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Maternal mental health, processing of emotion and maternal sensitivity

Webb, R. (2017). Maternal mental health, processing of emotion and maternal sensitivity. (Unpublished Doctoral thesis, City, University of London)


Background: Research suggests that postnatal affective disorders such as anxiety, depression and post-traumatic stress disorder (PTSD) are associated with lower levels of maternal sensitivity. Understanding the mechanisms through which maternal affective disorders influence maternal sensitivity is important as it could lead to more tailored effective interventions to improve outcomes for women and their infants. One mechanism that is yet to be explored is the way in which mothers’ process infant-related information. This thesis therefore developed a cognitive model that aimed to examine this mechanism.

Aim: The aim of this thesis was to test this cognitive model of maternal sensitivity using a range of experimental, observational and questionnaire studies. The model proposed that maternal affective symptoms would be associated with maternal processing of infant-related information, which in turn would be associated with maternal sensitivity.

Methods & Results: The aims were addressed through a systematic review and a study of women with (n = 23) and without (n = 47) affective symptoms and their infants (aged 2-8 months) after birth. The systematic review found that mothers with perinatal affective disorders are faster to disengage from sad infant faces and are more accurate at identifying sadness in infant faces (Article 1). To assess how mothers process infant-related information, validated pictures of infants’ emotional faces were needed. Therefore, a validated set of infant emotional expressions was created and validated on student midwives and nurses and members of the general public. The images were found to have high criterion validity and good test–retest reliability (Article 2). Mothers processing of infant-related information and its relationship with maternal sensitivity was tested using a series of questionnaires, computerised and observational tasks. Results are reported in Articles 3, 4 and 5.

Conclusion: Overall, the cognitive model of maternal sensitivity was only partly supported, in that maternal affective symptoms explained more of the variance of maternal sensitivity than maternal processing of infant-related information. Despite this, the work in this thesis provides a novel contribution to the literature by developing and testing a model based on previous research and by using robust measures such as eye-tracking technology and observational measures of mother-infant interaction. However, interpretation of the data is hindered due to methodological issues such as small sample sizes, homogeneous sample and demand characteristics. Therefore, more research is needed to test this model on a larger, more heterogenous sample.

Publication Type: Thesis (Doctoral)
Subjects: R Medicine > RC Internal medicine
R Medicine > RG Gynecology and obstetrics
Departments: Doctoral Theses
School of Health & Psychological Sciences > School of Health & Psychological Sciences Doctoral Theses
School of Health & Psychological Sciences
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