Summary Background The perinatal period is a time of high risk for onset of depressive disorders and is associated with substantial morbidity and mortality, including maternal suicide. Perinatal depression comprises a heterogeneous group of clinical subtypes, and further refinement is needed to improve treatment outcomes. We sought to empirically identify and describe clinically relevant phenotypic subtypes of perinatal depression, and further characterise subtypes by time of symptom onset within pregnancy and three post-partum periods. Methods Data were assembled from a subset of seven of 19 international sites in the Postpartum Depression: Action Towards Causes and Treatment (PACT) Consortium. In this analysis, the cohort was restricted to women aged 19–40 years with information about onset of depressive symptoms in the perinatal period and complete prospective data for the ten-item Edinburgh postnatal depression scale (EPDS). Principal components and common factor analysis were used to identify symptom dimensions in the EPDS. The National Institute of Mental Health research domain criteria functional constructs of negative valence and arousal were applied to the EPDS dimensions that reflect states of depressed mood, anhedonia, and anxiety. We used k-means clustering to identify subtypes of women sharing symptom patterns. Univariate and bivariate statistics were used to describe the subtypes. Findings Data for 663 women were included in these analyses. We found evidence for three underlying dimensions measured by the EPDS: depressed mood, anxiety, and anhedonia. On the basis of these dimensions, we identified five distinct subtypes of perinatal depression: severe anxious depression, moderate anxious depression, anxious anhedonia, pure anhedonia, and resolved depression. These subtypes have clear differences in symptom quality and time of onset. Anxiety and anhedonia emerged as prominent symptom dimensions with post-partum onset and were notably severe. Interpretation Our findings show that there might be different types and severity of perinatal depression with varying time of onset throughout pregnancy and post partum. These findings support the need for tailored treatments that improve outcomes for women with perinatal depression. Funding Janssen Research & Development.

Given the powerful implications of relationship quality for health and well-being, a central mission of relationship science is explaining why some romantic relationships thrive more than others. This large-scale project used machine learning (i.e., Random Forests) to 1) quantify the extent to which relationship quality is predictable and 2) identify which constructs reliably predict relationship quality. Across 43 dyadic longitudinal datasets from 29 laboratories, the top relationship-specific predictors of relationship quality were perceived-partner commitment, appreciation, sexual satisfaction, perceived-partner satisfaction, and conflict. The top individual-difference predictors were life satisfaction, negative affect, depression, attachment avoidance, and attachment anxiety. Overall, relationship-specific variables predicted up to 45% of variance at baseline, and up to 18% of variance at the end of each study. Individual differences also performed well (21% and 12%, respectively). Actor-reported variables (i.e., own relationship-specific and individual-difference variables) predicted two to four times more variance than partner-reported variables (i.e., the partner’s ratings on those variables). Importantly, individual differences and partner reports had no predictive effects beyond actor-reported relationship-specific variables alone. These findings imply that the sum of all individual differences and partner experiences exert their influence on relationship quality via a person’s own relationship-specific experiences, and effects due to moderation by individual differences and moderation by partner-reports may be quite small. Finally, relationship-quality change (i.e., increases or decreases in relationship quality over the course of a study) was largely unpredictable from any combination of self-report variables. This collective effort should guide future models of relationships.

We examined whether support underprovision (receiving less support than is desired) and support overprovision (receiving more support than is desired) should be examined as qualitatively distinct forms of inadequate support in marriage. Underprovision of partner support, overprovision of partner support, and marital satisfaction were assessed five times over the first five years in a sample of newlywed husbands and wives (N = 103 couples), and were analyzed via actor-partner interdependence modeling (APIM) and growth curve analytic techniques. Increases in underprovision and overprovision of support were each uniquely associated with declines in marital satisfaction over the first five years of marriage; however, overprovision of support was a greater risk factor for marital decline than underprovision. Further, when examining support from a multidimensional perspective, overprovision was at least as detrimental, if not more detrimental, than underprovision for each of four support types (i.e., informational, emotional, esteem, and tangible support). The present study is the first to examine the utility of differentiating between underprovision and overprovision of partner support. Theoretical, empirical, and clinical implications are discussed. KeywordsAPIM; couples; GCA; marriage; support; support adequacy A new era of marital research has emerged over the last two decades demonstrating that supportive exchanges between spouses significantly contribute to the developmental course of marital satisfaction (see Bradbury, Fincham, & Beach, 2000 for review) 1 . Consistent with a social learning model, individuals are generally more satisfied with their marriages to the extent Correspondence concerning this article should be addressed to Rebecca L. Brock, Department of Psychology, The University of Iowa, 11 Seashore Hall East, Iowa City, IA 52242-1407; rebecca-brock@uiowa.edu. Publisher's Disclaimer: The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The published version is available at www.apa.org/journals/fam. 1 In the general social support literature, researchers have examined two facets of support quantity: enacted support and received support. Enacted support refers to overt support behaviors provided during a supportive interaction, and is assessed through videotaped interaction tasks involving objective ratings of support provision (e.g., Lawrence et al., 2008). In contrast, received support refers to support behaviors perceived by a support recipient as being provided during a support transaction (Pierce, Sarason, Sarason, & Henderson, 1996). Members of one's support network may enact su...

The authors of the present study statistically address the largely conceptual debate about the multidimensional nature of received support in intimate relationships. The Support in Intimate Relationships Rating Scale (SIRRS) was factor analyzed in 3 samples of dating and married couples. A novel, 4-factor structure of support types was generated that constituted esteem/emotional, physical comfort, informational, and tangible support types. This structure was reliable and valid in dating and marital relationships, across men and women, and across time. Each support type also demonstrated incremental validity for explaining marital adjustment, depression symptoms, and anxiety symptoms longitudinally. This study is among the first to generate and cross-validate a factor analytically derived set of support types for received support and the first to do so regarding partner support specifically. This is also the first study to replicate a distinct set of support types across different types of intimate relationships, across both sexes, and over time within relationships. Implications for enhancing functional theories of support and for augmenting the construct validity of a multidimensional model of received support are discussed.

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