Substance Use
Exploring the mediating role of maternal functioning on the relationship between subjective stress and loneliness in postpartum individuals with opioid use disorder across acute and prolonged timeframes Arushi Chalke* Arushi Chalke Linnea Linde-Krieger Stacey Tecot Alicia Allen
Introduction: The “fourth trimester” (birth to 12 weeks postpartum) is a critical adjustment period, particularly for individuals with Opioid Use Disorder (OUD). Despite this, there is a lack of research on the links between stress, loneliness, and maternal functioning (ability to take care of self and infant) in this population. We investigated both the direct and indirect effects of stress on loneliness, focusing on maternal functioning as a mediator.
Methods: We enrolled pregnant people with OUD (n=50) and followed them through postpartum month 5. Subjective stress during the first postpartum month was a composite score from the following validated assessments’ total score: Postpartum Stressor Scale, Depression Anxiety Stress Scale, Adverse Childhood Events, and Stressful Life Events. Maternal functioning was assessed via Barkin Index of Maternal Functioning scale, and loneliness via the UCLA Loneliness Scale. SAS 9.4 was used to analyze mediation pathways for loneliness for acute (weeks 4-8) and prolonged (months 3-5) effects.
Results: Composite subjective stress score was significantly associated with maternal functioning (β=-0.55,p=0.002), which, in turn, was significantly linked to acute loneliness (β=-0.34,p=0.002). Maternal functioning mediated 60.8% of the effect of stress on acute loneliness. Stress was also significantly associated with maternal functioning (β=-0.42,p=0.02), which was not significantly associated (p=0.22) with prolonged loneliness, with only 18.8% mediated. For both pathways, the total effect of stress on loneliness was significant (β=0.37,p=0.02; β=0.36,p=0.01).
Conclusion: Maternal functioning’s stronger role in acute rather than prolonged loneliness, highlights the fourth trimester as an ideal time for targeted interventions for individuals with OUD. Future studies should employ larger samples and investigate biological or physiological mediators, such as cortisol levels or sleep patterns, to comprehensively understand stress effects.