Skip to main content

Advertisement

Log in

Perceived parenting stress in the course of postpartum depression: the buffering effect of maternal bonding

  • Original Article
  • Published:
Archives of Women's Mental Health Aims and scope Submit manuscript

Abstract

Research investigating maternal bonding and parenting stress in the course of postpartum depression is lacking. Aim of the study was to investigate the development and potential mediation of both constructs in the course of postpartum depression. n = 31 mothers with postpartum depression according to DSM-IV and n = 32 healthy controls completed the German version of the Postpartum Bonding Questionnaire and the Parenting Stress Index at two measuring times: acute depression (T1) and remission (T2). At T1, the clinical group reported lower bonding and higher parenting stress. Bonding was found to partially mediate the link between maternal diagnosis and parenting stress. Furthermore, the clinical group reported lower bonding and higher parenting stress averaged over both measurement times. However, at T2, the clinical group still differed from the controls even though they improved in bonding and reported less parenting stress. A significant increase of bonding was also observed in the control group. Maternal bonding seems to buffer the negative impact of postpartum depression on parenting stress. The results emphasize the need for interventions focusing on maternal bonding and mother-infant interaction in order to prevent impairment of the mother-child relationship.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Abidin RR (1995) Parenting stress index, 3rd edn. Psychological Assessment Resources, Odessa FL

    Google Scholar 

  • Baron RM, Kenny DA (1986) The moderator–mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol 51(6):1173–1182

    Article  CAS  PubMed  Google Scholar 

  • Beck AT, Steer RA (1995) Beck-Depressions-Inventar: BDI (2., überarb. Aufl. ed.). Huber, Bern; Göttingen

    Google Scholar 

  • Bortz J (2005) Statistik für Human- und Sozialwissenschaftler: mit242 Tabellen (6., vollst. überarb. und aktualisierte Aufl. ed.). Springer, Heidelberg

    Google Scholar 

  • Brockington I (2004) Postpartum psychiatric disorders. Lancet 363(9405):303–310

    Article  PubMed  Google Scholar 

  • Brockington I, Oates J, George S, Turner D, Vostanis P, Sullivan M, Murdoch C (2001) A screening questionnaire for mother-infant bonding disorders. Arch Womens Ment Health 3(4):133–140

    Article  Google Scholar 

  • Cohen J (1988) Statistical power analysis for the behavioral sciences (2. ed. ed.). Erlbaum, Hillsdale, NJ

    Google Scholar 

  • Cornish AM, McMahon CA, Ungerer JA, Barnett B, Kowalenko N, Tennant C (2006) Maternal depression and the experience of parenting in the second postnatal year. J Reprod Infant Psychol 24(2):121–132

    Article  Google Scholar 

  • Cumming G (2009) Inference by eye: reading the overlap of independent confidence intervals. Stat Med 28(2):205–220

    Article  PubMed  Google Scholar 

  • Deater-Deckard K, Pickering K, Dunn JF, Golding J (1998) Family structure and depressive symptoms in men preceding and following the birth of a child. The Avon Longitudinal Study of Pregnancy and Childhood Study Team. Am J Psychiatr 155(6):818–823

    CAS  PubMed  Google Scholar 

  • Eid M, Gollwitzer M, Schmitt M (2011) Statistik und Forschungsmethoden Lehrbuch. Beltz, Weinheim

    Google Scholar 

  • Faul F, Erdfelder E, Lang A, Buchner A (2007) GPower 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39:175–191

    Article  PubMed  Google Scholar 

  • Faul F, Erdfelder E, Buchner A, Lang A (2009) Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods 41:1149–1160

    Article  PubMed  Google Scholar 

  • Field T (2010) Postpartum depression effects on early interactions, parenting, and safety practices: a review. Infant Behav Dev 33(1):1–6

    Article  PubMed  PubMed Central  Google Scholar 

  • Field T, Hernandez-Reif M, Diego M (2006) Intrusive and withdrawn depressed mothers and their infants. Dev Rev 26(1):15–30

    Article  Google Scholar 

  • Forman DR, O’Hara MW, Stuart S, Gorman LL, Larsen KE, Coy KC (2007) Effective treatment for postpartum depression is not sufficient to improve the developing mother-child relationship. Dev Psychopathol 19(2):585–602. doi:10.1017/S0954579407070289

    Article  PubMed  Google Scholar 

  • Gelfand DM, Teti DM, Fox CR (1992) Sources of parenting stress for depressed and nondepressed mothers of infants. J Clin Child Psychol 21(3):262–272

    Article  Google Scholar 

  • Gerdes AC, Hoza B, Arnold LE, Pelham WE, Swanson JM, Wigal T, Jensen PS (2007) Maternal depressive symptomatology and parenting behavior: exploration of possible mediators. J Abnorm Child Psychol 35(5):705–714. doi:10.1007/s10802-007-9134-3

    Article  PubMed  Google Scholar 

  • Hoffenkamp HN, Tooten A, Hall RAS, Braeken J, Eliëns MPJ, Vingerhoets AJJM, Van Bakel HJA (2015) Effectiveness of hospital-based video interaction guidance on parental interactive behavior, bonding, and stress after preterm birth: a randomized controlled trial. J Consult Clin Psychol 83(2):416–429. doi:10.1037/a0038401

    Article  PubMed  Google Scholar 

  • Holden EW, Banez GA (1996) Child abuse potential and parenting stress within maltreating families. J Fam Violence 11(1):1–12

  • Hornstein C, Schenk S, Wortmann-Fleischer S, Downing G, Schwarz M (2006) Videotherapie bei postpartalen Störungen. Ein interaktionales Behandlungskonzept bei Müttern mit Depressionen und Psychosen. Psychotherapeut 51(5):363–368. doi:10.1007/s00278-006-0484-z

    Article  Google Scholar 

  • Hornstein C, Hohm E, Trautmann-Villalba P (2009) (1995). Bonding: building the foundations of secure attachment and independence. In: Bonding: building the foundations of secure attachment and independence. Addison-Wesley, Massachussetts

    Google Scholar 

  • Klaus MH, Kennel JH, Klaus P (1995) Symptoms in the postnatal period are associated with long-term impairment of mother-child bonding. Arch Womens Ment Health 9(5):273–278. doi:10.1007/s00737-006-0149-5

    Google Scholar 

  • Little R (1988) A test of missing completely at random for multivariate data with missing values. J Am Stat Assoc 83:1198–1202

    Article  Google Scholar 

  • Loh C-C, Vostanis P (2004) Perceived mother-infant relationship difficulties in postnatal depression. Infant Child Dev 13(2):159–171. doi:10.1002/icd.347

    Article  Google Scholar 

  • Main M (2000) The organized categories of infant, child and adult attachment: flexible vs. inflexible attention under attachment-related stress. J Am Psychoanal Assoc 48:1055–1095

    Article  CAS  PubMed  Google Scholar 

  • Main M, Kaplan N, Cassidy J (1985) Security in infancy, childhood, and adulthood: a move to the level of representation. Monogr Soc Res Child Dev 50:66–104

    Article  Google Scholar 

  • Mäntymaa M, Puura K, Luoma I, Salmelin RK, Tamminen T (2006) Mother’s early perception of her infant’s difficult temperament, parenting stress and early mother-infant interaction. Nord J Psychiatry 60(5):379–386. doi:10.1080/08039480600937280

    Article  PubMed  Google Scholar 

  • Mason ZS, Briggs RD, Silver EJ (2011) Maternal attachment feelings mediate between maternal reports of depression, infant social–emotional development, and parenting stress. J Reprod Infant Psychol 29(4):382–394. doi:10.1080/02646838.2011.629994

    Article  Google Scholar 

  • McMahon C, Trapolini T, Barnett B (2008) Maternal state of mind regarding attachment predicts persistence of postnatal depression in the preschool years. J Affect Disord 107(1–3):199–203

  • Mills-Koonce WR, Appleyard K, Barnett M, Deng M, Putallaz M, Cox M (2011) Adult attachment style and stress as risk factors for early maternal sensitivity and negativity. Infant Ment Health J 32(3):277–285. doi:10.1002/imhj.20296

    Article  PubMed  PubMed Central  Google Scholar 

  • Misri S, Kendrick K, Oberlander TF, Norris S, Tomfohr L, Zhang H, Grunau RE (2010) Antenatal depression and anxiety affect postpartum parenting stress: a longitudinal, prospective study. Can J Psychiatry 55(4):222–228

    PubMed  Google Scholar 

  • Moehler E, Brunner R, Wiebel A, Reck C, Resch F (2006) Maternal depressive Die postpartale Bindungsstörung: Eine Risikokonstellation für den Infantizid? Forensische Psychiatrie Psychologie Kriminologie 1:1–8. doi:10.1007/s11757-008-0111-7

    Google Scholar 

  • Mombour W, Spitzner S, Reger KH, Von Cranach M, Dilling H, Helmchen H (1990) Summary of the qualitative criticisms made during the ICD-10 field trial and remarks on the German translation of ICD-10. Pharmacopsychiatry 23:197–201

    Article  PubMed  Google Scholar 

  • Müller M, Zietlow A, Tronick E, Reck C (2015) What dyadic reparation Is meant to do: an association with infant cortisol reactivity. Psychopathology. doi:10.1159/000439225

  • Mulsow M, Caldera YM, Pursley M, Reifman A, Huston AC (2002) Multilevel factors influencing maternal stress during the first three years. J Marriage Fam 64(4):944–956. doi:10.1111/j.1741-3737.2002.00944.x

    Article  Google Scholar 

  • Murray L, Cooper P (1997a) Effects of postnatal depression on infant development. Arch Dis Child 77(2):99–101

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Murray L, Cooper P (1997b) Postpartum depression and child development. Psycholigal Med 27(2):253–260

    Article  CAS  Google Scholar 

  • Noorlander Y, Bergink V, van den Berg MP (2008) Perceived and observed mother-child interaction at time of hospitalization and release in postpartum depression and psychosis. Arch Womens Ment Health 11(1):49–56

    Article  CAS  PubMed  Google Scholar 

  • O’Hara MW, Swain AM (1996) Rates and risk of postpartum depression-a meta-analysis. Int Rev Psychiatry 8(1):37–54. doi:10.3109/09540269609037816

    Article  Google Scholar 

  • Papoušek H, Papoušek M (1995) Intuitive parenting. In: Bornstein MH (ed) Handbook of parenting, vol 2, Biology and ecology of parenting. Lawrence Erlbaum Associates, Inc., Hillsdale, NJ, England, pp 117–136

    Google Scholar 

  • R Development Core Team (2011) R: a language and environment for statistical computing. the R Foundation for Statistical Computing, Vienna, Austria. Available online at http://www.R-project.org/

  • Reck C, Klier CM, Pabst K, Stehle E, Steffenelli U, Struben K, Backenstrass M (2006) The German version of the postpartum bonding instrument: psychometric properties and association with postpartum depression. Arch Womens Ment Health 9(5):265–271. doi:10.1007/s00737-006-0144-x

    Article  CAS  PubMed  Google Scholar 

  • Reck C, Struben K, Backenstrass M, Stefenelli U, Reinig K, Fuchs T, Mundt C (2008) Prevalence, onset and comorbidity of postpartum anxiety and depressive disorders. Acta Psychiatr Scand 118:459–468. doi:10.1111/j.1600-0447.2008.01264.x

    Article  CAS  PubMed  Google Scholar 

  • Reck C, Noe D, Stefenelli U, Fuchs T, Cenciotti F, Stehle E, Tronick EZ (2011) Interactive coordination of currently depressed inpatient mothers and their infants during the postpartum period. Infant Ment Health J 32(5):542–562. doi:10.1002/imhj.20312

    Article  Google Scholar 

  • Reck C, Noe D, Gerstenlauer J, Stehle E (2012) Effects of postpartum anxiety disorders and depression on maternal self-confidence. Infant Behav Dev 35(2):264–272. doi:10.1016/j.infbeh.2011.12.005

    Article  PubMed  Google Scholar 

  • Riva Crugnola C, Gazzotti S, Spinelli M, Ierardi E, Caprin C, Albizzati A (2013) Maternal attachment influences mother-infant styles of regulation and play with objects at nine months. Attach Hum Dev 15(2):107–131

    Article  PubMed  Google Scholar 

  • Sidor, Anna, Kunz, Elisabeth, Schweyer, Daniel, Eickhorst, Andreas, & Cierpka, Manfred. (2011). Links between maternal postpartum depressive symptoms, maternal distress, infant gender and sensitivity in a high-risk population. Child and Adolescent Psychiatry and Mental Health, 5. doi: 10.1186/1753-2000-5-7

  • Sobel ME (1982) Asymptotic intervals for indirect effects in structural equations models. In: Leinhart S (ed) Sociological methodology. Jossey-Bass, San Francisco, pp 290–312

    Google Scholar 

  • Tharner A, Luijk MPCM, Van I, Marinus H, Bakermans K, Marian J, Jaddoe VWV, Hofman A, Tiemeier H (2012) Infant attachment, parenting stress, and child emotional and behavioral problems at age 3 years. Parenting Science Practice 12(4):261–281. doi:10.1080/15295192.2012.709150

    Article  Google Scholar 

  • Thomason E, Volling BL, Flynn HA, McDonough SC, Marcus SM, Lopez JF, Vazquez DM (2014) Parenting stress and depressive symptoms in postpartum mothers: bidirectional or unidirectional effects? Infant Behav Dev 37(3):406–415

  • Tronick EZ, Reck C (2009) Infants of depressed mothers. Harv Rev Psychiatry 17(2):147–156. doi:10.1080/10673220902899714

    Article  PubMed  Google Scholar 

  • Wilkinson RB, Mulcahy R (2010) Attachment and interpersonal relationships in postnatal depression. J Reprod Infant Psychol 28(3):252–265

  • Wittchen H-U, Wunderlich U, Gruschwitz S, Zaudig M (1997) SKID-I: Strukturiertes Klinisches Interview für DSM-IV. Achse I: Psychische Störungen. Hogrefe, Göttingen

    Google Scholar 

  • World Health Organization (WHO) (1992) The ICD-10 classification of mental and behavioural disorders, 10th edn. World Health Organization, Geneva

    Google Scholar 

Download references

Acknowledgments

We would like to thank the mothers and children participating in the study. Furthermore, we would like to express our thanks to the maternity clinics and their staff for their willingness to cooperate and their support in recruiting patients. The study was supported by a grant from the Program of Research Support of the Medical Faculty (funding period: 2003–2004), Dietmar Hopp as well as by Köhler and Jung foundation.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to C. Reck.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Reck, C., Zietlow, AL., Müller, M. et al. Perceived parenting stress in the course of postpartum depression: the buffering effect of maternal bonding. Arch Womens Ment Health 19, 473–482 (2016). https://doi.org/10.1007/s00737-015-0590-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00737-015-0590-4

Keywords

Navigation