Inside-out: the role of anger experience and expression in the development of postpartum mood disorders

PURPOSE: Among negative emotions, anger has not been studied in as much depth in her connection to postpartum mood disorders. The study aimed to investigate the role of anger as a potential vulnerability factor increasing the risk of Maternity Blues (MB) and Postpartum Depression (PPD). MATERIALS AND METHODS: Pregnant women in their third trimester of pregnancy underwent the following tests: the State Trait Anger Expression Inventory 2 - STAXI-2 (baseline visit), the Blues Questionnaire -BQ (3 and 5 days after delivery), and the Edinburgh Postnatal Depression Scale - Edinburgh Postnatal Depression Scale (EPDS) (3 and 6 months following delivery). RESULTS: One hundred ten subjects were included in this study. The prevalence rate of mothers with MB was about 35%, whereas about 4% of women developed a PPD. Significant positive correlations were found among State anger (SANG), Trait anger (TANG), anger expression out (AXO) and in (AXI) and postpartum depressive disorders, as measured by blues questionnaire (BQ) and EPDS. CONCLUSIONS: Anger experience and expression can be considered as vulnerability factors for postpartum mood disorders onset. Particularly, the expression of angry feelings toward other persons or objects in the environment (AXO) predicts the onset of MB, whereas holding in or suppressing angry feelings (AXI) could be a risk factor for subsequent PPD.