title: Depression and anxiety symptoms in mothers of newborns hospitalized on the neonatal intensive care unit.
abstract: BACKGROUND
  Mothers of infants hospitalized in the neonatal intensive care unit (NICU) are at risk for clinically significant levels of depression and anxiety symptoms; however, the maternal/infant characteristics that predict risk have been difficult to determine. Previous studies have conceptualized depression and anxiety symptoms separately, ignoring their comorbidity. Moreover, risk factors for these symptoms have not been assessed together in one study sample.
  
  
  OBJECTIVE
  The primary aim of this study was to determine whether a diagnostic classification approach or a common factor model better explained the pattern of symptoms reported by NICU mothers, including depression, generalized anxiety, panic, and trauma. A secondary aim was to assess risk factors of aversive emotional states in NICU mothers based on the supported conceptual model.
  
  
  METHODS
  In this cross-sectional study, a nonprobability convenience sample of 200 NICU mothers completed questionnaires assessing maternal demographic and infant health characteristics, as well as maternal depression and anxiety symptoms. Structural equation modeling was used to test a diagnostic classification model and a common factor model of aversive emotional states and the risk factors of aversive emotional states in mothers in the NICU.
  
  
  RESULTS
  Maximum likelihood estimates indicated that examining symptoms of depression and anxiety disorders as separate diagnostic classifications did not fit the data well, whereas examining the common factor of negative emotionality rendered an adequate fit to the data and identified a history of depression, infant illness, and infant prematurity as significant risk factors.
  
  
  CONCLUSIONS
  This study supports a multidimensional view of depression and should guide both clinical practice and future research with NICU mothers.
authors.affiliation: Lisa S. Segre, PhD, is Assistant Professor, College of Nursing, University of Iowa. Jennifer E. McCabe, BA, is Doctoral Candidate, Department of Psychology, University of Iowa. Rebecca Chuffo-Siewert, ARNP, DNP, NNP-BC, is Clinical Associate Professor, College of Nursing, University of Iowa, and Neonatal Nurse Practitioner, University of Iowa Children's Hospital. Michael W. O'Hara, PhD, is Professor, Department of Psychology, University of Iowa.
authors.forename: Lisa S
authors.initials: LS
authors.lastname: Segre
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: McCabe
authors.forename: Rebecca
authors.initials: R
authors.lastname: Chuffo-Siewert
authors.forename: Michael W
authors.initials: MW
authors.lastname: O'Hara
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D019052:Depression, Postpartum / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000628:therapy*; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D015931:Intensive Care, Neonatal / Q000523:psychology*; D008875:Middle Aged; D015146:Midwestern United States; D008960:Models, Psychological; D008962:Models, Theoretical; D009034:Mother-Child Relations / Q000523:psychology*; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology; D055815:Young Adult