Archives of Women's Mental Health

, Volume 16, Issue 5, pp 391–399 | Cite as

The mental health of mothers of unsettled infants: is there value in routine psychosocial assessment in this context?

  • Bettina Christl
  • Nicole Reilly
  • Michelle Smith
  • Deborah Sims
  • Fran Chavasse
  • Marie-Paule AustinEmail author
Original Article


This study aims to investigate the (1) pattern of psychosocial risk factors among mothers of unsettled infants, (2) the relationship between these risk factors and current mental health status and (3) acceptability of psychosocial risk assessment in the parentcraft setting. Women with unsettled infants aged up to 12 months were assessed using the Edinburgh Postnatal Depression Scale, a diagnostic interview (Mini-International Neuropsychiatric Interview (MINI)) and a psychosocial assessment tool, the Postnatal Risk Questionnaire (PNRQ). Of the women, 27.5 % met the MINI diagnostic criteria for a current (predominantly) anxiety disorder, and 43.1 %, for a past psychiatric diagnosis. On the Edinburgh Postnatal Depression Scale, 29.9 % of women scored above 12 (mean 9.8; SD 5.1). The most common psychosocial risk factors were high trait anxiety (40.9 %), past mental health problems (40.7 %), perfectionistic traits (38.1 %) and ‘abuse trauma’ of any kind (31.6 %). The likelihood of meeting diagnostic criteria for a current mental illness was significantly increased for women who experienced emotional abuse during childhood (adj. odds ratio (OR) 3.386; p = 0.006), had high trait anxiety (adj. OR = 2.63, p = 0.003) or had a negative birth experience (adj. OR 2.78; p = 0.015). The majority of women (78 %) felt moderately to very comfortable completing the PNRQ. The results showed high rates of current anxiety disorders (almost twice that of the general postnatal population) and multiple significant psychosocial risk factors among mothers with unsettled infants. Identification of specific psychosocial risk factors in mothers of unsettled infants can help to address issues beyond infant settling difficulties such as mother–infant interaction, especially for mothers with unresolved issues around their own parenting or trauma history.


Postnatal period Mental health Psychosocial risk assessment Parent craft Unsettled infants 



We gratefully acknowledge the Tresillian mothers and staff for supporting this study, the Research Fellowship funding from the NSW Institute of Psychiatry, the St John of God Health Care and Anne-Lyse De Guio and Catherine Fowler for facilitating the study at the Tresillian Family Centres.

Conflict of interest

There are no conflicts of interest, actual or potential, related to the submitted manuscript.


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Copyright information

© Springer-Verlag Wien 2013

Authors and Affiliations

  • Bettina Christl
    • 1
  • Nicole Reilly
    • 1
  • Michelle Smith
    • 2
    • 3
    • 4
  • Deborah Sims
    • 1
  • Fran Chavasse
    • 5
    • 6
  • Marie-Paule Austin
    • 7
    Email author
  1. 1.Perinatal and Women’s Mental Health Unit, St John of God Health Care and School of PsychiatryUniversity of New South WalesBurwoodAustralia
  2. 2.St John of God Hospital BurwoodBurwoodAustralia
  3. 3.Prince of Wales Hospital RandwickRandwickAustralia
  4. 4.University of New South WalesRandwickAustralia
  5. 5.Tresillian Family Care CentreBelmoreAustralia
  6. 6.University of Technology SydneySydneyAustralia
  7. 7.St John of God Chair Perinatal and Women’s Mental Health, Perinatal and Women’s Mental Health Unit, St John of God Health Care and School of PsychiatryUniversity of New South WalesBurwoodAustralia

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