The association of attachment style, postpartum PTSD and depression with bonding- A longitudinal path analysis model, from childbirth to six months.

Handelzalts, J. E., Levy, S., Molmen-Lichter, M. , Ayers, S. ORCID: 0000-0002-6153-2460, Krissi, H., Wiznitzer, A. & Peled, Y. (2020). The association of attachment style, postpartum PTSD and depression with bonding- A longitudinal path analysis model, from childbirth to six months.. Journal of Affective Disorders, 280(Pt A), pp. 17-25. doi: 10.1016/j.jad.2020.10.068

Abstract

BACKGROUND: There is substantial evidence that postpartum depression (PPD) is associated with a poor mother-infant bond, however, fewer studies have examined the role of other postpartum psychopathologies such as birth-related PTSD or relevant trait variables such as adult attachment styles in the quality of the mother-infant bond.

METHODS: 210 postpartum women were sampled in a maternity ward of a tertiary health care center. Participants completed questionnaires at three-time points. Demographics questionnaire and the Adult Attachment style scale were administrated at 1-4 days postpartum, the City Birth Trauma Scale and the Edinburgh Postpartum Depression Scale two months postpartum and the Postpartum Bonding questionnaire at six months postpartum.

RESULTS: The associations between adult attachment styles and postpartum bonding were fully mediated by postpartum psychopathology. Avoidant attachment had indirect effects on bonding through general PTSD symptoms (Beta=0.05, p=.019) and PPD (Beta=0.06, p=.010). Anxious attachment also had indirect effects on bonding through general PTSD symptoms (Beta=0.04, p=.044) and PPD (Beta=0.10, p=.001). In contrast, birth-related PTSD symptoms were not associated with bonding. The model presented a good fit.

LIMITATIONS: Women sampled from one health-care center and self-report measures used.

CONCLUSIONS: Our results suggest that although birth-related PTSD symptoms may cause difficulties, importantly they may not be associated with bonding difficulties six months postpartum. Therefore, women could be reassured that their birth-related PTSD symptoms, may not impact on bonding. Consequently, if interventions are specifically aimed at improving the mother-infant bond, the general-related PTSD, PPD symptoms and insecure attachment styles should be the focus of treatment.

Publication Type:	Article
Additional Information:	© 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Publisher Keywords:	Postpartum; Depression; PTSD; Attachment; Bonding
Subjects:	B Philosophy. Psychology. Religion > BF Psychology R Medicine > RG Gynecology and obstetrics R Medicine > RT Nursing
Departments:	School of Health & Psychological Sciences > Midwifery & Radiography