Postpartum bonding: the impact of maternal depression and adult attachment style.

Maternal depression poses a risk for the developing mother-infant relationship. Similarly, maternal insecure attachment styles may limit the ability to adequately connect with the newborn during the postpartum period. The aim of this study was to investigate the effect of maternal depression and insecure attachment (insecure and dual/disorganized) on maternal bonding in a sample of n = 34 women with depression according to DSM-IV and n = 59 healthy women. Maternal depression was assessed 3 to 4 months postpartum with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), bonding with the Postpartum Bonding Questionnaire, and maternal attachment style with the Attachment Style Interview. Women with current and lifetime depression as well as women with dual/disorganized attachment style reported lower bonding. Explorative analysis revealed that depression partially mediated the link between dual/disorganized attachment style and bonding with a medium-sized mediation effect. The combination of maternal depression and dual/disorganized attachment style may pose a special risk constellation for the developing mother-infant bond that should be addressed in prevention and early intervention programs.

The Correlation between Maternal Adult Attachment Style and Postpartum Depression and Parenting Stress / 신경정신의학

OBJECTIVES: We aimed to determine whether the adult attachment styles of pregnant women could predict development of postpartum depression. METHODS: Korean version of Revised Adult Attachment Scale, State Trait Anxiety Inventory-State/Trait (STAI-S/T), and Center for Epidemiologic Studies-Depression Scale (CES-D) were administered at baseline. Edinburgh Postnatal Depression Scale (EPDS), Parenthood Stress Questionnaire (PSQ), STAI-S, and CES-D were assessed at week 2 and 6 postpartum. Participants were categorized into the secure-mom (SM ; n=48) or insecure-mom (IM ; n=9) group. RESULTS: While STAI-S scores in SM showed a continuous decrease during the entire observation period, STAI-S scores in IM decreased during the first two weeks but increased during the next four weeks. While SM showed decreased CES-D scores from week 2 to 6, IM showed increased CES-D scores from week 2 to 6. Although SM showed decreased EPDS scores from week 2 to 6, IM showed increased EPDS scores from week 2 to 6. In SM, the change in EDPS score from week 2 to week 6 showed positive correlation with PSQ-ability and PSQ-social subscale scores. CONCLUSION: Assessing the maternal adult attachment style before giving birth appears to be helpful for screening the high-risk group who are vulnerable to development of postpartum depression.