Abstract
The mental health of fathers is often overlooked by researchers, mental health professionals, and fathers themselves. Yet, emergent research indicates that fathers experience a wide variety of mental health concerns. This chapter focuses on two prevalent mental health conditions that adversely impact fathers, particularly in the perinatal period: depression and anxiety. Both depression and anxiety have nuanced manifestations depending on the masculinity ideology of fathers. A prominent theme suggests that fathers adhering to more rigid masculinity ideologies are likely to externalize their depressive and anxious feelings in maladaptive anger, avoidance, risk-taking, and alcohol use. This chapter describes how mental health professionals can improve the screening, assessment, and treatment of fathers’ mental health. Future directions of research are also discussed.
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References
Abdollahi, F., Lye, M. S., Yazdani Cherati, J., & Zarghami, M. (2021). Depressive symptoms in men immediately after birth. Journal of Psychosomatic Research, 151, 110650. https://doi.org/10.1016/j.jpsychores.2021.110650
Addis, M. E. (2008). Gender and depression in men. Clinical Psychology: Science and Practice, 15(3), 153–168. https://doi.org/10.1111/j.1468-2850.2008.00125.x
American Psychiatric Association (APA). (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
Angst, J., Gamma, A., Gastpar, M., Lépine, J. P., Mendlewicz, J., Tylee, A., & Depression Research in European Society Study. (2002). Gender differences in depression. Epidemiological findings from the European DEPRES I and II studies. European Archives of Psychiatry and Clinical Neuroscience, 252(5), 201–209. https://doi.org/10.1007/s00406-002-0381-6
Bäckström, C., & Hertfelt Wahn, E. (2011). Support during labour: First-time fathers’ descriptions of requested and received support during the birth of their child. Midwifery, 27(1), 67–73. https://doi.org/10.1016/j.midw.2009.07.001
Baldoni, F., & Giannotti, M. (2020). Perinatal distress in fathers: Toward a gender-based screening of paternal perinatal depressive and affective disorders. Frontiers in Psychology, 11, 1–5. https://doi.org/10.3389/fpsyg.2020.01892
Baldwin, S., Malone, M., Sandall, J., & Bick, D. (2018). Mental health and wellbeing during the transition to fatherhood: A systematic review of first time fathers’ experiences. JBI Database of Systematic Reviews and Implementation Reports, 16(11), 2118–2191. https://doi.org/10.11124/JBISRIR-2017-003773
Bamishigbin, O. N., Wilson, D. K., Abshire, D. A., Mejia-Lancheros, C., & Dunkel Schetter, C. (2020). Father involvement in infant parenting in an ethnically diverse community sample: Predicting paternal depressive symptoms. Frontiers in Psychiatry, 11, 957. https://doi.org/10.3389/fpsyt.2020.578688
Bennett, I. M., Coco, A., Coyne, J. C., Mitchell, A. J., Nicholson, J., Johnson, E., et al. (2008). Efficiency of a two-item pre-screen to reduce the burden of depression screening in pregnancy and postpartum: An IMPLICIT network study. The Journal of the American Board of Family Medicine, 21(4), 317–325.
Bertakis, K. D., Helms, L. J., Callahan, E. J., Azari, R., Leigh, P., & Robbins, J. A. (2001). Patient gender differences in the diagnosis of depression in primary care. Journal of Women’s Health & Gender-Based Medicine, 10(7), 689–698. https://doi.org/10.1089/15246090152563579
Bradley, R., & Slade, P. (2011). A review of mental health problems in fathers following the birth of a child. Journal of Reproductive and Infant Psychology, 29(1), 19–42. https://doi.org/10.1080/02646838.2010.513047
Cameron, E. E., Sedov, I. D., & Tomfohr-Madsen, L. M. (2016). Prevalence of paternal depression in pregnancy and the postpartum: An updated meta-analysis. Journal of Affective Disorders, 206, 189–203. https://doi.org/10.1016/j.jad.2016.07.044
Cameron, E. E., Giesbrecht, G. F., & Tomfohr-Madsen, L. M. (2021). Psychometric properties of the Pregnancy-Related Anxiety Scale for use with fathers during pregnancy. Psychology of Men & Masculinities, 22(1), 26–38. https://doi.org/10.1037/men0000260
Chhabra, J., McDermott, B., & Li, W. (2020). Risk factors for paternal perinatal depression and anxiety: A systematic review and meta-analysis. Psychology of Men & Masculinities, 21(4), 593–611. https://doi.org/10.1037/men0000259
Cochran, S. V., & Rabinowitz, F. E. (2000). Men and depression: Clinical and empirical perspectives. Academic Press.
Cox, J., Holden, J., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150(6), 782–786. https://doi.org/10.1192/bjp.150.6.782
Davé, S., Petersen, I., Sherr, L., & Nazareth, I. (2010). Incidence of maternal and paternal depression in primary care: A cohort study using a primary care database. Archives of Pediatrics & Adolescent Medicine, 164(11), 1038–1044. https://doi.org/10.1001/archpediatrics.2010.184
Dennis, C. L., Marini, F., Dol, J., Vigod, S. N., Grigoriadis, S., & Brown, H. K. (2022). Paternal prevalence and risk factors for comorbid depression and anxiety across the first 2 years postpartum: A nationwide Canadian cohort study. Depression and Anxiety, 39(3), 233–245. https://doi.org/10.1002/da.23234
Don, B. P., & Mickelson, K. D. (2012). Paternal postpartum depression: The role of maternal postpartum depression, spousal support, and relationship satisfaction. Couple and Family Psychology: Research and Practice, 1(4), 323–334. https://doi.org/10.1037/a0029148
Earls, M. F., Yogman, M. W., Mattson, G., Rafferty, J., & Committee on Psychosocial Aspects of Child and Family Health. (2019). Incorporating recognition and management of perinatal depression into pediatric practice. Pediatrics, 143(1), e20183259. https://doi.org/10.1542/peds.2018-3259
Edmondson, O. J. H., Psychogiou, L., Vlachos, H., Netsi, E., & Ramchandani, P. G. (2010). Depression in fathers in the postnatal period: Assessment of the Edinburgh Postnatal Depression Scale as a screening measure. Journal of Affective Disorders, 125(1–3), 365–368. https://doi.org/10.1016/j.jad.2010.01.069
Eisler, R. M., & Blalock, J. A. (1991). Masculine gender role stress: Implications for the assessment of men. Clinical Psychology Review, 11(1), 45–60. https://doi.org/10.1016/0272-7358(91)90137-J
Fisher, S. D. (2016). Paternal mental health: Why is it relevant? American Journal of Lifestyle Medicine, 11(3), 200–211. https://doi.org/10.1177/1559827616629895
Fisher, K., Seidler, Z. E., King, K., Oliffe, J. L., & Rice, S. M. (2021a). Men’s anxiety: A systematic review. Journal of Affective Disorders, 295, 688–702. https://doi.org/10.1016/j.jad.2021.08.136
Fisher, S. D., Cobo, J., Figueiredo, B., Fletcher, R., Garfield, C. F., Hanley, J., et al. (2021b). Expanding the international conversation with fathers’ mental health: Toward an era of inclusion in perinatal research and practice. Archives of Women’s Mental Health, 24(5), 841–848. https://doi.org/10.1007/s00737-021-01171-y
Garfield, C. F., Isacco, A., & Bartlo, W. D. (2010). Men’s health and fatherhood in the urban Midwestern United States. International Journal of Men’s Health, 9(3), 161–174. https://doi.org/10.3149/jmh.0903.161
Garfield, C. F., Simon, C. D., Stephens, F., Castro Román, P., Bryan, M., Smith, R. A., et al. (2022). Pregnancy risk assessment monitoring system for dads: A piloted randomized trial of public health surveillance of recent fathers’ behaviors before and after infant birth. PLoS One, 17(1), e0262366. https://doi.org/10.1371/journal.pone.0262366
Genesoni, L., & Tallandini, M. A. (2009). Men’s psychological transition to fatherhood: An analysis of the literature, 1989–2008. Birth Issues in Perinatal Care, 36(4), 305–318. https://doi.org/10.1111/j.1523-536X.2009.00358.x
Gentile, S., & Fusco, M. L. (2017). Untreated perinatal paternal depression: Effects on offspring. Psychiatry Research, 252, 325–332. https://doi.org/10.1016/j.psychres.2017.02.064
Giallo, R., D’Esposito, F., Cooklin, A., Mensah, F., Lucas, N., Wade, C., & Nicholson, J. M. (2013). Psychosocial risk factors associated with fathers’ mental health in the postnatal period: Results from a population-based study. Social Psychiatry and Psychiatric Epidemiology, 48(4), 563–573. https://doi.org/10.1007/s00127-012-0568-8
Goodman, J. H. (2004). Paternal postpartum depression, its relationship to maternal postpartum depression, and implications for family health. Journal of Advanced Nursing, 45(1), 26–35. https://doi.org/10.1046/j.1365-2648.2003.02857.x
Hammen, C. L., & Padesky, C. A. (1977). Sex differences in the expression of depressive responses on the Beck Depression Inventory. Journal of Abnormal Psychology, 86(6), 609–614. https://doi.org/10.1037//0021-843x.86.6.609
Hasin, D. S., Sarvet, A. L., Meyers, J. L., Saha, T. D., Ruan, W. J., Stohl, M., & Grant, B. F. (2018). Epidemiology of adult DSM-5 major depressive disorder and its specifiers in the United States. JAMA Psychiatry, 75(4), 336–346. https://doi.org/10.1001/jamapsychiatry.2017.4602
Hayes, S. C. (2016). The ACT in context. Routledge.
Hildingsson, I., Johansson, M., Fenwick, J., Haines, H., & Rubertsson, C. (2014). Childbirth fear in expectant fathers: Findings from a regional Swedish cohort study. Midwifery, 30(2), 242–247. https://doi.org/10.1016/j.midw.2013.01.001
Holmes, D. S., & Jorgensen, B. W. (1971). Do personality and social psychologists study men more than women? Representative Research in Social Psychology, 2(1), 71–76.
Isacco, A., Talovic, E., Chromik, L. C., & Yallum, N. (2013). Addressing men’s mental health through a strength-based approach. In J. M. Rippe (Ed.), Lifestyle medicine (2nd ed.). CRC Press.
Isacco, A., Hofscher, R., & Molloy, S. (2016). An examination of fathers’ mental health help seeking: A brief report. American Journal of Men’s Health, NP33–NP38. https://doi.org/10.1177/1557988315581395
Johansson, M., Fenwick, J., & Premberg, A. (2015). A meta-synthesis of fathers’ experiences of their partner’s labour and the birth of their baby. Midwifery, 31(1), 9–18. https://doi.org/10.1016/j.midw.2014.05.005
Johansson, M., Wells, M. B., & Thies-Lagergren, L. (2021). A dreaded delight: A longitudinal qualitative interview study of paternal childbirth fear during the transition to fatherhood. European Journal of Midwifery, 5, 52. https://doi.org/10.18332/ejm/142783
Kessler, R. C., & Bromet, E. J. (2013). The epidemiology of depression across cultures. Annual Review of Public Health, 34, 119–138. https://doi.org/10.1146/annurev-publhealth031912-114409
Kiselica, M. S., & Englar-Carlson, M. (2010). Identifying, affirming, and building upon male strengths: The positive psychology/positive masculinity model of psychotherapy with boys and men. Psychotherapy: Theory, Research & Practice, 47, 276–287. https://doi.org/10.1037/a0021159
Kouros, C. D., Papp, L. M., Goeke-Morey, M., & Cummings, E. M. (2014). Spillover between marital quality and parent–child relationship quality: Parental depressive symptoms as moderators. Journal of Family Psychology, 28(3), 315–325. https://doi.org/10.1037/a0036804
Kuehner, C. (2017). Why is depression more common among women than among men? The Lancet Psychiatry, 4(2), 146–158. https://doi.org/10.1016/S2215-0366(16)30263-2
Leach, L. S., Poyser, C., Cooklin, A. R., & Giallo, R. (2016). Prevalence and course of anxiety disorders (and symptom levels) in men across the perinatal period: A systematic review. Journal of Affective Disorders, 190, 675–686. https://doi.org/10.1016/j.jad.2015.09.063
Leiferman, J. A., Farewell, C. V., Jewell, J., Lacy, R., Walls, J., Harnke, B., & Paulson, J. F. (2021). Anxiety among fathers during the prenatal and postpartum period: A meta-analysis. Journal of Psychosomatic Obstetrics and Gynaecology, 42(2), 152–161. https://doi.org/10.1080/0167482X.2021.1885025
Levant, R. F., Allen, P. A., & Lien, M.-C. (2014). Alexithymia in men: How and when do emotional processing deficiencies occur? Psychology of Men & Masculinities, 15(3), 324–334. https://doi.org/10.1037/a0033860
Levin, Y., & Sanacora, G. (2007). Depression. In J. E. Grant & M. N. Potenza (Eds.), Textbook of men’s mental health. American Psychiatric Publishing.
Luoma, J. B., Martin, C. E., & Pearson, J. L. (2002). Contact with mental health and primary care providers before suicide: A review of the evidence. The American Journal of Psychiatry, 159(6), 909–916. https://doi.org/10.1176/appi.ajp.159.6.909
Martin, L. A., Neighbors, H. W., & Griffith, D. M. (2013). The experience of symptoms of depression in men vs women: Analysis of the National Comorbidity Survey Replication. JAMA Psychiatry, 70(10), 1100–1106. https://doi.org/10.1001/jamapsychiatry.2013.1985
Massoudi, P., Hwang, C. P., & Wickberg, B. (2013). How well does the Edinburgh Postnatal Depression Scale identify depression and anxiety in fathers? A validation study in a population based Swedish sample. Journal of Affective Disorders, 149(1–3), 67–74. https://doi.org/10.1016/j.jad.2013.01.005
Matthey, S., Barnett, B., Ungerer, J., & Waters, B. (2000). Paternal and maternal depressed mood during the transition to parenthood. Journal of Affective Disorders, 60(2), 75–85. https://doi.org/10.1016/s0165-0327(99)00159-7
Matthey, S., Barnett, B., Kavanagh, D. J., & Howie, P. (2001). Validation of the Edinburgh Postnatal Depression Scale for men, and comparison of item endorsement with their partners. Journal of Affective Disorders, 64(2–3), 175–184. https://doi.org/10.1016/s0165-0327(00)00236-6
Melrose, S. (2010). Paternal postpartum depression: How can nurses begin to help? Contemporary Nurse, 34(2), 199–210. https://doi.org/10.5172/conu.2010.34.2.199
Möller-Leimkühler, A. M. (2002). Barriers to help-seeking by men: A review of sociocultural and clinical literature with particular reference to depression. Journal of Affective Disorders, 71(1–3), 1–9. https://doi.org/10.1016/s0165-0327(01)00379-2
O’Brien, A. P., McNeil, K. A., Fletcher, R., Conrad, A., Wilson, A. J., Jones, D., & Chan, S. W. (2017). New fathers’ perinatal depression and anxiety-treatment options: An integrative review. American Journal of Men’s Health, 11(4), 863–876. https://doi.org/10.1177/1557988316669047
Oren, C. Z., & Oren, D. C. (2009). Counseling fathers. Routledge.
Paulson, J. F., & Bazemore, S. D. (2010). Prenatal and postpartum depression in fathers and its association with maternal depression: A meta-analysis. Journal of the American Medical Association, 303(19), 1961–1969. https://doi.org/10.1001/jama.2010.605
Paulson, J. F., Bazemore, S. D., Goodman, J. H., & Leiferman, J. A. (2016). The course and interrelationship of maternal and paternal perinatal depression. Archives of Women’s Mental Health, 19(4), 655–663. https://doi.org/10.1007/s00737-016-0598-4
Philpott, L. F., Savage, E., FitzGerald, S., & Leahy-Warren, P. (2019). Anxiety in fathers in the perinatal period: A systematic review. Midwifery, 76, 54–101. https://doi.org/10.1016/j.midw.2019.05.013
Pierce, M., Hope, H., Kolade, A., Gellatly, J., Osam, C., Perchard, R., et al. (2020). Effects of parental mental illness on children’s physical health: Systematic review and meta-analysis. The British Journal of Psychiatry, 217(1), 354–363. https://doi.org/10.1192/bjp.2019.216
Pollack, W. S., & Levant, R. F. (1998). New psychotherapy for men. John Wiley & Sons, Inc..
Psouni, E., & Eichbichler, A. (2020). Feelings of restriction and incompetence in parenting mediate the link between attachment anxiety and paternal postnatal depression. Psychology of Men & Masculinity, 21(3), 416–429. https://doi.org/10.1037/men0000233
Quevedo, L., da Silva, R. A., Coelho, F., Pinheiro, K. A. T., Horta, B. L., Kapczinski, F., & Pinheiro, R. T. (2011). Risk of suicide and mixed episode in men in the postpartum period. Journal of Affective Disorders, 132(1–2), 243–246. https://doi.org/10.1016/j.jad.2011.01.004
Rabinowitz, F. E., & Cochran, S. V. (2008). Men and therapy: A case of masked male depression. Clinical Case Studies, 7(6), 575–591. https://doi.org/10.1177/1534650108319917
Rajyaguru, P., Kwong, A., Braithwaite, E., & Pearson, R. M. (2021). Maternal and paternal depression and child mental health trajectories: Evidence from the Avon Longitudinal Study of Parents and Children. BJPsych Open, 7(5), e166. https://doi.org/10.1192/bjo.2021.959
Ramchandani, P. G., Stein, A., O’Connor, T. G., Heron, J., Murray, L., & Evans, J. (2008). Depression in men in the postnatal period and later child psychopathology: A population cohort study. Journal of the American Academy of Child and Adolescent Psychiatry, 47(4), 390–398. https://doi.org/10.1097/CHI.0b013e31816429c2
Rice, S. M., Kealy, D., Seidler, Z. E., Walton, C. C., Oliffe, J. L., & Ogrodniczuk, J. S. (2021). Male-type depression symptoms in young men with a history of childhood sexual abuse and current hazardous alcohol use. Psychiatry Research, 304, 114110. https://doi.org/10.1016/j.psychres.2021.114110
Rodrigues, A. L., Ericksen, J., Watson, B., Gemmill, A. W., & Milgrom, J. (2022). Interventions for perinatal depression and anxiety in fathers: A mini-review. Frontiers in Psychology, 12, 744921. https://doi.org/10.3389/fpsyg.2021.744921
Schobinger, E., Stuijfzand, S., & Horsch, A. (2020). Acute and post-traumatic stress disorder symptoms in mothers and fathers following childbirth: A prospective cohort study. Frontiers in Psychiatry, 11, 562054. https://doi.org/10.3389/fpsyt.2020.562054
Shapiro, F. E. (2002). EMDR as an integrative psychotherapy approach: Experts of diverse orientations explore the paradigm prism (pp. vii–444). American Psychological Association.
Singley, D. B., & Edwards, L. M. (2015). Men’s perinatal mental health in the transition to fatherhood. Professional Psychology: Research and Practice, 46(5), 309–316. https://doi.org/10.1037/pro0000032
Singley, D. B., Cole, B. P., Hammer, J. H., Molloy, S., Rowell, A., & Isacco, A. (2018). Development and psychometric evaluation of the paternal involvement with infants scale. Psychology of Men & Masculinity, 19(2), 167–183. https://doi.org/10.1037/men0000094
Skjothaug, T., Smith, L., Wentzel, L. T., & Moe, V. (2018). Does fathers’ prenatal mental health bear a relationship to parenting stress at 6 months? Infant Mental Health Journal, 39(5), 537–551. https://doi.org/10.1002/imhj.21739
Society for the Psychological Study of Men and Masculinities. (2019). American Psychological Association Division 51: Society for the Psychological Study of Men and Masculinities. https://www.division51.net/
Spitzer, R. L., Kroenke, K., & Williams, J. B. (1999). Validation and utility of a self-report version of PRIME-MD: The PHQ primary care study. Primary care evaluation of mental disorders. Patient Health Questionnaire. Journal of the American Medical Association, 282(18), 1737–1744. https://doi.org/10.1001/jama.282.18.1737
Sundström Poromaa, I., Comasco, E., Georgakis, M. K., & Skalkidou, A. (2017). Sex differences in depression during pregnancy and the postpartum period. Journal of Neuroscience Research, 95(1–2), 719–730. https://doi.org/10.1002/jnr.23859
Swami, V. (2012). Mental health literacy of depression: Gender differences and attitudinal antecedents in a representative British sample. PLoS One, 7(11), e49779. https://doi.org/10.1371/journal.pone.0049779
Walker, R., Blackie, M., & Nedeljkovic, M. (2021). Fathers’ experience of perinatal obsessive-compulsive symptoms: A systematic literature review. Clinical Child and Family Psychology Review, 24(3), 529–541. https://doi.org/10.1007/s10567-021-00348-2
Warren, L. W. (1983). Male intolerance of depression: A review with implications for psychotherapy. Clinical Psychology Review, 3(2), 147–156. https://doi.org/10.1016/0272-7358(83)90009-0
Wexler, D. B. (2009). Men in therapy: New approaches for effective treatment. W.W. Norton & Co.
World Health Organization. (2019). International statistical classification of diseases and related health problems (11th ed.). https://icd.who.int/
Xue, W. L., Shorey, S., Wang, W., & He, H. G. (2018). Fathers’ involvement during pregnancy and childbirth: An integrative literature review. Midwifery, 62, 135–145. https://doi.org/10.1016/j.midw.2018.04.013
Zerach, G., & Magal, O. (2017). Exposure to stress during childbirth, dyadic adjustment, partner’s resilience, and psychological distress among first-time fathers. Psychology of Men & Masculinity, 18(2), 123–133. https://doi.org/10.1037/men0000048
Zierau, F., Bille, A., Rutz, W., & Bech, P. (2002). The Gotland male depression scale: A validity study in patients with alcohol use disorder. Nordic Journal of Psychiatry, 56(4), 265–271. https://doi.org/10.1080/08039480260242750
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Azzam, P., Reagan, K.M., Isacco, A., Singley, D.B. (2022). Paternal Mental Health in the Perinatal Period. In: Molloy, S., Azzam, P., Isacco, A. (eds) Handbook of the Psychology of Fatherhood. Springer, Cham. https://doi.org/10.1007/978-3-031-14498-1_10
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