Maternal Cognitions and Mother–Infant Interaction in Postnatal Depression and Generalized Anxiety Disorder

Journal of Abnormal Psychology (Impact Factor: 4.86). 01/2012; 121(4). DOI: 10.1037/a0026847
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Postnatal depression and anxiety have been shown to increase the risk of disturbances in mother-child interaction and child development. Research into mechanisms has focused on genetics and maternal behavior; maternal cognitions have received little attention. Our aim was to experimentally determine if worry and rumination in mothers with generalized anxiety disorder (GAD) and major depressive disorder (MDD), diagnosed in the postnatal 6 months, interfered with maternal responsiveness to their 10-month old infants. Mothers (N = 253: GAD n = 90; MDD n = 57; control n = 106) and their infants were randomized to either a worry/rumination prime (WRP) or a neutral prime (NP); mother-infant interactions were assessed before and after priming. Type of priming was a significant predictor of maternal cognitions, with WRP resulting in more negative thoughts, higher thought recurrence and more self-focus relative to NP across the entire sample. Interaction effects between group and priming were significant for two parenting variables: Compared with controls, WRP had a more negative impact on maternal responsiveness to infant vocalization for GAD, and to a lesser extent for MDD; WRP led to decreased maternal vocalization for GAD. Also, mothers with GAD used stronger control after the NP than WRP, as well as compared with other groups, and overall post-priming, their children exhibited lower emotional tone and more withdrawal. Across the entire sample, WRP was associated with increased child vocalization relative to NP. This study demonstrated that disturbances in maternal cognitions, in the context of postnatal anxiety and to a lesser degree depression, play a significant role in mother-child interaction. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

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    • "nd Eidelman , 2007 ) . Anxiety has a similar effect on the quality of mother – child interactions , even though the interactive behavior of these dyads has been less explored so far . In particular , recent literature focused on the cognitive components of anxiety and on the specific worries linked to the perinatal period ( Murray et al . , 2007 ; Stein et al . , 2012 ) ."
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    ABSTRACT: Maternal depression and anxiety represent risk factors for the quality of early mother-preterm infant interactions, especially in the case of preterm birth. Despite the presence of many studies on this topic, the comorbidity of depressive and anxious symptoms has not been sufficiently investigated, as well as their relationship with the severity of prematurity and the quality of early interactions. The Aim of this study was to evaluate the quality of early mother-infant interactions and the prevalence of maternal depression and anxiety comparing dyads of extremely low birth weight (ELBW) and very low birth weight (VLBW) preterm infants with full-term ones. Seventy seven preterm infants (32 ELBW; 45 VLBW) and 120 full term (FT) infants and their mothers were recruited. At 3 months of corrected age, 5 min of mother-infant interactions were recorded and later coded through the Global Ratings Scales. Mothers completed the Edinburgh Postnatal Depression Scale and Penn State Worry Questionnaire. Infant levels of development were assessed through the Griffiths Mental Development Scales. A relation emerged among the severity of prematurity, depression, anxiety, and the quality of interactions. When compared with the FT group, the ELBW interactions were characterized by high maternal intrusiveness and low remoteness, while the VLBW dyads showed high levels of maternal sensitivity and infant communication. Depression was related to maternal remoteness and negative affective state, anxiety to low sensitivity, while infant interactive behaviors were impaired only in case of comorbidity. ELBW's mothers showed the highest prevalence of depressive and anxious symptoms; moreover, only in FT dyads, low maternal sensitivity, negative affective state and minor infant communication were associated to the presence of anxious symptoms. The results confirmed the impact of prematurity on mother-infant interactions and on maternal affective state. Early diagnosis can help to plan supportive interventions.
    Frontiers in Psychology 09/2015; 6:1234. DOI:10.3389/fpsyg.2015.01234 · 2.80 Impact Factor
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    • "Depressed new mothers have been found to show a negative bias in interpreting infant facial expressions (Gil, Teissedre, Chambres, & Droit-Volet, 2011), to have more negative attitudes toward their baby and toward themselves as mothers (Fowles, 2010), to have lower levels of parenting efficacy (O'Neil, Wilson, Shaw, & Dishion, 2009), to think less of themselves as mothers (Horowitz, Damato, Duffey, & Solon, 2005), and to have more negative attitudes toward the mother role (Deave, 2005). Stein et al. (2012) found that anxious and depressed mothers of 10-month-old infants were significantly less responsive to their infants following priming with negative worry or ruminative thoughts. Parenting a neonate with an irritable temperament and poor motor control, characteristics that tend to inhibit a child's interpersonal responsiveness, has been associated with postnatal depression (Murray, 2006). "
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    ABSTRACT: Objective: This study explored the relationship of depressive cognitions, socially prescribed perfectionism and self-silencing, to postnatal depression and women’s beliefs about motherhood. The study aimed to replicate, with a postnatal sample, findings in the depression literature that link certain depressive cognitions with depressive symptoms. Additionally, the study explored a proposed model in which these cognitions influenced the development of dysfunctional maternal attitudes and postnatal depressive symptoms. Background: Postnatal depression and dysfunctional maternal attitudes are situated within the interactional model of depression. The importance of beliefs about interpersonal relationships that are thought to lead to depressive symptoms is explored and explained theoretically. Methods: A cross-sectional design used correlational and SEM path analysis to examine interrelationships between variables. Participants were 77 postnatal women from 18 to 38 years of age attending their regular gynaecological appointments 4–8 weeks after childbirth. Measures used included: Edinburgh Postnatal Depression Scale, Maternal Attitudes Questionnaire, Multidimensional Perfectionism Scale and the Silencing the Self Scale. Results: Socially prescribed perfectionism, externalised self-perception, self-silencing, the divided self and dysfunctional maternal attitudes were significantly correlated with postnatal depression (r = .354–.677) and with each other (r = .272–.574). SEM modelling (final model, χ2(7, 77) = .891, CFI = 1.000, RMSEA = .000) suggested that postnatal depression is most strongly related to externalised self-perception and socially prescribed perfectionism through the mediating effects of dysfunctional maternal attitudes and the divided self. Conclusions: Depressive cognitions were found to be related to postnatal depression in ways similar to depression in other life periods. The central finding of this study was the observation that dysfunctional maternal attitudes and the divided self-mediate the relationship between depressive cognitions and postnatal depression.
    Journal of Reproductive and Infant Psychology 01/2014; 32(1). DOI:10.1080/02646838.2013.858312 · 0.67 Impact Factor
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    • "Given the strong association between depression and anxiety,6 it is possible that some of the observed effects on child outcome are due, in part, to maternal anxiety or to the shared features of depression and anxiety. Also, there is emerging evidence that postpartum maternal GAD is associated with adverse childhood outcomes independent of maternal depression.20 Additionally, since the co-occurrence of GAD and MDD is associated with greater functional impairment than either disorder alone,21 it is possible that co-occurring GAD and MDD confers particular risk for negative outcomes among offspring. "
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    ABSTRACT: Background The objective was to examine the course and longitudinal associations of generalized anxiety disorder (GAD) and major depressive disorder (MDD) in mothers over the postpartum 2 years. Method Using a prospective naturalistic design, 296 mothers recruited from a large community pool were assessed for GAD and MDD at 3, 6, 10, 14, and 24 months postpartum. Structured clinical interviews were used for diagnoses, and symptoms were assessed using self-report questionnaires. Logistic regression analyses were used to examine diagnostic stability and longitudinal relations, and latent variable modeling was employed to examine change in symptoms. Results MDD without co-occurring GAD, GAD without co-occurring MDD, and co-occurring GAD and MDD, displayed significant stability during the postpartum period. Whereas MDD did not predict subsequent GAD, GAD predicted subsequent MDD (in the form of GAD + MDD). Those with GAD + MDD at 3 months postpartum were significantly less likely to be diagnosis free during the follow-up period than those in other diagnostic categories. At the symptom level, symptoms of GAD were more trait-like than those of depression. Conclusions Postpartum GAD and MDD are relatively stable conditions, and GAD is a risk factor for MDD but not vice versa. Given the tendency of MDD and GAD to be persistent, especially when comorbid, and the increased risk for MDD in mothers with GAD, as well as the potential negative effects of cumulative exposure to maternal depression and anxiety on child development, the present findings clearly highlight the need for screening and treatment of GAD in addition to MDD during the postpartum period.
    Depression and Anxiety 06/2013; 30(6). DOI:10.1002/da.22040 · 4.41 Impact Factor
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