Archives of Women's Mental Health

, Volume 17, Issue 5, pp 433–442 | Cite as

Maternal bonding in mothers with postpartum anxiety disorder: the crucial role of subclinical depressive symptoms and maternal avoidance behaviour

  • A. TietzEmail author
  • A.-L. Zietlow
  • C. Reck
Original Article


Hardly any research has examined the link between postpartum anxiety disorder and maternal bonding. This study examined if postpartum anxiety disorder and maternal bonding are related in the postpartum period. Thereby, subclinical depressive symptoms and specific aspects of an anxious symptomatology were also taken into consideration. The German sample of N = 78 mother–infant dyads is composed of n = 30 mothers with postpartum anxiety disorders but without major or minor depression according to the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) and n = 48 healthy mothers. Subjects were interviewed with the Structured Clinical Interview for DSM-IV Disorders at an average infant age of M = 4.1 months. Moreover, mothers filled out the Postpartum Bonding Questionnaire-16. The Anxiety Cognitions Questionnaire, the Body Sensations Questionnaire and the Mobility Inventory were chosen to assess different aspects of anxious symptomatology. To control for concurrent subclinical depressive symptoms, we used the German Edinburgh-Postnatal-Depression Scale. Mothers with postpartum anxiety disorder reported significantly lower bonding than healthy mothers. However, in a linear regression analysis, concurrent subclinical depressive symptoms and avoidance of anxiety-related situations in company explained 27 % of the overall variance in maternal bonding. The perceived lower bonding of mothers with anxiety disorder could be due to aspects of a concurrent subclinical depressive symptomatology. This notion emphasizes the need to target even mild depressive symptoms in the treatment of postpartum anxiety disorders. The outcomes also underline that the severity of anxious symptomatology, reflected by avoidance behaviour in company, puts the mother–infant bond at risk.


Maternal bonding Postpartum anxiety disorder Depressive symptoms Maternal avoidance behaviour 



This research was supported by the German Research Foundation (Deutsche Forschungsgemeinschaft (DFG)). We would also like to take the opportunity to thank the participants of the study who made this research undertaking possible.


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Copyright information

© Springer-Verlag Wien 2014

Authors and Affiliations

  1. 1.Center for Psychosocial Medicine, General PsychiatryHeidelberg University HospitalHeidelbergGermany
  2. 2.Department of Psychology and PedagogyLudwig-Maximilians UniversityMunichGermany

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