Letter to the "The Effects of Pilates-Based Tele-Exercise on Physical and Mental Health in Primary Dysmenorrhea": Methodological Considerations on the Effects of Pilates-Based Tele-Exercise for Primar

Historical trauma (HT), also known as collective trauma, refers to the cumulative emotional and psychological wounding experienced across generations due to systemic oppression, colonization, slavery, and other collective traumatic events, has profound and enduring effects on individual and community well-being as a result of traumatic events or experiences that occurred in the past often spanning across generations (). This concept is particularly relevant in understanding the mental health challenges faced by populations subjected to such adversities. Postpartum depression (PPD), a significant mental health condition characterized by persistent sadness, anxiety, and fatigue following childbirth (DSM-5-TRR, 2022), affects approximately between 7% to 63% of women globally (). Moreover, research suggests that AI/AN mothers experience postpartum depression at higher rates than the general population (, ). While PPD is widely recognized as a pressing public health issue, its relationship with the intergenerational effects of HT remains underexplored in empirical literature. To develop interventions to help reduce PPD among this subpopulation, a better understanding of the potential causes of the higher rate of PPD is needed. For the current study, we sought to evaluate perceptions of HT as a potential antecedent of PPD among a sample of AI/AN mothers. This study aims to statistically analyze the relationship between HT, as measured by the historical loss scale (HLS; ), and PPD symptoms, among a sample of women who identified as indigenous. Grounded in the theoretical framework Historical Trauma Framework (including epigenetic models of trauma transmission) this study provides empirical data on how historical trauma influences PPD. Historical trauma provides a framework to understand unique risk factors for PPD in these populations, beyond typical biological or individual-level causes. Studying historical trauma also integrates sociocultural and intergenerational factors into models of maternal mental health, providing a more comprehensive understanding of PPD. Populations historically affected by systemic oppression and collective trauma, such as Indigenous peoples and descendants of enslaved individuals, often experience higher rates of mental health challenges, including PPD (). As such, understanding historical trauma is crucial for developing effective interventions and support systems for affected communities, as well as for promoting broader social understanding and healing. Based on the current literature and previous findings, we believe there will be a statistically significant positive correlation between experiencing historical trauma and developing postpartum depression.