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The impact of maternal depression and personality disorder on early infant care

  • Susan ConroyEmail author
  • Maureen N. Marks
  • Robin Schacht
  • Helen A. Davies
  • Paul Moran
Original Paper

Abstract

Aim

Previous studies have reported detrimental effects of maternal depression on infant care but have not taken into account the potential confounding effects of co-morbid personality disorder. We aimed to examine the independent effects of maternal depression and personality disorder on infant care.

Method

Assessments with 200 mothers who had a diagnosis of depression, personality disorder, both conditions, or neither condition, when their infants were aged 2 months, included structured clinical interviews, an interview about infant care practices, and standardised measures of quality of the home environment, maternal involvement with the baby, maternal sensitivity and infant irritability.

Results

The presence of depression and personality disorder had significant independent detrimental effects on infant care practices and maternal involvement with the baby, while depression alone had a negative effect on quality of the home environment.

Conclusion

Women with depression are less likely to use recommended infant care practices only when they also meet criteria for co-morbid personality disorder. Professionals working with women and babies need to consider the particular difficulties that mothers with both personality disorder and depression may have in providing satisfactory infant care.

Keywords

Personality disorder Depression Infant care 

Notes

Acknowledgments

The study was funded by the Foundation for the Study of Infant Deaths, with some additional funding from the Psychiatry Research Trust. We are grateful to the women who took part in the study and to Liz Hicks and the staff at Kings College Hospital for facilitating the recruitment of participants. We also thank Laura Jones for her assistance with recruitment and screening.

References

  1. 1.
    Abela JR, Skitch SA, Auerbach RP, Adams P (2005) The impact of parental borderline personality disorder on vulnerability to depression in children of affectively ill parents. J Personal Disord 19:68–83CrossRefGoogle Scholar
  2. 2.
    American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th edn, text revision. American Psychiatric Association, Washington DCCrossRefGoogle Scholar
  3. 3.
    Brazelton TB, Nugent JK (1995) Neonatal behavioural assessment scale, 3rd edn. Mac Keith, CambridgeGoogle Scholar
  4. 4.
    Caldwell BM, Bradley RH (1984) Home observation for measurement of the environment. University of Arkansas, Little RockGoogle Scholar
  5. 5.
    Campbell SB, Cohn JF, Meyers T (1995) Depression in first-time mothers: mother–infant interaction and depression chronicity. Dev Psychol 31:349–357CrossRefGoogle Scholar
  6. 6.
    Cassidy B, Zoccolillo M, Hughes S (1996) Psychopathology in adolescent mothers and its effects on mother-infant interactions: a pilot study. Can J Psychiatry 41:379–384PubMedGoogle Scholar
  7. 7.
    Coid J, Tyrer P, Roberts A, Ullrich S (2006) Prevalence and correlates of personality disorder in Great Britain. Br J Psychiatry 188:423–431Google Scholar
  8. 8.
    Conroy S, Marks MN (2003) Maternal psychological vulnerability and early infant care in a sample of materially disadvantaged women. J Reprod Infant Psychol 21:5–22CrossRefGoogle Scholar
  9. 9.
    Crandell LE, Patrick MPH, Hobson RP (2003) Still-face interactions between mothers with borderline personality disorder and their 2-month-old infants. Br J Psychiatry 183:239–247CrossRefPubMedGoogle Scholar
  10. 10.
    Crittenden P (2001) CARE-Index coding manual. Family Relations Institute, USAGoogle Scholar
  11. 11.
    Danon G, Rosenblum C, Heroux D, Tarnopolski D, Annick L (2001) Maternal borderline personality disorder, motherhood and mother-infant interactions. Arch Womens Ment Health 3:4–5Google Scholar
  12. 12.
    DeMulder EK, Tarull LB, Klimes-Dougan B, Free K, Radke-Yarrow M (1995) Personality disorders of affectively ill mothers: links to maternal behaviour. J Personal Disord 9:199–212Google Scholar
  13. 13.
    Department of Health (2004) Reduce the risk of cot death. Department of Health, LondonGoogle Scholar
  14. 14.
    Ertem IO, Forsyth BWC, Avni-Singer AJ, Damour LK, Cicchetti DV (1996) Development of a supplement to the HOME scale for children living in impoverished urban environments. J Dev Behav Pediatr 18:322–328CrossRefGoogle Scholar
  15. 15.
    Farran D, Kasari C, Comfort M, Jay S (1986) Parent/caregiver involvement scale. Vanderbilt University, NashvilleGoogle Scholar
  16. 16.
    Field TF (2002) Early interactions between infants and their postpartum depressed mothers. Infant Behav Dev 7:517–522Google Scholar
  17. 17.
    First MB, Spitzer RL, Gibbon M, Williams JBW, Smith Benjamin L (1997) Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II). American Psychiatric Press, Washington DCGoogle Scholar
  18. 18.
    First MB, Spitzer RL, Gibbon M, Williams JBW (1997) Structured Clinical Interview for DSM-IV Axis I Disorders, Research Version, Non-patient Edition. (SCID-I/NP) Biometrics Research, New YorkGoogle Scholar
  19. 19.
    Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T (2005) Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol 106:1071–1083PubMedGoogle Scholar
  20. 20.
    Hirschfeld RM (1999) Personality disorders and depression: comorbidity. Depress Anxiety 10:142–146CrossRefPubMedGoogle Scholar
  21. 21.
    Johnson JG, Cohen P, Kasen S, Ehrensaft MK, Crawford TN (2006) Associations of parental personality disorders and Axis I disorders with childrearing behaviour. Psychiatry 69:336–350PubMedGoogle Scholar
  22. 22.
    Kim-Cohen J, Moffit TE, Taylor A et al (2005) Maternal depression and children’s antisocial behaviour. Arch Gen Psychiatry 62:173–181CrossRefPubMedGoogle Scholar
  23. 23.
    Kroenke K, Spitzer RL, Williams JB (2001) The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 16:606–613CrossRefPubMedGoogle Scholar
  24. 24.
    Moran P, Leese M, Lee T, Walters P, Thornicroft G, Mann A (2003) Standardised Assessment of Personality-Abbreviated Scale (SAPAS): preliminary validation of a brief screen for personality disorder. Br J Psychiatry 183:228–232CrossRefPubMedGoogle Scholar
  25. 25.
    Mulder RT (2002) Personality pathology and treatment outcome in major depression: a review. Am J Psychiatry 159:359–371CrossRefPubMedGoogle Scholar
  26. 26.
    Murray L, Fiori-Cowley A, Hooper R (1996) The impact of postnatal depression and associated adversity on early mother-infant interactions and later infant outcome. Child Dev 67:2512–2526CrossRefPubMedGoogle Scholar
  27. 27.
    Murray L, Cooper P, Creswell C, Schofield E, Sack C (2007) The effects of maternal social phobia on mother-infant interactions and infant social responsiveness. J Child Psychol Psychiatry 48:45–52CrossRefPubMedGoogle Scholar
  28. 28.
    Newman LK, Stevenson CS, Bergman LR, Boyce P (2007) Borderline personality disorder, mother-infant interaction and parenting perceptions: preliminary findings. Aust N Z J Psychiatry 41:598–605CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Susan Conroy
    • 1
    Email author
  • Maureen N. Marks
    • 2
  • Robin Schacht
    • 2
  • Helen A. Davies
    • 2
  • Paul Moran
    • 2
  1. 1.PO71, Section of Perinatal Psychiatry, Institute of PsychiatryKings College LondonLondonUK
  2. 2.Institute of PsychiatryKings College LondonLondonUK

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