Cross-lagged analysis of interdependence and psychological symptom clusters in postpartum women: A prospective study

The aim of this study is to investigate the longitudinal interaction mechanism between interdependence and clusters of psychological emotional symptoms in postpartum women. Three waves of follow-up assessments were conducted on 389 postpartum women at T1 (before discharge), T2 (42 days post-delivery), and T3 (3 months post-delivery). The assessments utilized the general information questionnaire, the 10-item Connor-Davidson resilience scale (CD-RISC-10), the Edinburgh Postnatal depression scale (EPDS), the post-traumatic stress disorder (PTSD) Checklist-Civilian version (PCL-C-7), and the mutuality scale (MS) to evaluate resilience, depression, PTSD, and marital mutuality. Cross-lagged panel analysis was employed to examine the causal paths between variables over time. The autoregressive effect indicated that all variables exhibited significant temporal stability (β = 0.50-0.65, P < .001), with resilience demonstrating the highest stability (T1 → T2: β = 0.65; T2 → T3: β = 0.62); The protective pathway revealed that resilience significantly enhanced the subsequent marital relationship (T1 → T2: β = 0.28; T2 → T3: β = 0.26), and a negative marital relationship predicted depressive symptoms (T2 → T3: β = -0.22). Resilience also directly reduced the risk of depression (T2 → T3: β = -0.23); and Inter-symptom reinforcement showed that depression increased the risk of subsequent PTSD (T1 → T2: β = 0.38; T2 → T3: β = 0.42), and PTSD exacerbation was followed by depression (T2 → T3: β = 0.37). Psychological resilience indirectly ameliorates emotional symptoms by bolstering marital relationships, while depression and PTSD establish a bidirectional vicious cycle. The research endorses a three-tiered prevention strategy that focuses on fostering resilience and intervening in partner relationships during the early postpartum period.