Browsing by Author "Roos, Leslie"

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    Sleep and mental health in pregnancy during COVID-19: A parallel process growth model
    (Elsevier, 2022-07-21) Tomfohr-Madsen, Lianne; Rioux, Charlie; MacKinnon, Anna; Silang, Katherine; Roos, Leslie; Lebel, Catherine
    Pregnancy is associated with elevated risk for poor sleep quality, which increases the risk for poor obstetrical outcomes and parent mental health problems. The COVID-19 pandemic has seen increased reports of disturbed sleep worldwide; however, the degree this extends to pregnancy or influences pregnancy mental health outcomes has not been examined. The goal of this study was to examine changes in pregnant individuals’ sleep, anxiety and depression during the pandemic, and to understand how sleep was associated with symptoms of anxiety and depression over time. The Pregnancy During the COVID-19 Pandemic (PdP) study is a prospective longitudinal cohort of pregnant individuals (at enrollment) with repeated follow ups during pregnancy and the postpartum period. 3747 pregnant individuals participated between April and July 2020. The present analysis was restricted to participants who completed at least two assessments, yielding a final sample of 1842 pregnant individuals. Depression symptoms were elevated at baseline, and declined gradually over time, but remained elevated relative to pre pandemic levels. Shorter sleep duration, higher sleep disturbance, and more sleep related impairments at baseline predicted a slower decline in depression symptoms over time. More sleep disturbances at baseline also predicted slower decline in anxiety symptoms over time. In contrast, rates of depression and anxiety symptoms at baseline were not predictive of changes in any of the three sleep variables over time. These findings highlight the importance of early intervention for sleep problems in pregnancy, in order to optimize mental health throughout pregnancy and mitigate long term negative outcomes.
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    The Efficacy of a Mental Health and Parenting Intervention (BEAM) and the Role of Romantic Relationship Quality: How do Partners Influence Treatment Response?
    (2024-06-18) Xie, Elisabeth Bailin; Tomfohr-Madsen, Lianne; Giesbrecht, Gerald; Roos, Leslie; Noel, Melanie
    Background: Parental mental health concerns are common during the first few years following childbirth and are associated with adverse consequences for mothers and their children. The COVID-19 pandemic contributed to elevated levels of maternal mental health problems and introduced unique parenting stressors, highlighting the urgent need for accessible digital mental health interventions. There is a robust association between the quality of romantic relationships and psychopathology, and romantic relationship quality can influence the effectiveness of individual mental health interventions. Therefore, the current dissertation 1) evaluated the preliminary effectiveness and feasibility of a novel app-based program for mothers of infants and toddlers presenting with depression and/or anxiety (BEAM), 2) discussed program revisions, and 3) assessed the association between relationship factors and treatment effectiveness. Methods: The first manuscript was a pilot study of the BEAM program. The transition chapter discusses adaptations to the BEAM program and observations from the initial study that helped to inform the second manuscript. The second manuscript examined relationship factors as moderators of treatment outcomes using a phase-III longitudinal RCT. Results: The first manuscript (n = 46) demonstrated moderate levels of feasibility and strong preliminary efficacy of the BEAM program, with significant reductions in maternal depression, anxiety, parenting stress, and child internalizing symptoms. The second manuscript (n = 116) found that there was a high proportion of individuals who reported notable relationship distress (60%). Better overall partner support and satisfaction were associated with less mental health concerns. Moderation analyses revealed that BEAM contributed to greater reductions in overreactive discipline for mothers with lower levels of partner support or relationship satisfaction at baseline and that BEAM contributed to greater reductions in anxiety and anger at 6-month follow-up for mothers with lower levels of partner information support at baseline. Conclusion: The BEAM program shows promise as an accessible and scalable digital intervention for mothers. Many individuals report relationship dissatisfaction, and those with lower satisfaction and support appeared to benefit more from BEAM. Findings will help direct the program to the most suitable populations. Implementing relationship enhancement strategies may be a future direction to address this population's high levels of relationship dissatisfaction.