Comparative study of the factors involved in the mother-infant bonding in women with and without postpartum depression
- Autores: Bruma Palacios Hernández
- Directores de la Tesis: Susana Subirà (dir. tes.), Lluïsa García Esteve (codir. tes.)
- Lectura: En la Universitat Autònoma de Barcelona ( España ) en 2015
- Idioma: inglés
- Tribunal Calificador de la Tesis: Maria Luisa Lazaro Garcia (presid.), Jorge Javier Osma López (secret.), Glòria Albacar Sancho (voc.)
- Materias:
- Enlaces
- Resumen
Previous studies have identified a higher prevalence of mother-infant bonding disorders in women that suffer from postpartum depression. Nevertheless not all the depressed mothers present a disturbance in their early relationship with their infants and there is few information that identifies the factors that are more related to a mother-infant bonding disorder in depressed mothers, specially in Spanish postpartum women. The present doctoral thesis had as main objective to study the early mother-infant bonding process in postpartum depressed mothers and compare them with mothers without depression. To fulfill the main objective of the thesis three studies were developed with their own particular design, methodology and population.
The first study assessed the psychometric properties of the Postpartum Bonding Questionnaire (PBQ, Brockington et al, 2001, 2006) in a sample of 847 Spanish mothers at 4-6 weeks of postpartum. The total sample included 513 mothers from the general population and 327 mothers from a clinical sample, that attended a Perinatal Psychiatry Program. The original four-structure of the PBQ could not be replicated and a general factor was identified as the most stable solution. Good psychometric properties were reported in the Spanish version of the PBQ. The second study had a cross-sectional design and identified an association between the severity of postpartum depressive episode and not breastfeeding with early mother-infant bonding disturbances in 77 mothers diagnosed with a major depressive episode at 4-6 weeks of postpartum. Study 2 allowed to identify a prevalence of 33.8% of mother-infant bonding disturbances in depressed mothers using the PBQ (total score ¿26). The third study assessed the mother-infant bonding in a sample of 45 mothers with mental health disorders in the postpartum. It also allowed the comparison of the psychometric properties of three questionnaires that assess mother-infant bonding: PBQ, MPAS (Condon & Corkindale, 2006) and MIBS (Taylor et al, 2005) and their utility in clinical samples. Of the three questionnaires, the PBQ show the highest psychometric properties. Preliminary cutoff points to identify a mother-infant bonding disorder were identified for the 3 questionnaires with the use of the Birmingham Interview for Maternal Mental Health (Brockington et al 2006) as the gold standard.
The main conclusions were that the severity of depression and not breastfeeding are negatively associated to mother-infant bonding disturbances (MIBD) in depressed mothers. Also the depressed mothers reported a higher prevalence of MIBD than mothers with mental health disorders and mothers from the general population. Also the PBQ was confirmed as a valid and reliable questionnaire to assess mother-infant bonding difficulties in Spanish postpartum mothers with the best psychometric properties when compared with the MPAS and the MIBS. Specific associations between primiparity, psychopharmacological treatment, depression (specifically sleeping problems, crying due to unhapinness and suicidal thoughts) and anxiety were also identified associated with mother-infant bonding difficulties.
