The Coexistence of Paternal Stress, Anxiety, and Depression Symptoms in Ireland During the Early Postnatal Period

Main Article Content

Lloyd Philpott

Abstract

Background: For most fathers, the early postnatal period is a time of great joy and happiness; however, some fathers experience difficulties in repositioning themselves in relation to their partner, child, and work, which can lead to increased stress, anxiety and depression. The aim of this study was to investigate the coexistence
of paternal stress, anxiety, and depression symptoms in the early postnatal period (0–4 days).


Methods: A quantitative, cross-sectional, descriptive correlational design was used. Data were collected using a self-administered questionnaire comprising the Perceived Stress Scale, the State–Trait Anxiety Inventory, and the Edinburgh Postnatal Depression Scale. Demographic data collected included the father’s age, number of children, level of education, relationship status, nationality, and their mental health history including that of their partner. Univariable and multivariable logistic regression were used to investigate factors associated the coexistence of symptoms.


Results: A total of 336 fathers were included in the study. Forty-three fathers (12.8%) met the criteria for the coexistence of stress, anxiety, and depression symptoms. The coexistence of two or more symptoms of stress, anxiety, or depression was almost twice as common as having only one symptom. A self-reported history of anxiety (P < 0.001), a negative experience of labor and birth (P < 0.001), and being of a younger age (P = 0.034) were significantly associated with the coexistence of stress, anxiety, and depression symptoms.


Limitations: The data collected was cross-sectional; therefore, causal links cannot be determined.


Conclusion: The findings highlight the need to move away from the predominant focus on depression which has existed among researchers and clinicians, to encompass a broader understanding of adverse paternal mental health outcomes to include stress, anxiety, and the coexistence of symptoms.

Downloads

Download data is not yet available.

Article Details

How to Cite
Philpott, L. (2022). The Coexistence of Paternal Stress, Anxiety, and Depression Symptoms in Ireland During the Early Postnatal Period. International Journal of Mens Social and Community Health, 5(3), e33-e46. https://doi.org/10.22374/ijmsch.v5i3.95
Section
Articles
Author Biography

Lloyd Philpott, University College Cork, Cork, Republic of Ireland

School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork,
Republic of Ireland

References

1. Leach LS, Poyser C, Cooklin AR, Giallo R. Prevalence and course of anxiety disorders (and symptom levels) in men across the perinatal period: A systematic review. J Affect Disord. 2016;190:675–86. http://dx.doi.org/10.1016/j.jad.2015.09.063
2. Darwin Z, Galdas P, Hinchliff S, Littlewood E, McMillan D, McGowan L, et al. Fathers’ views and experiences of their own mental health during pregnancy and the first postnatal year: A qualitative interview study of men participating in the UK born and bred in Yorkshire (BaBY) cohort. BMC Pregnancy Childbirth. 2017;17(1):45. http://dx.doi.org/10.1186/s12884-017-1229-4
3. Edelstein RS, van Anders SM, Chopik WJ, Goldey KL, Wardecker BM. Dyadic associations between testosterone and relationship quality in couples. Horm Behav. 2014;65(4):401–7. http://dx.doi.org/10.1016/j.yhbeh.2014.03.003
4. Genesoni L, Tallandini MA. Men’s psychological transition to fatherhood: An analysis of the literature, 1989–2008. Birth. 2009;36(4):305–17. http://dx.doi.org/10.1111/j.1523-536X.2009.00358.x
5. Chin R, Hall P, Daiches A. Fathers’ experiences of their transition to fatherhood: A metasynthesis. J Reprod Infant Psychol. 2011;29(1):4–18. http://dx.doi.org/10.1080/02646838.2010.513044
6. Kumar SV, Oliffe JL, Kelly MT. Promoting postpartum mental health in fathers: Recommendations for nurse practitioners. Am J Mens Health. 2018;12(2):221–8. http://dx.doi.org/10.1177/1557988317744712
7. Baldwin S, Bick DE. Mental health of first time fathers—It’s time to put evidence into practice. JBI Database System Rev Implement Rep. 2018;16(11):2064. http://dx.doi.org/10.11124/JBISRIR-2017-003983
8. Shorey S, Chan V. Paternal mental health during the perinatal period: A qualitative systematic review. J Adv Nurs. 2020;76(6):1307–19. http://dx.doi.org/10.1111/jan.14325
9. Cameron EE, Sedov ID, Tomfohr-Madsen LM. Prevalence of paternal depression in pregnancy and the postpartum: An updated meta-analysis. J Affect Disord. 2016;206:189–203. http://dx.doi.org/10.1016/j.jad.2016.07.044
10. Philpott LF, Leahy-Warren P, FitzGerald S, Savage E. Stress in fathers in the perinatal period: A systematic review. Midwifery. 2017;55:113–27. http://dx.doi.org/10.1016/j.midw.2017.09.016
11. Philpott LF, FitzGerald S, Savage E, Leahy-Warren P. Anxiety in fathers in the perinatal period: A systematic review. Midwifery. 2019;76:54–101. http://dx.doi.org/10.1016/j.midw.2019.05.013
12. Hildingsson I, Thomas J. Parental stress in mothers and fathers one year after birth. J Reprod Infant Psychol. 2014;32:41–56. http://dx.doi.org/10.1080/02646838.2013.840882
13. Wee KY, Skouteris H, Richardson B, McPhie S, Hill B. The inter-relationship between depressive, anxiety and stress symptoms in fathers during the antenatal period. J Reprod Infant Psychol. 2015;33:359–73. http://dx.doi.org/10.1080/02646838.2015.1048199
14. Vismara L, Rollè L, Agostini F, Sechi C, Fenaroli V, Molgora S, et al. Perinatal parenting stress, anxiety, and depression outcomes in first-time mothers and fathers: A three to six-months postpartum follow-up study. Front Psychol. 2016;7:938. http://dx.doi.org/10.3389/fpsyg.2016.00938 3- to 6-
15. Kalin NH. The critical relationship between anxiety and depression. Am J Psychiatry. 2020;177(5):365–7. http://dx.doi.org/10.1176/appi.ajp.2020.20030305
16. Cohen S, Kamarck T, Mermelstein R. Perceived stress scale. J Health Soc Behav. 1983;24(4):385–96. http://dx.doi.org/10.2307/2136404
17. Swaminathan A, Viswanathan S, Gnanadurai T, Ayyavoo S, Manickam T. Perceived stress and sources of stress among first-year medical undergraduate students in a private medical college–Tamil Nadu. Natl J Physiol Pharm Pharmacol. 2016;6(1):9–14. http://dx.doi.org/10.5455/njppp.2015.5.1909201574
18. Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA. Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press; 1983.
19. Julian LJ. Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Arthritis Care Res (Hoboken). 2011;63 Suppl 11(0 11):S467–72. http://dx.doi.org/10.1002/acr.20561
20. Emons WH, Habibovic M, Pedersen SS. Prevalence of anxiety in patients with an implantable cardioverter defibrillator: Measurement equivalence of the HADS-A and the STAI-S. Qual Life Res. 2019;28(11):3107–16. http://dx.doi.org/10.1007/s11136-019-02237-2
21. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987; 150:782–86. http://dx.doi.org/10.1192/bjp.150.6.782
22. Massoudi P, Hwang CP, Wickberg B. Fathers’ depressive symptoms in the postnatal period: Prevalence and correlates in a population-based Swedish study. Scand J Public Health. 2016;44(7):688–94. http://dx.doi.org/10.1177/1403494816661652
23. Fisher SD. Paternal mental health: Why is it relevant? Am J Lifestyle Med. 2017;11(3):200–11. http://dx.doi.org/10.1177/1559827616629895
24. Park J, Moghaddam B. Impact of anxiety on prefrontal cortex encoding of cognitive flexibility. Neuroscience. 2017;14(345):193–202. http://dx.doi.org/10.1016/j.neuroscience.2016.06.013
25. Eysenck MW, Derakshan N, Santos R, Calvo MG. Anxiety and cognitive performance: Attentional control theory. Emotion. 2007;7(2):336–53. http://dx.doi.org/10.1037/1528-3542.7.2.336
26. Wilson CG, Nusbaum AT, Whitney P, Hinson JM. Trait anxiety impairs cognitive flexibility when overcoming a task acquired response and a pre-existing bias. PLoS One. 2018;13(9):e0204694. http://dx.doi.org/10.1371/journal.pone.0204694
27. Goette L, Bendahan S, Thoresen J, Hollis F, Sandi C. Stress pulls us apart: Anxiety leads to differences in competitive confidence under stress. Psychoneuroendocrinology. 2015;54:115–23. http://dx.doi.org/10.1016/j.psyneuen.2015.01.019
28. Lu L. The transition to parenthood: Stress, resources, and gender differences in a Chinese society. J Community Psychol. 2006;34:471–88. http://dx.doi.org/10.1002/jcop.20110
29. Habib C. Paternal perinatal depression: An overview and suggestions towards an intervention model. Journal of Family Studies. 2012;18(1):4–16. http://dx.doi.org/10.5172/jfs.2012.18.1.4
30. Stramrood CA, Doornbos B, Wessel I, van Geenen M, Aarnoudse JG, van den Berg PP, et al. Fathers with PTSD and depression in pregnancies complicated by preterm preeclampsia or PPROM. Arch Gynaecol Obstet. 2013;287(4):653–61. http://dx.doi.org/10.1007/s00404-012-2611-0
31. Skjothaug T, Smith L, Wentzel-Larsen T, Moe V. Prospective fathers’ adverse childhood experiences, pregnancy-related anxiety, and depression during pregnancy. Infant Ment Health J. 2015;36(1):104–13. http://dx.doi.org/10.1002/imhj.21485
32. Koh YW, Lee AM, Chan CY, Fong DY, Lee CP, Leung KY, et al. Survey on examining prevalence of paternal anxiety and its risk factors in perinatal period in Hong Kong: A longitudinal study. BMC Public Health. 2015;15:1131. http://dx.doi.org/10.1186/s12889-015-2436-4.
33. Kannenberg K, Weichert J, Rody A, Banz-Jansen C. Treatment-associated anxiety among pregnant women and their partners: What is the influence of sex, parity, age and education? Geburtshilfe Frauenheilkd. 2016;76(7):809–13. http://dx.doi.org/10.1055/s-0042-101546
34. Philpott LF, Corcoran P. Paternal postnatal depression in Ireland: Prevalence and associated factors. Midwifery. 2018;56:121–27. http://dx.doi.org/10.1016/j.midw.2017.10.009
35. Lee Y, Fagan J, Chen WY. Do late adolescent fathers have more depressive symptoms than older fathers? J Youth and Adolesc. 2012;41(10):1366–81. http://dx.doi.org/10.1007/s10964-011-9717-8
36. Garfield CF, Duncan G, Rutsohn J, McDade TW, Adam EK, Levine Coley R, et al. A longitudinal study of paternal mental health during transition to fatherhood as young adults. Pediatrics. 2014;133(5):836–42. http://dx.doi.org/10.1542/peds.2013-3262
37. Recto P, Lesser J. “Fathers Need Help Too”: Adolescent fathers and depression. Issues Ment Health Nurs. 2021;42(5):515–18. http://dx.doi.org/10.1080/01612840.2020.1752866
38. Clayton CL. The lives of young fathers: A review of selected evidence. Social Policy and Society. 2016;15(1):129–40. http://dx.doi.org/10.1017/S1474746415000470
39. Gürber S, Baumeler L, Grob A, Surbek D, Stadlmayr W. Antenatal depressive symptoms and subjective birth experience in association with postpartum depressive symptoms and acute stress reaction in mothers and fathers: A longitudinal path analysis. Eur J Obstet Gynecol. 2017;215:68–74. http://dx.doi.org/10.1016/j.ejogrb.2017.05.021
40. Etheridge J, Slade P. “Nothing’s actually happened to me.”: The experiences of fathers who found childbirth traumatic. BMC Pregnancy Childbirth. 2017;17(1):80. http://dx.doi.org/10.1186/s12884-017-1259-y
41. Hughes C, Foley S, Devine RT, Ribner A, Kyriakou L, Boddington L, et al. Worrying in the wings? Negative emotional birth memories in mothers and fathers show similar associations with perinatal mood disturbance and delivery mode. Arch Womens Ment Health. 2020;23(3):371–7. http://dx.doi.org/10.1007/s00737-019-00973-5
42. Glasser S, Lerner-Geva L. Focus on fathers: Paternal depression in the perinatal period. Perspect Public Health. 2018;139(4):195–8. http://dx.doi.org/10.1177/1757913918790597
43. Baldwin S, Malone M, Sandall J, Bick D. A qualitative exploratory study of UK first-time fathers’ experiences, mental health and well-being needs during their transition to fatherhood. BMJ Open. 2019;9(9):e030792. http://dx.doi.org/10.1136/bmjopen-2019-030792
44. Lee JY, Knauer HA, Lee SJ, MacEachern MP, Garfield CF. Father-inclusive perinatal parent education programs: A systematic review. Pediatrics. 2018;142(1):e20180437. http://dx.doi.org/10.1542/peds.2018-0437
45. Recto P, Champion JD. Psychosocial factors associated with paternal perinatal depression in the United States: A systematic review. Issues Ment Health Nurs. 2020;41(7):608–23. http://dx.doi.org/10.1080/01612840.2019.1704320
46. Bostwick WB, Boyd CJ, Hughes TL, McCabe SE. Dimensions of sexual orientation and the prevalence of mood and anxiety disorders in the United States. Am J Public Health. 2010;100(3):468–75. http://dx.doi.org/10.2105/AJPH.2008.152942
47. Bostwick W, Boyd CJ, Hughes TL, West BT, McCabe SE. Discrimination and mental health among lesbian, gay and bisexual adults in the United States. Am J Orthopsychiatry. 2014;84(1):35–45. http://dx.doi.org/10.1037/h0098851
48. Parahoo K. Nursing research: Principles, process and issues. 3rd ed. Basingstoke, UK: Palgrave Macmillan; 2014.
49. Setia MS. Methodology series Module 3: Cross-sectional studies. Indian J Dermatol. 2016;61(3):261–4. http://dx.doi.org/10.4103/0019-5154.182410
50. Woodall A, Howard L, Morgan C. Barriers to participation in mental health research: Findings from the Genetics and Psychosis (GAP) Study. Int Rev Psychiatry. 2011;23(1):31–40. http://dx.doi.org/10.3109/09540261.2010.546777