months of age.ResultsPostnatal depression scores were more in mothers than fathers, the rates of secure attachment and social support were similar between mothers and fathers. Factors associated with the neurodevelopmental outcomes including prematurity degree and risk groups, EPDS, AASS and MSPSS scores were analyzed for both parents. In multivariate analysis, fathers’ depression scores were inversely associated with cognitive development (p = 0.030, R² = 0.080, B=-0.283) and mothers’ anxious/ambivalent attachment style was inversely associated with language development (p = 0.011, R² = 0.108, B=-0.329) at the age of corrected 6 months old.ConclusionsOur findings underscore that the efforts to improve developmental outcomes of premature infants should include parental well-being taking into account new fathers’ depressive symptomatology and maternal anxious/ambivalent attachment.     

Maternal Depression and Adolescent Emotions: The Role of Family Functioning

Maternal depression may affect children through various mechanisms, including the stressful contexts of the children’s lives and maternal maladaptive affection, behaviors, and cognition, which affect the psychopathological development of children and contribute to disorders. The aims of the present study were to explore how family functioning mediates the relationship between maternal depression and the positive and negative emotions of adolescents. A total of 430 paired questionnaires were collected from junior high school students and their mothers. The mothers completed the Center for Epidemiologic Studies Depression Scale (CESD), and the adolescents completed the CESD, Mood and Anxiety Symptom Questionnaire, and Family Function Scale. The results revealed significant correlations among maternal depression, family functioning, and positive and negative emotions in the adolescents. The family functioning subscales of conflict and emotional expression partially mediated the relationship between maternal depression and the positive and negative emotions of the adolescents. Furthermore, the family functioning subscales of cohesion, problem solving, and responsibility fully mediated the relationship between maternal depression and positive moods in the adolescents. Analysis of the results for maternal depression, family functioning, and the emotional adjustment of the adolescents indicated that family functioning is the mediator between maternal depression and the positive and negative emotions of the adolescents. The current results suggest that adequate family functioning can prevent depression being transmitted from mothers to their adolescent children.     

Catastrophizing,Depression and Anxiety During Pregnancy: Relation Between Lumbopelvic Pain and Physical/Social Functioning

Catastrophizing, a cognitive behavioral aspect of pain, is defined as an excessively negative orientation against a noxious stimulus. The primary goal of the present study is to assess the association between catastrophizing and lumbopelvic pain intensity during the pregnancy period, the secondary goal is to explore the variation of pain catastrophizing, anxiety and depression, and the tertiary goal is to investigate the relationship between catastrophizing and quality of life. After approval, pregnant women with lumbopelvic pain were invited to join in the study. During admission, participants were asked to complete questionnaires including Pain Catastrophizing Scale, Beck Anxiety Inventory, Beck Depression Inventory-II, and Short Form-36. Age, gravida, parity, number of abortus, number of live-births and the pain intensity score were recorded. A total of 429 women were enrolled in the study. Pain catastrophizing scores showed a fluctuation during pregnancy, and were significantly correlated with the scores of Beck Anxiety Inventory, Beck Depression Inventory, Visual Analog Scale, and Short Form-36 sub-scales including social functioning, vitality, physical functioning and mental health. The present study demonstrated that catastrophizing level shows an alteration throughout the pregnancy period, and variation in catastrophizing shows an approximately similar course with pain intensity, depression and anxiety.