Top

Published in:

01-10-2009 | Original Contribution

Postpartum depression, suicidality, and mother-infant interactions

Authors: Ruth Paris, Rendelle E. Bolton, M. Katherine Weinberg

Published in: Archives of Women's Mental Health | Issue 5/2009

Abstract

To date, few studies have examined suicidality in women with postpartum depression. Reports of suicidal ideation in postpartum women have varied (Lindahl et al. Arch Womens Ment Health 8:77–87, 2005), and no known studies have examined the relationship between suicidality and mother-infant interactions. This study utilizes baseline data from a multi-method evaluation of a home-based psychotherapy for women with postpartum depression and their infants to examine the phenomenon of suicidality and its relationship to maternal mood, perceptions, and mother-infant interactions. Overall, women in this clinical sample (n = 32) had wide ranging levels of suicidal thinking. When divided into low and high groups, the mothers with high suicidality experienced greater mood disturbances, cognitive distortions, and severity of postpartum symptomotology. They also had lower maternal self-esteem, more negative perceptions of the mother-infant relationship, and greater parenting stress. During observer-rated mother-infant interactions, women with high suicidality were less sensitive and responsive to their infants’ cues, and their infants demonstrated less positive affect and involvement with their mothers. Implications for clinical practice and future research directions are discussed.

Abidin RR (1995) Parenting stress index, 3rd edn. Professional manual. Psychological Assessment Resources, Lutz FL

Abrams LS, Dornig K (2007) Bridging the gap: Barriers to service use among low-income women with postpartum depression. UCLA, Department of Social Welfare, School of Public Affairs. Available via UCLA. http://www.spa.ucla.edu/sw/webfiles/Barriers_to_Service_Use-Among_Low-Income_Women_with_PPD_and_PPD_Toolkit.pdf. Accessed 1 Nov 2008.

Adam KS (1990) Environmental, psychosocial and psychoanalytic aspects of suicidal behavior. In: Blumenthal SJ, Kupfer DJ (eds) Suicide over the life cycle: risk factors, assessment, and treatment of suicidal patients. American Psychiatric Press, Washington DC, pp 89–97

Appleby L (1991) Suicide after pregnancy and the first postnatal year. Br Med J 302:137–140CrossRef

Appleby L, Turnbull G (1995) Parasuicide in the first postnatal year. Psychol Med 25:1087–1090PubMedCrossRef

Appleby L, Mortensen PB, Faragher EB (1998) Suicide and other causes of mortality after post-partum psychiatric admission. Br J Psychiatry 173:209–211PubMedCrossRef

Barr JA (2006) Postpartum depression, delayed maternal adaptation, and mechanical infant caregiving: a phenomenological hermeneutic study. Int J Nurs Stud 45:362–369PubMedCrossRef

Beck CT (2002) Postpartum depression: a metasynthesis. Qual Health Res 12:453–472PubMedCrossRef

Beck CT, Gable RK (2000) Postpartum depression screening scale: development and psychometric testing. Nurs Res 5:272–282CrossRef

Beck CT, Indman P (2005) The many faces of postpartum depression. J Obstet Gynecol Neonatal Nurs 34:569–572PubMedCrossRef

Bernstein IH, Rush AJ, Yonkers K, Carmody TJ, Woo A, McConnell K, Trivedi MH (2006) Symptom features of postpartum depression: Are they distinct? Depress Anxiety 25:20–26CrossRef

Brockington IF (2004) Postpartum psychiatric disorders. Lancet 363:303–310PubMedCrossRef

Cooper PJ, Tomlinson M, Swartz L, Woolgar M, Murray L, Molteno C (1999) Postpartum depression and the mother-infant relationship in a South African peri-urban settlement. Br J Psychiatry 175:554–558PubMedCrossRef

Cooper C, Jones L, Dunn E, Forty L, Haque S, Oyebode F, Craddock N, Jones I (2007) Clinical presentation of postnatal and non-postnatal depressive episodes. Psychol Med 37:1273–1280PubMedCrossRef

Cowan PA, Cowan CP, Mening G, Garrett ET, Coysh WE, Curtis-Boles H, Boles A (1985) Transitions to parenthood: His, hers, and theirs. J Fam Issues 6:451–481PubMedCrossRef

Cramer B (1993) Are postpartum depressions a mother-infant relationship disorder? Infant Ment Health J 14:283–287CrossRef

Cramer B (1998) Mother-infant psychotherapies: a widening scope in technique. Infant Ment Health J 19:151–167CrossRef

Derogatis LR (1975) Brief symptom inventory. Clinical Psychometric Research, Baltimore MD

Derogatis LR (1993) The Brief Symptom Inventory (BSI): administration, scoring and procedures manual , 4th edn. National Computer Systems, Minneapolis MN

Evans J, Heron J, Francomb H, Oke S, Goldberg J (2001) Cohort study of depressed mood during pregnancy and after childbirth. Br Med J 323:257–260CrossRef

Feldman (1998) Coding Interactive Behavior (CIB). Unpublished manuscript, Bar Ilan University, Israel

Feldman R (2003) Testing a family intervention hypothesisL the contribution of mother-infant skin-to-skin contact (Kangaroo Care) to family interaction, proximity, and touch. J Fam Psychol 17:94–107PubMedCrossRef

Feldman R (2007) Maternal versus child risk and the development of parent-child and family relationships in five high-risk populations. Dev Psychopathol 19:293–312PubMed

Feldman R, Eidelman AI (2009) Biological and environmental initial conditions shape the trajectories of cognitive and social-emotional development across the first years of life. Dev Sci 1:194–200CrossRef

Feldman R, Granat A, Pariente C, Kanety H, Kuint J, Gilboa-Schechtman E. (2009) Maternal depression and anxiety across the postpartum year and infant social engagement, fear regulation, and stress reactivity. J Am Acad Child Adolesc Psychiatry.

Field T (2008) Problems in infancy. In: Hersen M, Gross AM (eds) Handbook of clinical psychology vol II: children and adolescents. Wiley, Hoboken NJ, pp 966–1011

Field T, Hernandez-Reif M, Diego M, Feijo L, Vera Y, Gil K, Sanders C (2007) Still-face and separation effects on depressed mother-infant interactions. Infant Ment Health J 28:314–323CrossRef

Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T (2005) Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol 106:1071–1083PubMed

Georgiopolous AM, Bryan TL, Wollan P, Yawn BP (2001) Routine screening for postpartum depression. J Fam Pract 50:122–127

Henshaw C (2007) Maternal suicide. In: Cockburn J, Pawson M (eds) Psychological challenges in obstetrics and gynecology: the clinical Management. Springer, New York, pp 157–164CrossRef

Högberg U, Innala E, Sandström A (1994) Maternal mortality in Sweden, 1980–1988. Obstet Gynecol 84:240–244PubMed

Hornstein C, Trautmann-Villalba P, Hohm E, Rave E, Wortmann-Fleisher S, Schwarz M (2006) Maternal bond and mother-child interaction in severe postpartum psychiatric disorders: Is there a link? Arch Womens Ment Health 9:279–284PubMedCrossRef

Kendall-Tackett KA (2005) Depression in new mothers: causes, consequences, and treatment alternatives. Haworth, New York

Lindahl V, Pearson JL, Colpe L (2005) Prevalence of suicidality during pregnancy and the postpartum. Arch Womens Ment Health 8:77–87PubMedCrossRef

Lyons-Ruth K (2008) Contributions of the mother-infant relationship to dissociative, borderline, and conduct symptoms in young adulthood. Infant Ment Health J 29:203–218PubMedCrossRef

McDonough SC (2004) Interaction guidance: promoting and nurturing the care giving relationship. In: Sameroff AJ, McDonough SC, Rosenblum KL (eds) Treating parent-infant relationship problems. Guilford, New York, pp 79–96

Milgrom J, Westley DT, Gemmill AW (2004) The mediating role of maternal responsiveness in some longer term effects of postnatal depression on infant development. Infant Behav Dev 27:443–454CrossRef

Murray L, Cooper PJ (1997) Postpartum depression and child development. Guilford, New York

Noorlander Y, Bergink V, van den Berg MP (2008) Perceived and observed mother-child interaction at time of hospitalization and release in postpartum depression and psychosis. Arch Womens Ment Health 11:49–56PubMedCrossRef

Nylen KJ, Moran TE, Franklin CL, O’Hara M (2006) Maternal depression: a review of relevant treatment approaches for mothers and infants. Infant Ment Health J 27:327–343CrossRef

Paris R, Spielman E, Bolton RE (2009) Mother-infant psychotherapy: examining the therapeutic process of change. Infant Ment Health J 30:301–319CrossRef

Pollock LR, Williams JMG (1998) Problem solving and suicidal behavior. Suicide Life-Threat Behave 28:375–387

Pollock LR, Williams JMG (2004) Problem-solving in suicide attempters. Psych Med 34:163–167CrossRef

Qin P, Mortensen PB (2003) The impact of parental status on the risk of parental suicide. Arch Gen Psychiatry 60:797–802PubMedCrossRef

Righetti-Veltema M, Bousquet A, Manzano J (2003) Impact of postpartum depressive symptoms on mother and her 18-month-old infant. Eur Child Adoles Psychiatry 12:75–83CrossRef

Shea SC (2002) The practical art of suicide assessment: a guide for mental health professionals and substance abuse counselors. Wiley, Hoboken, NJ

Shea E, Tronick EZ (1988) The Maternal Self-Report Inventory: a research and clinical instrument for assessing maternal self-esteem. Theory Res Behav Pediatr 4:101–141

Slade A, Sadler L, De Dios-Kenn C, Webb D, Currier-Ezepchick J, Mayes L (2005) Minding the baby: A reflective parenting program. Psychoanal Study Child 60:74–100PubMed

Sokolowski MS, Hans SL, Bernstein V, Cox SM (2007) Mothers representations of their infants and parenting behavior: Associations and personal and social-contextual variables in a high risk sample. Infant Ment Health J 28:344–365CrossRef

Spanier GB (1976) Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads. J Marriage Fam 38:15–28CrossRef

Spielman E (2002) Early Connections: Mother-infant psychotherapy in support of perinatal mental health. Zero to Three 22:26–30

Stern DN (1995) The motherhood constellation: a unified view or parent-infant psychotherapy. Basic Books, New York

Teti DM (2000) Maternal depression and child-mother attachment in the first three years: a view from the intermountain West. In: Crittenden PM, Claussen AH (eds) The organization of attachment relationships: Maturation, culture, and context. Cambridge University Press, New York, pp 190–213

Teti DM, Gelfand DM (1997) Maternal cognitions as mediators of child outcomes in the context of postpartum depression. In: Murray L, Cooper PJ (eds) Postpartum depression and child development. Guilford, New York, pp 136–164

Weinberg MK, Tronick EZ (1998) Emotional characteristics of infants associated with maternal depression and anxiety. Pediatr 102:1298–1304

Weinberg MK, Tronick EZ, Beeghly M, Olson KL, Kernan H, Riley JM (2001) Subsyndromal depressive symptoms and major depression in postpartum women. Am J Orthopsychiatry 71:87–97PubMedCrossRef

Wisner KL, Parry BL, Piontek CM (2002) Postpartum depression. N England J Med 347:194–199CrossRef

Title: Postpartum depression, suicidality, and mother-infant interactions
Authors: Ruth Paris
Rendelle E. Bolton
M. Katherine Weinberg
Publication date: 01-10-2009
Publisher: Springer Vienna
Published in: Archives of Women's Mental Health / Issue 5/2009
Print ISSN: 1434-1816
Electronic ISSN: 1435-1102
DOI: https://doi.org/10.1007/s00737-009-0105-2

At a glance: The STEP trials

Springer Medicine

Postpartum depression, suicidality, and mother-infant interactions

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 5/2009

“One end has nothing to do with the other:” Patient attitudes regarding help seeking intention for depression in gynecologic and obstetric settings

Two types of classification in female alcoholism

Beyond screening: assessment of perinatal depression in a perinatal care setting

Antenatal depression and suicidal ideation among rural Bangladeshi women: a community-based study

Antenatal maternal depressive mood and parental–fetal attachment at the end of pregnancy

Depressive and anxiety symptoms through late pregnancy and the first year post birth: an examination of prospective relationships