Skip to main content
Top
Published in: Archives of Women's Mental Health 3/2009

01-06-2009 | Original Contribution

Depressive symptomatology in pregnant and postpartum women. An exploratory study of the role of maternal antenatal orientations

Authors: Johan C. H. van Bussel, Bernard Spitz, Koen Demyttenaere

Published in: Archives of Women's Mental Health | Issue 3/2009

Login to get access

Abstract

Little is known about how an expecting woman’s view of pregnancy, the child, and motherhood relates to antenatal and postpartum depressive symptomatology. In this study, we investigated the influence of the maternal orientations, as described by Raphael-Leff (Psychological processes of childbearing. The Anna Freud Centre, London, 2005), on the prevalence of depressive symptoms in pregnant and postpartum women. Four hundred three pregnant women participated in a longitudinal study and completed the EPDS and the HADS-D in each pregnancy trimester and between 8 to 12 and 20 to 25 weeks postpartum. In addition, measures of maternal orientation (PPQ), personality (NEO-FFI), coping styles (UCL), adult attachment (RQ), and parental bonding (PBI) were completed antenatally. Bivariate and multivariate analyses revealed that Neuroticism and the Regulator orientation are positively associated with the EPDS and HADS-D in both pregnant and postpartum women. These associations decreased in strength but remained significant after controlling for previous responses on the EPDS and HADS-D. Small negative associations were found between the Facilitator orientation and the HADS-D scores during pregnancy and the early postpartum period. However, this association did not hold its statistical significance within the hierarchical multiple regression models. The maternal orientations have a small but significant and independent contribution in the variance of depressive symptomatology in pregnant and postpartum women.
Literature
go back to reference Austin MP, Tully L, Parker G (2007) Examining the relationship between antenatal anxiety and postnatal depression. J Affect Disord 101(1–3):169–174PubMedCrossRef Austin MP, Tully L, Parker G (2007) Examining the relationship between antenatal anxiety and postnatal depression. J Affect Disord 101(1–3):169–174PubMedCrossRef
go back to reference Bartholomew K, Horowitz LM (1991) Attachment styles among young adults: a test of a four-category model. J Pers Soc Psychol 61(2):226–244PubMedCrossRef Bartholomew K, Horowitz LM (1991) Attachment styles among young adults: a test of a four-category model. J Pers Soc Psychol 61(2):226–244PubMedCrossRef
go back to reference Britton JR (2007) Maternal anxiety: course and antecedents during the early postpartum period. Depress Anxiety 25:793–800CrossRef Britton JR (2007) Maternal anxiety: course and antecedents during the early postpartum period. Depress Anxiety 25:793–800CrossRef
go back to reference Brouwers EP, van Baar AL, Pop VJ (2001) Does the Edinburgh postnatal depression scale measure anxiety? J Psychosom Res 51(5):659–663PubMedCrossRef Brouwers EP, van Baar AL, Pop VJ (2001) Does the Edinburgh postnatal depression scale measure anxiety? J Psychosom Res 51(5):659–663PubMedCrossRef
go back to reference Carter MM, Sbrocco T, Lewis EL, Friedman EK (2001) Parental bonding and anxiety: differences between African American and European American college students. J Anxiety Disord 15(6):555–569PubMedCrossRef Carter MM, Sbrocco T, Lewis EL, Friedman EK (2001) Parental bonding and anxiety: differences between African American and European American college students. J Anxiety Disord 15(6):555–569PubMedCrossRef
go back to reference Chen H, Chan Y, Tan K, Lee T (2004) Depressive symptomatology in pregnancy. Soc Psychiatry Psychiatr Epidemiol 39(12):975–979PubMedCrossRef Chen H, Chan Y, Tan K, Lee T (2004) Depressive symptomatology in pregnancy. Soc Psychiatry Psychiatr Epidemiol 39(12):975–979PubMedCrossRef
go back to reference Chung TK, Lau TK, Yip AS, Chiu HF, Lee DT (2001) Antepartum depressive symptomatology is associated with adverse obstetric and neonatal outcomes. Psychosom Med 63(5):830–834PubMed Chung TK, Lau TK, Yip AS, Chiu HF, Lee DT (2001) Antepartum depressive symptomatology is associated with adverse obstetric and neonatal outcomes. Psychosom Med 63(5):830–834PubMed
go back to reference Colin C (2006) Robust regression and outliers detection with the ROBUSTREG procedure. SAS Institute, Cary, NC, pp 265–227 Colin C (2006) Robust regression and outliers detection with the ROBUSTREG procedure. SAS Institute, Cary, NC, pp 265–227
go back to reference Costa P, McCrae R (1990) Personality: another ‘hidden factor’ in stress research. Psychol Inq 1(1):22–24CrossRef Costa P, McCrae R (1990) Personality: another ‘hidden factor’ in stress research. Psychol Inq 1(1):22–24CrossRef
go back to reference Costa P, McCrae R (1992) NEO PI-R. Professional manual. Psychological Assessment Resources, Odessa, FL Costa P, McCrae R (1992) NEO PI-R. Professional manual. Psychological Assessment Resources, Odessa, FL
go back to reference Cox JL, Holden JM (1994) Perinatal psychiatry: use and misuse of the Edinburgh Postnatal Depression Scale EPDS. Gaskell, London Cox JL, Holden JM (1994) Perinatal psychiatry: use and misuse of the Edinburgh Postnatal Depression Scale EPDS. Gaskell, London
go back to reference Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 150:782–786PubMedCrossRef Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 150:782–786PubMedCrossRef
go back to reference Da Costa D, Larouche J, Dritsa M, Brender W (2000) Psychosocial correlates of prepartum and postpartum depressed mood. J Affect Disord 59(1):31–40PubMedCrossRef Da Costa D, Larouche J, Dritsa M, Brender W (2000) Psychosocial correlates of prepartum and postpartum depressed mood. J Affect Disord 59(1):31–40PubMedCrossRef
go back to reference Dayan J, Creveuil C, Herlicoviez M, Herbel C, Baranger E, Savoye C et al (2002) Role of anxiety and depression in the onset of spontaneous preterm labor. Am J Epidemiol 155(4):293–301PubMedCrossRef Dayan J, Creveuil C, Herlicoviez M, Herbel C, Baranger E, Savoye C et al (2002) Role of anxiety and depression in the onset of spontaneous preterm labor. Am J Epidemiol 155(4):293–301PubMedCrossRef
go back to reference Dayan J, Creveuil C, Marks MN, Conroy S, Herlicoviez M, Dreyfus M et al (2006) Prenatal depression, prenatal anxiety, and spontaneous preterm birth: a prospective cohort study among women with early and regular care. Psychosom Med 68(6):938–946PubMedCrossRef Dayan J, Creveuil C, Marks MN, Conroy S, Herlicoviez M, Dreyfus M et al (2006) Prenatal depression, prenatal anxiety, and spontaneous preterm birth: a prospective cohort study among women with early and regular care. Psychosom Med 68(6):938–946PubMedCrossRef
go back to reference Demyttenaere K, Lenaerts H, Nijs P, Van Assche FA (1995) Individual coping style and psychological attitudes during pregnancy and predict depression levels during pregnancy and during postpartum. Acta Psychiatr Scand 91(2):95–102PubMedCrossRef Demyttenaere K, Lenaerts H, Nijs P, Van Assche FA (1995) Individual coping style and psychological attitudes during pregnancy and predict depression levels during pregnancy and during postpartum. Acta Psychiatr Scand 91(2):95–102PubMedCrossRef
go back to reference Evans J, Heron J, Francomb H, Oke S, Golding J (2001) Cohort study of depressed mood during pregnancy and after childbirth. BMJ 323(7307):257–260PubMedCrossRef Evans J, Heron J, Francomb H, Oke S, Golding J (2001) Cohort study of depressed mood during pregnancy and after childbirth. BMJ 323(7307):257–260PubMedCrossRef
go back to reference Griffin DW, Bartholomew K (1994) The metaphysics of measurement: the case of adult attachment. In: BartholomewK., PerlmanD. (eds) Advances in personal relationships (vol. 5: attachment processes in adulthood). Kingsley, London, pp 17–52 Griffin DW, Bartholomew K (1994) The metaphysics of measurement: the case of adult attachment. In: BartholomewK., PerlmanD. (eds) Advances in personal relationships (vol. 5: attachment processes in adulthood). Kingsley, London, pp 17–52
go back to reference Harwood K, McLean N, Durkin K (2007) First-time mothers’ expectations of parenthood: what happens when optimistic expectations are not matched by later experiences? Dev Psychol 43(1):1–12PubMedCrossRef Harwood K, McLean N, Durkin K (2007) First-time mothers’ expectations of parenthood: what happens when optimistic expectations are not matched by later experiences? Dev Psychol 43(1):1–12PubMedCrossRef
go back to reference Heron J, O’Connor TG, Evans J, Golding J, Glover V (2004) The course of anxiety and depression through pregnancy and the postpartum in a community sample. J Affect Disord 80(1):65–73PubMedCrossRef Heron J, O’Connor TG, Evans J, Golding J, Glover V (2004) The course of anxiety and depression through pregnancy and the postpartum in a community sample. J Affect Disord 80(1):65–73PubMedCrossRef
go back to reference Herrmann C (1997) International experiences with the Hospital Anxiety and Depression Scale—a review of validation data and clinical results. J Psychosom Res 42(1):17–41PubMedCrossRef Herrmann C (1997) International experiences with the Hospital Anxiety and Depression Scale—a review of validation data and clinical results. J Psychosom Res 42(1):17–41PubMedCrossRef
go back to reference Hoekstra HA, Ormel J, de Fruyt F (1996) Handleiding NEO persoonlijkheids-vragenlijsten NEO-PI-R en NEO-FFI. Swets Test Services, Lisse Hoekstra HA, Ormel J, de Fruyt F (1996) Handleiding NEO persoonlijkheids-vragenlijsten NEO-PI-R en NEO-FFI. Swets Test Services, Lisse
go back to reference Jylha P, Isometsa E (2006) The relationship of neuroticism and extraversion to symptoms of anxiety and depression in the general population. Depress Anxiety 23(5):281–289PubMedCrossRef Jylha P, Isometsa E (2006) The relationship of neuroticism and extraversion to symptoms of anxiety and depression in the general population. Depress Anxiety 23(5):281–289PubMedCrossRef
go back to reference Kurki T, Hiilesmaa V, Raitasalo R, Mattila H, Ylikorkala O (2000) Depression and anxiety in early pregnancy and risk for preeclampsia. Obstet Gynecol 95(4):487–490PubMedCrossRef Kurki T, Hiilesmaa V, Raitasalo R, Mattila H, Ylikorkala O (2000) Depression and anxiety in early pregnancy and risk for preeclampsia. Obstet Gynecol 95(4):487–490PubMedCrossRef
go back to reference Lowyck B, Luyten P, Hutsebaut J, Corveleyn J (2003) De relatievragenlijst van Bartholomew & Horowitz. Center for Psychoanalysis and Psychodynamic Psychology (K.U.Leuven), Leuven Lowyck B, Luyten P, Hutsebaut J, Corveleyn J (2003) De relatievragenlijst van Bartholomew & Horowitz. Center for Psychoanalysis and Psychodynamic Psychology (K.U.Leuven), Leuven
go back to reference Matthey S, Barnett B, Ungerer J, Waters B (2000) Paternal and maternal depressed mood during the transition to parenthood. J Affect Disord 60(2):75–85PubMedCrossRef Matthey S, Barnett B, Ungerer J, Waters B (2000) Paternal and maternal depressed mood during the transition to parenthood. J Affect Disord 60(2):75–85PubMedCrossRef
go back to reference McCrae RR, Costa PT (1986) Personality, coping, and coping effectiveness in an adult sample. J Person 54(2):385–404CrossRef McCrae RR, Costa PT (1986) Personality, coping, and coping effectiveness in an adult sample. J Person 54(2):385–404CrossRef
go back to reference McLaren L, Kuh D, Hardy R, Mishra G (2007) Postnatal depression and the original mother–child relationship: a prospective cohort study. J Affect Disord 100(1–3):211–219PubMedCrossRef McLaren L, Kuh D, Hardy R, Mishra G (2007) Postnatal depression and the original mother–child relationship: a prospective cohort study. J Affect Disord 100(1–3):211–219PubMedCrossRef
go back to reference Mickelson KD, Kessler RC, Shaver PR (1997) Adult attachment in a nationally representative sample. J Pers Soc Psychol 73(5):1092–1106PubMedCrossRef Mickelson KD, Kessler RC, Shaver PR (1997) Adult attachment in a nationally representative sample. J Pers Soc Psychol 73(5):1092–1106PubMedCrossRef
go back to reference Misri S, Oberlander TF, Fairbrother N, Carter D, Ryan D, Kuan AJ et al (2004) Relation between prenatal maternal mood and anxiety and neonatal health. Can J Psychiatry 49(10):684–689PubMed Misri S, Oberlander TF, Fairbrother N, Carter D, Ryan D, Kuan AJ et al (2004) Relation between prenatal maternal mood and anxiety and neonatal health. Can J Psychiatry 49(10):684–689PubMed
go back to reference Murphy B, Bates GW (1997) Adult attachment style and vulnerability to depression. Pers Individ Differ 22(6):835–844CrossRef Murphy B, Bates GW (1997) Adult attachment style and vulnerability to depression. Pers Individ Differ 22(6):835–844CrossRef
go back to reference Murray D, Cox JL (1990) Screening for depression during pregnancy with the Edinburgh Depression Scale (EPDS). J Reprod Infant Psychol 8(2):99–107CrossRef Murray D, Cox JL (1990) Screening for depression during pregnancy with the Edinburgh Depression Scale (EPDS). J Reprod Infant Psychol 8(2):99–107CrossRef
go back to reference Murray G, Rawlings D, Allen N, Trinder J (2003) NEO Five-Factor Inventory Scores: psychometric properties in a community sample. Meas Eval Couns Dev 36(3):140–149 Murray G, Rawlings D, Allen N, Trinder J (2003) NEO Five-Factor Inventory Scores: psychometric properties in a community sample. Meas Eval Couns Dev 36(3):140–149
go back to reference O’Connor TG, Heron J, Glover V (2002) Antenatal anxiety predicts child behavioral/emotional problems independently of postnatal depression. J Am Acad Child Adolesc Psychiatry 41(12):1470–1477PubMedCrossRef O’Connor TG, Heron J, Glover V (2002) Antenatal anxiety predicts child behavioral/emotional problems independently of postnatal depression. J Am Acad Child Adolesc Psychiatry 41(12):1470–1477PubMedCrossRef
go back to reference Orr ST, James SA, Blackmore Prince C (2002) Maternal prenatal depressive symptoms and spontaneous preterm births among African-American women in Baltimore, Maryland. Am J Epidemiol 156(9):797–802PubMedCrossRef Orr ST, James SA, Blackmore Prince C (2002) Maternal prenatal depressive symptoms and spontaneous preterm births among African-American women in Baltimore, Maryland. Am J Epidemiol 156(9):797–802PubMedCrossRef
go back to reference Parker G (1979a) Parental characteristics in relation to depressive disorders. Br J Psychiatry 134:138–147PubMedCrossRef Parker G (1979a) Parental characteristics in relation to depressive disorders. Br J Psychiatry 134:138–147PubMedCrossRef
go back to reference Parker G (1979b) Reported parental characteristics in relation to trait depression and anxiety levels in a non-clinical group. Aust N Z J Psychiatry 13(3):260–264PubMedCrossRef Parker G (1979b) Reported parental characteristics in relation to trait depression and anxiety levels in a non-clinical group. Aust N Z J Psychiatry 13(3):260–264PubMedCrossRef
go back to reference Parker G (1989) The parental bonding instrument: psychometric properties reviewed. Psychiatr Dev 7(4):317–335PubMed Parker G (1989) The parental bonding instrument: psychometric properties reviewed. Psychiatr Dev 7(4):317–335PubMed
go back to reference Parker G, Tupling H, Brown L (1979) A parental bonding instrument. J Med Psychol 52:1–10 Parker G, Tupling H, Brown L (1979) A parental bonding instrument. J Med Psychol 52:1–10
go back to reference Perris C, Andersson P (2000) Experiences of parental rearing and patterns of attachment in adulthood. Clin Psychol Psychother 7(4):279–288CrossRef Perris C, Andersson P (2000) Experiences of parental rearing and patterns of attachment in adulthood. Clin Psychol Psychother 7(4):279–288CrossRef
go back to reference Pop VJ, Komproe IH, van Son MJ (1992) Characteristics of the Edinburgh Post Natal Depression Scale in The Netherlands. J Affect Disord 26(2):105–110PubMedCrossRef Pop VJ, Komproe IH, van Son MJ (1992) Characteristics of the Edinburgh Post Natal Depression Scale in The Netherlands. J Affect Disord 26(2):105–110PubMedCrossRef
go back to reference Priel B, Besser A (1999) Vulnerability to postpartum depressive symptomatology: dependency, self-criticism and the moderating role of antenatal attachment. J Soc Clin Psych 18:240–253 Priel B, Besser A (1999) Vulnerability to postpartum depressive symptomatology: dependency, self-criticism and the moderating role of antenatal attachment. J Soc Clin Psych 18:240–253
go back to reference Raphael-Leff J (1985) Facilitators and regulators: vulnerability to postnatal disturbance. J Psychosom Obstet Gynaecol 4:151–168CrossRef Raphael-Leff J (1985) Facilitators and regulators: vulnerability to postnatal disturbance. J Psychosom Obstet Gynaecol 4:151–168CrossRef
go back to reference Raphael-Leff J (2005) Psychological processes of childbearing. The Anna Freud Centre, London Raphael-Leff J (2005) Psychological processes of childbearing. The Anna Freud Centre, London
go back to reference Reti IM, Samuels JF, Eaton WW, Bienvenu Iii OJ, Costa PT Jr, Nestadt G (2002) Influences of parenting on normal personality traits. Psychiatry Res 111(1):55–64PubMedCrossRef Reti IM, Samuels JF, Eaton WW, Bienvenu Iii OJ, Costa PT Jr, Nestadt G (2002) Influences of parenting on normal personality traits. Psychiatry Res 111(1):55–64PubMedCrossRef
go back to reference Roberts JE, Gotlib IH, Kassel JD (1996) Adult attachment security and symptoms of depression: the mediating roles of dysfunctional attitudes and low self-esteem. J Pers Soc Psychol 70(2):310–320PubMedCrossRef Roberts JE, Gotlib IH, Kassel JD (1996) Adult attachment security and symptoms of depression: the mediating roles of dysfunctional attitudes and low self-esteem. J Pers Soc Psychol 70(2):310–320PubMedCrossRef
go back to reference Robertson E, Grace S, Wallington T, Stewart DE (2004) Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry 26(4):289–295PubMedCrossRef Robertson E, Grace S, Wallington T, Stewart DE (2004) Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry 26(4):289–295PubMedCrossRef
go back to reference Ruble DN, Brooks-Gunn J, Fleming AS, Fitzmaurice G, Stangor C, Deutsch F (1990) Transition to motherhood and the self: measurement, stability, and change. J Pers Soc Psychol 58(3):450–463PubMedCrossRef Ruble DN, Brooks-Gunn J, Fleming AS, Fitzmaurice G, Stangor C, Deutsch F (1990) Transition to motherhood and the self: measurement, stability, and change. J Pers Soc Psychol 58(3):450–463PubMedCrossRef
go back to reference Sanderman R, Ormel J (1992) De Utrechtse Copinglijst. Gedrag en Gezondheid 20:32–37 Sanderman R, Ormel J (1992) De Utrechtse Copinglijst. Gedrag en Gezondheid 20:32–37
go back to reference SAS Institute Inc (2002) SAS software version 9.1 of the SAS system for windows (version 9.1). SAS Institute, Cary, NC SAS Institute Inc (2002) SAS software version 9.1 of the SAS system for windows (version 9.1). SAS Institute, Cary, NC
go back to reference Schreurs P, van de Willige G (1988) Omgaan met problemen en Gebeurtenissen. De Utrechtse Copinglijst. Swets & Zeitlinger, Lisse Schreurs P, van de Willige G (1988) Omgaan met problemen en Gebeurtenissen. De Utrechtse Copinglijst. Swets & Zeitlinger, Lisse
go back to reference Sharp H, Bramwell R (2004) An empirical evaluation of a psychoanalytic theory of mothering orientation: implications for the antenatal prediction of postnatal depression. J Reprod Infant Psychol 22(2):71–89CrossRef Sharp H, Bramwell R (2004) An empirical evaluation of a psychoanalytic theory of mothering orientation: implications for the antenatal prediction of postnatal depression. J Reprod Infant Psychol 22(2):71–89CrossRef
go back to reference Spinhoven P, Ormel J, Sloekers PP, Kempen GI, Speckens AE, Van Hemert AM (1997) A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychol Med 27(2):363–370PubMedCrossRef Spinhoven P, Ormel J, Sloekers PP, Kempen GI, Speckens AE, Van Hemert AM (1997) A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychol Med 27(2):363–370PubMedCrossRef
go back to reference Steer RA, Scholl TO, Hediger ML, Fischer RL (1992) Self-reported depression and negative pregnancy outcomes. J Clin Epidemiol 45(10):1093–1099PubMedCrossRef Steer RA, Scholl TO, Hediger ML, Fischer RL (1992) Self-reported depression and negative pregnancy outcomes. J Clin Epidemiol 45(10):1093–1099PubMedCrossRef
go back to reference Uehara T, Sakado K, Sato T, Someya T (1999) Do perceived parenting styles influence stress coping in patients with major depressive disorders? Stress Med 15(3):197–200CrossRef Uehara T, Sakado K, Sato T, Someya T (1999) Do perceived parenting styles influence stress coping in patients with major depressive disorders? Stress Med 15(3):197–200CrossRef
go back to reference van Bussel JCH, Spitz B, Demyttenaere K (2006) Women’s mental health before, during, and after pregnancy: a population-based controlled cohort study. Birth 33(4):297–302PubMedCrossRef van Bussel JCH, Spitz B, Demyttenaere K (2006) Women’s mental health before, during, and after pregnancy: a population-based controlled cohort study. Birth 33(4):297–302PubMedCrossRef
go back to reference van Bussel JCH, Spitz B, Demyttenaere K (2009) Maternal antenatal orientations on pregnancy, the child and motherhood, reliability and construct validity of a brief measure. Individual Differences Research van Bussel JCH, Spitz B, Demyttenaere K (2009) Maternal antenatal orientations on pregnancy, the child and motherhood, reliability and construct validity of a brief measure. Individual Differences Research
go back to reference Verschueren K, Marcoen A (1993) Gehechtheidsstijl, intimiteit en vertrouwen in de jongvolwassenheid: een reflectie van de ervaren ouderlijke sensitiviteit? Psychol Belg 33:49–76 Verschueren K, Marcoen A (1993) Gehechtheidsstijl, intimiteit en vertrouwen in de jongvolwassenheid: een reflectie van de ervaren ouderlijke sensitiviteit? Psychol Belg 33:49–76
go back to reference Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6):361–370PubMedCrossRef Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6):361–370PubMedCrossRef
Metadata
Title
Depressive symptomatology in pregnant and postpartum women. An exploratory study of the role of maternal antenatal orientations
Authors
Johan C. H. van Bussel
Bernard Spitz
Koen Demyttenaere
Publication date
01-06-2009
Publisher
Springer Vienna
Published in
Archives of Women's Mental Health / Issue 3/2009
Print ISSN: 1434-1816
Electronic ISSN: 1435-1102
DOI
https://doi.org/10.1007/s00737-009-0061-x

Other articles of this Issue 3/2009

Archives of Women's Mental Health 3/2009 Go to the issue