Postpartum self-injurious thoughts vary by socioeconomic status: The moderating effects of mindfulness and emotion dysregulation.

BACKGROUND: Lower socioeconomic status (SES) is associated with increased risk for self-injurious thoughts (SITs), yet this association remains understudied in the postpartum period, when vulnerability to mood disorders and financial strain increases. OBJECTIVE: This study examined whether distinct socioeconomic contexts during pregnancy were associated with postpartum SITs and whether mindfulness and emotion dysregulation moderated these associations. METHODS: Using data from a longitudinal cohort assessed during pregnancy and postpartum, we constructed person-centered SES subgroups using multiple objective and subjective indicators of socioeconomic context. Generalized linear models tested associations between SES subgroup membership and postpartum SITs, as well as moderation by mindfulness and emotion dysregulation. RESULTS: Three SES subgroups emerged, reflecting distinct socioeconomic contexts: a consistently advantaged group (high SES), a group characterized by material stability alongside financial stress (middle SES), and a group experiencing broad objective and subjective disadvantage (low SES). Participants in the low- and middle-SES subgroups had higher odds of postpartum SITs compared to the high-SES group. Emotion dysregulation was associated with higher odds of SITs across all SES subgroups. Mindfulness was associated with lower odds of SITs in the low-SES subgroup but, unexpectedly, higher odds in the high-SES subgroup. LIMITATIONS: Limitations include reliance on a single cohort and a person-centered SES classification approach that may be sample dependent, potentially limiting generalizability. CONCLUSIONS: Findings underscore the importance of socioeconomic context in shaping risk and protective factors for postpartum self-injurious thoughts. Person-centered approaches that account for structural inequities may improve the contextual relevance of suicide risk assessment and intervention during the postpartum period.

Duke Scholars

Author Elisabeth D Conradt Psychiatry, Child & Family Mental Health & Community Psychia ...