TY  - EJOU
AU  - Nie, Xiaofei 
AU  - Pakpour, Amir 
AU  - Ouyang, Yanqiong 
AU  - Björk, Maria 

TI  - Longitudinal Pathways between Psychological Distress, Mindfulness, Childbirth Trauma, and Postpartum PTSD among Chinese Postpartum Women: A Three-Wave Cross-Lagged Panel Analysis
T2  - International Journal of Mental Health Promotion

PY  - 
VL  - 
IS  - 
SN  - 2049-8543

AB  - <b>Objectives:</b> This study aims to examine the temporal associations among psychological distress, mindfulness, childbirth trauma, and postpartum post-traumatic stress disorder (PTSD) symptoms across the first three months postpartum and test whether mindfulness mediates these longitudinal pathways. <b>Methods:</b> This prospective longitudinal cohort study followed Chinese postpartum women at one week (T1), one month (T2), and three months (T3) after childbirth. A total of 210 women completed baseline assessments, with 173 and 148 participants retained at T2 and T3, respectively. Psychological distress, mindfulness, childbirth trauma, and postpartum PTSD symptoms were assessed using validated self-report measures. Cross-lagged panel models (CLPM) with bootstrapping were applied to examine temporal associations and the mediating role of mindfulness. <b>Results:</b> Mindfulness demonstrated a complex mediating role across the postpartum period. Psychological distress at T1 showed a significant negative indirect association with childbirth trauma at T3 via mindfulness at T2 (<i>β</i> = −0.110, 95% CI [−0.188, −0.037]), while simultaneously exerting a positive direct effect (<i>β</i> = 0.151, 95% CI [0.030, 0.272]), resulting in an inconsistent mediation pattern (<i>β</i> = 0.041, 95% CI [−0.158, 0.240]). In contrast, psychological distress at T1 showed a significant indirect longitudinal association with postpartum PTSD symptoms at T3 via mindfulness at T2 (<i>β</i> = −0.206, 95% CI [−0.310, −0.101]). This pattern was consistent with mediation, although the findings should be interpreted cautiously given the CLPM framework and the modest model fit. <b>Conclusions:</b> Mindfulness functions as a central but non-uniform mechanism in postpartum mental health. These findings underscore both its protective potential and the methodological and conceptual complexity of interpreting mindfulness in longitudinal postpartum research.
KW  - Postpartum women; psychological distress; mindfulness; childbirth trauma; postpartum post-traumatic stress disorder; prospective longitudinal cohort study

DO  - 10.32604/ijmhp.2026.078747