The current study examined whether behavioral activation strategies, characterized by engaging in activities that promote well-being, such as exercise and mindfulness practices, during the COVID-19 pandemic, were associated with postpartum depressive and anxiety symptoms, and whether mental health diagnoses during pregnancy moderated these associations. Participants were 351 mothers of infants aged 8-10 months, drawn from the Perinatal Experience and COVID-19 Effects (PEACE) Study. Participants completed baseline and follow-up surveys via REDCap, assessing demographics, maternal mental health history, depressive and anxiety symptoms, and behavioral activation. Among participants, 29.7% reported clinically relevant depressive symptoms and 19.5% reported generalized anxiety symptoms; 12.8% reported a depression diagnosis and 19.4% reported a generalized anxiety diagnosis. Behavioral activation was associated with fewer postpartum maternal mental health symptoms. Mental health diagnoses during pregnancy were positively associated with postpartum mental health symptoms within this pandemic cohort. Importantly, depression diagnosis during pregnancy moderated the association between behavioral activation and postpartum mental health symptoms, with more behavioral activation linked to lower symptomatology, particularly for mothers with a depression diagnosis. Behavioral activation through work during the pandemic was associated with fewer postpartum mental health symptoms, especially for mothers with a depression or anxiety diagnosis. Engaging in behavioral activation may mitigate postpartum mental health symptoms among mothers with mental health diagnoses during pregnancy. Interventions that promote behavioral activation may enhance maternal resilience during crises.
Keywords: maternal mental health, depression, anxiety, diagnosis, behavioral activation, COVID-19 pandemic