Archives of Women's Mental Health

, Volume 18, Issue 2, pp 197–208 | Cite as

Optimistic outlook regarding maternity protects against depressive symptoms postpartum

  • Thalia K. RobakisEmail author
  • Katherine E. Williams
  • Susan Crowe
  • Heather Kenna
  • Jamie Gannon
  • Natalie L. Rasgon
Original Article


The transition to motherhood is a time of elevated risk for clinical depression. Dispositional optimism may be protective against depressive symptoms; however, the arrival of a newborn presents numerous challenges that may be at odds with initially positive expectations, and which may contribute to depressed mood. We have explored the relative contributions of antenatal and postnatal optimism regarding maternity to depressive symptoms in the postnatal period. Ninety-eight pregnant women underwent clinician interview in the third trimester to record psychiatric history, antenatal depressive symptoms, and administer a novel measure of optimism towards maternity. Measures of depressive symptoms, attitudes to maternity, and mother-to-infant bonding were obtained from 97 study completers at monthly intervals through 3 months postpartum. We found a positive effect of antenatal optimism, and a negative effect of postnatal disconfirmation of expectations, on depressive mood postnatally. Postnatal disconfirmation, but not antenatal optimism, was associated with more negative attitudes toward maternity postnatally. Antenatal optimism, but not postnatal disconfirmation, was associated with reduced scores on a mother-to-infant bonding measure. The relationships between antenatal optimism, postnatal disconfirmation of expectations, and postnatal depression held true among primigravidas and multigravidas, as well as among women with prior histories of mood disorders, although antenatal optimism tended to be lower among women with mental health histories. We conclude that cautious antenatal optimism, rather than immoderate optimism or frank pessimism, is the approach that is most protective against postnatal depressive symptoms, and that this is true irrespective of either mood disorder history or parity. Factors predisposing to negative cognitive assessments and impaired mother-to-infant bonding may be substantially different than those associated with depressive symptoms, a finding that merits further study.


Postpartum depression Optimism Maternal attitudes Mother–infant bonding Parenthood 


  1. Austin M, Hadzi-Pavlovic D, Saint K, Parker G (2005) Antenatal screening for the prediction of postnatal depression: validation of a psychosocial pregnancy risk questionnaire. Acta Psychiatr Scand 112(4):310–317CrossRefPubMedGoogle Scholar
  2. Austin M, Lumley J (2003) Antenatal screening for postnatal depression: a systematic review. Acta Psychiatr Scand 107(1):10–17CrossRefPubMedGoogle Scholar
  3. Banti S, Mauri M, Oppo A, Borri C, Rambelli C, Ramacciotti D et al (2011) From the third month of pregnancy to 1 year postpartum. Prevalence, incidence, recurrence, and new onset of depression. Results from the perinatal depression–research & screening unit study. Compr Psychiatry 52(4):343–351CrossRefPubMedGoogle Scholar
  4. 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):1173CrossRefPubMedGoogle Scholar
  5. Belsky J (1985) Exploring individual differences in marital change across the transition to parenthood: the role of violated expectations. J Marriage Fam 47:1037–1044CrossRefGoogle Scholar
  6. Bifulco A, Figueiredo B, Guedeney N, Gorman LL, Hayes S, Muzik M et al (2004) Maternal attachment style and depression associated with childbirth: preliminary results from a european and US cross-cultural study. Br J Psychiatry Suppl 46:s31–s37CrossRefPubMedGoogle Scholar
  7. Bouchard G (2009) Parents-to-be with overly optimistic expectations of parenthood: who are they and what should counsellors do? Can J Counsel Psychother 43(3):165–178Google Scholar
  8. Boyce P, Hickey A, Gilchrist J, Talley N (2001) The development of a brief personality scale to measure vulnerability to postnatal depression. Arch Womens Ment Health 3(4):147–153CrossRefGoogle Scholar
  9. Boyce P, Hickie I, Gordon P (1991) Parents, partners or personality? Risk factors for post-natal depression. J Affect Disord 21(4):245–255CrossRefPubMedGoogle Scholar
  10. Brand SR, Brennan PA (2009) Impact of antenatal and postpartum maternal mental illness: how are the children? Clin Obstet Gynecol 52(3):441–455CrossRefPubMedGoogle Scholar
  11. Cantwell R, Smith S (2009) Prediction and prevention of perinatal mental illness. Psychiatry 8(1):21–27CrossRefGoogle Scholar
  12. Carver CS, Gaines JG (1987) Optimism, pessimism, and postpartum depression. Cogn Ther Res 11(4):449–462CrossRefGoogle Scholar
  13. Chronis AM, Lahey BB, Pelham WE Jr, Williams SH, Baumann BL, Kipp H et al (2007) Maternal depression and early positive parenting predict future conduct problems in young children with attention-deficit/hyperactivity disorder. Dev Psychol 43(1):70CrossRefPubMedGoogle Scholar
  14. Church NF, Brechman-Toussaint ML, Hine DW (2005) Do dysfunctional cognitions mediate the relationship between risk factors and postnatal depression symptomatology? J Affect Disord 87(1):65–72CrossRefPubMedGoogle Scholar
  15. Churchill AC, Davis CG (2010) Realistic orientation and the transition to motherhood. J Soc Clin Psychol 29(1):39–67CrossRefGoogle Scholar
  16. Cohen J, Cohen P (1983) Applied multiple regression/correlation analysis for the behavioral sciences, 2nd edn. Erlbaum, HillsdaleGoogle Scholar
  17. Cooper PJ, Murray L (1995) Course and recurrence of postnatal depression. evidence for the specificity of the diagnostic concept. Br J Psychiatry 166(2):191–195CrossRefPubMedGoogle Scholar
  18. Cox JL, Holden JM, Sagovsky R (1987). Detection of postnatal depression. Development of the 10- item Edinburgh Postnatal Depression Scale. Br J Psychiatry 150(6):782–786Google Scholar
  19. Dennis C, Boyce P (2004) Further psychometric testing of a brief personality scale to measure vulnerability to postpartum depression. J Psychosom Obstet Gynecol 25(3–4):305–311CrossRefGoogle Scholar
  20. Dietz PM, Williams SB, Callaghan WM, Bachman DJ, Whitlock EP, Hornbrook MC (2007) Clinically identified maternal depression before, during, and after pregnancies ending in live births. Am J Psychiatry 164(10):1515–1520CrossRefPubMedGoogle Scholar
  21. Evans EC, Bullock LF (2012) Optimism and other psychosocial influences on antenatal depression: a systematic review. Nurs Health Sci 14(3):352–361CrossRefPubMedGoogle Scholar
  22. Field T (2010) Postpartum depression effects on early interactions, parenting, and safety practices: a review. Infant Behav Dev 33(1):1–6CrossRefPubMedCentralPubMedGoogle Scholar
  23. First MB, Spitzer RL, Gibbon M, Williams JB (2012). Structured Clinical Interview for DSM-IV® Axis I Disorders (SCID-I), Clinician Version, Administration Booklet. Am Psychiatr PubGoogle Scholar
  24. Fontaine KR, Jones LC (1997) Self‐esteem, optimism, and postpartum depression. J Clin Psychol 53(1):59–63CrossRefPubMedGoogle Scholar
  25. Freeman MP, Smith KW, Freeman SA, McElroy SL, Kmetz G, Wright R et al (2002) The impact of reproductive events on the course of bipolar disorder in women. J Clin Psychiatry 63(4):284–287CrossRefPubMedGoogle Scholar
  26. Giltay EJ, Zitman FG, Kromhout D (2006) Dispositional optimism and the risk of depressive symptoms during 15 years of follow-up: the Zutphen Elderly Study. J Affect Disord 91(1):45–52CrossRefPubMedGoogle Scholar
  27. Goodman JH (2004) Paternal postpartum depression, its relationship to maternal postpartum depression, and implications for family health. J Adv Nurs 45(1):26–35CrossRefPubMedGoogle Scholar
  28. Grote NK, Bledsoe SE (2007) Predicting postpartum depressive symptoms in new mothers: the role of optimism and stress frequency during pregnancy. Health Soc Work 32(2):107–118CrossRefPubMedGoogle Scholar
  29. Hackel LS, Ruble DN (1992) Changes in the marital relationship after the first baby is born: predicting the impact of expectancy disconfirmation. J Pers Soc Psychol 62(6):944CrossRefPubMedGoogle Scholar
  30. Halligan SL, Murray L, Martins C, Cooper PJ (2007) Maternal depression and psychiatric outcomes in adolescent offspring: a 13-year longitudinal study. J Affect Disord 97(1):145–154CrossRefPubMedGoogle Scholar
  31. Harwood K, McLean N, Durkin K (2007) First-time mothers' expectations of parenthood: what happens when optimistic expectations are not matched by later experiences? Dev Psychol 43(1):1CrossRefPubMedGoogle Scholar
  32. Monk C, Leight KL, Fang Y (2008) The relationship between women’s attachment style and perinatal mood disturbance: implications for screening and treatment. Arch Womens Ment Health 11(2):117–129CrossRefPubMedGoogle Scholar
  33. Muscat T, Obst P, Cockshaw W, Thorpe K (2014) Beliefs about infant regulation, early infant behaviors and maternal postnatal depressive symptoms. Birth 41(2):206–213CrossRefPubMedGoogle Scholar
  34. Muscat T, Thorpe K, Obst P (2012) Disconfirmed expectations of infant behaviours and postnatal depressive symptoms among parents. J Reprod Infant Psychol 30(1):51–61CrossRefGoogle Scholar
  35. O’Higgins M, Roberts ISJ, Glover V, Taylor A (2013) Mother–child bonding at 1 year; associations with symptoms of postnatal depression and bonding in the first few weeks. Arch Womens Ment Health 1–9Google Scholar
  36. O’Hara MW, McCabe JE (2013) Postpartum depression: current status and future directions. Annu Rev Clin Psychol 9:379–407CrossRefPubMedGoogle Scholar
  37. O’Hara MW, Swain AM (1996) Rates and risk of postpartum depression—a meta-analysis. Int Rev Psychiatry 8(1):37–54CrossRefGoogle Scholar
  38. Paulson JF, Dauber S, Leiferman JA (2006) Individual and combined effects of postpartum depression in mothers and fathers on parenting behavior. Pediatrics 118(2):659–668CrossRefPubMedGoogle Scholar
  39. Plomin R, Scheier MF, Bergeman CS, Pedersen NL, Nesselroade JR, McClearn GE (1992) Optimism, pessimism and mental health: a twin/adoption analysis. Personal Individ Differ 13(8):921–930CrossRefGoogle Scholar
  40. Radloff LS (1977). The CES-D scale a self-report depression scale for research in the general population. Appl Psychol Meas 1(3):385–401Google Scholar
  41. Rholes WS, Simpson JA, Kohn JL, Wilson CL, Martin AM III, Tran S et al (2011) Attachment orientations and depression: a longitudinal study of new parents. J Pers Soc Psychol 100(4):567CrossRefPubMedGoogle Scholar
  42. Ross CE, Mirowsky J (1984) Components of depressed mood in married men and women. The Center for Epidemiologic Studies' Depression Scale. Am J Epidemiol 119(6):997–1004PubMedGoogle Scholar
  43. Scheier MF, Carver CS (1993) On the power of positive thinking: the benefits of being optimistic. Curr Dir Psychol Sci 2:26–30CrossRefGoogle Scholar
  44. Sharma V, Khan M (2010) Identification of bipolar disorder in women with postpartum depression. Bipolar Disord 12(3):335–340CrossRefPubMedGoogle Scholar
  45. Taylor A, Atkins R, Kumar R, Adams D, Glover V (2005) A new mother-to-infant bonding scale: links with early maternal mood. Arch Womens Ment Health 8(1):45–51CrossRefPubMedGoogle Scholar
  46. Taylor SE, Brown JD (1988) Illusion and well-being: a social psychological perspective on mental health. Psychol Bull 103(2):193CrossRefPubMedGoogle Scholar
  47. Taylor SE, Brown JD (1994) Positive illusions and well-being revisited: separating fact from fiction. Psychol Bull 116(1):21–27Google Scholar
  48. Tharner A, Luijk MP, Van Ijzendoorn MH, Bakermans-Kranenburg MJ, Jaddoe VW, Hofman A et al (2012) Maternal lifetime history of depression and depressive symptoms in the prenatal and early postnatal period do not predict infant–mother attachment quality in a large, population-based Dutch cohort study. Attach Hum Dev 14(1):63–81CrossRefPubMedGoogle Scholar
  49. Verkerk GJ, Denollet J, Van Heck GL, Van Son MJ, Pop VJ (2005) Personality factors as determinants of depression in postpartum women: a prospective 1-year follow-up study. Psychosom Med 67(4):632–637CrossRefPubMedGoogle Scholar
  50. Vickers KS, Vogeltanz ND (2000) Dispositional optimism as a predictor of depressive symptoms over time. Personal Individ Differ 28(2):259–272CrossRefGoogle Scholar
  51. Warner R, Appleby L, Whitton A, Faragher B (1997) Attitudes toward motherhood in postnatal depression: development of the maternal attitudes questionnaire. J Psychosom Res 43(4):351–358CrossRefPubMedGoogle Scholar
  52. Wisner KL, Sit DK, McShea MC, Rizzo DM, Zoretich RA, Hughes CL et al (2013) Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression. Findings depression screening in postpartum women. JAMA Psychiatry 70(5):490–498CrossRefPubMedGoogle Scholar
  53. Wittkowski A, Wieck A, Mann S (2007) An evaluation of two bonding questionnaires: a comparison of the mother-to-infant bonding scale with the postpartum bonding questionnaire in a sample of primiparous mothers. Arch Womens Ment Health 10(4):171–175CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Wien 2014

Authors and Affiliations

  • Thalia K. Robakis
    • 1
    Email author
  • Katherine E. Williams
    • 1
  • Susan Crowe
    • 2
  • Heather Kenna
    • 1
    • 3
  • Jamie Gannon
    • 3
  • Natalie L. Rasgon
    • 1
  1. 1.Department of Psychiatry and Behavioral ScienceStanford University School of MedicineStanfordUSA
  2. 2.Department of Obstetrics and GynecologyStanford University School of MedicineStanfordUSA
  3. 3.Palo Alto UniversityPalo AltoUSA

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