Article

The impact of paternity leave and paternal involvement in child care on maternal postpartum depression

Authors:
  • Université de Poitiers, Centre de Recherches sur la Cognition et l’Apprentissage
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Abstract

Objectives: The aim of the study was to explore the impact of paternity leave and paternal involvement and notably paternal participation in infant care on the development of symptoms of maternal postpartum depression. Method: At 2–5 days postpartum, a sample of 119 couples completed the Edinburgh Postnatal Depression Scale (EPDS), assessing postpartum depression. Mothers also completed the Multidimensional Scale of Perceived Social Support (MSPSS). At 2 months postpartum, 4 questionnaires were completed: the EPDS, the MSPSS, the Maternal Attitude Questionnaire (MAQ), measuring cognitions relating to role change and expectations of motherhood, as well as a questionnaire assessing paternal involvement in infant care. Fathers also completed the EPDS and a questionnaire assessing paternal involvement in infant care. Results: Paternity leave was not highlighted as a significant protective factor against postpartum depression. However, the lack of paternal involvement in infant care was significantly associated with maternal depression intensity. Discussion: Our findings highlight the importance of encouraging and taking into account paternal involvement in infant care as early as possible.

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... 17 studies were based on a quasi-experimental design, [17][18][19][20][21][22][23]26,27,29,31,36,37,40,44,48,61 including six uncontrolled before-after studies, [19][20][21]36,37,61 six controlled beforeafter studies, 18,22,23,31,40,44 two cohort studies, 27,29 and three cross-sectional studies. 17,26,48 28 studies were observational, 24,25,28,30,[32][33][34][35]38,39,[41][42][43][45][46][47][49][50][51][52][53][54][55][56][57][58][59][60] including 15 cohort studies 25,30,34,35,39,41,42,45,47,[49][50][51]53,56,60 and 13 cross-sectional studies. 24,28,32,33,38,43,46,52,54,55,[57][58][59] 38 studies were of medium or high quality. ...
... 17 studies were based on a quasi-experimental design, [17][18][19][20][21][22][23]26,27,29,31,36,37,40,44,48,61 including six uncontrolled before-after studies, [19][20][21]36,37,61 six controlled beforeafter studies, 18,22,23,31,40,44 two cohort studies, 27,29 and three cross-sectional studies. 17,26,48 28 studies were observational, 24,25,28,30,[32][33][34][35]38,39,[41][42][43][45][46][47][49][50][51][52][53][54][55][56][57][58][59][60] including 15 cohort studies 25,30,34,35,39,41,42,45,47,[49][50][51]53,56,60 and 13 cross-sectional studies. 24,28,32,33,38,43,46,52,54,55,[57][58][59] 38 studies were of medium or high quality. ...
... Studies were done in Australia, 21,36,60 Canada, 19,30 Chile, 17 Denmark, 20 Europe, 18 France, 56 Germany, 53 Ireland, 52 Japan, 49,61 Norway, 23 Sweden, 37,45,47,55 and the USA. 22,[24][25][26][27][28][29][31][32][33][34][35][38][39][40][41][42][43][44]46,48,50,51,54,[57][58][59] Most studies examined parents aged between 18 years and 40 years. ...
Article
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Mental health disorders during the post-partum period are a common morbidity, but parental leave might help alleviate symptoms by preventing or reducing stress. We aim to summarise available evidence on the effect of different types of parental leave on mental health outcomes among parents. For this systematic review, we searched Ovid MEDLINE, Web of Science, PsycINFO, CINAHL, and Scopus from database inception to Aug 29, 2022, for peer-reviewed, quantitative studies written in English. We included studies if the exposure was postnatal parental leave; a relevant comparison group was present (eg, paid vs unpaid leave); and if indicators related to general mental health, including depression, anxiety, stress, and suicide, for either parent were evaluated or recorded at any time after childbirth. The Review is registered with PROSPERO (registration number CRD42021227499). Of the 3441 records screened, 45 studies were narratively synthesised. Studies were done in high-income countries, and they examined generosity by any parental leave (n=5), benefit amount (n=13), and leave duration (n=31). 38 studies were of medium or high quality. Improved mental health was generally observed among women (referred to as mothers in this Review) with more generous parental leave policies (ie, leave duration and paid vs unpaid leave). For example, increased duration of leave was generally associated with reduced risk of poor maternal mental health, including depressive symptoms, psychological distress and burnout, and lower mental health-care uptake. However, the association between fathers’ leave and paternal mental health outcomes was less conclusive as was the indirect effect of parental leave use on partners’ mental health.
... Partner parental support was considered as an important resource to compensate for parenting stress and to prevent parenting-related exhaustion since it helps to maintain or restore the parent's equilibrium between demands and resources in the specific area of parenthood (Parfitt and Ayers 2014;Séjourné et al. 2012). Partner parental support is defined as the support that partners offer each other in the specific area of parenting. ...
... parental burnout) are recent concepts, previous studies rather considered general couple or spousal support in relation to parenting stress. Couple support has been shown to play a protective role with regard to stress and emotional difficulties related to parenting (Parfitt and Ayers 2014;Séjourné et al. 2012). For example, Sampson et al. (2015) highlighted a negative association between emotional and concrete support and parenting stress in mothers at one year postpartum, and we reported a negative relation between spousal support and distress symptoms in new fathers at three months after childbirth (Gillis et al. 2019). ...
... Over a week, the more mothers received parental support from their partner, the higher the quality of the relationship with her child(ren) was during the next weekend. This was consistent with previous studies, in which parental support from the father was found to be an essential resource (Parfitt and Ayers 2014;Sampson et al. 2015;Séjourné et al. 2012). In addition, for mothers who were slightly exhausted, partner parental support played a moderating role within the association between parenting-related exhaustion and the quality of the mother-child relationship. ...
Article
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Objective The current study aimed to analyze the effect of parenting-related exhaustion on the quality of the parent–child relationship and to explore the moderating role of partner parental support within this association. Method The method was based on longitudinal data collection and a multi-informant design in which 157 mothers and 157 fathers completed questionnaires once a day during one week. Our statistical model used structural equation modeling. Results Analyses revealed that parenting-related exhaustion had a negative impact on the quality of the parent–child relationship both for mothers (β = −0.17, p < 0.05) and fathers (β = −0.22, p < 0.05). Our results also provide evidence that partner parental support plays a role in compensating for deleterious consequences of parenting-related exhaustion among mothers as long as such exhaustion remains at a low level (β = −0.26, p < 0.05). Conclusions Our results provide support for ongoing research into this topic in relation to both mothers and fathers not only in clinically-referred families but also in ordinary ones, to allow preventive measures to be developed and implemented.
... While there is less information on the specific domains of support women need postnatally from their partners, emotional and instrumental support frequently have a protective effect against postpartum depression (Small et al., 1994;Stuchbery et al., 1998;Takeda et al., 1998;Cooper et al., 1999;Ramchandani et al., 2009;Séjourné et al., 2012;Kara et al., 2013). For example, in the large South African cohort, lack of emotional support from the partner was significantly associated with postpartum depression (Ramchandani et al., 2009). ...
... For example, in the large South African cohort, lack of emotional support from the partner was significantly associated with postpartum depression (Ramchandani et al., 2009). In 119 postpartum couples in France, partner practical support was a significant protective factor for postpartum depression (Séjourné et al., 2012). Similar findings have also been reported in the United Kingdom (Stuchbery et al., 1998), Australia (Small et al., 1994), Turkey (Kara et al., 2013), and elsewhere. ...
... While the sampling period was 2001-2002, we believe that the PPSS is time-invariant, given the fundamental nature of social support and the theoretical relationships between support and depression which continue to be supported empirically (Spangenberg and Pieters 1991;Jadresic et al., 1993;Small et al., 1994;McGill et al., 1995;Viinamaki et al., 1997;Stuchbery et al., 1998;Takeda et al., 1998;Cooper et al., 1999;Glasser et al., 2000;Matthey et al., 2000;Danaci et al., 2002;Fisher et al., 2002;Gross et al., 2002;Patel et al., 2002;Lee et al., 2004;Figueiredo et al., 2008;Ramchandani et al., 2009;Escriba-Aguir and Artzacoz, 2011;Fisher et al., 2012;Giardinelli et al., 2012;Séjourné et al., 2012;Kara et al., 2013;Martini et al., 2015). While initial support for the reliability and validity of the PPSS was provided, this instrument should be tested in more diverse samples and across cultures before being applied widely in clinical settings. ...
Article
The majority of women discontinue breastfeeding before the recommended 6 months postpartum. If health professionals are to improve breastfeeding outcomes, predisposing factors amenable to intervention need to be identified. One possible risk factor to target is breastfeeding self-efficacy, which has been shown to significantly influence breastfeeding outcomes. The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) was originally designed to assess a mother's confidence in her ability to breastfeed. Fathers play an important role in supporting their breastfeeding partner and their self-efficacy may also influence breastfeeding outcomes. However, it is unknown if the BSES-SF is a valid and reliable measure for measuring self-efficacy among fathers. The goal of this study is to assess the psychometric properties of the BSES-SF among fathers. Fathers (n=214) whose partners were breastfeeding were recruited from a large hospital in Toronto, Canada. Fathers completed the modified BSES-SF in-hospital and at 6 weeks postpartum. The unidimensional structure of the BSES-SF was confirmed, with the best model fit found at 6 weeks. Cronbach's alpha coefficient was 0.91 at baseline and 0.92 at 6 weeks. Paternal BSES-SF scores were significantly correlated with maternal BSES-SF scores, fathers' breastfeeding attitude, importance fathers place on breastfeeding, breastfeeding level and exclusivity, and perception of breastfeeding progress. While paternal in-hospital BSES-SF scores did not predict breastfeeding at 6 and 12 weeks, 6 week BSES-SF scores predicted exclusivity at 12 weeks. This study provides initial evidence that the modified BSES-SF is a valid and reliable measure of breastfeeding self-efficacy among fathers, especially when used following hospital discharge.
... While there is less information on the specific domains of support women need postnatally from their partners, emotional and instrumental support frequently have a protective effect against postpartum depression (Small et al., 1994;Stuchbery et al., 1998;Takeda et al., 1998;Cooper et al., 1999;Ramchandani et al., 2009;Séjourné et al., 2012;Kara et al., 2013). For example, in the large South African cohort, lack of emotional support from the partner was significantly associated with postpartum depression (Ramchandani et al., 2009). ...
... For example, in the large South African cohort, lack of emotional support from the partner was significantly associated with postpartum depression (Ramchandani et al., 2009). In 119 postpartum couples in France, partner practical support was a significant protective factor for postpartum depression (Séjourné et al., 2012). Similar findings have also been reported in the United Kingdom (Stuchbery et al., 1998), Australia (Small et al., 1994), Turkey (Kara et al., 2013), and elsewhere. ...
... While the sampling period was 2001-2002, we believe that the PPSS is time-invariant, given the fundamental nature of social support and the theoretical relationships between support and depression which continue to be supported empirically (Spangenberg and Pieters 1991;Jadresic et al., 1993;Small et al., 1994;McGill et al., 1995;Viinamaki et al., 1997;Stuchbery et al., 1998;Takeda et al., 1998;Cooper et al., 1999;Glasser et al., 2000;Matthey et al., 2000;Danaci et al., 2002;Fisher et al., 2002;Gross et al., 2002;Patel et al., 2002;Lee et al., 2004;Figueiredo et al., 2008;Ramchandani et al., 2009;Escriba-Aguir and Artzacoz, 2011;Fisher et al., 2012;Giardinelli et al., 2012;Séjourné et al., 2012;Kara et al., 2013;Martini et al., 2015). While initial support for the reliability and validity of the PPSS was provided, this instrument should be tested in more diverse samples and across cultures before being applied widely in clinical settings. ...
Article
Background: postpartum depression is a significant public health issue with well-documented negative consequences. A strong risk factor that has been consistently identified in international samples is a poor partner relationship. However, no instrument exists to measure postpartum-specific partner support. Objectives: the objective of this methodological study was to develop and psychometrically test an instrument to assess the perception of postpartum partner support to guide interventions. Design: using a theoretical model of social relationships and the functional elements of social support, the Postpartum Partner Support Scale was developed and content validity was judged by experts. Following a pilot test, the Postpartum Partner Support Scale was psychometrically assessed. Settings: the study was conducted in a health region near Vancouver, British Columbia. Participants: 396 women at 1, 4, and 8 weeks postpartum. Methods: the psychometric assessment included analysis of internal consistency, exploratory factor analysis, composite reliability, and concurrent and predictive validity. Findings: the Cronbach's alpha for the Postpartum Partner Support Scale was 0.96, and exploratory factor analysis revealed a unidimensional solution. The Postpartum Partner Support Scale was positively correlated with general partner support and global social support and negatively correlated with perceived stress and child care stress. It also predicted maternal depressive and anxiety symptoms at 8 weeks postpartum among those without depression or anxiety at 1 or 4 weeks postpartum, respectively. Conclusions: following further psychometric testing, the Postpartum Partner Support Scale may be used to (1) identify women with inadequate partner support who are at risk for poor mental health, (2) individualise postnatal care, and (3) evaluate preventive interventions.
... 2,3 Feeling socially supported as well as reporting overall relationship satisfaction have been associated with reduced odds of post-partum depression among mothers and fathers. [4][5][6] Because paternity leave can provide fathers with the opportunity to support their partner in the household and in child-rearing tasks as well as increase opportunities for father-child bonding moments, 4,5 its use might be a protective factor against post-partum depression onset in mothers and fathers. 4 According to two meta-analyses done in 2010 8 and 2018, 7 post-partum depression is common in new parents. ...
... 7 For fathers, the prevalence of post-partum depression varied in the year following their child's birth: 8·0% (5·0-11·0) from birth to 3 months, 26·0% (17·0-36·0) at 3-6 months, and 9·0% (5·0-15·0) at 6-12 months. Considering the detrimental consequences of post-partum depression on family health and children's development, 9 including marital and sibling conflict, 5,6 difficulty breastfeeding, 5,10 lack of mother-child bonding, 5,11 and slowed emotional development in children, 9,10 policies that can contribute to reducing the burden of post-partum depression, are important and need to be investigated. ...
Article
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Background Several countries are expanding their paternity leave policies, which can have positive effects on parental mental health. We examined whether 2 weeks of paid paternity leave are associated with post-partum depression in mothers and fathers at 2 months after the birth of their child. Methods We used data from the Etude Longitudinale Française depuis l’Enfance (ELFE) cohort study. Participating mothers gave birth in 2011 in a representative sample of 320 maternity hospitals in mainland France. Inclusion criteria were single or twin livebirths born after at least 33 weeks’ gestation; mother's age at least 18 years; no plans to leave metropolitan France within 3 years. Mothers were interviewed face-to-face shortly after the child's birth. Fathers and mothers were both interviewed by telephone 2 months after the child's birth, reporting whether the father had the right to paternity leave and if yes, if he had taken or intended to take it. We used the Edinburgh Postnatal Depression Scale to assess post-partum depression among fathers and mothers at 2 months. Logistic regression models, using survey-weighted data and adjusted for confounders using inverse probability weights, yielded odds ratios (ORs). Findings We included 10 975 fathers and 13 075 mothers with reported information on paternity leave and post-partum depression at 2 months in the statistical analyses. Fathers had a median age of 32·6 years (IQR 36·9–22·6) and mothers had a median age of 30·5 years (34·0–27·1) at the time of the ELFE child's birth. The prevalence of depression in fathers according to paternity leave status was 4·5% among those who used paternity leave, 4·8% among those who intended to use paternity leave, and 5·7% among those who did not use paternity leave. For mothers, the prevalence of post-partum depression was 16·1% among those whose partner used paternity leave, 15·1% among those whose partner intended to use paternity leave, and 15·3% among those whose partner did not use paternity leave. Fathers who took paternity leave had reduced odds of post-partum depression (OR 0·74 [95% CI 0·70–0·78]) as did fathers who intended to take paternity leave (0·76 [0·70–0·82]) compared with fathers who did not take paternity leave. However, we did not find such beneficial effects for mothers whose partners took (1·13 [1·05–1·20]) or intended to take paternity leave (1·02 [0·96–1·08]). Interpretation Taking and intending to take 2-weeks’ paid paternity leave was associated with a reduced likelihood of reporting post-partum depression in fathers. However, offering 2-weeks’ paternity leave might place mothers at a greater risk of post-partum depression, suggesting that optimal length and timing of the leave, among other factors, need further investigation. Funding The French National Research Agency.
... Furthermore, the role of paternal involvement in maternal mental health is especially under studied in Eastern countries as most previous studies on the relationship between fathers' involvement and maternal mental health are in Western cultural backgrounds (Kim et al. 2020;Sejourne et al. 2012). Actually, the role of paternal childcare involvement in maternal mental health warrants special attention in Eastern culture because Chinese father's role in childcare was traditionally absent for a large part of history. ...
... Our finding that fathers' childcare involvement is associated with lower levels of PPD is consistent with previous research conducted in Western and Asian countries (de Mendonça et al. 2012;Kasamatsu et al. 2021;Lin et al. 2017;Sejourne et al. 2012;Yakupova & Liutsko 2021). Maselko and colleagues found that greater paternal involvement predicted lower levels of maternal depression in rural Pakistan (Maselko et al. 2019). ...
Article
Full-text available
Depression and anxiety are among the most common morbidities during the perinatal period. Very few studies have been conducted to examine the association between paternal childcare involvement and postpartum depression (PPD) and anxiety (PPA) in East Asian cultures. This study aims to examine the association between fathers’ involvement in childcare and mothers’ mental health and explores the potential mediating effects of the mother and child’s health among a national sample of Chinese women. This is a cross-sectional, self-administered online survey of maternal women (N = 778) within 1 year after childbirth in China. The questionnaire comprised of sociodemographics, fathers’ childcare involvement, child and mother’s physical health, and mothers’ postpartum mental health status. A path analysis model was constructed to examine the correlation between paternal childcare involvement and maternal depression and anxiety within 1-year postpartum. The mediating effect of the mother and child’s physical health was also explored in the model. Paternal involvement in childcare was significantly associated with lower PPD (β = − .36, p < 0.001) and PPA (β = − .29, p < 0.001) levels of mothers after covariates were adjusted. Furthermore, women’s physical health partially mediated the association between paternal involvement and PPD, and child’s health partially mediated the association between paternal involvement and PPA and PPD. Our findings emphasize the essential role of father’s childcare involvement and the need to promote culturally tailored intervention programs, which may improve the mental health status among Chinese postpartum mothers.
... 4 Paternal leave has also been associated with improved maternal health outcomes, improved childhood educational outcomes, lower rates of divorce, and improved paternal engagement in the child-parent relationship. [9][10][11] While there is the impression that taking parental leave has a negative effect on a physician's career and colleagues, physicians view their colleagues taking leave less negatively. 12 Institutional culture also likely plays a significant role in how physicians view the impact of parental leave. ...
... 14 Many other countries such as Australia and countries in the European Union have national leave policies which apply to their medical trainees. 11,12 There is a paucity of similar Canadian literature around parental leave policies for medical trainees and Canadian provincial or federal policies do not universally apply to medical residents. ...
Article
Background In recent decades, the gender makeup of Canadian medical residents has approached parity. As residency training years coincide closely with childbearing years and paid parental leave is associated with numerous benefits for both parents and children, it is important for there to be clarity about parental leave benefits. Objectives We aimed to conduct a comprehensive review of maternity and parental leave policies in all residency education programs in Canada, to highlight gaps that might be improved or areas in which Canadian programs excel. Methods We searched websites of the 8 provincial housestaff organizations (PHOs) for information regarding pregnancy workload accommodations, maternity leave, and parental leave policies in each province in effect as of January 2020. We summarized the policies and analyzed their readability using the Flesch Reading Ease. Results All Canadian PHOs provide specific accommodations around maternity and parental leave for medical residents. All organizations offer at least 35 weeks of total leave, while only 3 PHOs offer extended leave of about 63 weeks, in line with federal regulations. All but 2 PHOs offer supplemental income to their residents, although not for the full duration of offered leave. All PHOs offer workplace accommodations for pregnant residents in their second and/or third trimester. Conclusions Although all provinces had some form of leave, significant variability was found in the accommodations, duration of leave, and financial benefits provided to medical residents on maternity and parental leave across Canada. There is a lack of clarity in policy documents, which may be a barrier to optimal uptake.
... Blocks of predictor (independent) variables were selected based on pre-defined factors in research protocols informed by a systematic review preceding this work [26]. Explicit conceptual framework on variables selection is provided in the research protocol [34]. Details of these blocks of independent variables were entered into each of the successive multinomial logistic regression models, and their measurements are described below. ...
... In a systematic review, it was inferred that mothers suffering from depression are less likely to initiate breastfeeding; if they do, it will be with decreased duration, and EBF will be less likely [81]. Based on a literature review, it was noted that negative outcomes for infants are due to maternal depression and disorganized infant feeding practices [82], which result in overfeeding or undernutrition [34,83,84]. Another recent study has found that postpartum anxiety increases breastfeeding difficulties and may negatively affect breastfeeding behaviors [85]. ...
Article
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Background: Infant feeding practices are imperative for babies' and mothers' health and emotional wellbeing. Although infant feeding may seem simple, the decisions surrounding it are complex and have far-reaching implications for women globally. This is an especially difficult concern among mothers living with HIV because breastfeeding can transmit HIV from mother to child. This is further complicated by cultural expectations in case of Black mothers living with HIV. This paper discusses determinants of infant feeding practices among Black mothers living with HIV who were on anti-retroviral therapy (ART) in two North American cites and one African city. Methods: A cross-sectional, multi-country survey using venue-based convenience sampling of Black mothers living with HIV was employed. The effective response rates were 89% (n = 89) in Ottawa, Canada; 67% (n = 201) in Miami, Florida, US; and 100% (n = 400) in Port Harcourt, Nigeria, equaling a total sample size of 690. Data were collected in Qualtrics and managed in Excel and SPSS. Multinomial logistic regression analyses were used to determine the factors influencing the mothers' infant feeding practices (Exclusive Formula Feeding [EFF] = 1; Mixed Feeding [MF] = 2; and Exclusive Breastfeeding [EBF while on ART] =3). Results: The results highlight socio-demographics, EFF determinants, and EBF determinants. The statistically significant determinants of infant feeding practices included national guideline on infant feeding, cultural beliefs and practices, healthcare systems, healthcare personnel, infant feeding attitudes, social support, and perceived stress. Mothers' mean ages were Ottawa (36.6 ± 6.4), Miami (32.4 ± 5.8), and Port Harcourt (34.7 ± 5.7). All sampled women gave birth to least one infant after their HIV diagnoses. Statistically significant (p < .05) determinants of EFF relative to MF were the national guideline of EFF (relative risk [RR] = 218.19), cultural beliefs (RR = .15), received healthcare (RR = 21.17), received healthcare through a nurse/midwife (RR = 3.1), and perceived stress (RR = .9). Statistically significant determinants of EBF relative to MF were received healthcare (RR = 20.26), received healthcare through a nurse/midwife (RR = 2.31), functional social support (RR = 1.07), and perceived stress (RR = .9). Conclusion: While cultural beliefs and perceived stress favoured MF over EFF, advice of healthcare workers, and the care received from a nurse/midwife improved EFF over MF. Also while the mothers' perceived stress favoured MF over EBF, advice of their nurses or midwife and the social support improved EBF over MF. The providers advice was congruent with WHO and national guidelines for infant feeding among mothers living with HIV. These results have implications for nursing, healthcare practice, and policies on infant feeding practices for mothers living with HIV.
... When fathers on leave are perceived as helpful, their physical and emotional availability is one of the larger contributing factors to the psychological wellbeing of childbearing mothers in the period after childbirth (Seiger & Weise 2011). According to Sejourne et al. (2012), "Generally, a high level of perceived social support is associated with less psychological distress during the postpartum period" (136). When men take leave, mothers are better supported in the period around childbirth, which Saxbe, Rossin-Slater, and Goldenberg (2018) as a critical window for adult health. ...
... When men take leave, mothers are better supported in the period around childbirth, which Saxbe, Rossin-Slater, and Goldenberg (2018) as a critical window for adult health. In a study on the impact of paternity leave-taking on maternal postpartum depression (PPD), Sejourne et al. (2012) find that while fathers' leave-taking does not protect against PPD, paternal involvement in the early stages of infancy is strongly correlated with mothers' wellbeing. In another case, following implementation of a 4-week "daddy quota" in Norway, couples reported fewer conflicts over household division of labor than those who had children before the reform. ...
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Across high and low-income countries alike, paid parental leave has been identified for its strong potential to improve health outcomes for both children and parents and to reduce economic and gendered inequality (Heyman et al. 2017). This review will evaluate the welfare arguments for extending equitable leave rights to fathers in order to improve family wellbeing and related sustainable development outcomes. Using Amartya Sen's capabilities approach and Martin Seligman's PERMA indicator model for mental and emotional wellbeing as complementary frameworks, I analyze how gender-inclusive leave policies, as opposed to mother-only and gender-neutral leave, enable happier and more capable families while also advancing economic prosperity and gender equality. In particular this paper will focus on 2030 Sustainable Development Goals 3, 5, and 8-good health and wellbeing, gender equality, and decent work and economic growth. My results find that the inclusion of equitable leave for fathers in paternity leave schemes enables families to 'be and do' more, more happily when parents are able to choose who works and who cares for their child amongst themselves.
... Several studies have highlighted the role of partners in buffering children's development from the impact of parental psychosocial functioning, especially in terms of mental health and affective disorders, which arise during the first 12 months postpartum [24]. Indeed, fathers represent an important source of support and assistance for mothers during the first months postpartum [25]. For these reasons, it may be hypothesized that the protective role of paternal involvement in sleep care and children's sleep quality could be stronger during the first year of life than during toddlerhood. ...
... Research has suggested that paternal involvement may have a positive effect on parental well-being and family functioning. For example, paternal involvement in child-caregiving responsibilities was found to be a central buffer against maternal distress and depression during the transition to parenthood [25,48]. Indeed, high paternal involvement may relate to a better emotional climate of the family [49] and thus provide a better source of emotional and instrumental support for the mothers [50]. ...
Article
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Background: Sleep regulation and consolidation represent critical developmental processes that occur in the first years of life. Recent studies have highlighted the contribution of caregivers to sleep development. However, the majority of them have primarily focused on maternal behaviors, overlooking fathers. The main goal of the present study was to investigate the associations between paternal and maternal involvement in children's sleep care and the number of night awakenings reported by both parents in infants and toddlers. Methods: One-hundred-and-one families of infants aged 8 to 12 months and 54 families of toddlers aged 18 to 36 months filled out the following self-report questionnaires: The Brief Infant Sleep Questionnaire and an ad hoc questionnaire to assess parental involvement in sleep care for children. A moderate actor-partner interdependence (APIM) with path analysis was performed to test the predictive role of parental involvement on the children's sleep (no. of nocturnal awakenings) and the moderation role of age on these relationships. Results: Paternal involvement in children's sleep care was associated with the number of night awakenings reported by both parents. Moreover, a significant interaction effect emerged between the children's age and paternal involvement in children's sleep care for predicting nocturnal awakenings. Conclusions: The main outcomes of this study point to the protective role of paternal involvement in children's sleep during the first years of life.
... Increased support from fathers may also be more beneficial to working mothers, compared to mothers who do not work. Indeed, evidence from European studies suggests that paternity leave may help to reduce mothers' stress and facilitate a quicker return to the labor force for working mothers (Gault et al., 2014;Johansson, 2010;Sejourne et al., 2012). Thus, paternity leave may be more likely to promote relationship satisfaction and reduce conflict in dual-income families, compared to families in which only the father works in paid labor. ...
... Taking time off work may signal a commitment by fathers to learn how to coparent, and negotiate a balanced work and family life, together (Rehel, 2014). Paternity leave may also enable fathers to help out after returning home from the hospital, which may alleviate some of mothers' stress and allow mothers to recover physically and mentally from childbirth (Gault et al., 2014;Sejourne et al., 2012). As such, paternity leave-taking and longer lengths of leave may enable mothers to (re)enter the labor force sooner (Johansson, 2010). ...
Article
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Objective: This study examines the associations between paternity leave and parents' reports of relationship satisfaction and relationship conflict and whether the associations vary by parent gender and mothers' work statuses. Background: Paternity leave research in the United States has focused on implications for father involvement, but paternity leave may also help to strengthen parental relationships by promoting a more equitable division of domestic labor. Given gender gaps in child care, the association between paternity leave and parental relationship outcomes may also vary by gender and mothers' work statuses. Method: The sample consists of 4,700 couples (i.e., parent dyads) from the Early Childhood Longitudinal Study, Birth Cohort. Multilevel models are used to assess the associations between paternity leave and both relationship satisfaction and conflict and whether these associations vary by gender and mothers' work statuses. Results: Paternity leave‐taking is positively associated with parents' reports of relationship satisfaction, but length of paternity leave is only positively associated with mothers' reports of relationship satisfaction. Also, among mothers who worked prior to the child's birth, paternity leave‐taking and length of leave are negatively associated with their reports of relationship conflict. In contrast, among `mothers who did not work in paid labor prebirth, paternity leave is positively associated with mothers' reports of relationship conflict. Conclusion: Paternity leave may have implications for parental relationships (and especially mothers' perceptions of their relationships with fathers).
... Early recognition of maternal depression may enhance and promote healthy infant development and prevent adverse health outcomes like excessive weight gain in infants due to inappropriate feeding practices. Manson et al. (2011), in their study examining whether positive results in maternal postpartum depression screening was associated with maternal reports of poorer infant social-emotional development, found that negative outcomes for infants were due to maternal depression and disorganized infant feeding practices that resulted in overfeeding or under-nutrition (Rondinelli et al., 2011;Sejourne, Vaslot, Beaume, Goutaudier, & Chabrol, 2012). Other studies reported that maternal factors such as high BMI, lower SES, and depressive symptoms are associated with more controlling and less sensitive feeding styles and more hospitalizations of infants (Ertel et al., 2011;Freed et al., 2012;Flykt et al., 2010;Haycraft et al., 2013;Holland et al., 2011;Sejourne et al., 2012). ...
... Manson et al. (2011), in their study examining whether positive results in maternal postpartum depression screening was associated with maternal reports of poorer infant social-emotional development, found that negative outcomes for infants were due to maternal depression and disorganized infant feeding practices that resulted in overfeeding or under-nutrition (Rondinelli et al., 2011;Sejourne, Vaslot, Beaume, Goutaudier, & Chabrol, 2012). Other studies reported that maternal factors such as high BMI, lower SES, and depressive symptoms are associated with more controlling and less sensitive feeding styles and more hospitalizations of infants (Ertel et al., 2011;Freed et al., 2012;Flykt et al., 2010;Haycraft et al., 2013;Holland et al., 2011;Sejourne et al., 2012). ...
Thesis
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Childhood overweight and obesity are public health concerns that have negative health consequences and affect many children. Efforts are needed to identify children who are at a higher risk of developing overweight and obesity so that early detection and treatment may be offered. The intent of this study was to investigate the differences in the effects of postpartum depression on infant feeding practices and infant weight gain between Hispanic and African American women. Data were obtained from Infant Feeding Practices Study 11, a longitudinal study involving mothers in their third trimester through infants first year of life. The overall test of model coefficient of complete cases (N = 192, missing = 443) was not statistically significant (x² = 4.842, df =2, p = 0.089). The result of the overall test after multiple imputation (n = 289) remained insignificant (on average x² = 4.031, df = 2, p = 0.133). However, results indicated a significant association between excessive infant weight gain and feeding practices (breast feeding vs. formula feeding; r = 0.207, p = 0.01), supporting previous research on the protective effect of breast feeding on excess infant weight gain. Positive social change implications include an understanding of how maternal and infant characteristics may identify early symptoms of maternal depression, through increased awareness and reduced incidents of childhood obesity and maternal postpartum depression.
... Os estudos que avaliaram as relações entre a depressão materna e o envolvimento paterno indicaram, predominantemente, relações inversas entre as duas variáveis, como os estudos de Goodman (2008), Séjourné et al. (2012) e Smith e Howard (2008), que investigaram, a partir da percepção das mães, o envolvimento paterno no contexto da depressão materna. Tais achados sugerem um maior risco de que fi lhos de mães deprimidas experimentem menor contato com o pai, ou que essas interações tenham menor qualidade. ...
... De qualquer modo, é preciso considerar o fato de que diferentes estudos internacionais revisados respaldavam a previsão de correlações negativas entre a depressão materna e o envolvimento paterno (Goodman, 2008;Séjourné et al., 2012;Smith & Howard, 2008). Nesse sentido, é importante que estudos brasileiros continuem investigando essa problemática, para que seja possível explorar melhor a hipótese acerca do impacto positivo da depressão materna sobre o envolvimento paterno, e se essa relação pode estar permeada por fenômenos típicos da nossa cultura, já que os estudos internacionais não confi rmam essa tendência. ...
Article
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This longitudinal study evaluated the relationship between indicators of mother's depression and their perception of paternal involvement. Nineteen mothers of boys, recruited at public maternity hospitals in Salvador, Bahia, were assessed for maternal depression with the Beck's Depression Inventory (BDI) at the first and 18th month of the child. The participants responded a structured interview regarding maternal perceptions about paternal involvement at the 30th month of the child. The maternal depression scores at the first month of the baby's life were positively correlated to maternal perceptions of paternal availability at the 30th month, particularly concerning to routine care, leisure and child health. The impact of postpartum depression on this specific dimension of paternal involvement are discussed, emphasizing the changes that may occur in the dynamics of family interactions during the transitionto parenthood. Further studies are suggested concerning the relation between maternal depression and paternal involvement, with reports of both fathers and mothers.
... Unlike postpartum depression, 'postpartum blues' (involving symptoms such as tearfulness, depressive symptoms and/or mood lability) constitute a transient condition that is usually benign and lasts 12-24 hours. Severe postpartum blues in the first days following childbirth could be predictive of the development maternal postpartum depression symptoms [7][8][9]. ...
... Stressful life events during pregnancy, difficult pregnancy and/ or delivery, marital problems, lack of social support, history of mood disorders, mild depressive mood and/or manifestations of anxiety during pregnancy have been highlighted as risk factors for maternal postpartum depression [9,22]. Similarly, personal history of depression, paternal antenatal depression, low social support, poor quality of life, low marital relationship satisfaction and -mainly -the presence of partner's depression have been significantly correlated with paternal postpartum depression [12,23,24]. ...
... Prior studies have already shown that social support can decrease the level of parental burnout (Ardic, 2020;Szczygiel et al., 2020). Moreover, partner support not only reduces parenting pressure, but also helps to maintain the balance between parenting demands and resources (Séjourné et al., 2012;Parfitt and Ayers, 2014). Therefore, Hypothesis 4 was proposed: the relationship between parenting anxiety and parental burnout is moderated by family function. ...
Article
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This study aimed to explore the effect of parents’ education anxiety on children’s academic burnout, and the mediation effect of parental burnout and the moderating effect of family function. A total of 259 paired parents and children from two middle schools in central China participated in the survey. The questionnaire was conducted using the Educational Anxiety Scale, Parental Burnout Scale, Adolescent Student Burnout Inventory, and Family APGAR Index. Our results indicated that parental education anxiety had a positive predictive effect on children’s academic burnout. Moreover, parental burnout played a complete mediating role between parents’ education anxiety and children’s academic burnout. Finally, the relationship between education anxiety and parental burnout was moderated by family function, and higher family function buffered the effect of education anxiety on parental burnout. The results suggest the mechanism of parental education anxiety on children’s academic burnout, and the role of family function in alleviating parental burnout.
... Spousal support is defined as the support provided by an individual's partner or spouse. In the parenting field, spousal support appears as a very efficient protective factor of mental health (Parfitt & Ayers, 2014;S ejourn e et al., 2012). The impact of spousal support on mothers' psychological wellbeing has been demonstrated consistently (Chen & Feeley, 2014;Glenn et al., 2009;Okabayashi et al., 2004). ...
Article
This study examined the mental health of mothers, assessing the impact of the perceived availability of partner for social support on mothers’ symptoms of depression, anxiety, and parental burnout. 315 French-speaking mothers over the age of 18, with at least one child living regularly at home, completed an online set of questionnaires in a cross-sectional study. The mothers responded to the Maslach Burnout Inventory adapted to the parental context (MBI-Parental), the Social Support Questionnaire-6 (SSQ-6), and the Hospital and Anxiety Depression Scale (HADS). ANOVA and ANCOVA revealed a significant association of perceived availability and satisfaction with the partner’s social support on the mothers’ psychological state. Single mothers reported lower levels of emotional exhaustion than mothers with a partner who was perceived as unavailable or moderately available. Mothers with a partner perceived as very available showed fewer symptoms of parental burnout, anxiety, and depression than mothers whose partner was perceived as moderately available. Perceived partner support has a significant statistical impact on mothers’ mental health and may be a protective factor against parental burnout, depression, and anxiety. • HIGHLIGHTS • Perceived spousal support has a statistical impact on mothers’ mental health • Poor perceived spousal availability contributes to parental burnout • Satisfactory spousal support may protect against parental burnout
... A growing body of literature highlights the impact of paternal distress in the postpartum period on both the child and partner. Paternal depression can be linked to decreased levels of paternal involvement [2], decreased marriage satisfaction [3], and negative impacts on both the parent-infant interactions and the infant's cognitive development [4]. Men in the postpartum period have been found to feel neglected, pressured to adhere to gender expectations, and to repress feelings [5]. ...
Article
The experience of having a child in the neonatal intensive care unit (NICU) is often unexpected, traumatic, and presents numerous stressors for new fathers. Past research has shown that parents of all genders with children in the NICU experience clinically significant psychological symptoms, yet the bulk of research and intervention efforts to date have focused on the needs of mothers. This paper will provide a review of the literature, outline current knowledge about the specific needs of men with children in the NICU, and recommend areas of focus for future research. The paper will also highlight the need to tailored interventions that specifically address the unique needs of fathers.
... An informal analysis of the few relevant studies indicates that the father's presence following birth and his assistance with the infant's care can improve the father's engagement with the child, decrease the intensity of depressive symptoms in the mother, and improve the child's overall development. 59,60 In synthesizing the available literature, we recommend that the United States develop a national paid maternity leave policy that would allow all mothers sufficient time to be home with their infants after the birth or arrival of the child, regardless of their employer or socioeconomic status. We recommend a national paid leave of at least 12 weeks for several reasons. ...
Article
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For decades, national paid maternity leave policies of 12 weeks or more have been established in every industrialized country except the United States. Despite women representing 47% of the current U.S. labor force, only 16% of all employed American workers have access to paid parental leave through their workplace. As many as 23% of employed mothers return to work within ten days of giving birth, because of their inability to pay living expenses without income. We reviewed recent studies on the possible effects of paid maternity leave on the mental and physical health of mothers and children. We found that paid maternity leave is associated with beneficial effects on (1) the mental health of mothers and children, including a decrease in postpartum maternal depression and intimate partner violence, and improved infant attachment and child development, (2) the physical health of mothers and children, including a decrease in infant mortality and in mother and infant rehospitalizations, and an increase in pediatric visit attendance and timely administration of infant immunizations, and (3) breastfeeding, with an increase in its initiation and duration. Given the substantial mental and physical health benefits associated with paid leave, as well as favorable results from studies on its economic impact, the United States is facing a clear, evidence-based mandate to create a national paid maternity leave policy. We recommend a national paid maternity leave policy of at least 12 weeks.
... Paternity leave is associated with more frequent father involvement and higher levels of well-being among European mothers (Bratberg and Naz 2014;Haas and Hwang 2008;Huerta et al. 2014;Pragg and Knoester 2017;Sejourne et al. 2012). However, studies have yet to consider how paternity leave (and related increases in father involvement) may influence parental relationships. ...
Article
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Research has begun to examine the consequences of paternity leave, focusing primarily on whether paternity leave-taking increases father involvement. Yet, other consequences of paternity leave-taking have not been considered using U.S data. This study uses longitudinal data from the Fragile Families and Child Wellbeing Study to examine whether fathers' time off from work after the birth of a child is associated with relationship quality, relationship support, and coparenting quality. We also consider whether these relationships are mediated by father involvement. Results suggest that fathers' time off of work after a birth and length of time off are each positively associated with relationship quality and coparenting quality one year after a child's birth. They are also positively associated with trajectories of relationship quality and coparenting quality over the first five years after birth. Father involvement at least partially mediates these relationships. Overall, this study suggests that the potential benefits of fathers' time off of work after the birth of a child may extend beyond father involvement and may improve parental relationships.
... Fathers (partners) are also reported to be a major influence in mothers' recovery from perinatal mood disorders such as major depression and psychosis (Brandon et al., 2012;Séjourné, Vaslot, Beaumé, Goutaudier, & Chabrol, 2012). When mothers who had recovered from postnatal depression (n = 158) were asked to list the "essential" elements in their recovery, three of the eight factors were emotional support from partner, improved communication with partner, and, practical support from partner (Di Mascio, Kent, Fiander, & Lawrence, 2008). ...
Article
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There is increasing recognition of the issues facing men in the perinatal period. Vulnerability factors and issues in the partner relationship contribute to mental health risk and can impact the quality of the father-infant relationship. Yet, there is limited understanding of fathers' help-seeking when they or their partner are experiencing mental health issues in the context of caring for a new baby. The present study examines fathers' contacts with the Perinatal Anxiety and Depression Australia (PANDA) National Helpline. The study reviewed contacts from fathers and their identified needs for assistance, relationship issues, and support needs; 70% of male callers (N = 129) reported concerns about the mother's mental health, and 57% were concerned about relationship breakdown. Significant numbers of men raised issues about their own mental health (43%) and many were concerned about the impact of maternal mental state on the relationship with the infant. When compared to community data, there were elevated rates of concerns about depression and anxiety. Men also described difficulties with the fathering role and with regulating their own feelings of guilt and frustration. These findings highlight the needs of men for support when a mother experiences perinatal problems and also the risk for distress in fathers. © 2019 Michigan Association for Infant Mental Health.
... For many parents, support is necessary to cope with the costs and stressors associated with parenting. In particular, in two-parent families, couple support has been shown to play a protective role with regard to stress and emotional difficulties related to parenting (Parfitt & Ayers, 2014;Séjourné, Vaslot, Beaumé, Goutaudier, & Chabrol, 2012). The deleterious consequences of the absence of couple support have been documented in studies on single parenthood (Hughes, 1989). ...
... Resources to compensate for parenting stress are essential to prevent parenting-related exhaustion and to favor the parent's wellbeing and fulfillment in her or his role. Among common resources, partner parental support (i.e., the support that partners offer each other in the specific area of parenthood) seems to be an important factor in maintaining a parent's equilibrium (Parfitt & Ayers, 2014;Séjourné, Vaslot, Beaumé, Goutaudier, & Chabrol, 2012). The importance of this support can be explained by the fact that it is an immediate resource in the sense that the partner is the person whose physical presence is likely to be the most frequent and close at hand within the family home. ...
Article
The current article serves a dual purpose: to highlight the overlooked and recent concept of parenting-related exhaustion and to propose a specific methodology to test concurrent variations of the parent’s exhaustion with the partner’s exhaustion and her or his perceived and given support. Questionnaire data were collected from 97 mother–father couples over the course of 5 consecutive days. Results from multilevel model analyses revealed day-to-day dyadic variations as well as day-to-day regulation occurring in parental couples. The dyadic variations were shown by the fact that over the week, on the days when one parent felt more exhausted, the other parent’s exhaustion was also high. Dyadic regulation meant that greater exhaustion felt by one parent was associated with greater support from her or his partner. Partner’s extra support was both perceived by the exhausted parent and reported by the support provider (i.e., the partner).
... The negative association between maternal postpartum distress and partner support has been documented previously (Séjourné, Vaslot, Beaumé, Goutaudier, & Chabrol, 2012), as well as the positive association between such support and mothers' mental well-being during the transition to parenthood (Nelson, 2003). The vast majority of studies about the transition to parenthood and its consequences have been carried out with mothers and with a cross-sectional design (e.g., Henderson & Redshaw, 2013). ...
Article
The majority of previous studies focused on mothers’ distress and considered partner support from the father to the mother. The current research studies the level and the course of distress and partner support in new mothers and fathers during the transition to parenthood and tests the protective role of partner support against distress. Data were collected in a two-wave longitudinal design from 53 heterosexual couples. Mothers and fathers completed questionnaires at two measurement occasions, that is, in the third trimester of pregnancy and 3 months after childbirth. The results provided arguments in favor of a dyadic perspective on distress during the transition to parenthood. No difference was displayed between mothers and fathers before and after childbirth. The level of distress decreased in mothers and also in fathers but only for those whose partner’s distress also decreased. The importance of partner support against postpartum distress was highlighted for mothers and fathers.
... Postpartum depression is impacted by environmental factors such as access to affordable prenatal healthcare and family planning services, racial discrimination, and pay inequity (Sidebottom, Hellerstedt, Harrison, & Jones-Webb, 2017). Similarly, since lack of paid maternity and paternity leave impact family financial situations, family leave policies are related to postpartum mental health (Séjourné, Vaslot, Beaumé, Goutaudier, & Chabrol, 2012). ...
Article
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Postpartum depression (PPD) is a significant public health concern due to the physical, emotional, economic, and life course outcomes. Rates of PPD are significantly higher for marginalised populations and can impact low‐income, minority, and/or immigrant women differently when compared to white middle‐class women. Commonly studied negative effects of PPD include poor health outcomes, mother–child bonding challenges, and negative child educational outcomes. However, research surveying the postpartum experience and negative outcomes among marginalised women is sparse. This study implemented a qualitative meta‐interpretive synthesis (QIMS) methodology to synthesise themes across 12 qualitative research articles surveying postpartum experiences of marginalised women in North American countries. Articles included in the QIMS were extracted from online databases from a 10‐year window spanning January 2008–2018. The guiding research question was “What are the PPD experiences of women belonging to marginalized populations?” Constant comparative analysis was used with coding in atlas.ti and themes were synthesised with input of all three authors. Five main themes emerged. The themes are (a) intersections of PPD and poverty, (b) culture and PPD, (c) pressures of mothering, (d) strengths and coping, and (e) abuse affects my PPD experience. Subthemes such as “I keep it to myself” relating to cultural response to PPD and idealised mothering were also discovered. Implications for social workers, nurses, and future research are discussed.
... Similar findings from Norway [6] and Sweden [7] point to the fact that paternity leave is also associated with a reduction in mothers' absence by 5 to 10% due to sickness and an increase in mothers' earnings by 6.7% respectively. Also, in France [8], paternity and paternal leave is associated with a reduction in depression among new mothers. ...
Chapter
The aim of this paper is to make a persuasive case for the provision of paid paternity leave for fathers in Ghana by describing several benefits of paternity leave to the family and the business as a whole. The paper examines the arguments for paternity leave through series of literature review, the position of law on paid paternity leave in Ghana and its implications for gender parity. The paper also presents examples of countries that have ratified the ILO conventions on paternity leave provisions and enshrined them in their country-specific legal regulatory frameworks. Given the diverse benefits of paid paternity leave around the world, the need for paternity leave has become a necessity if not obligatory. The paper makes a strong case for expedite action on the amendment of Ghana’s labour law to incorporate at least five days paid leave for fathers in relation to childbirth in Ghana.
... By encouraging men to become invested in their child's life from birth, fathers may gain parenting mastery and take some of the burden of childcare away from mothers (Rehel, 2014). As a result, mothers may experience reduced stress and be able to re-enter the labor force sooner (Gault et al., 2014;Johansson, 2010;Sejourne et al., 2012). ...
Article
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Surprisingly few studies have focused on paternity leave-taking in the US. This study utilizes data from three national datasets to provide a comprehensive examination of the attitudes, practices and predictors of paid paternity leave-taking in the US. Specifically, this study focuses on (a) describing attitudes towards fathers receiving a share of paid parental leave, (b) describing rates and lengths of paid paternity leave-taking and (c) analyzing the extent to which economic capital, cultural capital, social capital and father identities predict paternity leave-taking practices. The results indicate that most people support fathers receiving a share of paid parental leave in the US. Yet, rates of paid paternity leave-taking are relatively low and the majority of fathers who take paid leave take only one week or less. Economic capital, cultural capital, social capital and father identities that prioritize engaged fathering are positively associated with taking paid leave and taking longer periods of leave. Overall, the results emphasize that the current structure of US paternity leave policies seems to limit access to paid paternity leave and contribute to patterns of inequality due to more advantaged fathers having greater access and ability to take paid paternity leave than less advantaged fathers.
... Numerous studies have been implemented to explore fathering and the impact of paternal practices on a host of outcomes including benefits for children (e.g., physical and mental health outcomes, educational and academic achievements, and social skills; Bronte-Tinkew et al., 2008;Dex & Ward, 2007;Dubowitz et al., 2001;Flouri & Buchanan, 2003a;2003b;Fogarty & Evans, 2009;Tanaka, 2005), benefits for parents (e.g., health outcomes and social and economic benefits; Månsdotter et al., 2007;Månsdotter & Lundin, 2010;McAllister, Burgess, Kato, & Barker, 2012;Séjourné et al., 2012), and benefits for family relationships (e.g., division of household labor; Almqvist, Sandberg, & Dahlgren, 2011;Estes, Noonan, & Maume, 2007;Hook, 2010;Kotsadam & Finseraas, 2011). However, most studies are focused on fathers living in industrialized Western countries. ...
Article
Research is limited on the ways in which men from post-Soviet countries, especially Asian Muslim men, define their paternal responsibilities and the factors that shape their fatherhood experiences. From February through August 2014, the first author conducted qualitative interviews with 30 fathers with children ages 0 to 19 years old who lived in urban areas of Tajikistan. Interviews explored fathers' perspectives about their childcare responsibilities, rewards, constraints, and difficulties of fatherhood. We clustered responses regarding respondents' childcare responsibilities into 4 interrelated themes: (a) teaching, (b) providing, © caregiving, and (d) nurturing. Fathers identified several constraints that affect their fatherhood experiences, including work and education responsibilities as well as the age and gender of their children. Overall, fathers indicated that the most difficult dimensions of fatherhood included responsibilities of fatherhood, finding effective disciplinarian approaches, and their inability to meet children's expectations. Most respondents commented on the joy, happiness, prosperity, inspiration, and support fatherhood brought to them. Results of this research may be useful for service providers and public health experts to define programs for increasing involvement of fathers in childcare. In addition, results may be useful to guide future fatherhood research, especially in post-Soviet societies. (PsycINFO Database Record
... Postnatal depression (PND) and its possible consequences for both the child's emotional adaptive functioning and the relational patterns in mother-child dyads have been examined thoroughly in recent international studies (Korja et al., 2008). Epidemiological data show that ∼13% of women suffer from symptoms of PND which do not improve or may worsen in the first few weeks after giving birth; these symptoms can also appear in the period immediately before the birth (Séjourné et al., 2012), as specified in the recently updated Diagnostic and Statistical Manual of Mental Disorders (DSM-5, American Psychiatric Association [APA], 2013). Research in this field has, thus far, focused mainly on the severity of mother's psycho-pathological symptoms associated with a PND diagnosis (Sutter-Dallay et al., 2011) and only recently has the work been expanded to consider possible paternal contributions to risk and protection factors (Paulson and Bazemore, 2010;Cimino et al., 2014). ...
Article
Full-text available
Background: Several studies have shown a connection between mothers with post-natal depression (PND) and emotional-behavioral problems in their children. Mothers' psychopathology may impair interactional patterns with children and these outcomes can be influenced by father's psychopathological symptoms. The primary aim of the study was to assess over time parent-infant interaction in families where mothers have experienced postnatal depression and have received psychological treatment during the child's first year of life considering the severity of parents' psychopathological symptoms and children's temperament. Methods: Three groups of families were involved: families with mothers with PND wherein both parents followed a psychological treatment (TxMF); families with mothers affected by PND wherein only the mother followed the treatment (TxM) and control families wherein the mothers did not have a psychopathological diagnosis and did not receive any treatment (Con). The families were assessed at two time points through Symptom Check-List-90-Revised (SCL-90-R), Questionari Italiani Temperamento (QUIT) and the video-recorded procedure observing mealtime Scala di Valutazione Interazioni Alimentari (SVIA). Results: Parents in the TxMF group had significantly lower SVIA scores (i.e . less maladaptive) at T2. TxMF group scored lower at T2 at SCL-90-R, whereas TxM showed no significant differences between T1 and T2. Involvement of fathers in the treatment was important to improve the psychopathological symptoms of both parents and the quality of interactions with their children.
... 2) L'influenza del padre sullo stato emotivo della madre e sullo sviluppo psicomotorio del bambino è ben documentata, ma è necessario considerare questi problemi all'interno di una visione tradica madre-bambino-padre. Per la prevenzione della depressione materna e per la tutela della relazione madre-bambino è fondamentale riconoscere l'importanza del padre sin dall'inizio della gravidanza, sostenendolo nel suo ruolo, individuando le sue difficoltà e promuovendo il suo coinvolgimento nelle visite ginecologiche, nelle attività di consultorio familiare e nell'assistenza per tutto l'anno successivo al parto (Buist, Morse e Durkin, 2003; Schumacher, Zubaran e White, 2008; Séjourné et al., 2012; Musser et al., 2013). 3) Prestare attenzione alla qualità del legame di coppia. ...
Chapter
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Durante il periodo perinatale una funzione specifica del padre è quella di fornire una base sicura alla propria compagna, aiutandola a superare le difficoltà materiali e psicologiche e favorendo lo sviluppo di una buona relazione tra madre e bambino. La ricerca empirica ha evidenziato come in questo periodo gli stati emotivi dei genitori siano correlati e come anche il padre possa soffrire di disturbi affettivi simili alla depressione perinatale materna. I padri insicuri, troppo ansiosi, depressi, assenti o quelli che manifestano alterazioni del comportamento di malattia (somatizzazioni, disturbi funzionali, preoccupazioni ipocondriache) o problemi comportamentali (aggressività patologica, alcolismo, disturbi di dipendenza) possono non essere in grado di offrire una base sicura adeguata e rappresentano perciò una minaccia per l'equilibrio emotivo della compagna e per lo sviluppo del figlio. Gli studi sull'attaccamento familiare e sul ruolo del padre nei primi anni di vita dei figli hanno portato a risultati significativi che costituiscono una guida utile per l'organizzazione di interventi di prevenzione e trattamento dei disturbi affettivi perinatali che tengano conto di entrambi i genitori e delle esigenze specifiche del bambino e della sua famiglia.
... 2) L'influenza del padre sullo stato emotivo della madre e sullo sviluppo psicomotorio del bambino è ben documentata, ma è necessario considerare questi problemi all'interno di una visione tradica madre-bambino-padre. Per la prevenzione della depressione materna e per la tutela della relazione madre-bambino è fondamentale riconoscere l'importanza del padre sin dall'inizio della gravidanza, sostenendolo nel suo ruolo, individuando le sue difficoltà e promuovendo il suo coinvolgimento nelle visite ginecologiche, nelle attività di consultorio familiare e nell'assistenza per tutto l'anno successivo al parto (Buist, Morse e Durkin, 2003; Schumacher, Zubaran e White, 2008; Séjourné et al., 2012; Musser et al., 2013). 3) Prestare attenzione alla qualità del legame di coppia. ...
... Postnatal depression (PND) and its possible consequences for both the child's emotional adaptive functioning and the relational patterns in mother-child dyads have been examined thoroughly in recent international studies (Korja et al., 2008). Epidemiological data show that ∼13% of women suffer from symptoms of PND which do not improve or may worsen in the first few weeks after giving birth; these symptoms can also appear in the period immediately before the birth (Séjourné et al., 2012), as specified in the recently updated Diagnostic and Statistical Manual of Mental Disorders (DSM-5, American Psychiatric Association [APA], 2013). Research in this field has, thus far, focused mainly on the severity of mother's psycho-pathological symptoms associated with a PND diagnosis (Sutter-Dallay et al., 2011) and only recently has the work been expanded to consider possible paternal contributions to risk and protection factors (Paulson and Bazemore, 2010;Cimino et al., 2014). ...
Article
Full-text available
Background: Several studies have shown a connection between mothers with post-natal depression (PND) and emotional-behavioral problems in their children. Mothers' psychopathology may impair interactional patterns with children and these outcomes can be influenced by father's psychopathological symptoms. The primary aim of the study was to assess over time parent-infant interaction in families where mothers have experienced postnatal depression and have received psychological treatment during the child's first year of life considering the severity of parents' psychopathological symptoms and children's temperament. Methods: Three groups of families were involved: families with mothers with PND wherein both parents followed a psychological treatment (TxMF); families with mothers affected by PND wherein only the mother followed the treatment (TxM) and control families wherein the mothers did not have a psychopathological diagnosis and did not receive any treatment (Con). The families were assessed at two time points through Symptom Check-List-90-Revised (SCL-90-R), Questionari Italiani Temperamento (QUIT) and the video-recorded procedure observing mealtime Scala di Valutazione Interazioni Alimentari (SVIA). Results: Parents in the TxMF group had significantly lower SVIA scores (i.e . less maladaptive) at T2. TxMF group scored lower at T2 at SCL-90-R, whereas TxM showed no significant differences between T1 and T2. Involvement of fathers in the treatment was important to improve the psychopathological symptoms of both parents and the quality of interactions with their children.
... For instance, paternal depression in the prenatal period is directly associated with infant irritability (van den Berg et al., 2009). Furthermore, lack of paternal involvement in the postpartum period is associated with increased severity in maternal postpartum depression (Séjourné, Vaslot, Beaume, Goutaudier, & Chabrol, 2012). Quality of father-infant interactions directly predicts subsequent behavioral development, with higher quality interactions foretelling fewer externalizing behavior problems (Ramchandani, Domoney, Sethna, Psychogiou, Vlachos, & Murray, 2013) and better social competence with strangers (Ferber, 2010) in toddlerhood. ...
... While the prepartum period was previously investigated with this tool [25], no validation study has focused on postpartum women. Several French studies used MSPSS translations during postpartum period without references of psychometric properties [2,[31][32][33][34]. In comparison with existing social support scales, the MSPSS is a very short scale that is well accepted by participants, particularly by new mothers. ...
Article
In the presence of physical and psychological disturbances in the postpartum period, perceived social support is often regarded as a protective factor in women's mental health. This work evaluates the psychometric properties of the French version of a questionnaire widely used internationally to measure perceived social support, which has not been yet validated in French: the Multidimensional Scale of Perceived Social Support (MSPSS). This study collected data from 148 women (30.5 ± 5.12 years) who agreed to complete the MSPSS and a scale assessing symptoms of postpartum depression (Edinburgh Post-Natal Depression Scale, EPDS) 1 and 4 months after childbirth. The results confirm the original three-factor structure of the scale. The Cronbach's alpha coefficients are excellent. The total scale score is correlated with all three dimensions and a significantly negative correlation is found between MSPSS and EPDS. The results suggest that the French tool has generally good internal reliability. The MSPSS can provide useful data helping to identify French-speaking people at risk for negative feelings (e.g., mood disorders of perinatal period).
... Given these two alternative theoretical models, it is not surprising that the findings linking maternal depression and paternal involvement are somewhat mixed. Consistent with the spillover hypothesis, mothers' higher depressive symptom levels are concurrently associated with lower levels of father involvement with their infants (Paulson, Dauber, & Leiferman, 2006;Sejourne, Vaslot, Beaume, Goutaudier, & Chabrol, 2012). Studies of families living in poverty, with nonresidential fathers, yielded similar findings (Paulson, Dauber, & Leiferman, 2011;Smith, Howard, & Centers for the Prevention of Child Neglect, 2008). ...
Article
Both concurrent and prospective associations between maternal depression and father involvement were tested to evaluate support for the spillover model (higher depressive symptom levels associated with lower father involvement) and the compensatory/buffering model (higher depressive symptom levels associated with higher father involvement). Participants in this longitudinal study were women at risk for perinatal depression in association with their histories of mood or anxiety disorders, their husbands/partners, and their infants at 3, 6, and 12 months of age. Maternal depressive symptoms were measured with depression rating scales at multiple times over the infants' first year. Paternal involvement was measured with a questionnaire (relative perceived responsibility) and a time diary (accessibility and engagement) inquiring about a recent weekday and a recent weekend, completed in a telephone interview, at infant ages 3, 6, and 12 months. Findings consistently supported the compensatory/buffering model for depression in the first 6 months' postpartum, along with an indication of spillover regarding maternal depressive symptoms that persist into the second half of the infants' first year. Findings are discussed in terms of implications for clinical practice and policy as well as suggestions for future research. © 2014 Michigan Association for Infant Mental Health.
... Modele + PEDPUE-1079; No. of Pages 8 concernant l'implication maternelle dans les soins au bébé prématuré et sur deux échelles d'implication maternelle créées préalablement par notre équipe de recherche [45,46], cette échelle comporte 8 items reflétant des aspects spécifiques de l'implication maternelle concernant les soins dispensés au bébé lors de la période de couveuse (ex. : j'ai fait du « peau à peau » avec mon bébé). ...
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Objectives Empirical data regarding depressive, anxiety and posttraumatic stress disorder (PTSD) symptom profile following premature birth are lacking. The present study aims to: firstly, identify the typology of women who delivered prematurely based on anxiety, depressive and PTSD symptoms; and secondly, examine whether these profiles differ on maternal perception of infant temperament, mother–infant bond and maternal involvement in infant care during the hospitalization process. Participants and method Within four weeks of a preterm infant's hospital discharge, 110 French mothers (mean age [SD] = 29.5 [4.3] years) completed questionnaires assessing PTSD symptoms, depressive and anxiety symptoms, maternal involvement in infant care, maternal perception of infant temperament and mother–infant bound. Results Three profiles were highlighted: a first one labeled “resilient group” (n = 41, 37 % of the sample), a second one labeled “depressive group” (n = 23, 21 % of the sample), and a third one labeled “depressive-anxious-traumatized group” (n = 46, 42 % of the sample). Our findings also highlight a negative impact of postpartum depressive symptoms on mother–infant bond. Discussion Within four weeks of infant's hospital discharge, only a third of mothers exhibited a resilient profile, while depressive symptom severity seems to have a negative impact on mother–infant bond. Further research focusing on the impact of postpartum depression using direct observation and developing is warranted.
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Maternal depressive symptoms are a robust risk factor for poor cognitive outcomes in children, yet the role of gene-environment interplay in this association is not well understood. The objective of this study was to evaluate gene-environment interaction in the association between maternal depressive symptoms and children’s cognitive school readiness. Data come from a population-based birth cohort of 538 twin pairs. Maternal depressive symptoms were self-reported (Centre for Epidemiologic Studies Depression Scale) when children were aged 6 and 18 months (a mean score was used). Children’s cognitive school readiness was assessed using the Lollipop Test when children were aged 5 years. Analyses were conducted with structural equation modeling. Maternal depressive symptoms were correlated with children’s cognitive school readiness (r = −0.10). Shared environmental factors explained most of the variance in children’s cognitive school readiness (52%). The remaining variance was accounted for by genetic (30%) and nonshared environmental factors (18%). As the level of maternal depressive symptoms increased, the relative contribution of nonshared environmental factors to the variance in children’s cognitive school readiness increased (0.14 [95% CI: 0.04 to 0.24]), whereas the relative contribution of genetic factors decreased (−0.28 [−0.64 to 0.08]). In contexts of elevated maternal depressive symptoms, environmental — and potentially modifiable — factors may be especially important for shaping children’s cognitive outcomes. This suggests that interventions to improve the early childhood environment of children exposed to maternal depressive symptoms may improve their cognitive outcomes.
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Paid family leave may mitigate stress and health challenges across the transition to parenthood. The current study examined whether paid paternity leave is associated with first-time parents' trajectories of depression, stress, and sleep from the prenatal to postpartum periods. Expectant parents (72 couples) reported on their depressive symptoms, perceived stress, and daytime fatigue during mid-to-late pregnancy and then again at six months postpartum. At one year postpartum, fathers reported on any paid or unpaid leave taken following their child's birth. We used a repeated-measures design to compare couples in which the father either did or did not access paid paternity leave. When fathers took paid paternity leave, their partners' stress and depressive symptoms showed smaller prenatal to postpartum increases than mothers whose partners did not take paid leave. Similarly, fathers who took paid paternity leave, compared to those who did not, reported smaller prenatal to postpartum increases in stress and daytime fatigue. These results remained largely unchanged when controlling for the length of fathers' leave. The study's longitudinal, within-subject design allows us to examine parents' mental health relative to their own prenatal baseline, helping to account for some of the pre-existing differences between fathers who did and did not take paid paternity leave. The results suggest that paid paternity leave may be associated with greater well-being across the transition to parenthood for both fathers and mothers.
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Background Although men have a higher risk of developing a mental disorder during the perinatal period, few studies have focused on new fathers’ mental health screening. This study compares anxiety and depression symptoms between fathers with newborn infants in the neonatal intensive care unit (NICU) and fathers of healthy full-term infants, assessing the impact of stress caused by the NICU. Methods A longitudinal and prospective study with control (n= 33) and study groups (n=51) was designed. The dependent variables assessed were post-natal depression and anxiety-state while the social and demographic information, health background and the parental stress in the neonatal unit were the independent variables. The fathers were assessed twice during the first month after birth. Results Significant differences in the EPDS scores were found between both groups in the first assessment (p = .006) but not in the second assessment (p = .60). Significant differences in STAI scores were found between the groups for both assessments (p = .003 and p = .002). The stress caused by the infant's appearance and behavior was predictive of depression and anxiety in the study group. Limitations The sample was collected at one hospital, immigrants were underrepresented, and no prenatal assessment of paternal mental health is available. Conclusions Our results suggest that the hospitalization of newborn infants increases the risk of developing anxiety or depression disorder in fathers. Health providers should be aware of the emotional changes in men shortly after childbirth and include them in the screening of and support for mental health disorders.
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Father involvement can promote the psychosocial health of family members (i.e., fathers, mothers, and children). However, the association between father involvement and individual members' psychosocial health may depend on the quality of the marital relationship and the perceptions of the reporting family member. Research with multiple reporters from the same family is needed identify how family members perceive the impact of father involvement on family member well-being. Using a risk and resilience theoretical framework applied to a family systems perspective, the current study examines associations between father involvement, family flexibility, marital quality, and psychosocial health with a sample of 207 military families (including fathers, mothers, and their adolescents). After accounting for military context, a conditional structural equation model was used to examine the associations between fathers' involvement and family members' psychosocial health. Family flexibility was examined as a mediator between these associations and marital quality as a moderator. Findings suggest that when fathers are more involved, both mothers and fathers report less family flexibility, and that family flexibility was positively associated with family member (father, mother, and adolescent) well-being. Further, father involvement was indirectly related to mothers' psychosocial health through family flexibility, and father involvement was directly associated with better psychosocial health for fathers and adolescents. Marital quality moderated these associations for fathers, mothers, and adolescents. Given the combined benefits of father involvement, family flexibility, and positive marital relationships, clinical efforts to provide information to increase knowledge and skills around maintaining a healthy relationship could serve to promote psychosocial health by improving marital quality and family flexibility.
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Fragile families are defined as those that include unmarried or romantically unstable parents who have children and are socioeconomically disadvantaged. Mothers in fragile families may experience risk factors that lead to increased depressive symptoms that inhibit their ability to bounce back after stressful events. Risk factors for poorer maternal mental health may include declines in father involvement and a lack of coparenting support. This study examined the connected nature of coparenting and father involvement over time among continuously unmarried mothers from the Fragile Families and Child Wellbeing Study. A bidirectional latent growth curve analysis demonstrated that early father involvement was associated with a more gradual decline in coparenting support over the child's first 5 years, while early coparenting support also predicted a slower decline in father involvement over time. Steeper declines in coparenting support and father involvement over time were linked with more maternal depression and lower maternal life satisfaction when their child was nine. Results demonstrate a clear need for targeted intervention with both parents in fragile families to promote involved fathering behavior and enhance coparental relationships.
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Although postpartum depression is common and well-studied in mothers, many fathers also experience symptoms. This qualitative study investigated fathers’ experiences of postpartum depression. Data from secondary sources such as blogs, websites, forums, and chat rooms were analyzed using a combination of phenomenological and content analysis methods to understand father’s experiences of paternal postpartum depression. Six themes emerged from the data including fathers’ needing education, adhering to gender expectations, repressing feelings, being overwhelmed, resentment of baby, and the experience of neglect. These data provide useful information that can aid health care providers, researchers, clinicians, and families in understanding the experience of paternal postpartum depression and in better coping with the challenges these families face.
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Background: Postnatal depression (PND) is a key cause of maternal morbidity, with current systems of initial recognition in the UK detecting only 50% of cases. In attempts to predict those potentially at risk, this review suggests a novel approach. Aim: Implementing the concept of ‘ideal mother’ versus ‘real mother’, and asking the woman to compare their ‘ideal self’ against ‘existent self’, the aim of this instrument development review was to determine themes from the literature that relate to women’s perceptions of self as a mother, and from this identification develop questions for inclusion within a proposed new measure entitled the Self-Image as Mother Scale (SIMS). Method: A scoping review of the literature was carried out to identify themes considered to affect perception of self as mother, and from this identification, evidence-based questions for inclusion in the SIMS were developed. Findings: Themes identified included (1) marital dissatisfaction, (2) inadequate partner support, (3) lack of family support, (4) socioeconomic status and associated poverty, (5) concern about infant, (6) antenatal/postnatal complications, (7) acceptance of infant gender, (8) history of mental health problems, (9) unplanned pregnancy. Conclusions: From this scoping review 18 questions were developed for inclusion in the SIMS, which will then be evaluated for psychometric properties, scale refinement and validation.
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Extensive evidence points to the importance of father-child relationship in the development and for the wellbeing of children, mothers and fathers. Father involvement is multidimensional and includes direct and indirect father-child involvements. In order to progress in this area, a valid measure of this construct, like the Inventory of Father Involvement (IFI), is needed in Brazil. The objective of this study was to investigate the structure of factors and internal reliability of the Brazilian version of IFI (IFI-BR). A sociodemographic questionnaire and the IFI-BR were filled in by 200 men who had five- to ten-year-old children. The results prove internal validity of the IFI-BR and confirms a structure of factors very similar to that of the original IFI, including eight of the nine original first-order factors and a general second-order factor, with indicators of internal reliability that were adequate for these eight factors.
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An ample body of scientific evidence exists, documenting the importance of the father-child relationship. The objective of this study was to develop a theoretical model of father involvement, organized according to the principles of Structural Equation Modeling, which require specification of the variables associated with the central construct, based on empirical data. In 2015, a systematic search was conducted in the databases APA PsycNET, Bireme, PEPSIC, Web of Science and IndexPsi Periódicos, using the descriptors "involvement" and "father", crossed with "measure", "scale", "tool" or "instrument", in both the English and Portuguese languages. There were no restrictions on the year of publication. In total, 39 complete texts were located, that included data on father involvement. The information in these texts was grouped into three categories: (a) dimensions of father involvement, (b) factors affecting father involvement and (c) impacts of father involvement on other variables. The model presented synthesizes the results of these studies, representing an advance in theory development in this area. This model increases the visibility of conceptual issues about father involvement and its correlates, and, following empirical testing, may contribute to the improvement of intervention programs for fathers.
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An ample body of scientific evidence exists, documenting the importance of the father-child relationship. The objective of this study was to develop a theoretical model of father involvement, organized according to the principles of Structural Equation Modeling, which require specification of the variables associated with the central construct, based on empirical data. In 2015, a systematic search was conducted in the databases APA PsycNET, Bireme, PEPSIC, Web of Science and IndexPsi Periódicos, using the descriptors "involvement" and "father", crossed with "measure", "scale", "tool" or "instrument", in both the English and Portuguese languages. There were no restrictions on the year of publication. In total, 39 complete texts were located, that included data on father involvement. The information in these texts was grouped into three categories: (a) dimensions of father involvement, (b) factors affecting father involvement and (c) impacts of father involvement on other variables. The model presented synthesizes the results of these studies, representing an advance in theory development in this area. This model increases the visibility of conceptual issues about father involvement and its correlates, and, following empirical testing, may contribute to the improvement of intervention programs for fathers.
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The assessment of paternal postpartum depression (PPD) is not part of the standard evaluations despite its relevance. The following study aimed to identify and describe how PPD and/or depressive symptoms in men have been assessed during the first year of fatherhood, specifically to identify the main methodological and diagnostically characteristics of the studies with a specific respect to the reported frequency of paternal and maternal depression in the first year after the birth of a child. Peer-reviewed studies published between January 2005 and January 2016, documenting depression or depressive symptoms in men within the first trimester to one-year postpartum were retrieved from different databases. 52 meet the inclusion criteria Most of them were performed in Europe, were longitudinal, and used self-applied questionnaires. Paternal depressive symptoms showed frequencies between 1.8 and 47 per cent and the presence of maternal depression showed a range that fluctuated between 2.3 and 58.05 per cent of prevalence.
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Objective As biological mothers during the postpartum period, women who adopt a child might suffer from depressive symptoms. Thus, women who enter in the adoption process experience sudden life changes with the arrival of the child which increase parental stress and the risk of developing depressive symptoms. The aim of this study was to evaluate the prevalence rate of depression in mothers who have recently adopted a child and to examine factors associated with this symptomatology. Methods One hundred and twenty-two participants aged 28 to 54 years (M = 41.38, ET = 5.78) were approached through Internet forums and 93 French departmental associations for family who adopt a child. Participants who met the inclusion criterion (i.e. having adopted a child over the past 36 months) were invited to participate to the study and to complete questionnaires on a database platform. All women who agreed to participate completed an anamnestic questionnaire focusing on personal data, adoption procedure, and child-related information. Perceived social support from family and friends and child difficulties were also assessed using five-point scales. Then, all women completed four questionnaires assessing perceived stress during adoption (Perceived Stress Scale), depressive symptomatology (Edinburgh Postnatal Depression Scale), perception of quality of marital relationship (Dyadic Adjustment Scale) and parenting stress (Parenting Stress Index Short Form). Given the adoption process and the six months following child arrival, all measures were completed retrospectively. Results Seventeen percent of the sample scored above the cutoff for probable depression, this rate is similar to that which can be observed in postpartum depression. Depressive symptoms were significantly associated with a high rate of stress during the adoption process and after the arrival of the child, the difficulties of child's adaptation as well as the quality of conjugal adjustment. Multiple regression analysis showed that the intensity of perceived stress during the adoption process, scores on two subscales of the Parental Stress Index “difficulty of the child” and “parental distress” and difficulties of child's adaptation rated by the mother were significant predictors of the intensity of depressive symptoms post-adoption. Conclusion Despite the limits of a retrospective study, these results suggest the importance of implementing specific preventive interventions considering both the adoption process and the post-adoption period to prevent depressive symptoms from developing.
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Few programs to enhance fathers' engagement with children have been systematically evaluated, especially for low-income minority populations. In this study, 289 couples from primarily low-income Mexican American and European American families were randomly assigned to one of three conditions and followed for 18 months: 16-week groups for fathers, 16-week groups for couples, or a 1-time informational meeting. Compared with families in the low-dose comparison condition, intervention families showed positive effects on fathers' engagement with their children, couple relationship quality, and children's problem behaviors. Participants in couples' groups showed more consistent, longer term positive effects than those in fathers-only groups. Intervention effects were similar across family structures, income levels, and ethnicities. Implications of the results for current family policy debates are discussed.
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Although some studies suggest the efficacy of psychotherapy or antidepressant drugs for postnatal depression, their acceptability has not been extensively studied. Four hundred and five women consecutively admitted in obstetrical clinics were questioned about acceptability of treatments for postnatal depression using a repeated measures design after delivery, during their stay at the clinic. Mothers completed questionnaires assessing the degree of acceptability of different therapies for postnatal depression before and after receiving information about the current knowledge on antidepressant for postnatal depression and breastfeeding. The different therapies proposed were: psychotherapy by consultation, psychotherapy by home visits and antidepressant medication. The acceptability of antidepressants was significantly lower than either mode of psychotherapy before information was presented about the effects of antidepressants on breastmilk and significantly more so again after the information was given to mothers.
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The development of a self-report measure of subjectively assessed social support, the Multidimensional Scale of Perceived Social Support (MSPSS), is described. Subjects included 136 female and 139 male university undergraduates. Three subscales, each addressing a different source of support, were identified and found to have strong factorial validity: (a) Family, (b) Friends, and (c) Significant Other. In addition, the research demonstrated that the MSPSS has good internal and test-retest reliability as well as moderate construct validity. As predicted, high levels of perceived social support were associated with low levels of depression and anxiety symptomatology as measured by the Hopkins Symptom Checklist. Gender differences with respect to the MSPSS are also presented. The value of the MSPSS as a research instrument is discussed, along with implications for future research.
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Despite the proliferation of fatherhood programs designed to promote paternal involvement and positive family outcomes, evaluations of these programs are scarce. The Supporting Father Involvement (SFI) study is a randomized clinical trial comprised of 289 low-income Spanish- and English-speaking families living in California. The evaluation design reflects a partnership stance that promotes empowerment of staff and social service agencies. This article examines lessons learned from the program's first 3 years (2002–2004) from the perspectives of both evaluators and program staff. The lessons cover a broad range of areas, including communication procedures, training, staffing, recruitment/retention, clinical needs, intervention content and process, and maintaining cultural sensitivity.
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The average prevalence rate of non-psychotic postpartum depression based on the results of a large number of studies is 13%. Prevalence estimates are affected by the nature of the assessment method (larger estimates in studies using self-report measures) and by the length of the postpartum period under evaluation (longer periods predict high prevalences). A meta-analysis was undertaken to determine the sizes of the effects of a number of putative risk factors, measured during pregnancy, for postpartum depression. The strongest predictors of postpartum depression were past history of psychopathology and psychological disturbance during pregnancy, poor marital relationship and low social support, and stressful life events. Finally, indicators of low social status showed a small but significant predictive relation to postpartum depression. In sum, these findings generally mirror the conclusions from earlier qualitative reviews of postpartum depression risk factors.
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Prevention of postnatal mental disorders in women is an important component of comprehensive health service delivery because of the substantial potential benefits for population health. However, diverse approaches to prevention of postnatal depression have had limited success, possibly because anxiety and adjustment disorders are also problematic, mental health problems are multifactorially determined, and because relationships amongst psychosocial risk factors are complex and difficult to modify. The aim of this paper is to describe the development of a novel psycho-educational intervention to prevent postnatal mental disorders in mothers of firstborn infants. Data from a variety of sources were synthesised: a literature review summarised epidemiological evidence about neglected modifiable risk factors; clinical research evidence identified successful psychosocial treatments for postnatal mental health problems; consultations with clinicians, health professionals, policy makers and consumers informed the proposed program and psychological and health promotion theories underpinned the proposed mechanisms of effect. The intervention was pilot-tested with small groups of mothers and fathers and their first newborn infants. What Were We Thinking! is a psycho-educational intervention, designed for universal implementation, that addresses heightened learning needs of parents of first newborns. It re-conceptualises mental health problems in mothers of infants as reflecting unmet needs for adaptations in the intimate partner relationship after the birth of a baby, and skills to promote settled infant behaviour. It addresses these two risk factors in half-day seminars, facilitated by trained maternal and child health nurses using non-psychiatric language, in groups of up to five couples and their four-week old infants in primary care. It is designed to promote confidence and reduce mental disorders by providing skills in sustainable sleep and settling strategies, and the re-negotiation of the unpaid household workload in non-confrontational ways. Materials include a Facilitators' Handbook, creatively designed worksheets for use in seminars, and a book for couples to take home for reference. A website provides an alternative means of access to the intervention. What Were We Thinking! is a postnatal mental health intervention which has the potential to contribute to psychologically-informed routine primary postnatal health care and prevent common mental disorders in women.
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Universal interventions to prevent postnatal mental disorders in women have had limited success, perhaps because they were insufficiently theorized, not gender-informed and overlooked relevant risk factors. This study aimed to determine whether an innovative brief psycho-educational program for mothers, fathers and first newborns, which addressed salient learning needs about infant behaviour management and adjustment tasks in the intimate partner relationship, prevented postpartum mental health problems in primiparous women. A before and after controlled study was conducted in primary care in seven local government areas in Victoria, Australia. English-speaking couples with one-week old infants were invited consecutively to participate by the maternal and child health nurse at the universal first home visit. Two groups were recruited and followed sequentially: both completed telephone interviews at four weeks and six months postpartum and received standard health care. Intervention group participants were also invited to attend a half-day program with up to five couples and one month old infants, facilitated by trained, supervised nurses. The main outcome was any Composite International Diagnostic Interview (CIDI) diagnosis of Depression or Anxiety or Adjustment Disorder with Depressed Mood, Anxiety, or Mixed Anxiety and Depressed Mood in the first six months postpartum. Factors associated with the outcome were established by logistic regression controlling for potential confounders and analysis was by intention to treat. In total 399/646 (62%) women were recruited; 210 received only standard care and 189 were also offered the intervention; 364 (91%) were retained at follow up six months postpartum. In women without a psychiatric history (232/364; 64%), 36/125 (29%) were diagnosed with Depression or Anxiety or Adjustment Disorder with Depressed Mood, Anxiety, or Mixed Anxiety and Depressed Mood in the control group, compared with 16/107 (15%) in the intervention group. In those without a psychiatric history, the adjusted odds ratio for diagnosis of a common postpartum mental disorder was 0.43 (95% CI 0.21, 0.89) in the intervention group compared to the control group. A universal, brief psycho-educational group program for English-speaking first time parents and babies in primary care reduces de novo postpartum mental disorders in women. A universal approach supplemented by an additional program may improve effectiveness for women with a psychiatric history. ACTRN 12605000567628.
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Postnatal depression commonly affects women after the birth of a child, and is associated with an increased risk of adverse outcomes for their children. A wide variety of measures have been used to screen for depression in the postnatal period but little research has investigated such measures with men. However depression can also affect men at this time, and this is associated with an independently increased risk of adverse child outcomes. The present study aimed to determine whether a reliable cut off point for the Edinburgh Postnatal Depression Scale (EPDS) can be established to screen fathers. A sample of fathers was sent the EPDS at 7 weeks after the birth of their child. A structured clinical interview was conducted with 192 men to determine whether they were suffering from depression. Fathers with depression scored significantly higher on the EPDS than non-depressed fathers. A score of greater than 10 was found to be the optimal cut off point for screening for depression, with a sensitivity of 89.5% and a specificity of 78.2%. The relatively modest participation rate means the results may not be fully generalisable to the whole population. The EPDS is shown to have reasonable sensitivity and specificity at a cut off score of over 10. The study shows that it is possible to screen fathers for depression in the postnatal period and it may be valuable to administer this measure to new fathers.
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This panel study examines changes in the psychological distress of 280 new mothers over a one-year period. Regression analyses show that when social support is indexed as the extent of the mother's social network, this variable has no impact on changes in psychological distress. However, the cognitive experience of social support and the degree of marital intimacy make significant independent contributions to changes in psychological distress. The results also provide no confirmation for the hypothesis that the elevated levels of psychological distress reported in recent community studies of young mothers can be accounted for by the inclusion of cases of postpartum depression.
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Objectives The aim of this study was to explore the role of the paternity leave in the appearance of the maternal postpartum depression.
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The expectant father has been traditionally left out from childbirth. His growing and current attendance in the delivery ward is reviewed in this article. In his case, how did we go from interdiction to a quasi-obligation? Upon what grounds is he in demand? Could his presence be dangerous? Is not his ritualised involvement in the antenatal stage, aiming to lead him at least to the labour room, synonymous with arbitrary prescriptions? How can we help him find his real place in accordance with his identity as a male? Facing the impossibility of his attendance in the delivery room, the author lays stress on the fact that the expectant fathers' words should be free within the couple. As a first step toward the knowledge of identity troubles specific to nascent fatherhood, in a developmental viewpoint, father groups help in accepting that impossibility of attendance. Moreover, the emergence of words facilitates a potential request for individual psychological support.
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Maternal postpartum depression (PPD) has been shown to negatively influence mother–infant interaction; however, little research has explored how fathers and father–infant interaction are affected when a mother is depressed. This study examined the influence of maternal PPD on fathers and identified maternal and paternal factors associated with father–infant interaction in families with depressed as compared with nondepressed mothers. A convenience sample of 128 mother–father–infant triads, approximately half of which included women with significant symptoms of PPD at screening, were recruited from a screening sample of 790 postpartum women. Mothers and fathers completed measures of depression, marital satisfaction, and parenting stress at 2 to 3 months' postpartum and were each videotaped interacting with their infants. Results indicate that maternal PPD is associated with increased paternal depression and higher paternal parenting stress. Partners of depressed women demonstrated less optimal interaction with their infants, indicating that fathers do not compensate for the negative effects of maternal depression on the child. Although mother–infant interaction did not influence father–infant interaction, how the mother felt about her relationship with the infant did, even more so than maternal depression. The links between maternal PPD, fathers, and father–infant interaction indicate a need for further understanding of the reciprocal influences between mothers, fathers, and infants.
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Current literature indicates that risk for maternal depression is substantial in low-income families. A large body of research also indicates that when mothers are depressed, children are at risk for a number of developmental difficulties. While mutual influence between child and parental difficulties has been noted, few studies examine risk factors for both depression and child aggression within ecological models. The present cross-site study examined the unique and additive contributions of contextual factors, including SES and family functioning, on maternal depression and child aggression in Early Head Start families. A multiethnic sample of parents and their children, between the ages of 12 and 43 months, participated in this study. Families came from five Early Head Start programs across the United States, representing both urban and rural areas. Structural equation models (SEM) demonstrate mutual links between depression and aggression, mediated at least in part by ecological factors. SEM indicated that 36.4% of the variance in child aggression is accounted for in a model linking aggressive behavior to parent depression, stress, and couple-level functioning, as well as other family interaction variables. A second model focusing on maternal depression revealed that 44.5% of the variance in maternal depression was accounted for through family factors, including couple-related support and satisfaction and parenting stress. In this second model, child aggression was indirectly linked to maternal depression. These data have important implications for programs serving at-risk families.
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This study compares the efficacy of two screening programs, of prevention and of treatment of postpartum depression on 450 mothers at an obstetrical clinic. On the third day postpartum, 450 mothers filled out the EPDS (Edinburgh Postnatal Depression Scale, Cox et al.,1987). All the mothers (N = 131) who had an EPDS score above or equal to nine were randomised into two groups: one group of 71 mothers benefited from a preventive “multidimensional” intervention, with the semi-directive intervention guide, and another group, composed of 60 mothers benefited from the preventive intervention, non-directive support intervention. Around the sixth week postpartum, the mothers responded again to the EPDS. The mothers who presented scores above or equal to 12 indicating depression, also filled out the 13-items Beck Depression Inventory (BDI, Beck, 1988) and the French version of the Williams structured intervention guide (1988) for the Hamilton Depression Rating Scale (HDRS). From these evaluations, 45 mothers presented a postpartum depression and taking into account the initial randomisation, 21 mothers benefited from the eight “multidimensional” home visit interventions, and 24 mothers benefited from the eight non-directive home visit interventions. The results of this study indicate that the “multidimensional interventions” in prevention but also in treatment, reduce in a significant manner the depressive symptomatology of postpartum depression compared to “non-directive interventions”.
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Developing a sense of competence and satisfaction in the maternal role enhances positive parenting and healthy development of the child. There is limited longitudinal research on the predictive factors influencing maternal role competence and satisfaction. The aim of this study was to determine the predictive and concurrent associations of prenatal perceived maternal role competence, learned resourcefulness, social support, stress, and depression to perceived maternal role competence and satisfaction at 6 weeks postpartum. A longitudinal, descriptive design was used. A convenience sample of 184 first-time pregnant women with a singleton and uneventful pregnancy were recruited from two regional public hospitals in Hong Kong. The Parenting Sense of Competence Scale, Self-control Schedule, Medical Outcomes Study Social Support Survey, Social Readjustment Rating Scale, and Edinburgh Postnatal Depression Scale were used to assess maternal role competence and satisfaction, learned resourcefulness, social support, stress, and depressive symptoms, respectively. Data were collected during pregnancy and at 6 weeks postpartum. Multiple regression analysis showed that perceived maternal role competence and satisfaction at 6 weeks postpartum were predicted by prenatal perceived maternal role competence and learned resourcefulness and were associated with postnatal learned resourcefulness and depression. Social support and stress were not associated directly with perceived maternal role competence and satisfaction at 6 weeks postpartum. The present findings suggest that maternal learned resourcefulness and depression are important factors affecting perceived maternal role competence and satisfaction at postpartum. Culturally competent healthcare should be developed to promote the psychological well-being of women and to equip women with the learned resourcefulness skills to facilitate maternal role taking and enhance women's sense of competence and satisfaction in the maternal role.
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The validation of the French version of the Edinburgh Postnatal Depression Scale (EPDS), conducted on a sample of 87 women in the first 4 months of post-partum, is presented. The study of the sensitivity, specificity and predictive values versus research diagnosis criteria provide the cut-off score of 10.5 as the best (sensitivity: 0.80; specificity: 0.92). The EPDS as an index of severity of postnatal depression (PND) also had good criterion validity compared to the psychiatrist's assessment. Factor analysis shows that the internal structure of the EPDS is composed of two subscales which underline a more accurate description of PND. The reliability study confirms the good internal consistency of the global scale (Cronbach's alpha: 0.76) and its good short term test-retest reliability (0.98).
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Demographic, psychiatric, social, cognitive, and life stress variables were used to determine the etiology of depression in childbearing (CB; n = 182) and nonchildbearing (NCB; n = 179) women. Hormonal variables in postpartum depression were also evaluated. In the CB group predictors of depression diagnosis were previous depression, depression during pregnancy, and a Vulnerability (V) x Life Stress (LS) interaction; predictors of depressive symptomatology were previous depression, depressive symptoms during pregnancy, life events, and V x LS. Only estradiol was associated with postpartum depression diagnosis. In the NCB group V X LS was the only predictor of depression diagnosis; depressive symptoms during pregnancy and life events were predictors of depressive symptomatology. Previous findings about depression vulnerability were replicated. The significant V x LS interactions support the vulnerability-stress model of postpartum depression.
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We examined the role of a number of psychosocial variables in the onset of postpartum depression and in recovery from depression that occurs during pregnancy. Women (N = 730) were recruited during pregnancy and were followed through 1 month postpartum. They were assessed on demographic variables and on measures of depressive symptomatology and diagnostic status, perceived stress, marital satisfaction, perceptions of their own parents, dysfunctional cognitions, and coping style. Onset of depression in the postpartum was predicted by the levels during pregnancy of depressive symptomatology and perceived maternal and paternal care during childhood. In contrast, recovery in the postpartum from depression during pregnancy was not predicted by the variables examined in this study. These results are discussed with reference to previous investigations that have examined depression that occurs outside the context of childbirth.
Article
The development of a 10-item self-report scale (EPDS) to screen for Postnatal Depression in the community is described. After extensive pilot interviews a validation study was carried out on 84 mothers using the Research Diagnostic Criteria for depressive illness obtained from Goldberg's Standardised Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity, and was also sensitive to change in the severity of depression over time. The scale can be completed in about 5 minutes and has a simple method of scoring. The use of the EPDS in the secondary prevention of Postnatal Depression is discussed.
Article
A sample of 99 women was studied prospectively from the second trimester of pregnancy until nine weeks post partum. Depressed and nondepressed women identified at the second-trimester assessment and the postpartum assessment were compared on measures of stressful life events and social support provided by their spouses and close confidants. Nine percent of women during pregnancy and 12% of women after delivery were depressed. Women experiencing postpartum depression reported more stressful life events and less support from their spouses after delivery than the women not experiencing postpartum depression. Women experiencing depression during pregnancy reported somewhat less support from their spouses and more support from their confidants than nondepressed women. The results of the study suggest that different causes may be responsible for prepartum and postpartum depression.
Article
In the first study to systematically examine postnatal depression in fathers, we examined depression in 200 postnatal couples, using a two-stage design. The prevalence of depression ascertained by the 13-item Edinburgh Postnatal Depression Scale (EPDS), using a cut-off score for 'caseness' of 13 or more in an unselected postnatal sample, was 27.5% in mothers at six weeks postpartum, 25.7% in mothers at six months postpartum, 9.0% in fathers at six weeks postpartum, and 5.4% in fathers at six months postpartum. The prevalence did not differ significantly in either mothers or fathers from a control group of parents with children between three and five years of age. As expected, mothers had a significantly higher prevalence of psychiatric 'caseness' at both six weeks and six months postpartum than fathers. Fathers were significantly more likely to be cases if their partners were also cases. The hypothesis that different aetiological factors would be important in brief and persistent disorders in mothers was upheld.
Article
Interviews were carried out at 36 weeks antenatal with 63 married couples, in 36 of which the woman had a history of affective disorder and in 27 the woman had no previous psychiatric history. The men's attitudes to their wives were assessed using expressed emotion methodology. Also assessed were psychiatric history, neuroticism, satisfaction with the marital relationship and attitudes to sex, pregnancy and parenthood in both the woman and her partner. Women with psychiatric histories who did not relapse in the six months following delivery had partners who were more positive about them than partners of high-risk women who remained well and control women. This effect is explored further by examining which characteristics of the man and which of the woman contributed to his critical and positive comment score. Criticism of his wife was associated with each partner reporting less marital satisfaction and also with the man's psychiatric history. No characteristic of the woman contributed to her partner's criticism. In contrast, the men's positive comments about their wives were associated with the woman's satisfaction with key aspects of her femaleness. Positive husbands had wives were pleased to be pregnant, happy with their pregnant bodies and enjoying the sexual aspect of the marital relationship. In women with psychiatric histories the time which had elapsed since her last psychiatric admission also influenced his positive comments.
Article
This article describes the development of the Maternal Attitudes Questionnaire (MAQ), a 14-item self-report instrument measuring cognitions relating to role change, expectations of motherhood, and expectations of the self as a mother in postnatal women. This questionnaire was found to have good test-retest and internal reliability. In a large sample of women (n = 483) at 6-8 weeks postpartum, scores on the questionnaire were highly correlated with scores on the Edinburgh Postnatal Depression Scale (EPDS) and the Revised Clinical Interview Schedule (CIS-R). Cluster analysis demonstrated that, among depressed women with similar symptom scores on the CIS-R, the MAQ discriminated a group with low MAQ scores and a group with high MAQ scores. This finding supports the hypothesis that women who are depressed postnatally are cognitively heterogeneous; such differences may be important in understanding the etiology and determining the treatment of postnatal depression.
Article
The adverse, short-term effects of postpartum depression on maternal-infant interaction have been repeatedly documented. Are there long-term sequelae for children whose mothers had experienced postpartum depression? The purpose of this meta-analysis was to determine the magnitude of the effect of postpartum depression on the cognitive and emotional development of children older than the age of 1 year. Nine studies which met the sample criteria were included in this meta-analysis. Results indicated that postpartum depression had a small but significant effect on children's cognitive and emotional development. The r indicator for effect size ranged from .18 to .22 whereas the d indicator ranged from .36 to .45. Implications for future research are addressed.
Article
A community sample of depressed and well mothers, recruited at 2 months postpartum and assessed through to 18 months, was followed up at 5 years. The quality of mother-child interactions was assessed, as was the children's behavioural and social adjustment, using maternal reports and observations of child behaviour during free play at school. Several aspects of child outcome were found to be associated with postnatal depression, even when taking account of current adverse circumstances (maternal depression and parental conflict). These included the child's behaviour with the mother, the presence of behavioural disturbance at home, and the content and social patterning of play at school. These associations with postnatal depression were independent of the child's gender. The child's relationship with the mother appeared to be mediated by the quality of infant attachment at 18 months. The mother's behaviour with her child was more affected by current difficulties, in particular by conflict with the child's father. Together these findings suggest that, while maternal behaviour varies with changing circumstances, exposure to maternal depression in the early postpartum months may have an enduring influence on child psychological adjustment.
Article
Postpartum depression (PPD) is known to have important negative effects on mother, infant and mother-child relationship. We present a case-control study of 35 mothers and their 18-month-old infants. These mothers suffered from postpartum depressive symptoms (PDS) when the infants were three months old, as rated with the Edinburgh Postnatal Depression Scale (EPDS, Cox 1987). A control group of 35 mothers without postpartum depressive symptoms (NPDS) with their 18-month-old infants was also evaluated. The infants were assessed using the Infant Behavior Record of the Bayley Scales of Infant Development, the Strange Situation and an object concept task. 15 months later, the PDS mothers were less affectionate and more anxious than the NPDS mothers. The PDS dyads demonstrated less verbal interaction and less playing interaction. 18-month-old infants of PDS mothers performed less well on object concept tasks, and were more often insecurely attached to their mothers. Only some results were linked to the mothers' depressive state (D-mothers) diagnosed at 18 months (e. g. responsiveness to persons). The important negative effects observed at 18 months on mother and infant of maternal PDS at 3 months confirm the need for early identification and therapeutic or preventive interventions.
Article
Pediatric anticipatory guidance has been associated with parenting behaviors that promote positive infant development. Maternal postpartum depression is known to negatively affect parenting and may prevent mothers from following anticipatory guidance. The effects of postpartum depression in fathers on parenting is understudied. Our purpose with this work was to examine the effects of maternal and paternal depression on parenting behaviors consistent with anticipatory guidance recommendations. The 9-month-old wave of data from a national study of children and their families, the Early Childhood Longitudinal Study, provided data on 5089 2-parent families. Depressive symptoms were measured with a short form of the Center for Epidemiologic Studies Depression Scale. Interviews with both parents provided data on parent health behaviors and parent-infant interactions. Logistic and linear regression models were used to estimate the association between depression in each parent and the parenting behaviors of interest. These models were adjusted for demographic and socioeconomic status indicators. In this national sample, 14% of mothers and 10% of fathers exhibited levels of depressive symptoms on the Center for Epidemiologic Studies Depression Scale that have been associated with clinical diagnoses, confirming other findings of a high prevalence of postpartum maternal depression but highlighting that postpartum depression is a significant issue for fathers as well. Mothers who were depressed were approximately 1.5 times more likely to engage in less healthy feeding and sleep practices with their infant. In both mothers and fathers, depressive symptoms were negatively associated with positive enrichment activity with the child (reading, singing songs, and telling stories). Postpartum depression is a significant problem in both mothers and fathers in the United States. It is associated with undesirable parent health behaviors and fewer positive parent-infant interactions.
Le congé de paternité (DREES, Études et résultats, n°442). Retrieved from www
  • D Bauer
  • D Penet
Bauer, D. & Penet, D. (2005). Le congé de paternité (DREES, Études et résultats, n°442). Retrieved from www.sante.gouv.fr/IMG/pdf/er442.pdf.
Psychopathologie de la périnatalité
  • J Dayan
  • G Andro
  • M Dugnat
Dayan, J., Andro, G., & Dugnat, M. (2003). Psychopathologie de la périnatalité. Issy-Les-Moulineaux: Masson. Collection: Les âges de la vie.
Le rôle des facteurs liés au nourrisson dans la dépression maternelle
  • L Murray
Murray, L. (1998). Le rôle des facteurs liés au nourrisson dans la dépression maternelle. Devenir, 10, 63-77.