The mediating role of maternal responsiveness in some longer term effects of postnatal depression on infant development

We hypothesized a mediating role for low maternal responsiveness in certain child developmental deficits found previously to be associated with postnatal depression. Forty depressed inpatients and 48 control (non-depressed) mothers and their infants were followed until 42 months postpartum. Mother–infant interactions were impaired at 6 months postpartum in the depressed group. Subsequent cognitive deficits were found in children's Full Scale IQ on the Wechsler Preschool Primary Scale of Intelligence (Revised) at 42 months of age. Statistical modeling of the mediation hypothesis confirmed that these effects were overwhelmingly explained by lowered maternal responsiveness at 6 months. Similarly, increased temperamental difficulties were apparent in children of depressed mothers but were not correlated with maternal responsiveness. Male infants of depressed mothers were disproportionately vulnerable (compared to females) to impaired cognitive abilities associated with maternal depression. The data concur with previous work and provide empirical support for the theoretical prediction that early disturbances of the mother–infant interaction will mediate some developmental deficits in the children of depressed mothers.     

A Counselor's Primer on Postpartum Depression

Women are more likely than men to experience depression, and they are particularly vulnerable to depression during the postpartum period. Postpartum depression is distinguished from normal postpartum adjustment, postpartum blues, and postpartum psychosis. Biological, psychodynamic, and diathesis-stress perspectives on postpartum depression are described. Counselors are encouraged to fashion individualized treatments for postpartum depression that are matched to the stressors and vulnerabilities of their clients.     

Prospective study of postpartum depression: 4 1/2-year follow-up of women and children

The consequences of maternal postpartum depression for mothers and children were investigated in a 4 1/2-year follow-up study, which included 70 of 99 women who had participated in an earlier study of postpartum depression. Information about maternal adjustment and depression during the follow-up period and child adjustment at age 4 1/2 years was obtained. Women who had experienced a postpartum depression were predicted to be at increased risk for subsequent depression and poor adjustment of their child. Postpartum depression was directly related to subsequent depression but not child problems. Later depression was related to child problems at 4 1/2 years. We concluded that postpartum depression may increase risk for later maternal depression and in turn increases risk for child behavior problems. Intervening with women who have experienced a postpartum depression may reduce likelihood of future depressions and child behavior problems.     

产后抑郁预防干预方法现状分析

本文通过分析现有产后抑郁预防干预方法,为探索产后抑郁预防干预模式提供依据。研究中提及的产后抑郁预防干预方法众多,但缺乏效果评价,总体干预思路是以早发现为前哨,疏导为重点,建立社会支持系统为支撑,调整生活习惯为保障。集体心理干预值得推广,应加强实施效果评估,并将产后抑郁干预融入孕产妇保健体系。     

UNDERSTANDING THE CONNECTION BETWEEN ATTACHMENT TRAUMA AND MATERNAL SELF‐EFFICACY IN DEPRESSED MOTHERS

Maternal self‐efficacy predicts sensitive and responsive caregiving. Low maternal self‐efficacy is associated with a higher incidence of postpartum depression. Maternal self‐efficacy and postpartum depression can both be buffered by social support. Maternal self‐efficacy and postpartum depression have both been linked independently, albeit in separate studies, to the experience of violent trauma, childhood maltreatment, and spousal abuse. This study proposed a model in which postpartum depression mediates the relation between attachment trauma and maternal self‐efficacy, with emotional support as a moderator. Participants were 278 first‐time mothers of infants under 14 months. Cross‐sectional data were collected online. Mothers completed questionnaires on attachment trauma, maternal self‐efficacy, postpartum depression, and emotional support. A moderated mediation model was tested in a structural equation modeling framework using Mplus’ estimate of indirect effects. Postpartum depression fully mediated the relation between trauma and maternal self‐efficacy. Emotional support moderated only the pathway between postpartum depression and maternal self‐efficacy. Attachment trauma's implications for maternal self‐efficacy should be understood in the context of overall mental health. Mothers at the greatest risk for low maternal self‐efficacy related to attachment trauma also are those suffering from postpartum depression. Emotional support buffered mothers from postpartum depression, though, which has implications for intervention and future research.     

Effects of male postpartum depression on father–infant interaction: The mediating role of face processing

It is estimated that postpartum depression affects up to 25% of men. Despite such high prevalence, the majority of studies on postpartum depression are focused on mothers, and the role of paternal depression and its effects on infant development have been overlooked by researchers and clinicians. The present study aimed to fill this gap by investigating the effect of paternal postpartum depression on father–infant interactions. In addition, we examined whether differences in face recognition mediated the effects of paternal postpartum depression on father–infant interactions. A total of 61 father–infant dyads (17 postpartum depression, 44 controls) took part in the study. Results revealed that compared to controls, fathers with postpartum depression had a worse pattern of interaction with their infants on measures of responsiveness, mood, and sensitivity; they also had greater difficulty in recognizing happy adult faces, but greater facility in recognizing sad adult faces. Depressed fathers attributed greater intensities to sad adult and infant faces. The tendency to attribute greater intensity to sad adult faces was confirmed as a partial mediator of the effect of paternal postpartum depression on measures of father responsiveness and as a full mediator of the effects of paternal depression on father sensitivity. Clinical implications and suggestions for further studies are discussed.     

Successful treatment of the mother-infant relationship in a mother suffering from severe postpartum depression

This paper discusses the treatment of severe postpartum depression in home-based infant-parent psychotherapy. Severe postpartum depression is examined as a psychiatric disorder in which childbirth is a necessary but insufficient cause. Home-based treatment that involved both mother and infant permitted a more comprehensive approach. By facilitating assessment of the risks to the infant from the mother's impairment by direct observation of the mother-infant relationship, infant-parent psychotherapy helped to avoid an unnecessary hospitalization of the mother in the case example. Instead, treatment helped to build on the ego strengths of the mother in order to stabilize precarious defenses and to support her bonding with her baby.     

Nonpsychotic postpartum depression among adolescent mothers

This study examined the extent to which childbearing increases vulnerability to clinical depression and depressive symptomatology among primiparous adolescent girls (ages 14 to 18). Childbearing Ss (n = 128) were assessed during pregnancy, 6 weeks postpartum, and 1 year postpartum. Matched nonchildbearing Ss (n = 114) were assessed at corresponding time points. Six weeks postpartum, 6% of the childbearing adolescents met Research Diagnostic Criteria for major depression and 20% for minor depression. These rates were not significantly different from those found for nonchildbearing Ss (4% major depression, 10% minor depression). However, higher rates of somatic symptoms of depression were found among the childbearing Ss than among the nonchildbearing Ss.     

Postpartum depression and attachment: Is anybody here?

Abstract

The paper presents a developmental and dynamic multitheoretical overview of many dimensions of attachment-related processes activated under the conditions of maternal depression. The clinical vignette (from the analytic practice of Eva D. Papiasvili) of reconstructive anaytic work with an adult patient illustrates the profound impact of maternal depression on precocious early differentiation between the attachment styles, of the depressed parent and the substitute caregiver, at the root of early “counterdependent” self-sufficiency. Through reconstructive interpretive work, first with enactments and then dreams, pertaining to not-remembered, represented, or symbolized events of earliest infancy, the patient is able to make a series of developmentally transformative symbolic leaps, restoring the capacity for intimacy, hope, trust, and pleasure. This breaks the intergenerational mother–daughter transmission of postpartum depression and related problematic attachment.     

Mother's prenatal and postpartum depression symptoms and infant's sleep problems at 6 months

Mother's prenatal and postpartum depression have been associated with infant's sleep problems. This study aimed to analyze (a) the effects of mother's prenatal and postpartum depression symptoms, including the effects of prenatal and postpartum anxiety and depression scores of the Edinburgh Postnatal Depression Scale (EPDS), on infant's sleep problems at 6 months, and (b) the interaction effect between mother's prenatal and postpartum depression symptoms and infant's sex on infant's sleep problems at 6 months. The sample was comprised of 164 mother–infant dyads whose mothers completed measures of depression at the third trimester of pregnancy, 2 weeks, 3 and 6 months postpartum and a measure of infant's sleep problems at 6 months (CSHQ-I). Mother's prenatal depression symptoms, specifically depression scores of the EPDS, predicted more infant's sleep anxiety and daytime sleepiness, while mother's depression symptoms at 2 weeks postpartum, specifically anxiety scores of the EPDS, predicted more bedtime resistance and CSHQ-I total scores at 6 months. Boys of mothers with more prenatal depression symptoms presented more sleep anxiety at 6 months. Both mother's prenatal and early postpartum depression symptoms have a negative effect on the emergence of infant's sleep problems. Additionally, boys seem more vulnerable to mother's prenatal depression symptoms.     

Do postpartum anxiety and breastfeeding self-efficacy and bonding at early postpartum predict postpartum depression and the breastfeeding method?

We investigated whether postpartum anxiety (PPA) and breastfeeding self-efficacy and bonding at the early postpartum period can be used to predict postpartum depression and the breastfeeding method, and we sought to identify factors related to postpartum depression. Of the 510 eligible women, 185 (36%) returned the questionnaire on all three occasions (1 day, 3 days, and 1 month after childbirth). The mothers' progress on the State-Trait Anxiety Inventory (STAI), Breastfeeding Self-Efficacy Scale Short Form (BFSES-SF), and Postnatal Bonding Questionnaire (PBQ) was observed over three periods. A repeated-measures ANOVA revealed that the mothers at high risk of developing postpartum depression (PPD) were those who did not show an increase in BFSES-SF score at early postpartum, and mothers whose bonding disorders have deteriorated rapidly. The results of the logistic regression analysis revealed a significant difference in employment as a factor related to postpartum depression. Compared to Regular, Part-time status was 4.4 times more likely and Unemployed status was 2.3 times more likely to cause postpartum depression. For the early detection of PPD, it is necessary to identify (1) mothers who do not show an increase in the BFSES-SF score, (2) mothers whose bonding disorders have deteriorated rapidly, and (3) part-time or unemployed mothers as characteristic of postpartum depression.     

Maternal Depression and Family Media Use: A Questionnaire and Diary Analysis

We describe the association between postpartum depression and the quantity and content of infant media use. Households with depressed mothers viewed twice as much television as households with non-depressed mothers did, and depressed mothers appeared to derive comparatively greater pleasure from television viewing. Maternal depression was associated with an increased exposure to child-directed content by 6–9-month-old infants, although it was not associated with an increased exposure to adult-directed programming. Depressed mothers also reported being less likely to sit and talk with their children during television use or to consult outside sources of information about media. This increase in television exposure without corresponding parental involvement could negatively affect developmental outcomes.     

Combining Ericksonian and Sandplay Approaches to Therapy with Children who Manifest Depression as a Developmental Barrier

This study reports on the use of the Ericksonian approach combined with sandplay therapy to assist children who present with depression, a troublesome developmental barrier. Participants were six children and/or adolescents with depression (two males and four females; age range 7 to 18; ethnicity: five white and one black). The intervention occurred once a week over a two-month period (eight 60-minute sessions in total). Outcome data were collected using qualitative interview and thematically analyzed. The Ericksonian approach to sandplay therapy had an overall positive effect on children who experienced depression as a developmental barrier.     

Postpartum Depression: An Overview

Occurring in about 12% of postpartum women, postpartum depression has been the focus of considerable research. Variables that have been correlated with postpartum depression range from biological causes, to lack of social support, to relationship with husband, to attributional styles, to psychodynamic explanations. There is a need for a more circumscribed operational definition of the syndrome and norming of depression measures. It is also important to assess each person individually and to design interventions that focus on particular contributive factors.     

剖宫产产后抑郁的发生与社会支持、应对方式及防御方式的相关性

了解剖宫产产后抑郁的发生与社会支持、应对方式及防御方式的相关性,对剖宫产患者进行抑郁状况的调查,并对其影响因素进行分析。对抑郁组与非抑郁组的一般情况构成比比较,并采用抑郁自评量表（SDS）、应付方式评定量表（YFFS）、社会支持问卷（ISSI）、防御方式问卷（DSQ）进行测评。社会支持、应对方式及防御方式对产后抑郁的发生均产生一定作用。应付方式、社会支持及防御方式是影响剖宫产患者产后抑郁的重要因素。     

Hope,Social Support,and Postpartum Depression: Disentangling the Mediating Effects of Negative Affectivity

We examined the potentially mediating effects of negative affectivity (NA) on the hope–depression relationship among a sample of postpartum women. We also assessed the social support reported by these women and examined the possible mediating effects of NA on the social support–postpartum depression relationship. Correlational analyses of data obtained from women (N = 98) who had given birth in the previous 6 months revealed that NA did not mediate either hope or social support in the prediction of postpartum depression. Hope accounted for a significant degree of variance in postpartum depression. These data suggest that hope has palliative effects among women following childbirth and these effects are not nullified or explained by emotional predispositions.     

Die postpartale Bindungsstörung: Eine Risikokonstellation für den Infantizid ?

Background

The effectiveness of preventive approaches in the field of child protection depends, amongst other things, upon identifying typical risk constellations of infanticide. Postpartum bonding disorder, a disorder affecting a mother’s emotional relationship with her child, is one of those risk constellations alongside other negative consequences to child development. It frequently accompanies postpartum depression, which is determined by other emotional qualities. The therapeutic response is a determinant factor for the success of preventive measures.

Method

42 mothers with postpartum disorders (25 depressive, 17 schizophrenic) undergoing treatment at a mother-baby-unit were examined for bonding disorders and the therapeutic response, primarily regarding the mother-child relationship. Perception of bonding, maternal self-efficacy and objectively measured parameters of mother-child interaction were the most important parameters assessed. Results. Nearly 60% of the mothers suffered from a bonding disorder. Overall, the results indicated a clear improvement in psychiatric disorder as well as in the assessed parameters for the mother-child relationship and the experience of motherhood.

Conclusions.

Maternal bonding disorders are strongly associated with postpartum depression and low maternal self-efficacy, which can lead to a risk constellation for infanticide. The data confirm the therapeutic response, thus demonstrating that early diagnosis and treatment of postpartum depression can represent a timely and effective preventive approach in the field of child protection.     

产后抑郁相关危险因素分析

本文通过分析引发产后抑郁的相关危险因素及其对健康的影响,为探索干预措施提供依据。危险因素重要性的分析显示“夫妻关系不佳”位居危险因素之首;产妇的性格特征和孕期心理状态是产后抑郁发生的重要心理影响因素。因此,丈夫角色不容忽视,社会支持系统的建立意义重大,干预效果显著的因素应作为研究重点。     

Prenatal maternal depression predicts neural maturation and negative emotion in infants

Despite widespread acceptance that prenatal symptoms of depression in mothers are detrimental to infants’ long-term emotional and cognitive development, little is known about the mechanisms that may integrate outcomes across these domains. Rooted in the integrative perspective that emotional development is grounded in developing cognitive processes, we hypothesized that prenatal symptoms of depression in mothers would be associated with delays in neural maturation that support sociocognitive function in infants, leading to more problematic behaviors. We used a prospective longitudinal study of mothers (N = 92) and their infants to test whether self-reported symptoms of depression in mothers during the second and third trimesters were associated with neural development and infant outcomes at 4 months of age. While controlling for postpartum symptoms of depression, more prenatal symptoms of depression in mothers predicted less neural maturation in the parietal region of 4-month-old infants. Less neural maturation, in turn, was associated with greater infant negativity, suggesting neural maturation as a putative mechanism linking maternal symptoms of depression with infant outcomes. Differences in neural regions and developmental timing are also discussed.     

Treating Prepartum Depression to Improve Infant Developmental Outcomes: A Study of Diabetes in Pregnancy

Whether and how the co-occurrence of depression and diabetes in pregnancy may worsen infant development has not been reported. Pregnant women with diabetes and with (n?=?34) or without (n?=?34) major depressive disorder (MDD) were followed during pregnancy and 6-months postpartum. The MDD subset received randomly assigned treatment with cognitive behavior therapy (CBT) or supportive counseling (SC). Depression severity was measured with the Beck Depression Inventory (BDI); infant developmental outcomes were measured with the Bayley Scales of Infant Development (BSID) and its Behavior Rating Scale (BRS). Infants of women with MDD had lower BRS scores (p?=?.02). Reduction in depression scores was associated with better infant outcomes on the BSID and BRS (p values <.03). These preliminary findings suggest depression occurring in pregnant women with diabetes is associated with poorer infant development and improvement in prepartum depression is associated with improvement in measures of infant development.