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      Trait Mindfulness, Resilience, Self-Efficacy, and Postpartum Depression: A Dominance Analysis and Serial-Multiple Mediation Model

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          Abstract

          Background

          Postpartum depression affects many women after childbirth, impacting both maternal and child well-being. Psychological traits such as trait mindfulness, resilience, and self-efficacy have been linked to postpartum depression, but their interactions and collective influence are not well understood.

          Objective

          The study aims to examine the associations between trait mindfulness, resilience, self-efficacy, and postpartum depression.

          Methods

          A cross-sectional survey was conducted from August 2022 to May 2023 using the Mindful Attention Awareness Scale, the 10-item Connor-Davidson Resilience Scale, the General Self-efficacy Scale, and the Edinburgh Postnatal Depression Scale. Dominance analysis, latent profile analysis, and serial-multiple mediation models were employed for data analysis.

          Results

          Dominance analysis showed that trait mindfulness, resilience, and self-efficacy explained 36.3%, 35.4%, and 28.3% of the variance in postpartum depression, respectively. Three trait mindfulness profiles were identified as mild (23.2%), moderate (55.5%), and high (21.3%). Postpartum women in the mild group exhibited higher postpartum depressive symptoms than those in the moderate and high groups. The effects of trait mindfulness on postpartum depression were significantly mediated by resilience ( B=−0.064, 95% CI −0.088 to −0.044), self-efficacy ( B=−0.014, 95% CI −0.023 to −0.006), and serial mediation between resilience and self-efficacy ( B=−0.027, 95% CI −0.040 to −0.015). Similar significant mediation effects were observed for moderate (resilience: B=−0.126, 95% CI −0.169 to −0.065, self-efficacy: B=−0.041, 95% CI −0.078 to −0.010, resilience and self-efficacy: B=−0.053, 95% CI −0.090 to −0.023) and high trait mindfulness profiles (resilience: B=−0.381, 95% CI −0.514 to −0.267, self-efficacy: B=−0.082, 95% CI −0.139 to −0.033, resilience and self-efficacy: B=−0.160, 95% CI −0.237 to −0.089) when compared to the mild reference group.

          Conclusion

          Trait mindfulness significantly impacts postpartum depression and exhibits heterogeneity among postpartum women. The relationship between trait mindfulness and postpartum depression was mediated by resilience and self-efficacy.

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          Most cited references68

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          Common method biases in behavioral research: A critical review of the literature and recommended remedies.

          Interest in the problem of method biases has a long history in the behavioral sciences. Despite this, a comprehensive summary of the potential sources of method biases and how to control for them does not exist. Therefore, the purpose of this article is to examine the extent to which method biases influence behavioral research results, identify potential sources of method biases, discuss the cognitive processes through which method biases influence responses to measures, evaluate the many different procedural and statistical techniques that can be used to control method biases, and provide recommendations for how to select appropriate procedural and statistical remedies for different types of research settings.
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            Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC).

            Resilience may be viewed as a measure of stress coping ability and, as such, could be an important target of treatment in anxiety, depression, and stress reactions. We describe a new rating scale to assess resilience. The Connor-Davidson Resilience scale (CD-RISC) comprises of 25 items, each rated on a 5-point scale (0-4), with higher scores reflecting greater resilience. The scale was administered to subjects in the following groups: community sample, primary care outpatients, general psychiatric outpatients, clinical trial of generalized anxiety disorder, and two clinical trials of PTSD. The reliability, validity, and factor analytic structure of the scale were evaluated, and reference scores for study samples were calculated. Sensitivity to treatment effects was examined in subjects from the PTSD clinical trials. The scale demonstrated good psychometric properties and factor analysis yielded five factors. A repeated measures ANOVA showed that an increase in CD-RISC score was associated with greater improvement during treatment. Improvement in CD-RISC score was noted in proportion to overall clinical global improvement, with greatest increase noted in subjects with the highest global improvement and deterioration in CD-RISC score in those with minimal or no global improvement. The CD-RISC has sound psychometric properties and distinguishes between those with greater and lesser resilience. The scale demonstrates that resilience is modifiable and can improve with treatment, with greater improvement corresponding to higher levels of global improvement. Copyright 2003 Wiley-Liss, Inc.
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                Author and article information

                Journal
                Psychol Res Behav Manag
                Psychol Res Behav Manag
                prbm
                Psychology Research and Behavior Management
                Dove
                1179-1578
                31 March 2025
                2025
                : 18
                : 743-757
                Affiliations
                [1 ]School of Nursing, Hong Kong Polytechnic University , Hong Kong, People’s Republic of China
                [2 ]Department of Breast Oncology, Guangzhou Institute of Cancer Research, The Affiliated Cancer Hospital, Guangzhou Medical University , Guangzhou, People’s Republic of China
                [3 ]Nursing Department, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital , Zhengzhou, People’s Republic of China
                [4 ]School of Nursing, Guangzhou University of Chinese Medicine , Guangzhou, People’s Republic of China
                [5 ]School of Nursing, Guangzhou Medical University , Guangzhou, People’s Republic of China
                Author notes
                Correspondence: Zengjie Ye, Email zengjieye@qq.com
                Author information
                http://orcid.org/0000-0003-2721-5784
                http://orcid.org/0000-0002-3593-5805
                http://orcid.org/0000-0002-5311-9190
                http://orcid.org/0000-0002-6797-1376
                http://orcid.org/0000-0002-0716-4871
                http://orcid.org/0009-0003-2450-5505
                http://orcid.org/0000-0002-4437-3947
                Article
                509684
                10.2147/PRBM.S509684
                11970526
                40191180
                6f4d1379-076c-4ebc-ad15-3b05e17fb990
                © 2025 Mei et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v4.0) License ( http://creativecommons.org/licenses/by-nc/4.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 13 December 2024
                : 25 March 2025
                Page count
                Figures: 4, Tables: 7, References: 68, Pages: 15
                Funding
                This research was funded by grants from National Natural Science Foundation of China (No. 72274043 and 71904033), Young Elite Scientists Sponsorship Program by CACM (No. 2021-QNRC2-B08), Science and Technology Projects in Guangzhou (No. 2023A04J2473).
                Categories
                Original Research

                Clinical Psychology & Psychiatry
                postpartum depression,resilience,self-efficacy,trait mindfulness

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