The masking effects of self-efficacy and marital satisfaction on the association between childhood trauma and postpartum depressive symptoms: a cross-sectional study

Adequate mental health underlies individuals' overall well-being. This study aims to probe the relationship between childhood trauma and postpartum depressive symptoms among women and dissect the mediating roles of self-efficacy and marital satisfaction, and endeavors to supply pragmatic directives for precluding and taking remedial action on postpartum depression. The study was conducted from December 2023 to June 2024 at the postpartum clinics of three representative tertiary hospitals in Nantong City, with the participants being mothers undergoing their 42-day postpartum check-up. Participants completed the childhood trauma questionnaire (CTQ), the Edinburgh postnatal depression scale (EPDS), the general self-efficacy scale (GSES), and the marital satisfaction scale (MSS). Using SPSS 27.0 and the process macro (Model 4), our parallel mediation analysis revealed that self-efficacy and marital satisfaction acted as masking mediators. These mediators accounted for 64.0% and 133.3% of the total effect, respectively (absolute values), indicating suppression effects. Importantly, the explanatory value of the integrated model lies in its ability to simultaneously assess both pathways, showing how these mediators jointly influence the association between childhood trauma and postpartum depression. This study clarifies the complex relationships among childhood trauma, self-efficacy, marital satisfaction, and postpartum depressive symptoms. Identifying self-efficacy and marital satisfaction as masking mediators offers crucial guidance for PPD prevention and intervention, supplying targeted evidence for alleviating postpartum depressive symptoms by strengthening the former two. It holds significant reference value for comprehensive measures to boost the mental health and well-being of postpartum women and their families.