Journal of Clinical Psychology in Medical Settings

, Volume 10, Issue 3, pp 157–164 | Cite as

Obsessional Thoughts in Postpartum Females and Their Partners: Content, Severity, and Relationship with Depression

  • Jonathan S. Abramowitz
  • Stefanie A. Schwartz
  • Katherine M. Moore

Abstract

Only a few studies have examined the development or exacerbation of obsessive–compulsive disorder (OCD) during pregnancy and the postpartum. Although the available literature suggests that OCD symptoms, particularly obsessional problems, develop at higher than expected rates among postpartum females, the overall prevalence of such symptoms in the postpartum remains unknown. Previous findings also suggest that intrusive distressing thoughts related to situational stressors are common in the general population. Therefore, the present study was designed to assess the presence and phenomenology of postpartum obsessive-like intrusive thoughts, images, and impulses in a large sample of parents with very young infants. Surveys were mailed to 300 childbearing women and their partners. Results were obtained from approximately one fifth of the sample; and 65% of respondents indicated the presence of obsessional intrusive thoughts. Intrusions were similar to “normal obsessions” as reported in previous research. Results are discussed in terms of the content of intrusive thoughts, their relationship to depression, and implications for etiological models of OCD and perinatal education.

postpartum obsessive–compulsive disorder obsessions depression 

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References

  1. Abramowitz, J., Schwartz, S., Moore, K., & Luenzmann, K. (2003). Obsessive–compulsive symptoms in pregnancy and the puerperium: A review of the literature. Journal of Anxiety Disorders, 17, 461–478.CrossRefPubMedGoogle Scholar
  2. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Google Scholar
  3. Angst, J. (1993). Comorbidity of anxiety, phobia, compulsion and depression. International Clinical Psychopharmacology, 8, 21–25.Google Scholar
  4. Antony, M. M., Downie, F., & Swinson, R. P. (1998). Diagnostic issues and epidemiology in obsessive–compulsive disorder. In R. Swinson & M. M. Antony (Eds.), Obsessive-compulsive disorder: Theory, research, and treatment. New York: Guilford.Google Scholar
  5. Baer, L. (1994). Factor analysis of symptom subtypes of obsessive compulsive disorder and their relation to personality and tic disorders. Journal of Clinical Psychiatry, 55, 18–23.Google Scholar
  6. Brewin, C. R., Christodoulides, J., & Hutchinson, G. (1996). Intrusive thoughts and intrusive memories in a nonclinical sample. Cognition and Emotion, 10, 107–112.CrossRefGoogle Scholar
  7. Brewin, C. R., Hunter, E., Carroll, F., & Tata, P. (1996). Intrusive memories in depression: An index of schema activation? Psychological Medicine, 26, 1271–1276.PubMedGoogle Scholar
  8. Buttolph, L., & Holland, A. (1990). Obsessive–compulsive disorder in pregnancy and childbirth. In M. Jenike, L. Baer, & W. Minichiello (Eds.), Obsessive–compulsive disorder: Theory and management (pp. 89–95). Chicago: Yearbook Medical Publishers.Google Scholar
  9. Freeston, M. H., Ladouceur, R., Thibodeau, N., & Gagnon, F. (1991). Cognitive intrusions in a non-clinical population: I. Response style, subjective experience, and appraisal. Behaviour Research and Therapy, 29, 585–597.CrossRefPubMedGoogle Scholar
  10. Gibbs, N. A. (1996). Nonclinical populations in research on obsessive–compulsive disorder: A critical review. Clinical Psychology Review, 16, 729–773.CrossRefGoogle Scholar
  11. Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Delgado, P., Henninger, G., & Charney, D. (1989a). The Yale-Brown Obsessive Compulsive Scale: I. Development, use, and reliability. Archives of General Psychiatry, 46, 1006–1011.PubMedGoogle Scholar
  12. Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Fleischmann, R., Hill, C., Henninger, G., & Charney, D. (1989b). The Yale-Brown Obsessive Compulsive Scale: II. Validity. Archives of General Psychiatry, 46, 1012–1016.PubMedGoogle Scholar
  13. Horowitz, M. J. (1975). Intrusive and repetitive thoughts after experimental stress. Archives of General Psychiatry, 32, 1457–1463.PubMedGoogle Scholar
  14. Jennings, K. D., Ross, S., Popper, S., & Elmore, M. (1999). Thoughts of harming infants in depressed and nondepressed mothers. Journal of Affective Disorders, 54, 21–28.CrossRefPubMedGoogle Scholar
  15. Karno, M., Golding, J. M., Sorenson, S. B., & Burnam, M. A. (1988). The epidemiology of obsessive–compulsive disorder in five US communities. Archives of General Psychiatry, 45, 1094–1099.PubMedGoogle Scholar
  16. Maina, G., Albert, U., Bogetto, F., Vaschetto, P., & Ravizza, L. (2000). Recent life events and obsessive–compulsive disorder (OCD): The role of pregnancy/delivery. Psychiatry Research, 89, 49–58.CrossRefGoogle Scholar
  17. Newth, S., & Rachman, S. (2001). The concealment of obsessions. Behaviour Research and Therapy, 39, 457–464.CrossRefPubMedGoogle Scholar
  18. O'Hara, M. W., Zekoski, E. M., Philipps, L. H., & Wright, E. J. (1990). Controlled prospective study of postpartum mood disorders: Comparison of childbearing and nonchildbearing women. Journal of Abnormal Psychology, 99, 3–15.CrossRefPubMedGoogle Scholar
  19. Parkinson, L., & Rachman, S. J. (1980). Are intrusive thoughts subject to habituation? Behaviour Research and Therapy, 18, 409–418.CrossRefPubMedGoogle Scholar
  20. Purdon, C., & Clark, D. A. (1993). Obsessive intrusive thoughts in nonclinical subjects: I. Content and relation with depressive, anxious and obsessional symptoms. Behaviour Research and Therapy, 31, 713–720.CrossRefPubMedGoogle Scholar
  21. Rachman, S. (1998). A cognitive theory of obsessions: Elaborations. Behaviour Research and Therapy, 36, 385–401.CrossRefPubMedGoogle Scholar
  22. Rachman, S., & de Silva, P. (1978). Abnormal and normal obsessions. Behaviour Research and Therapy, 16, 233–248.CrossRefPubMedGoogle Scholar
  23. Rachman, S., & Hodgson, R. (1980). Obsessions and compulsions. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
  24. Radoff, L. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Journal of Applied Psychological Measurement, 1, 385–401.Google Scholar
  25. Ricciardi, J. N., & McNally, R. J. (1995). Depressed mood is related to obsessions, but not to compulsions, in obsessive–compulsive disorder. Journal of Anxiety Disorders, 9, 249–256.CrossRefGoogle Scholar
  26. Salkovskis, P. M. (1999). Understanding and treating obsessive–compulsive disorder. Behaviour Research and Therapy, 37, S29-S52.CrossRefPubMedGoogle Scholar
  27. Salkovskis, P. M., & Harrison, J. (1984). Abnormal and normal obsessions: A replication. Behaviour Research and Therapy, 22, 549–552.CrossRefPubMedGoogle Scholar
  28. Shafran, R., Thordarson, D. S., & Rachman, S. (1996). Thought-action fusion in obsessive compulsive disorder. Journal of Anxiety Disorders, 10, 379–391.CrossRefGoogle Scholar
  29. Steketee, G., Frost, R., & Bogart, K. (1996). The Yale-Brown obsessive compulsive scale: Interview versus self-report. Behaviour Research and Therapy, 34, 675–684.CrossRefPubMedGoogle Scholar
  30. Williams, K. E., & Koran, L. M. (1997). Obsessive–compulsive disorder in pregnancy, the peurperium, and the premenstruum. Journal of Clinical Psychiatry, 58, 330–334.PubMedGoogle Scholar
  31. Wisner, K. L., Peindl, K. S., Gigliotti, T., & Hanusa, B. H. (1999). Obsessions and compulsions in women with postpartum depression. Journal of Clinical Psychiatry, 60, 176–180.PubMedGoogle Scholar
  32. Wroe, A. L., Salkovskis, P. M., & Richards, H. C. (2000). “Now I know it could happen, I have to prevent it”: A clinical study of the specificity of intrusive thoughts and the decision to prevent harm. Behavioural and Cognitive Psychotherapy, 28, 63–70.Google Scholar

Copyright information

© Plenum Publishing Corporation 2003

Authors and Affiliations

  • Jonathan S. Abramowitz
    • 1
  • Stefanie A. Schwartz
    • 1
  • Katherine M. Moore
    • 1
  1. 1.Department of Psychiatry and PsychologyMayo ClinicRochester

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