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Applied Child Psychology > Postpartum depression, parentings and child outcomes > Flashcards

Postpartum depression, parentings and child outcomes Flashcards

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1
Q

Discuss the key to good parenting being the quality of the relationship

A
  • emotional availability
  • be sensitive/attuned
  • provide appropriate structure (stimulation, activities)
  • don’t be intrusive
  • don’t be hostile
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2
Q

What is optimal structuring?

A
  • provides appropriate guidance and suggestions
  • emotional and cognitive scaffolding
  • sets limits and boundaries appropriate to context
  • remains firm in the face of pressure
  • adult is clearly “older and wiser”
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3
Q

what are Belsky’s 1984 determinants of individual differences in parenting

A
  • child characteristics
  • parent characteristics: personality, developmental history, mood, own attachment to parents
  • context: culture/support
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4
Q

Discuss the importance of attachment theory re parenting characteristics in how people parent

A
  • the quality of caregiving in early childhood/through childhood of parent is important to their own parenting
    e. g. how the parent mentally represents this/state of mind regarding attachment
  • compelling evidence for this determining child’s attachment
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5
Q

Discuss the important of mood re parenting characteristics in how people parent

A
  • anxiety/depression
  • lots of evidence saying that parental loss/harsh parenting in childhood predisposes adults to mood disorders, especially chronic depression
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6
Q

What is postnatal depression ?

A

-depressed mood meeting DSM-V criteria for mood disorder during first year after birth

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7
Q

what percentage of people with PND can be persistent

A

30%

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8
Q

discuss the difficulty in identifying PND

A
  • there is a difficulty in disentangling “normal” adjustment difficulties to a clinical mood disorder
  • also confounded my stigma associated with PND: should be happiest time of life etc.
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9
Q

What percentage of women experience postnatal depression

A

13%

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10
Q

what is the plan in Australia associated with PND and what does it do

A

National Perinatal Depression Plan - identifies, refers and supports women with perinatal mood disorders and train health professionals

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11
Q

when does PND usually show itself

A

-symptoms usually appear between 6 weeks and 6 months after birth

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12
Q

how does PND meet the DSM-IV criteria

A

when symptoms last most of the day everyday for at least 2 weeks, to the extent that function is compromised

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13
Q

what are the symptoms of PND

A

-symptoms are the same as symptoms of depression at any other time in life

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14
Q

what are the shared symptoms between exhaustion and PND

A
  • teariness
  • sleep disturbance
  • loss of concentration
  • feeling you can’t cope
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15
Q

what are the distinguishing symptoms between exhaustion and PND

A
  • inability to sleep even when baby is sleeping
  • loss of pleasure
  • morbid/suicidal thoughts
  • low self-esteem
  • loss of interest in eating
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16
Q

discuss the problems with denial/minimising/normalising PND

A
  • rates of treatment uptake and acceptance of the “label” are very low despite public health education campaigns
  • many people confused PND with postpartum psychosis, therefore distance themselves from it
  • many woman have to reach crisis point before seeking help
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17
Q

who is vulnerable to PND

A

-everybody but some more than others

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18
Q

what are teh risk factors of PND

A
  • past history/family history of mental illness
  • unsupportive critical relationship
  • stressful life events
  • social factors - low income, migrant families
  • personality factors
  • a difficult/unsettled infant
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19
Q

discuss the difference between a transient “adjustment disorder” to a life transition & PND (percentages)

A
  • many recover (70%) by the time baby is 6 mths old

- some (30%) have ongoing and severe depression

20
Q

who is vulnerable to persistent or late onset depression

A
  • depends on severity of symptoms
  • depression/anxiety in pregnancy
  • low ses
  • migrant background
  • low marital satisfaction 4 mths
  • infant health problems/temperament in first 4 mths
21
Q

What are the mechanisms through which PND may impact on the infant: four pathways

A
  • genetic predisposition: effects on babies serotonin transporter gene
  • in utero environment effects: impact of maternal stress hormones
  • postnatal caretaking effects: mothers negative perception of infant behaviour, mother’s behaviour towards child
  • the stressful social/ecologial context of the children’s lives
22
Q

Discuss the impact of depression symptoms on the baby in regards to affect, cognitions and behaviour

A

affect - low mood, anxiety, irritability - baby can imitate mother’s mood
cognitions - negative/distorted thinking of baby behaviours
behaviour - hostile, irritable, unresponsive

23
Q

Discuss the caretaking: mutual regulation model

A

Mother fails to respond sensitively to infant’s signals. Infant then becomes inattentive and/or rejecting of mother’s stimulation as a way of coping. Infant gives fewer cues to mother - mother has less chance to practice responsive caregiving.

24
Q

Discuss Field’s 2010 caregiving/interaction style problems associated with depression

A

Interaction style:
irritability and hostility during interaction, less engagement, less warmth, less turntaking/gameplaying, less attunement to infant responses, different vocalisations, less stimulation

25
Q

What are two common profiles of depressed mothers and what is their main element

A

withdrawn - affectively restricted behaviours

intrusive - high affectivity and irritability

26
Q

Discuss the findings of the Tresillian Family Adjustment Study 2000-2009 in regards to PND impact on infants

A
27
Q

Why does PND effect cognitive development? (Hay, 1997)

A
  • early social experiences that interfere with the infant’s capacity to attend to the environment result in decreased capacity for learning
  • process of learning by following mother & observing her interactions with the world may be compromised
  • if mother fails to provide support for regulation of emotion, this may compromise information processing
28
Q

Why does PND effect relationship/attachment in children?

A

mutual regulation model- impaired pattern of day to day interaction between mother and infant

29
Q

Why does PND cause behaviour problems in children

A
  • genetic predisposition to internalising/externalising problems
  • parent fails to provide optimal support for child’s developing emotional regulation
  • disciplinary/parenting styles related to concurrent mood e.g. hostility
30
Q

Discuss the finding that not all children of depressed mothers

A
  • it is the nature of caregiving not depression per se that contributes to adverse outcomes for children
  • research shows that in cases where depressed mothers behave sensitively with their infants, the infants are not securely attached
  • intervention studies have shown that treatment of depression ‘on its own’ has little or no impact on the quality of the parent-child relationship
31
Q

What are other moderators of the effect of maternal depression, other than caregiving style

A
  • father’s/alternative carers health and involvement with the child
  • course, severity and timing of mother’s depression
  • characteristics of the child - gender, temperament
  • characteristics of the mother
  • characteristics of the environment
32
Q

Discuss the sample in the Tresillian Family Adjustment Study 2000-2009 in regards to PND impact on infants

A

-sample: mothers who presented to a parent-craft hospital with unsettled infants. Recruited child at 4 mths. 70% tertiary education, 20% from migrant families migrant

33
Q

In the Tresillian Family Adjustment study 2000-2009 how was depression assesed in mothers, and how was the impact assessed in the babies

A
  • mothers: both diagnostic and symptom measures when baby was 4 mths, 12 mths, 4 yrs, 7 yrs
  • babies: Bayley scales 15 mths, WPPSI 4 yrs, Peabody Picture Vocabulary Test 7 yrs
34
Q

In the Tresillian study, at 4 mths what percentage of mothers met the DSM-IV criterion for an episode of depression since childbirth. What percentage continued to experience depression at a diff time-point?

A

62% & 30%

35
Q

Discuss the findings in the Tresillians study for cognitive development

A
  • cognitive: chronic depression related to lower cognitive performance at 15 mths
  • no significant associated between depression and cognitive outcomes at 4 or 7 years
36
Q

Discuss the findings for the Tresillian study for internalising and externalising behaviour problems at 4 yrs

A
  • children exposed to chronic maternal depression were rated by their parents as significantly more problematic
  • at 15mths, this finding was not supported by an independent rater but it was at 4 yrs (e.g. teacher)
37
Q

Discuss the correlation between parenting styles and being never depressed, brief depression & chronic depression (McMahon et al. 2006)

A

-never depressed: secure/autonomous most high
-brief depression: secure/autonomous most high, but closely followed by dismissing
chronic depression: pre-occupied most high closely followed by dismissing

38
Q

Discuss the correlation between the attachment between the child and mother and mother’s depression for never depressed, brief depression, chronic depression (McMahon 2006)

A
  • never depressed: most highly secure
  • brief depression: most high secure
  • chronic depression: most high avoidant & secure, some ambivalent
39
Q

Discuss the finding that a secure attachment state of mind in the mother is protective

A
  • non depressed mothers with a secure state of mind of attachment, 60% of children securely attached
  • briefly depressed mothers with a secure state of mind of attachment, about 65% children securely attached

BUT when you combine brief or chronic depression with an insecure state of mind, the probability of your child being securely attached is much less

40
Q

What did Trapolini 2008 find using the depression & maternal emotional availability scale at 4 yrs

A

-chronically depressed mothers are less sensitive

41
Q

What did Trapolini 2008 find using the depression & maternal caregiving representations scale at 4 yrs

A

chronically depressed mothers have lower perspective taking and lower pleasure in child

42
Q

In summary, what is chronic maternal depression associated with at 15 mths & 4 yrs

A

15 mths: more likelihood of insecure attachment with child (moderated by mother’s state of mind about attachment)
4 years: less optimal maternal caretaking representations, lower maternal sensitivity during interactions

43
Q

What conclusions can be drawn from the relatively low-risk sample on maternal impacts of depression

A
  • chronic, but not brief depression was associated with ongoing social and emotional problems with children
  • mothers with an insecure state of mind about attachment 7 times more likely to have chronic depression
  • relationship effects moderated by state of mind
  • effects on cognitive development minimal
44
Q

Adverse child outcomes for kids with mothers with PND is higher in….

A

high SES risk samples: cumulative risk

45
Q

What are the clinical implications for all of this

A
  • universal screening important
  • evidence that treating only depression does not influence parenting
  • need to address maternal state of mind about attachment
  • need to support mothers in providing positive parenting

Applied Child Psychology (4 decks)

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