Skip to main content

Advertisement

SpringerLink
Log in

Coping strategies as psychological risk factor for antenatal anxiety, worries, and depression among Greek women

  • Original Article
  • Published:
Archives of Women's Mental Health Aims and scope Submit manuscript

Abstract

A range of psychosocial, medical, and demographic variables may influence pregnant women’s psychological status. However the association between coping strategies, anxiety, worries, and depression during pregnancy is a relatively neglected area of research. Therefore, the aim of this study was to examine the relationship between coping strategies, antenatal anxiety, pregnancy worries, and depressive symptomatology after controlling for the effects of background variables. The study sample consisted of 163 pregnant women, with gestational age ranging from 11 to 26 weeks, attending antenatal screening at a Greek public hospital. Coping strategies were measured with Brief COPE, pregnancy worries were measured with Cambridge Worry Scale (CWS), anxiety was assessed using State-Trait Anxiety Inventory (STAI-X version), and depression was measured with Center for Epidemiologic Studies—Depression scale (CES-D). Pearson’s correlation coefficients were calculated among all study variables, followed by hierarchical multiple linear regression. In the univariate analysis, low annual income, unemployment, conception after an IVF treatment, and a previous history of miscarriage were associated with anxiety, depression, and worries. Additionally, almost all coping strategies (denial, behavioral disengagement, self-blame, self-distraction, substance use, acceptance, positive reframing, active coping, and seeking emotional support) were significantly associated with antenatal anxiety, worries, and depression. Linear regression analysis showed that only previous history of miscarriage, conception after IVF, as well as denial, behavioral disengagement and acceptance coping strategies were significantly related to anxiety, worries and depressive symptomatology. The risk factors found in this study could help clinicians target anxiety and depression screening to high-risk populations of pregnant women. Provision of adequate training for obstetricians and midwives in the detection and management of anxiety and depression among pregnant women should help to decrease the psychological burden during pregnancy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Anderson L, Sundstrom-Poromma I, Wuff M, Astrom M, Bixo M (2004) Implications of antenatal depression and anxiety for obstetric outcome. Obstet Gynecol 104:476

    Article  Google Scholar 

  • Bodecs T, Horvath B, Kovacs L, Diffelne Nemeth M, Sandor J (2009) Prevalence of depression and anxiety on a population based Hungarian sample. Orv Hetil 150(41):1888–1893

    Article  PubMed  Google Scholar 

  • Boivin J, Appleton TC, Baetens P et al (2001) Guidelines for counseling in infertility: outline version. Hum Reprod 16(6):1301–1304

    Article  PubMed  CAS  Google Scholar 

  • Breedlove G, Fryzelka D (2011) Depression screening during pregnancy. J Midwifery Womens Health 56(1):18–25

    Article  PubMed  Google Scholar 

  • Carver C (1997) You want to measure coping but your protocol’s too long: consider the Brief COPE. Int J Behav Med 4(1):92–100

    Article  PubMed  CAS  Google Scholar 

  • Carver CS, Pozo C, Harris SD, Noriega V, Scheier MF, Robinson DS, Ketcham AS, Moffat FL Jr, Clark KC (1993) How coping mediates the effect of optimism on distress: a study of women with early stage breast cancer. J Pers Soc Psychol 65:375–390

    Article  PubMed  CAS  Google Scholar 

  • Faul F, Erdlfelder E, Lang A, Buchner A (2007) G* Power 3: a flexible statistical power analysis program for the social, behavioral and biomedical sciences. Behav Res Methods 39:175–191

    Article  PubMed  Google Scholar 

  • Faisal-Cury A, Menezes R (2007) Prevalence of anxiety and depression during pregnancy in a private setting sample. Arch Womens Ment Health 10:25–32

    Google Scholar 

  • Faisal-Cury A, Savoia M, Menezes P (2012) Coping style and depressive symptomatology during pregnancy in a private setting sample. Span J Psychol 15(1):295–305

    Article  PubMed  Google Scholar 

  • Field A (2009) Discovering statistics using SPSS. Sage, London

    Google Scholar 

  • Field T, Diego M, Dieter J, Hernandez-Reif M, Schanberg S, Kuhn C, Gonzalez-Quintero V (2004) Prenatal depression effects on the fetus and the newborn. Infant Behav Dev 27:216–229

    Google Scholar 

  • Folkman S, Moskowitz T (2000) Positive affect and the other side of coping. Am Psychol 55(6):647–654

    Article  PubMed  CAS  Google Scholar 

  • Gourounti K, Lykeridou K, Taskou C, Kafetsios K, Sandall J (2011) A survey of worries of pregnant women: Reliability and validity of the Greek version of the Cambridge Worry Scale. Midwifery. doi:10.1016/j.midw.2011.09.004

    Google Scholar 

  • Gourounti K, Anagnostopoulos F, Lykeridou K, Griva F, Vaslamatzis G. (2013) Prevalence of women’s worries, anxiety and depression during pregnancy in a public hospital setting in Greece. Clin Experim Obstet Gynecol. Accepted 19 Nov 2012

  • Green JM, Kafetsios K, Statham HE, Snowden CM (2003) Factor structure, validity and reliability of the Cambridge Worry Scale in a pregnant population. J Health Psychol 8:753–764

    Article  PubMed  Google Scholar 

  • Green S (1991) How many subjects does it take to do a regression analysis? Multivar Behav Res 26:499–510

    Article  Google Scholar 

  • Hammarberg K, Fisher J, Wynter K (2008) Psychological and social aspects of pregnancy, childbirth and early parenting after assisted conception: a systematic review. Hum Reprod Update 14 5:395–414

    Article  Google Scholar 

  • Hellenic Statistical Authority (2006) Annual income for Greek population report. Retrieved January 15, 2007, from http://www.statistics.gr/portal/page/portal/ver-1/ESYE/BUCKET/A0103/Other/A0103_SJO46_TB_4Y_00_2006_03_F_GR.pdf

  • Hjelmstedt A, Widström A, Wramsby H, Matthiesen A, Collins A (2003) Personality factors and emotional responses to pregnancy among IVF couples in early pregnancy: a comparative study. Acta Obstet Gynecol Scand 82(2):152–161

    Article  PubMed  Google Scholar 

  • Huizink AC, Mulder EJH, Robels de Medina P, Visser G, Buitelaar J (2004) Is pregnancy anxiety a distinctive syndrome? Early Hum Dev 79:81–91

    Article  PubMed  Google Scholar 

  • Kaaya S, Mbwambo J, Kilonzo G, Van Den Borne H, Leshabari M, Fawzi M, Schaalma H (2010) Socio-economic and partner relationship factors associated with antenatal depressive morbidity among pregnant women in Dar es Salaam, Tanzania. Tanzan J Health Res 12(1):23–35

    PubMed  CAS  Google Scholar 

  • Lancaster C, Gold K, Flynn H, Yoo H, Marcus S, Davis M (2010) Risk factors for depressive symptoms during pregnancy: a systematic review. Am J Obstet Gynecol 202(1):5–14

    Article  PubMed  Google Scholar 

  • Lazarus R, Folkman S (1984) Stress, appraisal and coping. Springer, New York

    Google Scholar 

  • Lazarus R (1999) Stress and emotion. In: Lazarus R (ed) Stress and emotion, a new synthesis. Springer, New York

    Google Scholar 

  • Lee A, Chong C, Chiu H, Lam S, Fong D (2007) Prevalence, course, and risk factors for antenatal anxiety and depression. Obstet Gynecol 110:1102–1112

    Article  PubMed  Google Scholar 

  • Leigh B, Milgrom J (2008) Risk factors for antenatal depression, postnatal depression and parenting stress. BMC Psychiatry 8:24

    Article  PubMed  Google Scholar 

  • Liakos A, Gianitsi S (1984) The validity and reliability of the revised Greek anxiety scale by Spielberger. Engefalos 21:71–76

    Google Scholar 

  • Madianos M, Stefanis C (1992) Changes in the prevalence of symptoms of depression and depression across Greece. Soc Psychiatry Psychiatr Epidemiol 27:211–219

    Article  PubMed  CAS  Google Scholar 

  • McQueeney D, Stanton A, Sigmon S (1997) Efficacy of emotion-focused and problem-focused group therapies for women with fertility problems. J Behavior Med 20(4):313–331

    Article  CAS  Google Scholar 

  • Melville J, Gavin A, Guo Y, Fan MY, Katon W (2010) Depressive disorders during pregnancy: prevalence and risk factors in a large urban sample. Obstet Gynecol 116(5):1064–1070

    Article  PubMed  Google Scholar 

  • Monti F, Agostini F, Fagandini P, La Sala G, Blickstein I (2009) Depressive symptoms during late pregnancy and early parenthood following assisted reproductive technology. Fertil Steril 91:851–857

    Article  PubMed  Google Scholar 

  • Mohammad K, Gamble J, Creedy D (2011) Prevalence and factors associated with the development of antenatal and postnatal depression among Jordanian women. Midwifery 27:238–245

    Article  Google Scholar 

  • Mosack V, Shore E (2006) Screening for depression among pregnant and postpartum women. J Community Health Nurs 23:37–47

    Article  PubMed  Google Scholar 

  • Mukhopadhaya N, Arulkumaran S (2007) Reproductive outcomes after in-vitro fertilization. Curr Opin Obstet Gynecol 19:113–119

    Article  PubMed  Google Scholar 

  • Ormel J, Wohlfarth T (1991) How neuroticism, long-term difficulties, and life situation change influence psychological distress: a longitudinal model. J Pers Soc Psychol 60(5):744–755

    Article  PubMed  CAS  Google Scholar 

  • Pakenham K, Smith A, Rattan S (2007) Application of a stress and coping model to antenatal depressive symptomatology. Psychol Health Med 12(3):266–277

    Article  PubMed  Google Scholar 

  • Radloff L (1977) The CES-D Scale: a self report depression scale for research in the general population. Appl Psychol Measur 1:385–401

    Article  Google Scholar 

  • Roussi P, Vassilaki E (2001) The applicability of the multiaxial model of coping to a Greek population. Anxiety Stress Coping 14:125–247

    Article  Google Scholar 

  • Rondó PH, Ferreira RF, Nogueira F, Ribeiro M, Lobert H, Artes R (2003) Maternal psychological stress and distress as predictors of low birth weight, prematurity and intrauterine growth retardation. Eur J Clin Nutr 57:266–272

    Google Scholar 

  • Stanton A (1991) Cognitive appraisals, coping processes, and adjustment to infertility. In: Stanton AL, Dunkel-Schetter C (eds) Infertility: perspectives from stress and coping research. Plenum, New York, pp 87–108

    Google Scholar 

  • Spielberger C (1972) Anxiety: current trends in research. Academic Press, London

    Google Scholar 

  • Tabachnic B, Fidell L (2007) Using multivariate analysis. Pearson Education, Boston

    Google Scholar 

  • Terry D, Hynes G (1998) Adjustment to a low-control situation: re-examining the role of coping responses. J Pers Social Psychol 74(4):1078–1092

    Article  Google Scholar 

  • Qiao YX, Wang J, Ablat A (2009) The prevalence and related risk factors of anxiety and depression symptoms among Chinese pregnant women in Shanghai. Austr New Zeal J Obstet Gynaecol 49:185–190

    Article  Google Scholar 

Download references

Funding

Τhere is no funding.

Author information

Author notes

  1. Kleanthi Gourounti

    Present address: , Αgnoston Martiron 33-37, Nea Smirni, 17123, Athens, Greece

Authors and Affiliations

  1. Department of Midwifery, TEI of Athens, Athens, Greece

    Kleanthi Gourounti & Katerina Lykeridou

  2. Department of Psychology, Panteion University, Athens, Greece

    Fotios Anagnostopoulos

Authors
  1. Kleanthi Gourounti
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fotios Anagnostopoulos
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Katerina Lykeridou
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kleanthi Gourounti.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gourounti, K., Anagnostopoulos, F. & Lykeridou, K. Coping strategies as psychological risk factor for antenatal anxiety, worries, and depression among Greek women. Arch Womens Ment Health 16, 353–361 (2013). https://doi.org/10.1007/s00737-013-0338-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00737-013-0338-y

Keywords

Search

Navigation