A Web-Based Survey of Mother-Infant Bond, Attachment Experiences, and Metacognition in Posttraumatic Stress Following Childbirth

Williams, Charlotte; Taylor, Emily P.; Schwannauer, Matthias

doi:10.1002/imhj.21564

Cited by 24 publications

(18 citation statements)

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“…Only one other study has investigated the mechanistic relationships of maternal postpartum affective symptoms (depression/anxiety/psychological distress), PTSD-CB, and mother-infant bonding within the first year postpartum. This study found that the relationship between PTSD-CB symptoms and mother-infant bonding was mediated by depressive symptoms ( 26 ). This is in contrast to our findings of a lack of a mediation between maternal PTSD-CB symptoms and mother-infant bonding by maternal psychological distress.…”

Section: Discussionmentioning

confidence: 90%

“…Results seem to vary depending on the instrument used ( 20 ), how postpartum PTSD is defined ( 21 ), or whether comorbid symptoms of depression are considered ( 22 ).There is also evidence that maternal PTSD-CB symptoms may affect mother-infant interactions ( 23 ) and mother-infant bonding in infants born at risk, such as preterm infants ( 24 ) or infants with perinatal asphyxia ( 25 ). One recent cross-sectional web-based survey reported a medium indirect relationship between (what the authors call) “postnatal maternal PTSD symptoms” and the mother-infant bond that was fully mediated by depression symptoms ( 26 ). The authors argued that the impact of postnatal PTSD symptoms on maternal affect, cognition and behavior, and, in turn, on bonding might be less important than that of depression ( 26 ).…”

Section: Introductionmentioning

confidence: 99%

“…One recent cross-sectional web-based survey reported a medium indirect relationship between (what the authors call) “postnatal maternal PTSD symptoms” and the mother-infant bond that was fully mediated by depression symptoms ( 26 ). The authors argued that the impact of postnatal PTSD symptoms on maternal affect, cognition and behavior, and, in turn, on bonding might be less important than that of depression ( 26 ). Regarding fathers, the evidence is still limited.…”

Section: Introductionmentioning

confidence: 99%

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Parental Birth-Related PTSD Symptoms and Bonding in the Early Postpartum Period: A Prospective Population-Based Cohort Study

2020

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The parent-infant bond following childbirth is an important facilitator of optimal infant development. So far, research has mainly focused on mother-infant bonding. Data on fathers are still sparse. Parental mental health, such as posttraumatic stress symptoms (PTSD), may influence mother-infant relations and/or interactions. There is evidence that both parents can experience PTSD symptoms following childbirth (PTSD-CB). The aim of this study is to investigate the prospective relationship between parental PTSD-CB symptoms at 1 month postpartum and perceived parent-infant bonding at 3 months postpartum, while adjusting for antenatal confounders. A subsample was used for this study ( n Totalsample 488, n mothers = 356, n fathers = 132) of an ongoing prospective cohort study. Future parents awaiting their third trimester antenatal appointments at a Swiss university hospital were recruited. Self-report questionnaires assessed PTSD-CB symptoms and psychological distress at 1 month postpartum, and parent-infant bonding at 3 months postpartum. Confounders included antenatal PTSD symptoms and social support measured via self-report questionnaires, and gestity and gestational age, extracted from medical records. Using structural equation modeling, the predictive ability of PTSD-CB symptoms at 1 month postpartum on parent-infant bonding at 3 months postpartum was assessed for both parents respectively. Maternal PTSD-CB symptoms at 1 month postpartum were found to be negatively prospectively associated with mother-infant bonding at 3 months postpartum; however, this effect disappeared after adjusting for psychological distress at 1 month postpartum. No such effects were found for fathers. There was no evidence of mediation of the relationship between parental PTSD-CB symptoms at 1 month postpartum and parental-infant bonding at 3 months postpartum via psychological distress at 1 month postpartum. However, such a mediation was found for maternal intrusion and hyperarousal symptom subscales. Results expand the current literature on the impact of PTSD-CB on parent-child relations to also include fathers, and to a community sample. Any adverse effects of mental health symptoms on parent-infant bonding were evidenced by 3 months postpartum only for mothers, not fathers. Our results may inform the development of prevention/intervention strategies.

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Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Parental Birth-Related PTSD Symptoms and Bonding in the Early Postpartum Period: A Prospective Population-Based Cohort Study

2020

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“…Similarly, a study on these associations specifically for PTSD following childbirth showed that PTSD symptoms had only an indirect effect on bonding via depression, but there was no direct effect (Blažević et al, 2019;Williams et al, 2016). Conversely, another study showed that depressive symptoms did not have a direct effect on bonding, while PTSD symptoms had ).…”

Section: Research On Ptsd Symptoms and The Couple's Relationship (Quamentioning

confidence: 98%

The role of posttraumatic stress and depression symptoms in mother-infant bonding

Radoš

Matijaš

Anđelinović

et al. 2020

Journal of Affective Disorders

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This is the accepted version of the paper.This version of the publication may differ from the final published version.Permanent repository link: https://openaccess.city.ac.uk/id/eprint/23962/ Link to published version: http://dx. AbstractBackground: There is some evidence posttraumatic stress disorder (PTSD) following childbirth may impact on the mother-infant bond. However, the evidence is inconsistent over whether PTSD or co-morbid depressive symptoms are primarily related to impaired bonding.This study therefore aimed to examine the relationship between PTSD symptoms, depressive symptoms and mother-infant bonding. Methods:A cross-sectional online study included 603 mothers of infants aged 1 to 12 months. Measures were taken of PTSD (City Birth Trauma Scale, Ayers et al., 2018) which has two subscales of birth-related PTSD symptoms and general PTSD symptoms; depression (Edinburgh Postnatal Depression Scale, Cox et al., 1987) and mother-infant bonding (Postpartum Bonding Questionnaire, Brockington et al., 2001). Results: Impaired bonding was related to both dimensions of PTSD symptoms and depressive symptoms in bivariate analysis. Path analysis testing the model of whether depressive symptoms mediated the effect of PTSD symptoms on mother-infant bonding found a differential role of birth-related and general PTSD symptoms. Birth-related PTSD symptoms did not have any effect on bonding or depressive symptoms. In contrast, general PTSD symptoms had a direct effect on bonding and an indirect effect on bonding via depressive symptoms. Limitations: Self-report measures of PTSD and depression symptoms were used. Conclusions: Further research regarding different aspects of postpartum PTSD, depression and other disorders in the context of mother-infant bonding are needed. Future preventive programs should focus on diminishing symptoms of postpartum PTSD and depression so that the motherinfant bonding remains optimal.Highlights  Both PTSD and depressive symptoms are related to impaired mother-infant bonding. A differential role of birth-related and general PTSD symptoms was found. Birth-related PTSD symptoms did not have effect on bonding or depressive symptoms. General PTSD symptoms had an indirect effect on bonding via depressive symptoms.

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“…Co-morbidity of PP-PTSD and postpartum depression is high, as evident in up to 72% of cases of women endorsing PP-PTSD (Yildiz et al, 2017), and some may also endorse suicide ideation, as evident in 23% of cases (Dekel et al, in preparation). PP-PTSD may impair maternal bonding and indirectly have adverse affects on infant health (Williams et al, 2016). Hence, PP-PTSD is a problem deserving of attention.…”

Section: Introductionmentioning

confidence: 99%

Childbirth Induced Posttraumatic Stress Syndrome: A Systematic Review of Prevalence and Risk Factors

2017

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Background: Posttraumatic stress related with the childbirth experience of full-term delivery with health outcomes has been recently documented in a growing body of studies. The magnitude of this condition and the factors that might put a woman at risk for developing childbirth-related postpartum posttraumatic stress disorder (PP-PTSD) symptoms are not fully understood.Methods: In this systematic review of 36 articles representing quantitative studies of primarily community samples, we set to examine PP-PTSD prevalence rates and associated predictors with a focus on the role of prior PTSD and time since childbirth.Results: A significant minority of women endorsed PP-PTSD following successful birth. Acute PP-PTSD rates were between 4.6 and 6.3%, and endorsement of clinically significant PP-PTSD symptoms was identified in up to 16.8% of women in community samples of high quality studies. Negative subjective experience of childbirth emerged as the most important predictor. Endorsement of PTSD before childbirth contributed to PP-PTSD; nevertheless, women without PTSD also exhibited PP-PTSD, with acute rates at 4.6%, signifying a new PTSD onset in the postpartum period.Conclusion: Although the majority of women cope well, childbirth for some can be perceived as a highly stressful experience and even result in the development of PP-PTSD symptoms. More research is needed to understand postpartum adaption and childbirth-related posttraumatic stress outcomes.

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A Web-Based Survey of Mother-Infant Bond, Attachment Experiences, and Metacognition in Posttraumatic Stress Following Childbirth

Abstract: Metacognition may have a key role in postnatal psychological distress. Where postnatal depression or traumatic birth experiences are identified, screening for posttraumatic stress is strongly indicated.

Cited by 24 publications

References 94 publications

Parental Birth-Related PTSD Symptoms and Bonding in the Early Postpartum Period: A Prospective Population-Based Cohort Study

Parental Birth-Related PTSD Symptoms and Bonding in the Early Postpartum Period: A Prospective Population-Based Cohort Study

The role of posttraumatic stress and depression symptoms in mother-infant bonding

Childbirth Induced Posttraumatic Stress Syndrome: A Systematic Review of Prevalence and Risk Factors

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