Social Support, Posttraumatic Stress, and Postpartum Depressive Symptomatology among Japanese Women

Background: In Japan, 13% of new mothers suffered from elevated postpartum depressive symptomatology (PPDS), and one-third of women had posttraumatic stress (PTS) symptoms following birth. Western researchers reported that women with elevated PPDS often had more PTS symptoms following birth. Although the importance of social support to alleviate PTS or PPDS has been reported, the role of social support in the relationship between PTS and PPDS is not known. Understanding how social support affects the relationship between PTS and PPDS is necessary to develop effective interventions to prevent elevated PPDS.;Purpose: To examine the role of social support in the relationship between PTS and PPDS among Japanese women.;Design and Methods: This study was a cross-sectional secondary data analysis. The study sample consisted of 207 Japanese women between one and three months after giving birth. Based on the Stress Process Model, two conceptual models (moderation and mediation), consisting of four study concepts (PPDS, PTS, social support, and maternal background factors) were examined, as well as the prediction model to examine the direct effect of each predictor on PPDS. PPDS was measured with the Postpartum Depression Screening Scale Short Form. PTS was measured with two items of posttraumatic stress disorder symptoms. Social support (by a partner/others) was measured with the adaptation of the Medical Outcomes Study Social Support Survey. Both multiple linear regressions and path analyses were used to examine the proposed models.;Results: Ninety-seven (46.9%) women had elevated PPDS. One hundred two (49.3%) women experienced at least one PTS symptom. PTS following birth (β = .24), health promotion behaviors (β = -.31), partner support (β = -.15), others' support (β = - .14), physical health problems (β = .14), and parity (β = -.13) had significant direct effects on PPDS (R2 = .30). However, neither a moderating effect of social support on the relationship between PTS and PPDS nor a mediating effect of PTS on the relationship between social support and PPDS was supported in this study.;Conclusions: Mental health care focusing on PTS following birth will contribute to preventing depressive symptoms. From the current study results, alternative moderation and mediation models that include coping or self-concepts are suggested for future study.