Middle Eastern Journal of Disability Studies

Background & Objectives: Postpartum depression is a kind of mood disorder. Postpartum depression has many adverse effects on women and their children. Negative body image in mothers after childbirth creates negative emotions for the mother. This discomfort and negative emotions caused by body image are pronounced in mothers with postpartum depression. One of the therapies that can be used for postpartum depression is dialectical behavior therapy. In dialectical behavior therapy, treatment bias is first achieved by controlling and mastering the client's performance, teaching behavioral skills, and finally helping empower the client to feel better about individual and social life and solve life problems, helping the client gain pleasure and satisfaction, and a sense of self–confidence in life. Dialectical behavioral therapy teaches mothers with postpartum depression to recognize these disturbing emotions, accept them, and instead of avoiding these emotions, face them with behavioral goals such as walking and proper diet. This study aimed to evaluate the effectiveness of dialectical behavior therapy on body image and depression in women with postpartum depression.
Methods: This research was a quasi–experimental study with a pretest–posttest design with a control group and a 60–day follow–up. The statistical population consisted of women with postpartum depression who were referred to Isfahan medical centers, Isfahan City, Iran, in February and March 2016. To collect information after obtaining the necessary permits, a statistical sample was selected by using the available sampling method. The inclusion criteria included a score of more than 12 on the Edinburgh Postnatal Depression Scale (EDPS) (Cox et al., 1987), being between six weeks and three months postpartum, the age range of 20 to 30 years, first pregnancy, no acute psychiatric disorder (self–reported), and not receiving concomitant psychotherapy or medication. The exclusion criteria for the experimental group were a lack of interest in continuing to participate in treatment sessions and the absence of more than one of the nine treatment sessions. A total of 28 women interested in participating in the study met the parameters of postpartum depression based on the score of the Edinburgh Postpartum Depression Scale (Cox et al., 1987). They were divided into two groups of dialectical behavior therapy training (14 people) and control (14 people) randomly. The study data were collected in pretest, posttest and follow–up stages in two groups via the Satisfaction with Body Image Scale (SWBIS) (Suoto and Garcia, 2002) and Beck Depression Inventory–II (Beck et al., 1996). The experimental group received dialectical behavior therapy as a group in nine 90–minute sessions. Data analysis was performed in SPSS software version 23 using descriptive statistics (mean, standard deviation, frequency and percentage) and inferential statistics (analysis of variance with repeated measures and Bonferroni post hoc test). The significance level for all tests was equal to or less than 0.05.
Results: The results showed that depression (p<0.001) and body image (p=0.042) were significantly different between the experimental and control groups. The variables of body image (p<0.001) and depression (p<0.001) had a significant difference from the posttest stage to follow–up. The interaction of the test stages with the group also shows that body image (p<0.001), and depression (p<0.001) had a significant difference. In the experimental group, there was a significant difference in the variables of depression (p<0.001) and body image (p<0.001) between pretest and posttest and also between pretest and follow–up stages. Also, in the experimental group, there was no significant difference between the posttest and follow–up stages in the depression variable (p=0.063), which indicated the stability of the effectiveness of dialectical behavior therapy in the follow–up stage on the mentioned variable. However, there was a significant difference between the posttest and follow–up stages in the body image variable (p<0.001), indicating that the effectiveness of dialectical behavior therapy in the follow–up stage for the body image variable was not stable.
Conclusion: According to the research findings, dialectical behavior therapy is effective in improving body image and reducing depression in women with postpartum depression.