Background: Postpartum Depression (PPD) affects up to one in five mothers. While
psychotherapy can effectively reduce symptoms of PPD, it is unclear how PPD treatment affects maternal psychophysiology. Determining physiological changes in response to cognitive
behavioural therapy (CBT) could provide insights into the mechanisms underlying effective
treatment and/or help predict treatment outcomes. This study examined if treating PPD with CBT led to changes in frontal cortical activity and heart rate variability, two markers of maternal emotion regulatory capacity.
Methods: Community-dwelling mothers with PPD (Edinburgh Postnatal Depression Scores
≥10) were randomized to receive nine weeks of group CBT delivered by recovered peers (i.e.,
those who had previously recovered from PPD) (n=26) or be put on a waitlist to receive the
intervention nine weeks later (n=24). Electroencephalographic (frontal alpha asymmetry),
electrocardiographic (heart rate variability), and clinical (depression, anxiety) data were collected at baseline and nine weeks later.
Results: Participants in both the immediate treatment and waitlist control groups reported
moderate levels of depression and anxiety at baseline. After treatment, mothers in the treatment group showed greater improvements in depression (p<0.01, Cohen d=1.22), and anxiety (p<0.005, Cohen d = 1.48), and high-frequency heart rate variability (p<0.05, Cohen d=0.70), but not frontal alpha asymmetry, compared to the waitlist control group.
Conclusion: Group CBT for PPD can improve symptoms of depression and anxiety and
parasympathetic nervous system function. Future research should attempt to replicate and extend these findings using larger samples, additional biomarkers, and longer periods of follow up. Examining how evidence-based treatments for PPD affect maternal psychophysiology can
improve our understanding and potentially predict treatment effects. / Thesis / Master of Science (MSc) / Postpartum depression affects up to one in five mothers in the first year after delivery. When
treated promptly with talking therapies (i.e., psychotherapy) such as cognitive behavioural
therapy (CBT), many experience significant improvements in their symptoms. However, the
changes occurring in the brain and the remainder of the nervous system occurring in response to psychotherapy is not well known. It is important that this is understood so that we can develop more effective treatments and better predict who will respond to different types of treatments. In particular, the role of the frontal lobe of the brain, and the body’s parasympathetic system is poorly understood in the context of PPD. This thesis aimed to examine the impact of CBT on women’s frontal lobe functioning using a measure called frontal alpha asymmetry (FAA) measured via electroencephalography (EEG), and parasympathetic nervous system-based heart rate variability (HRV) using electrocardiography (ECG). In this study, we compared mothers with PPD treated with CBT to those who did not receive this treatment. We found that HRV responded in mothers who received CBT compared to women who were in the control group. No significant changes were found for FAA after treatment. These results suggest that HRV may be explored further as a valid treatment outcome for CBT when provided to women with PPD.
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/27027 |
| Date | January 2021 |
| Creators | Karunagoda, Tarindhya |
| Contributors | Van Lieshout, Ryan, Neuroscience |
| Source Sets | McMaster University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis |
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