Postpartum Depression and Maternal Attachment Beyond Two Years: The Role of Maternal Self-Efficacy
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Aims: Although postpartum depression (PPD) negatively affects the quality of mother-infant attachment, little is known about the long term effects of depression on maternal attachment quality. This longitudinal follow-up study examined relationships between previous distress at childbirth, current depressive symptomatology, maternal self efficacy, and effects upon maternal attachment quality. Methods: Fifty-four women who had been screened for childbirth distress 2 years prior, agreed to participate in a telephone interview. Of these women 68.5 % were previously classified as distressed and the remainder were non-distressed. Women completed the Edinburgh Postnatal Depression Scale (EPDS), Maternal Postnatal Attachment Scale (MPAS) and Parental Sense of Competency Scale (PSCS). Their infants’ mean age was 28.9 months (SD = 2.33 months) with 53.7 % being male. Results: Seven participants, all previously distressed were still depressed (EPDS score of <12). Previous distress significantly increased the risk of depression at 2 years postpartum, and significantly decreased maternal attachment quality. Current depression negatively affected maternal attachment quality. Maternal self-efficacy was positively correlated with maternal attachment quality. Maternal self-efficacy was found to moderate, rather than mediate, the relationship between current depression and maternal attachment. Conclusions: Few studies follow-up participants beyond 2 years. Childbirth distress increases the risk of depression at 2 years postpartum. Childbirth distress and current depression negatively affect maternal attachment quality. Maternal self-efficacy appears to buffer the negative effect of depression upon maternal attachment quality. Limitations, clinical implications and recommendations for future research are discussed.
Archives of Women's Mental Health