Resilience, Recovery, and Therapeutic Interventions for Peripartum Women with Histories of Trauma

  • Minden B. SextonEmail author
  • Diana C. Bennett
  • Maria Muzik
  • Katherine L. Rosenblum
Part of the Integrating Psychiatry and Primary Care book series (IPPC)


Although traumatic experiences increase risk for myriad mental health sequelae, most individuals who experience marked adverse events do not meet the criteria for psychiatric disorders or appear to sustain chronic injury or functional impairments. This chapter entails several of the critical aspects of psychosocial resilience and recovery in the context of distal and proximal trauma. First, we review the literature on posttraumatic well-being among peripartum women. Second, we consider therapeutic processes central to trauma recovery and survivors’ care preferences. Finally, we present information on the current state of knowledge regarding the application of empirically supported interventions for major depressive disorder (MDD), posttraumatic stress disorder (PTSD), and affect regulation difficulties to trauma-exposed peripartum women.


Peripartum Women Posttraumatic Stress Disorder (PTSD) Affect Regulation Difficulties Postpartum PTSD Peripartum Depression 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Andersson L, Sundstrom-Poromaa I, Wulff M, Astrom M, Bixo M (2006) Depression and anxiety during pregnancy and six months postpartum: a follow-up study. Acta Obstet Gynecol Scand 85:937–944CrossRefPubMedGoogle Scholar
  2. Apter-Danon G, Candilis-Huisman D (2005) A challenge for perinatal psychiatry: therapeutic management of maternal borderline personality disorder and their very young infants. Clin Neuropsychiatr 2:302–314Google Scholar
  3. Arch JJ, Dimidjian S, Chessick CA (2012) Are exposure-based cognitive behavioral therapies safe during pregnancy? Arch Womens Ment Health 15:445–457CrossRefPubMedGoogle Scholar
  4. Ayers S, McKenzie-McHarg K, Eagle A (2007) Cognitive behaviour therapy for postnatal post-traumatic stress disorder: case studies. J Psychosom Obstet Gynaecol 28:177–184CrossRefPubMedGoogle Scholar
  5. Bradley R, Greene J, Russ E, Dutra L, Westen D (2005) A multidimensional meta-analysis of psychotherapy for PTSD. Am J Psychiatr 162:214–227CrossRefPubMedGoogle Scholar
  6. Connor M, Davidson JR (2003) Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety 18:76–82CrossRefPubMedGoogle Scholar
  7. Dossa NI, Hatem M (2012) Cognitive-behavioral therapy versus other PTSD psychotherapies as treatment for women victims of war-related violence: a systematic review. Sci World J 2012:1–9CrossRefGoogle Scholar
  8. Foa EB, Hembree EA, Rothbaum BO (2007) Prolonged exposure therapy for PTSD: emotional processing of traumatic experiences, therapist guide (treatments that work). Oxford University, New York, NYGoogle Scholar
  9. Gotlib IH, Whiffen VE, Wallace PM, Mount JH (1991) Prospective investigation of postpartum depression: factors involved in onset and recovery. J Abnorm Psychol 100:122–132CrossRefPubMedGoogle Scholar
  10. Harned M, Korslund K, Foa E, Linehan M (2012) Treating PTSD in suicidal and self-injuring women with borderline personality disorder: development and preliminary evaluation of a dialectical behavior therapy prolonged exposure protocol. Behav Res Ther 50:381–386CrossRefPubMedPubMedCentralGoogle Scholar
  11. Harville EW, Xiong X, Buekens P, Pridjian G, Elkind-Hirsch K (2010) Resilience after hurricane Katrina among pregnant and postpartum women. Womens Health Issues 20:20–27CrossRefPubMedPubMedCentralGoogle Scholar
  12. Hughes P, Riches S (2003) Psychological aspects of perinatal loss. Curr Opin Obstet Gynecol 15:107–111CrossRefPubMedGoogle Scholar
  13. Leahy-Warren P, McCarthy G, Corcoran P (2012) First-time mothers: social support, maternal parental self-efficacy and postnatal depression. J Clin Nurs 21:388–397CrossRefPubMedGoogle Scholar
  14. Linehan MM (1993) Cognitive behavioral treatment of borderline personality disorder. Guilford Press, New YorkGoogle Scholar
  15. Lynch TR, Trost WT, Salsman N, Linehan MM (2007) Dialectical behavior therapy for borderline personality disorder. Annu Rev Clin Psychol 3:181–205CrossRefPubMedGoogle Scholar
  16. Mouilso ER, Tuerk PW, Schnurr PP, Rauch SA (2015) Addressing the gender gap: prolonged exposure for PTSD in veterans. Psychol Serv 13(3):308–316. doi: 10.1037/ser0000040 CrossRefPubMedGoogle Scholar
  17. Muzik M, Ads M, Bonham C, Rosenblum K, Broderick A, Kirk R (2013) Perspectives on trauma-informed care from mothers with a history of childhood maltreatment: a qualitative study. Child Abuse Negl 37:1215–1224CrossRefPubMedGoogle Scholar
  18. Muzik M, Brier Z, Menke R, Davis MT, Sexton MB (2016) Longitudinal suicidal ideation across 18-months postpartum in mothers with childhood maltreatment histories: temporal trajectories and predictors of risk. J Affect Disord 204:138–145CrossRefPubMedPubMedCentralGoogle Scholar
  19. Muzik M, Umarji R, Sexton MB, Davis MT (2017) Social support buffers the relationships between childhood maltreatment severity, economic adversity and postpartum depressive symptoms. Matern Child Health J 21:1018–1025Google Scholar
  20. O’Hara MW, Stuart S, Gorman LL, Wenzel A (2000) Efficacy of interpersonal psychotherapy for postpartum depression. Arch Gen Psychiatry 57:1039–1045CrossRefPubMedGoogle Scholar
  21. Powers MB, Halpern JM, Ferenschak MP, Gillihan SJ, Foa EB (2010) A meta-analytic review of prolonged exposure for posttraumatic stress disorder. Clin Psychol Rev 30:635–641CrossRefPubMedGoogle Scholar
  22. Resick PA, Schnicke MK (1993) Cognitive processing therapy for sexual assault victims: a treatment manual. Sage Publications, Newbury ParkGoogle Scholar
  23. Resick PA, Nishith P, Weaver TL, Astin MC, Feuer CA (2002) A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. J Consult Clin Psychol 70:867–879CrossRefPubMedPubMedCentralGoogle Scholar
  24. Robertson E, Grace S, Wallington T, Stewart DE (2004) Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry 26:289–295CrossRefPubMedGoogle Scholar
  25. Sexton MB, Flynn HA, Lancaster C, Marcus S, McDonough S et al (2012) Predictors of recovery from prenatal depressive symptoms from pregnancy through postpartum. J Womens Ment Health 21:43–49CrossRefGoogle Scholar
  26. Sexton MB, Hamilton L, McGinnis EW, Rosenblum KL, Muzik M (2015) The roles of resilience and childhood trauma history: main and moderating effects on postpartum maternal mental health and functioning. J Affect Disord 174:562–568CrossRefPubMedGoogle Scholar
  27. Sockol LE, Epperson CN, Barber JP (2011) A meta-analysis of treatments for perinatal depression. Clin Psychol Rev 31:839–849Google Scholar
  28. Spinelli MB, Endicott J (2003) Controlled clinical trial of interpersonal psychotherapy versus parenting education program for depressed pregnant women. Am J Psychiatr 160:555–562CrossRefPubMedGoogle Scholar
  29. Swanson LM, Flynn H, Adams-Mundy JD, Armitage R, Arnedt JT (2013) An open pilot of cognitive-behavioral therapy for insomnia in women with postpartum depression. Behav Sleep Med 11:297–307CrossRefPubMedGoogle Scholar
  30. Turton P, Hughes P, Evans CDH, Fainman D (2001) Incidence, correlates, and predictors of posttraumatic stress disorder in the pregnancy after stillbirth. Br J Psychiatry 178:556–560CrossRefPubMedGoogle Scholar
  31. Twohig MP, O’Donohue WT (2007) Treatment of posttraumatic stress disorder with exposure therapy during late term pregnancy. Clin Case Stud 6:525–535CrossRefGoogle Scholar
  32. Walter KH, Varkovitzky RL, Owens GP, Lewis J, Chard KM (2014) Cognitive processing therapy for veterans with posttraumatic stress disorder: a cross-sectional and longitudinal comparison between outpatient and residential PTSD treatment. J Consult Clin Psychol 82:551–561CrossRefPubMedGoogle Scholar
  33. Zlotnick C, Miller IW, Pearlstein T, Howard M, Sweeney P (2006) A preventative intervention for pregnant women on public assistance at risk for postpartum depression. Am J Psychiatr 163:1443–1445CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Minden B. Sexton
    • 1
    • 2
    Email author
  • Diana C. Bennett
    • 1
    • 2
  • Maria Muzik
    • 2
  • Katherine L. Rosenblum
    • 2
  1. 1.Ann Arbor Veterans Healthcare SystemAnn ArborUSA
  2. 2.Department of PsychiatryUniversity of MichiganAnn ArborUSA

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