Longitudinal Course of Risk for Parental Postadoption Depression

Abstract

Objective: To determine whether the Postpartum Depression Predictors Inventory-Revised (PDPI-R) could be used to reveal distinct classes of adoptive parents across time.

Design: Longitudinal data were collected via online surveys at 4 to 6 weeks preplacement, 4 to 6 weeks postplacement, and 5 to 6 months postplacement.

Setting: Participants were primarily clients of the largest adoption agency in the United States.

Participants: Participants included 127 adoptive parents (68 mothers and 59 fathers).

Methods: We applied a latent class growth analysis to the PDPI-R and conducted mixed effects modeling of class, time, and class × time interaction for the following categories of explanatory variables: parental expectations, interpersonal variables, psychological symptoms, and life orientation.

Results: Four latent trajectory classes were found. Class 1 (55% of sample) showed a stably low level of PDPI-R scores over time. Class 2 (32%) reported mean scores below the cut-off points at all three time points. Class 3 (8%) started with scores at an intermediate level that increased after postplacement but decreased at 5 to 6 months postplacement. Class 4 (5%) had high mean scores at all three time points. Significant main effects were found for almost all explanatory variables for class and for several variables for time. Significant interactions between class and time were found for expectations about the child and amounts of love and ambivalence in parent's intimate relationship.

Conclusion: Findings may help nurses be alert to trajectories of risk for postadoption depression. Additional factors not included in the PDPI-R may be needed to determine risk for postadoption depression in adoptive parents.

Keywords: adoption; anxiety; longitudinal; nursing; postadoption depression; risk.