Maternal postpartum depression, maternal distress and sensitivity

Maternal postpartum depression,
maternal distress and sensitivity
Anna Sidor, Elisabeth Kunz,
Daniel Schweyer & Manfred Cierpka
University Clinic Heidelberg, Institute for Psychosomatic
Cooperation Research and Family Therapy
PFIFF
The project “Early Interventions for Families” (“PFIFF” –
“Projekt Frühe Interventionen für Familien”) is an
accompanying research project of the intervention project
“KfdN” (‘Nobody Slips through the Cracks ’). “KfdN” is an
intervention project for families during their infant’s first year of
life. The aim of “KfdN” is to support many different kinds of
young families, especially high risk families who would not
seek help on their own, to prevent child abuse and neglect
and to support their relationship.
Results
CARE-Index: maternal sensitivity
30,3%
32,6%
Background
Maternal postpartal depression, as a communicative disorder,
affects strongly the mother-infant–interaction. Mothers with
depression display less positive affect when interacting with their
infants; they are also less sensitive to infants´ signals compared
to non-depressed mothers. Depressed women also display more
distress and more adjustment difficulties to their role as a mother
than non-depressed ones.
The aim of the study was to explore possible links between
maternal postpartum depression (EPDS), maternal distress (PSI/
SF) and sensitivity (CARE-Index) as well as their control and
unresponsivity (CARE-Index) .
Design
M = 5.6
SD = 2.4
Range 0-12
n = 178
33,7%
EPDS: maternal postpartum depression
%
M = 7.4
SD = 5.9
Range 0-26
cut-off 13
n = 366
%
PFIFF is a quasi experimental longitudinal study, i.e. a controlled
study in a naturalistic setting. The control group was recruited
outside the implementation area. Data are raised at four points in
time : at 4 months, 6 months, 1 year, and 2 years of age.
Below we present results from the first point in time , when the
babies were about 19 weeks old (M = 19.00, SD= 3.09).
Sample
The sample is comprised of 106 mother-child-dyads at
psychosocial risk (i.e. poverty, alcohol or drug abuse, lack of social
support, teenage mothers, maternal psychiatric disorders).
Measures
• CARE-Index (Crittenden, 2005)
• Edinburgh Postnatal Depression Scale (EPDS, Cox, Holden &
Sargovsky, 1987)
• Parenting Stress Index-Short Form (PSI-SF, Abidin, 1995)
Additional self report questionnaires were applied to assess the
child’s and parental situation.
Procedure
The assessments were administered by trained psychology
students in a home setting and lasted approximately 1 hour.
Institut für Psychosomatische
Kooperationsforschung
und Familientherapie
Prediction of maternal postpartum depression
M 5,67 (2,49)
A hierarchical regression analysis yielded a highly significant
relation between PSI-SF “parental distress“ and “EDPS”-score
(R²= 0.55; F = 61.6; Beta = 0.66, p = 0.00).
The other variables: “maternal sensitivity”, “maternal control”,
“maternal unresponsivity” as well as “PSI–SF dysfunctional
parent-child interaction” were not significant.
Conclusions
1.  Depressive symptoms and maternal sensitivity were
not linked, perhaps due to different measuring methods
(self report and observation). Above that, the EDPS-score
should be regarded as a screening result and not as a
psychiatric diagnosis of depression.
2.  Maternal distress was strongly related to maternal
depressive symptoms and contributed to 55 % variance
of postpartum depressive symptoms.
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