Postnatal Depression, Attachment and Parenting Flashcards
• Optimal parenting – Baumrind’s authoritative parenting
o Shares reasoning behind rules with child
o Autonomous self-will and disciplined conformity are valued in child
o Exerts firm control, with reasonable demands
o Emotional availability
o Maternal sensitivity
o Structuring and scaffolding
o Non-intrusive/hostile
• Parent characteristics
o Attachment history
• What is PND?
o Depressed mood meeting DSM criteria for mood disorder during first year after birth
o Can persist for years untreated (30% persistent)
o Difficulty to distinguish from normal stressors
o Around 13% of women experience PND (7-20%)
• Presentation of PND
o Symptoms usually appear between 6 weeks and 6 months after birth
o When a cluster of symptoms last most of the day, every day for at least 2 weeks, to the extent that function is compromised a woman be suffering from PND
• What are the shared symptoms with exhaustion and PND – screening
o Teariness
o Sleep disturbance
o Loss of concentration
o Feeling you can’t cope
• What are the symptoms that distinguish PND from exhaustion?
o Inability to sleep even when baby is sleeping
o Loss of pleasure
o Morbid/suicidal thoughts
o Low self-esteem
o Loss of interest in eating
• Risk factors for PND
o Family history of mental illness
o Unsupportive/critical relationship
o Stressful LE
o Social factors – low SES, migrant family, low social support
o Personality factors – developmental history
o Difficult infant
• How many will have ongoing depression?
o 70% recover by time baby is 6 months
o 30% ongoing – risk factors same as for PND
• Mechanisms for which PND influence parenting
o Genetic predisposition – serotonin transported gene
o In utero effects – HPA axis – impact of stress hormones
o Postnatal caretaking effects
Mother’s negative perception of infant behaviour
Mother’s behaviour/affect
o Stressful social/ecological context of children’s lives
• Impact of depression on caretaking
o Affect – low mood, anxiety, irritability
Baby imitates mother’s mood
o Cognitions – negative/distorted thinking
Negative interpretation of neutral baby behaviours
Pre-occupation with self – disengagement
o Behaviour – hostile, irritable/unresponsive
• Mutual-regulation model of depressive impacts on mother-child dyad
o Mother fails to respond sensitively to infant’s signals
o Fails to provide infant with appropriate regulatory help
o Infant then becomes inattentive and/or rejecting of mother’s stimulation as a way of coping
o Infant gives fewer cues to mother – mother has less chance to practice responsive caregiving
• Individual difference in profiles of depressed maternal behaviour
o Withdrawn mothers
o Intrusive mothers
• Does PND impact on infants?
o Early social experiences that interfere with the infant’s capacity to attend to the environment result in decreased capacity for learning
o Process of learning by following mother and observing her interactions with the world may be compromised
o If mother fails to provide support for regulations of emotion, this may compromise information processing
o Not all children will have problems, contingent on c/g not just depression.
• Moderators of effect of maternal depression
o Father’s health and involvement with the child/alternate carers
o Course, severity and timing of mother’s depression
o Characteristics of the child – gender, temperament
o Characteristics of the mother – caretaking history, attachment IWM
o Characteristics of the environment – education, support
• Interventions for PND
o Involve fathers
o Relationship focus
o Strengths based intervention
o Interaction guidance to encourage perspective taking and maternal sensitivity
Can use video feedback
Circle of security
o Enhancing parental knowledge & understanding of infant development
o Strengthening family support networks
