Postpartum Body Concerns, Self-Criticism, and Psychological Distress: A Parallel Mediation Analysis

Background: Postpartum body concerns have been consistently associated with greater maternal psychological distress, although the psychological processes associated with this relationship remain insufficiently understood. This study examined whether self-criticism (inadequate self and hated self) and self-reassurance mediate the association between postpartum body concerns and symptoms of depression, anxiety, and stress. Methods: A cross-sectional study was conducted with 540 Portuguese mothers of infants aged 2 weeks to 24 months. Participants completed measures of postpartum body concerns, the Forms of Self-Criticizing and Self-Reassuring Scale (FSCRS), and Depression, Anxiety and Stress Scales-21 Items (DASS-21). Parallel mediation analyses with bootstrap estimation (5000 samples) were performed. Results: Greater postpartum body concerns were associated with higher depression, anxiety, and stress, as well as greater self-criticism and lower self-reassurance. Significant indirect associations involving self-relating styles were observed for depressive, anxiety, and stress symptoms. For anxiety and stress, the direct associations between postpartum body concerns and symptoms were no longer statistically significant after accounting for the three mediators. Inadequate self showed the strongest indirect associations, particularly for stress, while hated self and self-reassurance also showed significant indirect associations across all three models. Conclusions: Self-criticism and self-reassurance may represent candidate psychological processes involved in the associations between postpartum body concerns and psychological symptoms. Longitudinal research is needed to further examine their potential role in postpartum psychological adjustment.