The Association Between Postnatal Depression, Acculturation and Mother–Infant Bond Among Eritrean Asylum Seekers in Israel


We examined the association between postnatal depression (PND), acculturation and mother–infant bond among 38 Eritrean asylum seekers in Israel, who were within 6 months of delivery. Participants completed a survey in their native language. A high rate of women (81.6 %) met the clinical threshold for PND on the Edinburgh Postnatal Depression Scale. Higher severity of PND (partialr = −.64, p < .001), higher identification with Israeli culture (partialr = −.45, p = .02), and lower quality of romantic relationship were associated with impaired mother–infant bond (partialr = .58, p = .002). Findings highlight the need to establish services to screen and treat PND among this vulnerable population in the receiving countries.

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  1. 1.

    Collins CH, Zimmerman C, Howard LM. Refugee, asylum seeker, immigrant women and postnatal depression: rates and risk factors. Arch Womens Ment Health. 2011;14:3–11.

    PubMed  Google Scholar 

  2. 2.

    O’hara MW, Swain AM. Rates and risk of postpartum depression-a meta-analysis. Int Rev Psychiatry. 1996;8:37–54.

    Google Scholar 

  3. 3.

    Gaynes BN, Gavin N, Meltzer-Brody S, Lohr KN, Swinson T, Gartlehner G, et al. Perinatal depression: prevalence, screening accuracy, and screening outcomes. 2005.

  4. 4.

    Edhborg M, Nasreen H-E, Kabir ZN. Impact of postpartum depressive and anxiety symptoms on mothers’ emotional tie to their infants 2–3 months postpartum: a population-based study from rural Bangladesh. Arch Womens Ment Health. 2011;14:307–16.

    PubMed  Google Scholar 

  5. 5.

    Bouris SS, Merry LA, Kebe A, Gagnon AJ. Mothering here and mothering there: international migration and postbirth mental health. Obstet Gynecol Int J. 2012;2012:1–9.

    Google Scholar 

  6. 6.

    Stewart DE, Anita Gagnon R, Jean-Francois Saucier M, Olive Wahoush R. Postpartum depression symptoms in newcomers. Can J Psychiatry. 2008;53:121–4.

    PubMed  Google Scholar 

  7. 7.

    United Nations Population Fund. Shelter from the storm: a transformative agenda for women and girls in a crisis-prone world. 2015.

  8. 8.

    Porter M, Haslam N. Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons. JAMA. 2005;294:602–12.

    CAS  PubMed  Google Scholar 

  9. 9.

    Thomas SL, Thomas SD. Displacement and health. Br Med Bull. 2004;69:115–27.

    PubMed  Google Scholar 

  10. 10.

    Nakash O, Nagar M, Shoshani A, Lurie I. The association between acculturation patterns and mental health symptoms among Eritrean and Sudanese asylum seekers in Israel. Cultur Divers Ethnic Minor Psychol. 2015;21:468–76.

    PubMed  Google Scholar 

  11. 11.

    Brown-Bowers A, McShane K, Wilson-Mitchell K, Gurevich M. Postpartum depression in refugee and asylum-seeking women in Canada: a critical health psychology perspective. Health. 2015;19:318–35.

    PubMed  Google Scholar 

  12. 12.

    Nakash O, Wiesent-Brandsma C, Reist S, Nagar M. The contribution of gender-role orientation to psychological distress among male African asylum-seekers in Israel. J Immigr Refug Stud. 2013;11:78–90.

    Google Scholar 

  13. 13.

    Shoshani A, Nakash O, Zubida H, Harper RA. School engagement, acculturation, and mental health among migrant adolescents in Israel. Sch Psychol Q. 2015;. doi:

    PubMed  Google Scholar 

  14. 14.

    Berry JW. Immigration, acculturation, and adaptation. Appl Psychol. 1997;46:5–34.

    Google Scholar 

  15. 15.

    Phillimore J. Refugees, acculturation strategies, stress and integration. J Soc Policy. 2011;40:575–93.

    Google Scholar 

  16. 16.

    Nakash O, Nagar M, Shoshani A, Zubida H, Harper RA. The effect of acculturation and discrimination on mental health symptoms and risk behaviors among adolescent migrants in Israel. Cultur Divers Ethnic Minor Psychol. 2012;18:228–38.

    PubMed  Google Scholar 

  17. 17.

    Furst-Nichols R, Jacobsen K. African refugees in Israel. Forced Migr Rev. 2011;37:55–6.

    Google Scholar 

  18. 18.

    Reynolds S. Hope on hold: African asylum seekers in Israel. 2013. Accessed March 4th, 2014.

  19. 19.

    Mahmoodi Z, Karimlou M, Sajjadi H, Dejman M, Vameghi M. Development of mother’s lifestyle scale during pregnancy with an approach to social determinants of health. Glob J Health Sci. 2013;5:208–19.

    PubMed  PubMed Central  Google Scholar 

  20. 20.

    Szapocznik J, Kurtines WM, Fernandez T. Bicultural involvement and adjustment in Hispanic-American youths. Int J Intercult Relat. 1980;4:353–65.

    Google Scholar 

  21. 21.

    Cox JL, Holden J, Sagovsky R. Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150:782–6.

    CAS  Google Scholar 

  22. 22.

    Condon JT, Corkindale CJ. The assessment of parent-to-infant attachment: development of a self-report questionnaire instrument. J Reprod Infant Psychol. 1998;16:57–76.

    Google Scholar 

  23. 23.

    Stewart DE, Gagnon AJ, Merry LA, Dennis C-L. Risk factors and health profiles of recent migrant women who experienced violence associated with pregnancy. J Womens Health. 2012;21:1100–6.

    Google Scholar 

  24. 24.

    O’Mahony JM, Donnelly TT, Bouchal SR, Este D. Barriers and facilitators of social supports for immigrant and refugee women coping with postpartum depression. Adv Nurs Sci. 2012;35:E42–56.

    Google Scholar 

  25. 25.

    Sonuga-Barke EJ, Minocha K, Taylor EA, Sandberg S. Inter-ethnic bias in teachers’ ratings of childhood hyperactivity. Br J Dev Psychol. 1993;11:187–200.

    Google Scholar 

  26. 26.

    Lawrie T, Hofmeyr G, De Jager M, Berk M. Validation of the Edinburgh Postnatal Depression Scale on a cohort of South African women. S Afr Med J. 1998;88:1340–4.

    CAS  PubMed  Google Scholar 

  27. 27.

    Stapleton H, Murphy R, Kildea S. Lost in translation: staff and interpreters’ experiences of the Edinburgh Postnatal Depression Scale with women from refugee backgrounds. Issues Ment Health Nurs. 2013;34:648–57.

    PubMed  Google Scholar 

  28. 28.

    Gagnon AJ, Stewart DE. Resilience in international migrant women following violence associated with pregnancy. Arch Womens Ment Health. 2014;17:303–10.

    PubMed  Google Scholar 

  29. 29.

    O’Mahony JM, Donnelly TT, Este D, Bouchal SR. Using critical ethnography to explore issues among immigrant and refugee women seeking help for postpartum depression. Issues Ment Health Nurs. 2012;33:735–42.

    PubMed  Google Scholar 

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The study was supported by the UNHCR (United Nations High Commissioner of Refugees)—Israel.

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Correspondence to Ora Nakash.

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Nakash, O., Nagar, M. & Lurie, I. The Association Between Postnatal Depression, Acculturation and Mother–Infant Bond Among Eritrean Asylum Seekers in Israel. J Immigrant Minority Health 18, 1232–1236 (2016).

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  • Asylum seekers
  • Attachment
  • Acculturation
  • Postnatal depression
  • Eritrea