Archives of Women's Mental Health

, Volume 9, Issue 6, pp 329–337 | Cite as

Mood state and psychological adjustment to pregnancy

  • R. Hart
  • C. A. McMahon
Original contribution

Summary

The aim of this study was to investigate whether there is an association between antenatal mood state (depression and anxiety) and psychological adjustment to pregnancy. Participants were first-time, low obstetric risk mothers at a Sydney teaching hospital who completed self-report questionnaires measuring depression, anxiety, thoughts about motherhood and self as mother and relationship with the fetus. Higher symptom levels of antenatal anxiety were related to less optimal maternal-fetal quality of attachment, more negative attitudes towards motherhood and the self as mother. Similar trends were found for symptoms of depression, however depression was not significantly related to psychological adjustment to pregnancy variables. The significance of anxiety in the current study highlights the importance of considering anxiety in the psychological adjustment to pregnancy, as well as the in the context of perinatal mental health more generally. Implications of these findings for intervention are also briefly discussed.

Keywords: Antenatal depression; antenatal anxiety; psychological adjustment to pregnancy; self as mother; maternal-fetal attachment. 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Altshuler, LL, Hendrick, V, Cohen, LS 1998Course of mood and anxiety disorders during pregnancy and the postpartum periodJ Clin Psychiatry592933PubMedGoogle Scholar
  2. Anderson, VN, Fleming, AS, Steiner, M 1994Mood and the transition to motherhoodJ Reprod Infant Psychol126977Google Scholar
  3. Armstrong, D, Hutti, M 1997Pregnancy after perinatal loss: the relationship between anxiety and prenatal attachmentJ Obstet Gynecol Neonat Nurs27183189CrossRefGoogle Scholar
  4. Austin, M-P 2003Perinatal mental health: opportunities and challenges for psychiatryAustralas Psychiatry11399403CrossRefGoogle Scholar
  5. Austin, M-P 2004Antenatal screening and early intervention for “perinatal” distress, depression and anxiety: where to from here?Arch Womens Ment Health716PubMedCrossRefGoogle Scholar
  6. Austin, M-P, Lumley, J 2003Antenatal screening for postnatal depression: a systematic reviewActa Psychiatr Scand1071017PubMedCrossRefGoogle Scholar
  7. Barnett, B, Parker, G 1985Professional and non-professional intervention for highly anxious primiparous mothersBr J Psychiatry146287293PubMedGoogle Scholar
  8. Barnett, B, Parker, G 1986Possible determinants, correlates and consequences of high levels of anxiety in primiparous mothersPsychol Med16177185PubMedGoogle Scholar
  9. Barnett, B, Schaafsma, MF, Guzman, A-M, Parker, GB 1991Maternal anxiety: a 5 year review of an intervention studyJ Child Psychiatry32423438Google Scholar
  10. Benedeck, T 1959Parenthood as a developmental phaseAm Psychoanal Assoc78389417CrossRefGoogle Scholar
  11. Benoit, D, Parker, KCH, Zeanah, CH 1997Mother’s representations of their infants assessed prenatally: stability and association with infants’ attachment classificationsJ Child Psychol Psychiatry38307313PubMedGoogle Scholar
  12. Berryman, JC, Windridge, KC 1996Pregnancy after 35 and attachment to the fetusJ Reprod Infant Psychol14133143Google Scholar
  13. Bibring, GL, Dwyer, TF, Huntington, DC, Valenstein, AF 1961A study of the psychological processes in pregnancy and the earliest mother-child relationshipPsychoanal Study Child16944Google Scholar
  14. Bloom, KC 1995The development of attachment behaviours in pregnant adolescentsNurs Res44284288PubMedCrossRefGoogle Scholar
  15. Bosquet, M, Egeland, B 2001Associations among maternal depressive symptomatology, state of mind and parent child behaviours: Implications for attachment-based interventionsAttach Hum Dev3173199PubMedCrossRefGoogle Scholar
  16. Buist, A 2002Mental health in pregnancy: the sleeping giantAustralas Psychiatry10203206CrossRefGoogle Scholar
  17. Condon, JT 1993The assessment of antenatal emotional attachment: Development of a questionnaire instrumentBr J Med Psychol66167183PubMedGoogle Scholar
  18. Condon, JT, Corkindale, C 1997The correlates of antenatal attachment in pregnant womenBr J Med Psychol70359372PubMedGoogle Scholar
  19. Cooper, PJ, Murray, L, Hooper, R, West, A 1996The development and validation of a predictive index for postpartum depressionPsychol Med26627634PubMedCrossRefGoogle Scholar
  20. Cox, JL, Holden, JM, Sagovsky, R 1987Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression ScaleBr J Psychiatry150782786PubMedGoogle Scholar
  21. Cranley, M 1981Development of a tool for the measurement of maternal attachment during pregnancyNurs Res30281284PubMedCrossRefGoogle Scholar
  22. Cranley, MS 1993The origins of the mother-child relationship – A reviewPhys Occupat Ther Pediatr123951CrossRefGoogle Scholar
  23. Deutsch, FM, Ruble, DN, Fleming, A, Brooks-Gunn, J, Stangor, C 1988Information seeking and maternal self-definition during the transition to motherhoodJ Personal Soc Psychol55420431CrossRefGoogle Scholar
  24. Evans, J, Heron, J, Francomb, H, Oke, S, Golding, J 2001Cohort study of depressed mood during pregnancy and after childbirthBr Med J323257260CrossRefGoogle Scholar
  25. Fleming, AS, Ruble, DN, Flett, GL, Shaul, DL 1988Postpartum adjustment in first time mothers: effects of mood on maternal responsivenessDev Psychol247181CrossRefGoogle Scholar
  26. Fowles, ER 1996Relationships among prenatal maternal attachment, presence of postnatal depressive symptoms, and maternal role attainmentJ Soc Ped Nurs17582CrossRefGoogle Scholar
  27. Fuller, JR 1990Early patterns of maternal attachmentHealth Care Women Int11433446PubMedCrossRefGoogle Scholar
  28. Gaffney, KF 1986Maternal-fetal attachment in relation to self-concept and anxietyMatern Child Nurs J1591101PubMedGoogle Scholar
  29. Gloger-Tippelt, G 1983A process model of the pregnancy courseHum Dev26134148PubMedCrossRefGoogle Scholar
  30. Gotlib, IH, Whiffen, V, Wallace, PM, Mount, JH 1989Prospective investigation of postpartum depression: factors involved in onset and recoveryJ Abnorm Psychol100122132CrossRefGoogle Scholar
  31. Grace, JT 1989Development of maternal-fetal attachment during pregnancyNurs Res38228232PubMedCrossRefGoogle Scholar
  32. Green, JM 1998Postnatal depression or perinatal dysphoria? Findings from a longitudinal community-based study using the Edinburgh Postnatal Depression ScaleJ Reprod Infant Psychol16143155Google Scholar
  33. Heidrich, SM, Cranley, MS 1989Effect of fetal movement, ultrasound scans, and amniocentesis on maternal-fetal attachmentNurs Res388184PubMedCrossRefGoogle Scholar
  34. Heron, J, O’Connor, TG, Evans, J, Golding, J, Glover, V 2004The course of anxiety and depression through pregnancy and the postpartum in a community sampleJ Affect Disord806573PubMedCrossRefGoogle Scholar
  35. Honjo, S, Arai, S, Kaneko, H, Ujiie, T, Murase, S, Sechiyama, H, Sasaki, Y, Hatagaki, C, Inagaki, E, Usui, M, Miwa, K, Ishihara, M, Hashimoto, O, Nomura, K, Itakura, A, Inoko, K 2003Antenatal depression and maternal-fetal attachmentPsychopathology36304311PubMedCrossRefGoogle Scholar
  36. Kumar, R, Robson, K 1984A prospective study of emotional disorders in childbearing womenBr J Psychiatry1443547PubMedCrossRefGoogle Scholar
  37. Kunkel, GF, Doan, HMcK 2003Fetal attachment and depression: measurement mattersJ Prenat Perinat Psychol Health18149166Google Scholar
  38. Leifer, M 1977Psychological changes accompanying pregnancy and motherhoodGen Psychol Monogr955596Google Scholar
  39. Leifer, M 1980Psychological effects of motherhood: A study of first pregnancyPraegerNew YorkGoogle Scholar
  40. Lerum, CW, Major, RN, LoBiondo-Wood, G 1989The relationship of maternal age, quickening, and physical symptoms of pregnancy to the development of maternal-fetal attachmentBirth161317PubMedGoogle Scholar
  41. Lindgren, K 2001Relationships among maternal-fetal attachment, prenatal depression, and health practices in pregnancyRes Nurs Health24203217PubMedCrossRefGoogle Scholar
  42. McMahon C, Barnett B, Kowalenko N, Tennant C (in press) Maternal attachment state of mind moderates the impact of maternal depression on child attachment security. J Child Psychol Psychiatry.Google Scholar
  43. McNair, LM, Droppleman, LF 1981Manual: Profile of Mood StatesEDITSSan Diego, CAGoogle Scholar
  44. Marcus, SM, Flynn, HA, Blow, FC, Barry, KL 2003Depressive symptoms among pregnant women screened in obstetrics settingsJ Womens Health12373380CrossRefGoogle Scholar
  45. Martins, C, Gaffan, EA 2000Effects of early maternal depression on patterns of infant-mother attachment: A meta-analytic investigationJ Child Psychol Psychiatry41737746PubMedCrossRefGoogle Scholar
  46. Matthey, S 2004Detection and treatment of postnatal depression (perinatal depression or anxiety)Curr Opin Psychiatry172129CrossRefGoogle Scholar
  47. Matthey, S, Barnett, B, Howie, P, Kavanagh, DJ 2003Diagnosing postpartum depression in mothers and fathers: whatever happened to anxiety?J Affect Disord74139147PubMedCrossRefGoogle Scholar
  48. Mercer, R 1985The process of maternal role attainment over the first yearNurs Res34198204PubMedCrossRefGoogle Scholar
  49. Muller, ME 1996Prenatal and postnatal attachment: A modest correlationJ Obstet Gynecol Neonat Nurs25161166CrossRefGoogle Scholar
  50. Murray, D, Cox, JL 1990Screening for depression during depression with the Edinburgh Depression Scale (EPDS)J Reprod Infant Psychol899107Google Scholar
  51. O’Leary, J 2004Grief and its impact on prenatal attachment in the subsequent pregnancyArch Womens Ment Health7718PubMedCrossRefGoogle Scholar
  52. Pollock, PH, Percy, A 1999Maternal antenatal attachment style and potential fetal abuseChild Abuse Neglect2313451357PubMedCrossRefGoogle Scholar
  53. Raphael-Leff, J 1983Facilitators and regulators: Two approaches to motheringBr J Med Psychol56379390PubMedGoogle Scholar
  54. Raphael-Leff, J 1986Facilitators and regulators: Conscious and unconscious processes in pregnancy and early motherhoodBr J Med Psychol594355PubMedGoogle Scholar
  55. Rubin, R 1975Maternal tasks of pregnancyMatern Child Nurs J4143153PubMedGoogle Scholar
  56. Rubin, R 1984Maternal identity and the maternal experienceSpringerBerlin Heidelberg New YorkGoogle Scholar
  57. Ruble, DN, Fleming, AS, Stangor, C, Brooks-Gunn, J, Fitzmaurice, G, Deutsch, F 1990Transition to motherhood and the self: measurement, stability, and changeJ Personal Soc Psychol58450463CrossRefGoogle Scholar
  58. Salisbury, A, Law, K, La Gasse, L, Lester, B 2003Maternal-fetal attachmentJ Am Med Assoc2891701CrossRefGoogle Scholar
  59. Sedgmen, B, McMahon, C, Cairns, D, Benzie, R, Woodfield, R 2006The impact of two-dimensional versus three-dimensional ultrasound exposure on maternal-fetal attachment and maternal health behaviour in pregnancyUltrasound Obstet Gynecol27245251PubMedCrossRefGoogle Scholar
  60. Shereshefsky, PM, Yarrow, LJ 1973Psychological aspects of a first pregnancy and early postnatal adaptationRavenNew YorkGoogle Scholar
  61. Siddiqui, A, Hagglof, B 2000Does maternal prenatal attachment predict postnatal mother-infant interaction?Early Hum Dev591325PubMedCrossRefGoogle Scholar
  62. Siddiqui, A, Haggloff, B, Eisemann, M 2000Own memories of upbringing as a determinant of prenatal attachment in expectant womenJ Reprod Inf Psychol186774CrossRefGoogle Scholar
  63. Spielberger, CD, Gorsuch, RL, Lushene, RE 1970Manual for the State-Trait Anxiety Inventory (Self-evaluation Questionnaire)Consulting Psychologists PressPalo Alto, CAGoogle Scholar
  64. Warner, R, Appleby, L, Whitton, A, Faragher, B 1997Attitudes toward motherhood in postnatal depression: Development of the maternal attitudes questionnaireJ Psychosom Res43351358PubMedCrossRefGoogle Scholar
  65. Waters A-M, Dean JH, Sullivan EA (2006) Assisted reproductive technology in Australia and New Zealand 2003 AIHW Cat. No. PER 31. AIHW National Perinatal Statistics Unit (Assisted Reproductive Technology Series No 9), Sydney.Google Scholar
  66. Zigmond, AS, Snaith, RP 1983The Hospital Anxiety and Depression ScaleActa Psychiatr Scand67361370PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • R. Hart
    • 1
  • C. A. McMahon
    • 1
  1. 1.Psychology DepartmentMacquarie University, North RydeSydneyAustralia

Personalised recommendations