Exploring the paths between dysfunctional attitudes towards motherhood and postpartum depressive symptoms: The moderating role of self‐compassion

Abstract

Better understanding how cognitive processes operate to influence women's depressive symptoms during the postpartum period is crucial for informing preventive and treatment approaches. The present study aimed to examine the relationship between women's dysfunctional attitudes towards motherhood and depressive symptoms, considering the mediating role of negative automatic thoughts and the moderating role of self-compassion. A sample of 387 women in the postpartum period cross-sectionally answered a set of questionnaires to assess dysfunctional attitudes towards motherhood, negative automatic thoughts (general and postpartum-specific), depressive symptoms and self-compassion. Women with clinically significant depressive symptoms presented more dysfunctional attitudes towards motherhood, more frequent negative thoughts and lower self-compassion. More dysfunctional beliefs about others' judgments and about maternal responsibility were associated with higher depressive symptoms, and this effect occurred through both general and postpartum-specific thoughts related to the metacognitive appraisal of the thought content. Moreover, these relationships occurred only when women presented low or moderate levels of self-compassion. These results highlight the need to comprehensively assess women's cognitive variables during the postpartum period with appropriate measures, for the early identification of women with more dysfunctional beliefs about motherhood, who may be at higher risk of depression.Moreover, preventive/treatment approaches should aim not only to challenge women's pre-existing dysfunctional beliefs but also to promote a more self-compassionate attitude towards themselves. Key Practitioner Messages | Cognitive Psychology & Psychotherapy• Women's more dysfunctional attitudes towards motherhood (particularly related with others' judgments and with maternal responsibility) may lead to more frequent negative automatic thoughts, and these negative thoughts may go beyond the postpartum specific context;• The relationship between women's more dysfunctional attitudes towards motherhood and depressive symptoms seem to occur via negative automatic thoughts, particularly related with the metacognitive appraisal of the thoughts' content;• Higher self-compassion levels buffers the relationship between women's attitudes towards motherhood and postpartum depressive symptoms;• Preventive and treatment approaches for postpartum depression should address the reappraisal of women's beliefs about motherhood and the promotion of a more self-compassionate attitude;

Dysfunctional beliefs towards motherhood and postpartum depressive and anxiety symptoms: Uncovering the role of experiential avoidance

“…First, our results show that more dysfunctional beliefs toward motherhood related with others’ judgments and with maternal responsibility were associated not only with higher depressive symptoms, congruently with prior research (Fonseca & Canavarro, ; Sockol et al., ; Wittkowski et al., ), but also with higher anxiety symptoms, suggesting that dysfunctional beliefs toward motherhood may be conceptualized as a broad cognitive vulnerability for postpartum psychological disorders (anxiety and depression) and not only for postpartum depression. Dysfunctional beliefs related to maternal responsibility and to the judgment of others seem to have underpinned the self‐imposed high standards of performance (the myth of perfect motherhood ) in the maternal role (Blissett & Farrow, ), which may translate into the women's conditioning of their personal value as a mother to their performance and the fear of failure and of others’ criticisms.…”

“…In the postpartum context, when women self‐impose high standards in their maternal performance (i.e., have more dysfunctional beliefs related with maternal responsibility and others’ judgments), they may present with more frequent postpartum‐specific negative automatic thoughts (Fonseca & Canavarro, ) and negative emotions, which they may have greater difficulties in accepting, and increase their tendency to engage in experiential avoidance strategies. These experiential avoidance strategies are intentional strategies to diminish or extinguish painful private experiences (e.g., negative thoughts) with which they are unwilling to cope (Hayes et al., ; Hayes et al., ), and may include strategies, such as rumination (as a way to realize why the person is thinking and feeling in a negative way; Barnum et al., ), or behavioral avoidance of activities that may lead to negative thoughts and feelings (e.g., avoidance of new experiences with the baby, by fearing that something might go wrong).…”

“…Dysfunctional beliefs toward motherhood encompass motherhood‐related beliefs characterized by themes of high performance standards— perfect motherhood —and maternal responsibility, personal inadequacy in the maternal role, and maternal role idealization (Sockol, Epperson, & Barber, ). Several studies found that dysfunctional beliefs toward motherhood predict the occurrence of depressive symptoms in the postpartum period (Fonseca & Canavarro, ; Phillips, Sharpe, Matthey, & Charles, ; Sockol et al., ; Thompson & Bendell, ; Wittkowski, Garrett, Cooper, & Wieck, ), being a cognitive vulnerability factor for postpartum depresison. Moreover, the studies conducted by Phillips et al.…”

Be a Mom, a Web-Based Intervention to Prevent Postpartum Depression: The Enhancement of Self-Regulatory Skills and Its Association With Postpartum Depressive Symptoms

“…The greater women’s ability to enhance such skills in the postpartum period, the greater their ability to deal with the private negative experiences (emotions and thoughts) associated with their parenting experience by being more aware and accepting of such emotions and by using more adaptive emotion regulation strategies (Haga et al, 2012). These women may also be able to adopt a kinder and more self-compassionate attitude toward their own experiences (Felder et al, 2016; Fonseca and Canavarro, 2018), which may help them to better address the unrealistic expectations of “perfect motherhood,” accept their vulnerable and human nature and be less judgmental toward themselves in the presence of motherhood-related negative experiences, both external and internal (e.g., thoughts/emotions) (Fonseca and Canavarro, 2018).…”

“…Finally, the role of self-compassion, understood as the individual’s ability to have a kind and caring attitude toward oneself in the face of personal inadequacies or suffering while acknowledging that all individuals share a common human condition (Neff, 2009, 2012), has also been highlighted. Lower levels of self-compassion were found to be associated with higher levels of postpartum depressive symptoms (Felder et al, 2016; Fonseca and Canavarro, 2018), and Cohen (2010) found that greater self-compassion during pregnancy can exert a protective effect on the development of postpartum depressive symptoms.…”