Top

Published in:

01-06-2014 | Original Article

The relationship between maternal attitudes and symptoms of depression and anxiety among pregnant and postpartum first-time mothers

Authors: Laura E. Sockol, C. Neill Epperson, Jacques P. Barber

Published in: Archives of Women's Mental Health | Issue 3/2014

Abstract

Two studies examined the relationship between maternal attitudes and symptoms of depression and anxiety during pregnancy and the early postpartum period. In the first study, a measure of maternal attitudes, the Attitudes Toward Motherhood Scale (AToM), was developed and validated in a sample of first-time mothers. The AToM was found to have good internal reliability and convergent validity with cognitive biases and an existing measure of maternal attitudes. Exploratory and confirmatory factor analyses determined that the measure comprises three correlated factors: beliefs about others’ judgments, beliefs about maternal responsibility, and maternal role idealization. In the second study, we used the AToM to assess the relationship between maternal attitudes and other psychological variables. The factor structure of the measure was confirmed. Maternal attitudes predicted symptoms of depression and anxiety, and these attitudes had incremental predictive validity over general cognitive biases and interpersonal risk factors. Overall, the results of these studies suggest that maternal attitudes are related to psychological distress among first-time mothers during the transition to parenthood and may provide a useful means of identifying women who may benefit from intervention during the perinatal period.

Abramson L, Seligman M, Teasdale J (1978) Learned helplessness in humans: critique and reformulation. J Abnorm Psychol 87:49–74PubMedCrossRef

Appleby L, Warner R, Whitton A, Faragher B (1997) A controlled study of fluoxetine and cognitive behavioural counselling in the treatment of postnatal depression. Br Med J 314:932–936CrossRef

Beck A (1967) Depression: clinical, experimental & theoretical aspects. University of Pennsylvania Press, Philadelphia

Beck A (1976) Cognitive therapy and the emotional disorders. Penguin, New York

Beck A (1985) Anxiety disorders and phobias: a cognitive perspective. Basic Books, New York

Beck C (2001) Predictors of postpartum depression: an update. Nurs Res 50:275–285PubMedCrossRef

Belsky J (1985) Exploring individual differences in marital change across the transition to parenthood: the role of violated expectations. J Marriage Fam 47:1037–1044CrossRef

Bennett H, Einarson A, Taddio A, Koren G, Einarson T (2004) Prevalence of depression during pregnancy: systematic review. Obstet Gynecol 103:698–709PubMedCrossRef

Besser A, Priel B (2003) Trait vulnerability and coping strategies in the transition to motherhood. Curr Psychol: Dev Learn Pers Soc 22:57–72CrossRef

Besser A, Priel B, Flett G, Wiznitzer A (2007) Linear and nonlinear models of vulnerability to depression: personality and postpartum depression in a high-risk population. Individ Differ Res 5:1–29

Birnbaum MH (2004) Human research and data collection via the internet. Annu Rev Psychol 55:803–832PubMedCrossRef

Bloch M, Schmidt P, Danaceau M, Murphy J, Nieman L, Rubonow D (2000) Effects of gonadal steroids in women with a history of postpartum depression. Am J Psychiatr 157:924–930PubMedCrossRef

Block J (1963) Recognizing attenuation effects in the strategy of research. Psychol Bull 62(3):214–216CrossRef

Bosnjak M, Batinic B (2002) Understanding the willingness to participate in online surveys: the case of email questionnaires. In: Batinic B, Reips UD, Bosnjak M (eds) Online social sciences. Hogrefe & Huber, Göttingen, pp 81–92

Cattel RB (1966) The scree test for the number of factors. Multivar Behav Res 1:245–276CrossRef

Cheung GW, Rensvold RB (2002) Evaluating goodness-of-fit indexes for testing measurement invariance. Struct Equ Model 9(2):233–255CrossRef

Church N, Brechman-Toussaint M, Hine D (2005) Do dysfunctional cognitions mediate the relationship between risk factors and postnatal depression symptomatology? J Affect Disord 87:65–72PubMedCrossRef

Cooper PJ, Murray L (1995) Course and recurrence of postpartum depression: evidence for the specificity of the diagnostic concept. Br J Psychiatry 166:191–195PubMedCrossRef

Cooper PJ, Murray L, Wilson A, Romaniuk H (2003) Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression 1: impact on maternal mood. Br J Psychiatry 182(5):412–419PubMedCrossRef

Cox J, Holden J, Sagovsky R (1987) Detection of postnatal depression: development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatry 150:782–786PubMedCrossRef

Cox J, Chapman G, Murray D, Jones P (1996) Validation of the Edinburgh post-natal depression scale (EPDS) in non-postnatal women. J Affect Disord 39:185–189PubMedCrossRef

Cutrona C (1983) Causal attributions and perinatal depression. J Abnorm Psychol 92:161–172PubMedCrossRef

de Graaf LE, Roelofs J, Huibers MJH (2009) Measuring dysfunctional attitudes in the general population: the dysfunctional attitudes scale (Form A) revised. Cogn Ther Res 33(4):345–355CrossRef

DiPietro JA, Ghera M, Costigan KA, Hawkins M (2004) Measuring the ups and downs of pregnancy stress. J Psychosom Obstet Gynecol 25:189–201CrossRef

Eagly AH, Chaiken S (2007) The advantages of an inclusive definition of attitude. Soc Cogn 25:582–602CrossRef

Francis-Raniere EL, Alloy LB, Abramson LY (2006) Depressive personality styles and bipolar spectrum disorders: prospective tests of the event congruency hypothesis. Bipolar Disord 8:382–399PubMedCrossRef

Geweke JF, Singleton KJ (1980) Interpreting the likelihood ratio statistic in factor models when sample size is small. J Am Stat Assoc 75:133–137CrossRef

Grace S, Evindar A, Stewart D (2003) The effect of postpartum depression on child cognitive development and behavior: a review and critical analysis of the literature. Arch Women’s Ment Health 6:263–274CrossRef

Grazioli R, Terry D (2000) The role of cognitive vulnerability and stress in the prediction of postpartum depressive symptomatology. Br J Clin Psychol 39:329–347PubMedCrossRef

Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S, Katon WJ (2010) A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry 67(10):1012–1024PubMedCentralPubMedCrossRef

Halbreich U (2005) Postpartum disorders: multiple interacting underlying mechanisms and risk factors. J Affect Disord 88:1–7PubMedCrossRef

Hammen C, Marks T, de Mayo R, Mayol A (1985) Self-schemas and risk for depression: a prospective study. J Pers Soc Psychol 49:1147–1159PubMedCrossRef

Hammen C, Ellicott A, Gitlin M, Jamison K (1989) Sociotropy/autonomy and vulnerability to specific life events in patients with unipolar depression and bipolar disorders. J Abnorm Psychol 98(2):154–160PubMedCrossRef

Harwood K (2004) Women’s parenting expectations and their influence on adjustment to parenthood. Unpublished doctoral dissertation, University of Western Australia

Hilsman R, Garber J (1995) A test of the cognitive diathesis-stress model of depression in children: Academic stressors, attributional style, perceived competence, and control. J Pers Soc Psychol 69(2):370–380

Horn JL (1965) A rationale and test for the number of factors in factor analysis. Psychometrika 30:179–185PubMedCrossRef

Hull J, Mendolia M (1991) Modeling the relations of attributional style, expectancies and depression. J Pers Soc Psychol 61:85–97PubMedCrossRef

Joseffson A, Berg G, Nordin C, Sydsjo G (2001) Prevalence of depressive symptoms in late pregnancy and postpartum. Acta Obstet Gynecol Scand 80:251–255CrossRef

Kalmuss D, Davidson A, Cushman L (1992) Parenting expectations, experiences, and adjustment to parenthood: a test of the violated expectations framework. J Marriage Fam 54:516–526CrossRef

Kim DR, Sockol LE, Sammel M, Kelly C, Moseley M, Epperson CN (2013) Elevated risk of adverse obstetric outcomes in pregnant women with depression. Arch Women’s Ment Health 16:475–482CrossRef

Knapp F, Heidingsfelder M (2001) Drop-out analysis: effects of the survey design. In: Reips UD, Bosnjak M (eds) Dimensions of internet science. Pabst, Lengerich, pp 221–229

Kumar R, Robson KM, Smith AMR (1984) Development of a self-administered questionnaire to measure maternal adjustment and maternal attitudes during pregnancy and after delivery. J Psychosom Res 28:43–51PubMedCrossRef

Lee A, Lam S, Lau S, Chong C, Chui H, Fong D (2007) Prevalence, course, and risk factors for antenatal anxiety and depression. Obstet Gynecol 110:1102–1112PubMedCrossRef

Littleton H, Breitkopf C, Berenson A (2007) Correlates of anxiety symptoms during pregnancy and association with perinatal outcomes: a meta-analysis. Am J Obstet Gynecol 196:424–432PubMedCrossRef

Logsdon M, Usui W (2001) Psychosocial predictors of postpartum depression in diverse groups of women. West J Nurs Res 23:563–574PubMedCrossRef

Meng X-L, Rosenthal R, Rubin DB (1992) Comparing correlated correlation coefficients. Psychol Bull 111(1):172–175CrossRef

Musch J, Reips UD (2000) A brief history of web experimenting. In: Birnbaum MH (ed) Psychological experiments on the internet. Academic, New York, pp 61–87CrossRef

O’Conner T, Heron J, Glover V, the ALSPAC Study Team (2002) Antenatal anxiety predicts child behavioral/emotional problems independently of postnatal depression. J Am Acad Child Adolesc Psychiatry 41:1470–1477CrossRef

O’Hara MW, Swain A (1996) Rates and risk of postpartum depression: a meta-analysis. Int Rev Psychiatry 8:37–54CrossRef

O’Hara MW, Rehm L, Campbell S (1982) Predicting depressive symptomatology: cognitive-behavioral models and postpartum depression. J Abnorm Psychol 91:457–461PubMedCrossRef

O’Hara MW, Stuart S, Gorman L, Wenzel A (2000) Efficacy of interpersonal psychotherapy for postpartum depression. Arch Gen Psychiatry 57:1039–1045PubMedCrossRef

O’Mahen H, Fedock G, Henshaw E, Himle J, Forman J, Flynn HA (2012) Modifying CBT for perinatal depression: what do women want? A qualitative study. Cogn Behav Pract 19:359–371CrossRef

Olioff M (1991) The application of cognitive therapy to postpartum depression. In: Vallis T, Howes J, Miller P (eds) The challenge of cognitive therapy: applications to non-traditional populations. Plenum, New York, pp 111–134CrossRef

Peterson C, Maier S, Seligman M (1993) Learned helplessness: a theory for the age of personal control. Oxford University Press, New York

Robertson E, Grace S, Wallington T, Stewart D (2004) Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry 26:289–295PubMedCrossRef

Schmidt NB, Lerew DR, Jackson RJ (1997) Prospective evaluation of anxiety sensitivity in the pathogenesis of panic: replication and extension. J Abnorm Psychol 108(3):532–537

Segal ZV, Shaw BF, Vella DD, Katz R (1992) Cognitive and life stress predictors of relapse in remitted unipolar depressed patients: test of the congruency hypothesis. J Abnorm Psychol 101(1):26–36PubMedCrossRef

Seguin L, Potvin L, St. Denis M, Loiselle J (1995) Chronic stressors, social support and depression during pregnancy. Obstet Gynecol 85:583–589PubMedCrossRef

Sockol LE (2008) Predicting depressive symptoms during pregnancy: integrating cognitive, coping and social perspectives. Master’s thesis, University of Pennsylvania, Philadelphia

Sockol LE, Epperson CN, Barber JP (2011) A meta-analysis of treatments for perinatal depression. Clin Psychol Rev 31:839–849PubMedCrossRef

Sockol LE, Epperson CN, Barber JP (2013) Preventing postpartum depression: a meta-analytic review. Clin Psychol Rev 33:1205–1217PubMedCrossRef

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

Spielberger C (1983) Manual for the state-trait anxiety inventory (STAI). Consulting Psychologists Press, Palo Alto

Stuart S, Couser G, Schilder K, O’Hara MW, Gorman LL (1998) Postpartum anxiety and depression: onset and comorbidity in a community sample. J Nerv Ment Dis 186:420–424PubMedCrossRef

Surkan P, Peterson K, Hughes M, Gottlieb B (2006) The role of social networks and support in postpartum women’s depression: a multiethnic urban sample. Matern Child Health J 10:375–383PubMedCrossRef

Velicer WF (1976) Determining the number of components from the matrix of partial correlations. Psychometrika 41:321–327CrossRef

Warner R, Appleby L, Whitton A, Faragher B (1997) Attitudes toward motherhood in postnatal depression: development of the maternal attitudes questionnaire. J Psychosom Res 43:351–358PubMedCrossRef

Weissman A, Beck A (1978) Development and validation of the dysfunctional attitude scale: a preliminary investigation. Paper presented at the meeting of the American Educational Research Association, Toronto

Wenzel A, Haugen EN, Jackson LC, Brendle JR (2005) Anxiety disorders at eight weeks postpartum. J Anxiety Disord 19:295–311PubMedCrossRef

Woodall A, Morgan C, Sloan C, Howard L (2010) Barriers to participation in mental health research: are there specific gender, ethnicity, and age related barriers? BMC Psychiatry 10:103PubMedCentralPubMedCrossRef

Zimet G, Dahlem N, Zimet S, Farley G (1988) The multidimensional scale of perceived social support. J Pers Assess 52:30–41CrossRef

Title: The relationship between maternal attitudes and symptoms of depression and anxiety among pregnant and postpartum first-time mothers
Authors: Laura E. Sockol
C. Neill Epperson
Jacques P. Barber
Publication date: 01-06-2014
Publisher: Springer Vienna
Published in: Archives of Women's Mental Health / Issue 3/2014
Print ISSN: 1434-1816
Electronic ISSN: 1435-1102
DOI: https://doi.org/10.1007/s00737-014-0424-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The relationship between maternal attitudes and symptoms of depression and anxiety among pregnant and postpartum first-time mothers

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 3/2014

Maintaining remission of depression with repetitive transcranial magnetic stimulation during pregnancy: a case report

Anxiety in early pregnancy: prevalence and contributing factors

Sleep difficulties and the development of depression and anxiety: a longitudinal study of young Australian women

Returning to tricyclic antidepressants for depression during childbearing: clinical and dosing challenges

Low maternal serum vitamin D during pregnancy and the risk for postpartum depression symptoms

Body image satisfaction and depression in midlife women: the Study of Women’s Health Across the Nation (SWAN)