title: Maternal attachment style and depression associated with childbirth: preliminary results from a European and US cross-cultural study.
abstract: BACKGROUND
  Insecure attachment style relates to major depression in women, but its relationship to depression associated with childbirth is largely unknown. A new UK-designed measure, the Attachment Style Interview (ASI), has potential for cross-cultural use as a risk marker for maternal disorder.
  
  
  OBJECTIVE
  To establish there liability of the ASI across centres, its stability over a 9-month period, and its associations with social context and major or minor depression.
  
  
  METHODS
  The ASI was used by nine centres antenatally on 204 women, with 174 followed up 6 months postnatally. Interrater reliability was tested and the ASI was repeated on a subset of 96 women. Affective disorder was assessed by means of the Structured Clinical Interview for DSM-IV.
  
  
  RESULTS
  Satisfactory interrater reliability was achieved with relatively high stability rates at follow-up. Insecure attachment related to lower social class position and more negative social context. Specific associations of avoidant attachment style (angry-dismissive or withdrawn) with antenatal disorder, and anxious style (enmeshed or fearful) with postnatal disorder were found.
  
  
  CONCLUSIONS
  The ASI can be used reliably in European and US centres as a measure for risk associated with childbirth. Its use will contribute to theoretically under pinned preventive action for disorders associated with childbirth.
authors.affiliation: Lifespan Research Group, Royal Holloway, University of London, UK. A.Bifulco@rhul.ac.uk
authors.forename: A
authors.initials: A
authors.lastname: Bifulco
authors.forename: B
authors.initials: B
authors.lastname: Figueiredo
authors.forename: N
authors.initials: N
authors.lastname: Guedeney
authors.forename: L L
authors.initials: LL
authors.lastname: Gorman
authors.forename: S
authors.initials: S
authors.lastname: Hayes
authors.forename: M
authors.initials: M
authors.lastname: Muzik
authors.forename: E
authors.initials: E
authors.lastname: Glatigny-Dallay
authors.forename: V
authors.initials: V
authors.lastname: Valoriani
authors.forename: M H
authors.initials: MH
authors.lastname: Kammerer
authors.forename: C A
authors.initials: CA
authors.lastname: Henshaw
mesh_terms: D000328:Adult; D003431:Cross-Cultural Comparison; D019052:Depression, Postpartum / Q000208:ethnology / Q000523:psychology*; D003866:Depressive Disorder / Q000208:ethnology / Q000523:psychology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007406:Interview, Psychological / Q000379:methods; D007484:Iowa / Q000453:epidemiology; D009034:Mother-Child Relations / Q000208:ethnology*; D009769:Object Attachment; D010865:Pilot Projects; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology / Q000523:psychology; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors