Perinatal Posttraumatic Growth (PTG) in fathers and COVID-19 related PTG in mothers during the perinatal period

Bringer, Joy 2024. Perinatal Posttraumatic Growth (PTG) in fathers and COVID-19 related PTG in mothers during the perinatal period. ClinPsy Thesis, Cardiff University. Item availability restricted.

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Abstract

This thesis focused on posttraumatic growth (PTG) in parents during the perinatal period. PTG is defined as positive changes as a result of experiencing a traumatic or significant event that disrupts a person’s previous held beliefs about the world, themselves, or other people. Domains of growth in PTG include changes to a person’s beliefs about their psychological strength, appreciation of life, relationships with other people, recognising new possibilities for their life, and spiritual changes. The systematic review synthesised perinatal related PTG in fathers, and the empirical study examined PTG growth related to the COVID-19 pandemic in mothers. In the systematic review, perinatal is defined as the period from conception to 2 years after birth in recognition of the importance of the first 1,000 days of life. There may also be individual and contextual differences in the amount of time required for PTG to develop, thus this extended time period includes longitudinal studies. Data for the empirical paper was drawn from the Maternal Wellbeing, Mental Health and Life Experiences (MWMHLE) study led by the National Centre for Mental Health. As such, the perinatal period in the empirical paper refers to conception to 1 year after birth, which corresponds with the recruitment criteria for the MWMHLE study. The systematic review contributes to the evidence base in perinatal related PTG by focusing on fathers, who compared to mothers, have been underrepresented in previous systematic research. The aim of this review was to identify the degree of PTG among fathers following exposure to a stressor during the perinatal period and to identify factors that predict higher levels of PTG. A secondary aim was to summarise differences between mothers and fathers in PTG. A systematic review protocol was developed, registered with PROSPERO, and followed. Five databases were searched using terms related to posttraumatic growth, perinatal period, perinatal and paediatric trauma events, and father or parent. Studies were included if they reported fathers’ levels of PTG. If data from mothers were included, these findings were also summarised. Eighteen of the 215 unique studies identified in the database search met the eligibility criteria for the review. Using an evidence based risk of bias and quality assessment tool, one study was judged to be of poor quality, ten fair, and seven good. The review demonstrated that fathers experienced a small to moderate level of PTG in relation to a perinatal stressor, which was generally lower than what mothers exposed to the same type of stressor reported. The studies used 38 different questionnaires to measure a wide range of factors that could be related to PTG across four broad categories of stressful events: infant hospitalisation, pre-term birth, infant death, and transition to parenthood. Heterogeneity in study designs and measures limited the ability to synthesise findings and draw strong conclusions. Based on initial evidence from a few studies examining similar factors, PTG in fathers was positively associated with parental attachment anxiety, coping, parental stress, social support, and grief. Generic measures of anxiety and depression were not consistently associated with perinatal related PTG. Previous research has provided evidence that pregnant and postnatal women experienced significant rates of anxiety, depression, and posttraumatic stress disorder (PTSD) symptoms during the COVID-19 pandemic. Research in non-perinatal populations found evidence for COVID-19 related PTG, but very little research has been published to date on perinatal populations experience of COVID-19 related PTG. Pregnant and postnatal participants (n = 382) who had due dates, or gave birth, between May 2020 and December 2022 completed a range of online questionnaires covering mental health, social support, and their experience of COVID-19. The majority of participants reported experiencing COVID-19 related distress with two-thirds of the sample experiencing some PTG, although mostly very small to small amounts. Higher levels of worry and rumination about COVID-19, higher levels of perceived social support, and lower levels of depression were associated with higher degrees of PTG. The degree of PTG reported in this sample was smaller than comparative perinatal samples. Possible reasons for this are explored, and suggestions for improving the ethnic and socioeconomic diversity of future perinatal samples recruited for research are provided. This thesis provides a new contribution to the literature by synthesising research on PTG in fathers during the perinatal period and providing new data on mothers’ COVID-19 related PTG. Taken together these studies demonstrate that it is possible to experience PTG as a result of adverse events and stressors during the perinatal period. In both the systematic review and the empirical study, higher levels of perceived social support were a key factor associated with a greater degree of PTG. Policy makers should consider the importance of social support when setting policies that impact on the perinatal period, especially in future pandemics. Clinicians should consider interventions that may lead to increasing social support. Future research on perinatal related PTG would be improved by a theory driven approach and by using measures that are more specific to the stressor being studied, rather than using generic measures.

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of First Compliant Deposit:	1 August 2024
Last Modified:	07 Aug 2024 09:03
URI:	https://orca.cardiff.ac.uk/id/eprint/171079

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