An evaluation of two bonding questionnaires: A comparison of the Mother-to-Infant Bonding Scale with the Postpartum Bonding Questionnaire in a sample of primiparous mothers

Division of Clinical Psychology, School of Psychological Sciences, University of Manchester, Manchester, UK.
Archives of Women s Mental Health (Impact Factor: 2.16). 02/2007; 10(4):171-5. DOI: 10.1007/s00737-007-0191-y
Source: PubMed


The emotions and attitudes of mothers towards their infants are crucial for the child's well-being and development. Some mothers experience a delay in the onset of maternal affection after childbirth and occasionally a longer lasting failure to bond will ensue. Little is known about the precise prevalence of these difficulties, how they relate to maternal mental health, how they develop over time and what their biological and psychosocial correlates are. In research studies the mother-infant relationship has traditionally been assessed using observational methods but these are time consuming and not suited for screening in clinical practice. Two self-rating instruments have recently been developed to assess maternal bonding. Both can be used in large samples of recently delivered mothers including those suspected to be at high risk of bonding disorders. In this study, the psychometric properties of the 8-item Mother-to-Infant Bonding Scale (MIB) and the 25-item screening questionnaire for mother-infant bonding disorders, namely the Postpartum Bonding Questionnaire (PBQ), were examined in a sample of first-time mothers in order to establish their reliability and validity. Ninety-six women completed the MIB, PBQ and the Kennerley Blues Scale on day 2-4 postpartum. Both bonding instruments demonstrated acceptable reliability and reasonable validity, with the exception of the PBQ subscale of risk of abuse.

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Available from: Anja Wittkowski, Jun 17, 2015
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    • "The MIBS was soon after modified by Kumar's colleague Marks, which resulted in the addition of two adjectives (possessive and scared or panicky) for a total of ten items [18]. Although both the PBQ and the MIBS measure the spectrum of bonding disorders and have been found to be moderately associated with each other [19] [20], there are some conceptual differences between them. One difference was that Brockington included 'infant-focused anxiety', which was a subscale of the PBQ, as a criterion of bonding disorders . "
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    ABSTRACT: The purpose of this study was to develop the Japanese version of the Postpartum Bonding Questionnaire (PBQ) to gather data on Japanese mothers for comparison with other cultures and to examine the scale structure of the PBQ among Japanese mothers. We administered the PBQ to a cross-section of 244 mothers 4weeks after delivery and again 2weeks later to 199 mothers as a retest to examine reliability. We used exploratory factor analysis to evaluate the factor structure of the PBQ. Correlations with the Mother-to-Infant Bonding Scale (MIBS), the Maternal Attachment Inventory (MAI), Edinburgh Postnatal Depression Scale (EPDS), and sociodemographic variables were calculated for validation. The 14-item version of the PBQ extracted by exploratory analysis consisted of four factors: 'impaired bonding', 'rejection and anger', 'anxiety about care', and 'lack of affection'. We found significant correlations of the total scores of the PBQ and the 14-item version of the PBQ positively with the MIBS and negatively with the MAI. Moderate significant correlations with total scores were also found with the EPDS. Total scores for primiparous and depressed mothers were higher than those for multiparous mothers and mothers without depression. The results of this study demonstrated the reliability and validity of the PBQ and the 14-item version of the PBQ in Japanese mothers 4weeks after delivery. Copyright © 2015. Published by Elsevier Inc.
    Full-text · Article · Feb 2015 · Journal of Psychosomatic Research
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    • "This eightitem scale is intended to assess the mother's feelings of attachment to her infant. It has an internal reliability of 0.66 and its validity has been established in postpartum samples with respect to other available bonding instruments (Wittkowski et al. 2007). Other measures administered to this sample for concurrent studies on stress, coping, and personality factors with respect to PPD were not included in this analysis (our unpublished data). "
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    ABSTRACT: The transition to motherhood is a time of elevated risk for clinical depression. Dispositional optimism may be protective against depressive symptoms; however, the arrival of a newborn presents numerous challenges that may be at odds with initially positive expectations, and which may contribute to depressed mood. We have explored the relative contributions of antenatal and postnatal optimism regarding maternity to depressive symptoms in the postnatal period. Ninety-eight pregnant women underwent clinician interview in the third trimester to record psychiatric history, antenatal depressive symptoms, and administer a novel measure of optimism towards maternity. Measures of depressive symptoms, attitudes to maternity, and mother-to-infant bonding were obtained from 97 study completers at monthly intervals through 3 months postpartum. We found a positive effect of antenatal optimism, and a negative effect of postnatal disconfirmation of expectations, on depressive mood postnatally. Postnatal disconfirmation, but not antenatal optimism, was associated with more negative attitudes toward maternity postnatally. Antenatal optimism, but not postnatal disconfirmation, was associated with reduced scores on a mother-to-infant bonding measure. The relationships between antenatal optimism, postnatal disconfirmation of expectations, and postnatal depression held true among primigravidas and multigravidas, as well as among women with prior histories of mood disorders, although antenatal optimism tended to be lower among women with mental health histories. We conclude that cautious antenatal optimism, rather than immoderate optimism or frank pessimism, is the approach that is most protective against postnatal depressive symptoms, and that this is true irrespective of either mood disorder history or parity. Factors predisposing to negative cognitive assessments and impaired mother-to-infant bonding may be substantially different than those associated with depressive symptoms, a finding that merits further study.
    Full-text · Article · Aug 2014 · Archives of Women s Mental Health
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    • "Maternal emotional components are also thought to be able to promote bonding. For example, a positive early attitude of the mother (Wittkowski et al., 2007) and a mother's realistic expectation of the parenting role may promote maternal–infant bonding (Broedsgaard and Wagner, 2005). Examination of the literature revealed that in order to promote maternal–infant bonding, health-care providers should attempt to promote not only physical proximity of mother and newborn, but also a positive emotional state of the mother at birth. "
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    ABSTRACT: OBJECTIVE: to provide a principle-based analysis of the concept of maternal-infant bonding. DESIGN: principle-based method of concept analysis for which the data set included 44 articles published in the last decade from Pubmed, CINAHL, and PyschINFO/PsychARTICLES. SETTING: literature inclusion criteria were English language, articles published in the last decade, peer-reviewed journal articles and commentary on published work, and human populations. MEASUREMENT AND FINDINGS: after a brief review of the history of maternal-infant bonding, a principle-based concept analysis was completed to examine the state of the science with regard to this concept. The concept was critically examined according to the clarity of definition (epistemological principle), applicability of the concept (pragmatic principle), consistency in use and meaning (linguistic principle), and differentiation of the concept from related concepts (logical principle). Analysis of the concept revealed: (1) Maternal-infant bonding describes maternal feelings and emotions towards her infant. Evidence that the concept encompasses behavioural or biological components was limited. (2) The concept is clearly operationalised in the affective domain. (3) Maternal-infant bonding is linguistically confused with attachment, although the boundaries between the concepts are clearly delineated. KEY CONCLUSION: despite widespread use of the concept, maternal-infant bonding is at times superficially developed and subject to confusion with related concepts. Concept clarification is warranted. A theoretical definition of the concept of maternal-infant bonding was developed to aid in the clarification, but more research is necessary to further clarify and advance the concept. IMPLICATIONS FOR PRACTICE: nurse midwives and other practitioners should use the theoretical definition of maternal-infant bonding as a preliminary guide to identification and understanding of the concept in clinical practice.
    Full-text · Article · Feb 2013 · Midwifery
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