PND

Question 1

DMS-V diagnosis for PND

Answer 1

PND same diagnosis as MDD but specifically related to postpartum period - usually withing 4 weeks of birth

recurrent thoughts of death
diminished ability to think/concentrate
feelings of worthlessness 
fatigue/loss of energy
significant weight loss or loss of appetite 
insomnia/hypersomnia 
marked disinterest in almost all activities 
depressed mood

Question 2

O’Hara (2009)

Answer 2

PND is not baby blues

Question 3

What is baby blues?

Answer 3

2-4 days after birth is quite normal
emotional/liable to burst into tears 
difficulties sleeping 
loss of appetite 
feeling anxious sad or guilty 
questioning maternal skills 
affects 75% of mothers 
key thing is doesn't last
is persists then may develop to PND

Question 4

PND prevalence

Answer 4

affects 10% of mums compared to 75% with baby blues

can come on gradually or suddenly

50% of women are afraid to tell health professionals as worried may take child away or be seen as a bad mother

Question 5

Why do we need a PND diagnosis?

Answer 5

different to depression

• intense guilt
• societal pressures of being an ideal mum
• sense of inadequacy, inability to cope
• impacts infant
• debates on what medication are safe to use

Question 6

Murry (2003)

Answer 6

PND affects ability to cope with child

Question 7

what are the impacts of PND on child

Answer 7

children of depressed mothers are more likely to be associated with

• being overly clingy
• sleep disturbances
• eating difficulties
• insecure attachment

disturbances in child’s emotional and cognitive development

Question 8

Cogill et al (1986)

Answer 8

significant intellectual deficits in children whose mothers had suffered from depression

Question 9

Bowlby and Ainsworth

Answer 9

early infant-mother bond may have significant impact on developing infant

Question 10

Attachment and the internal working model

Answer 10

the internal working model is very important for expectations about self and others

if infant’s carer responds positively the infant will have a positive IWM, high self-worth and resolution crisis

if inconsistent response then low self-worth, crises not resolved and negative IWM

Question 11

why will there be bonding problems?

Answer 11

mum will be distracted due to 
low mood 
lack of motivation 
fear/guilt 
poor concentration 
lack of self-worth
low self-esteem 
effects of medication

Question 12

Steadman et al (2007) investigate?

Answer 12

serious MI in mothers including severe depression

Question 13

What did Steadman et al (2007) measure?

Answer 13

cognitive functioning - attention, speed and memory

perception of parenting skills and stress

observation of interaction with baby - how appropriate, the quality, sensitivity

Question 14

What was Steadman et al (2007) sample?

Answer 14

6 ill mums
12 healthy mums
recruited within 1st 6 months of birth

Question 15

what did Steadman et al (2007) find?

Answer 15

well mothers were - warm, affectionate and rewarding

ill mothers appeared disinterested - black face, baby was uncomfortable and unsure

Question 16

What did steadman et al (2007) find directly about the ill mums?

Answer 16

poorer mother-infant interaction
poorer cognitive functioning 
less sensitive 
infants less cooperative 
not sure when the child is interested 
use of tone not the same

Question 17

Murray and Cooper (1997)

Answer 17

what PND effects

cognitive development - poorer mental and motor development

emotional development - less sharing, insecure attachment, eating problems, tantrums

Question 18

Maternal depression and child development (2004)

Answer 18

impacts of PND at different stages

infant - withdrawal, protective style of coping, lower cog performance

toddler - lower interaction, less creative play

school age - impaired adaptation, ADHD and low IQ

adolescents - depression, anxiety, substance abuse, panic disorders, learning disorders