Perinatal depression, PTSD, and trauma: Impact on mother–infant attachment and interventions to mitigate the transmission of risk

Erickson, Nora L.; Julian, Megan M.; Muzik, Maria

doi:10.1080/09540261.2018.1563529

Cited by 106 publications

(95 citation statements)

References 151 publications

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“…Non-pharmacological interventions may benefit from the AS-based approach and help women to relieve psychological stress resulting from anxiety in close relationships. The AS-based intervention might mitigate maternal depression while indirectly improving mother–infant bonding which is an important mechanism for the transmission of depression to the offspring [ 54 , 55 ]. Moreover, the advance of our study was to perform a screening for PND during pregnancy and in the postpartum period, assessing crucial risk factors as recent life-stress events and the attachment style [ 50 , 56 ].…”

Section: Discussionmentioning

confidence: 99%

The anxious aspects of insecure attachment styles are associated with depression either in pregnancy or in the postpartum period

et al. 2020

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Background Perinatal depression (PND) is a major complication of pregnancy and many risk factors have been associated with its development both during pregnancy and postpartum. The transition to motherhood activates the attachment system. The aim of our study was to investigate the relationship between women’s attachment style (AS) and PND in pregnancy, and 1 month after childbirth, in a large cohort of women. We hypothesized that different patterns of AS were associated with either antenatal or postnatal depression. We, further, explored the role of other possible risk factors such as life-stress events. Methods A final sample of 572 women was enrolled. At the third trimester of pregnancy, clinical data sheet and self-report questionnaires (ASQ, PSS, LTE-Q, and EPDS) were administered. One month after delivery, EPDS was administered by telephone interview. Results We found 10.1% of the women with depression during pregnancy and 11.1% in the postpartum period. The first logistic regression showed that ASQ-CONF subscale (OR = 0.876, p < 0.0001), ASQ-NFA subscale (OR = 1.097, p = 0.002), foreign nationality (OR = 2.29, p = 0.040), low education levels (OR = 0.185, p = 0.012), PSS total score (OR = 1.376, p = 0.010), and recent life adversities (OR = 3.250, p = 0.012) were related to EPDS ≥ 14 during pregnancy. The second logistic regression showed that ASQ-PRE subscale (OR = 1.077, p < 0.001) and foreign nationality (OR = 2.88, p = 0.010) were related to EPDS ≥ 12 in the postpartum period. Conclusions Different dimensions of anxious insecure AS were, respectively, associated with either antenatal or postnatal depression. These findings support the literature investigating subtypes of perinatal depression. The PND may be heterogeneous in nature, and the comprehension of psychopathological trajectories may improve screening, prevention, and treatment of a disorder which has a long-lasting disabling impact on the mental health of mother and child. We provided a rationale for targeting an attachment-based intervention in this group of women.

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Section: Discussionmentioning

confidence: 99%

The anxious aspects of insecure attachment styles are associated with depression either in pregnancy or in the postpartum period

et al. 2020

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“…Postnatal mental disorders often begin during or before pregnancy, and it is difficult to disentangle the effects of genetics, prenatal exposure and broader familial/social confounding from the discrete effects of postnatal mental illness. However, a key mechanism for transmission of risk to infants, with substantial theoretical and empirical support, is impaired attachment related to low maternal sensitivity and “parental mentalization” 72,73 . Insecure or disorganized attachment is associated with externalizing (and, to a lesser extent, internalizing) childhood prob‐lems 74,75 .…”

Section: Association Between Perinatal Mental Disorders and Maternal mentioning

confidence: 99%

“…There is a parallel literature examining the impact of transdiagnostic interventions for the intergenerational cycles of developmental trauma often associated with perinatal mental disorders 73,94 . In addition, some perinatal interventions target depression, anxiety and/or trauma symptoms and other risk factors for adverse child outcomes, such as substance misuse, smoking and unsafe infant care practices, with promising results 95 .…”

Section: Interventionsmentioning

confidence: 99%

Perinatal mental health: a review of progress and challenges

2020

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Perinatal mental health has become a significant focus of interest in recent years, with investment in new specialist mental health services in some high‐income countries, and inpatient psychiatric mother and baby units in diverse settings. In this paper, we summarize and critically examine the epidemiology and impact of perinatal mental disorders, including emerging evidence of an increase of their prevalence in young pregnant women. Perinatal mental disorders are among the commonest morbidities of pregnancy, and make an important contribution to maternal mortality, as well as to adverse neonatal, infant and child outcomes. We then review the current evidence base on interventions, including individual level and public health ones, as well as service delivery models. Randomized controlled trials provide evidence on the effectiveness of psychological and psychosocial interventions at the individual level, though it is not yet clear which women with perinatal mental disorders also need additional support for parenting. The evidence base on psychotropic use in pregnancy is almost exclusively observational. There is little research on the full range of perinatal mental disorders, on how to improve access to treatment for women with psychosocial difficulties, and on the effectiveness of different service delivery models. We conclude with research and clinical implications, which, we argue, highlight the need for an extension of generic psychiatric services to include preconception care, and further investment into public health interventions, in addition to perinatal mental health services, potentially for women and men, to reduce maternal and child morbidity and mortality.

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“…Non pharmacological interventions may bene t from the AS based approach and help women to relieve psychological stress resulting from anxiety in close relationships. The AS based intervention might mitigate maternal depression while indirectly improving mother-infant bonding which is an important mechanism for the transmission of depression to the offspring [40,41]. Although our results along with the treatment implications are compelling, we recognize some limitations.…”

Section: Discussionmentioning

confidence: 83%

The Anxious Aspects of Insecure Attachment Styles are Associated with Depression Either in Pregnancy or in the Postpartum Period

Bianciardi¹,

Vito

Betrò

et al. 2020

Preprint

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Background: Perinatal depression (PND) is a major complication of pregnancy and many risk factors have been associated with its development both during pregnancy and postpartum. The transition to motherhood activates the attachment system. The aim of our study was to investigate the relationship between women`s attachment style (AS) and PND in pregnancy, and 1-month after childbirth, in a large cohort of women. We hypothesized that different patterns of AS were associated with either antenatal or postnatal depression. We, further, explored the role of other possible risk factors such as life stress events.Methods: A final sample of 572 women was enrolled. At the third trimester of pregnancy, clinical data sheet and self-report questionnaires (ASQ, PSS, LTE-Q, EPDS) were administered. One month after delivery, EPDS was administered by telephone interview.Results: We found 10.1% of the women with depression during pregnancy and 11.1% in the postpartum period. The first logistic regression showed that ASQ-CONF subscale (OR=0, respectively, .876, p<0.0001), ASQ-NFA subscale (OR=1.097, p=0.002), foreign nationality (OR=2.29, p=0.040), low education levels (OR=0.185, p=0.012), PSS total score (OR=1.376, p=0.010), and recent life adversities (OR=3.250, p=0.012) were related to EPDS ≥14 during pregnancy. The second logistic regression showed that ASQ-PRE subscale (OR=1.077, p<0.001) and foreign nationality (OR=2.88, p=0.010) were related to EPDS ≥12 in the postpartum period.Conclusions: Different dimensions of anxious insecure AS were, respectively, associated with either antenatal or postnatal depression. These findings support the literature investigating subtypes of perinatal depression. The PND may be heterogeneous in nature, and the comprehension of psychopathological trajectories may improve screening, prevention and treatment of a disorder which has a long-lasting disabling impact on the mental health of mother and child. We provided a rationale for targeting an attachment-based intervention in this group of women.

show abstract

Perinatal depression, PTSD, and trauma: Impact on mother–infant attachment and interventions to mitigate the transmission of risk

Cited by 106 publications

References 151 publications

The anxious aspects of insecure attachment styles are associated with depression either in pregnancy or in the postpartum period

The anxious aspects of insecure attachment styles are associated with depression either in pregnancy or in the postpartum period

Perinatal mental health: a review of progress and challenges

The Anxious Aspects of Insecure Attachment Styles are Associated with Depression Either in Pregnancy or in the Postpartum Period

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