title: Optimistic outlook regarding maternity protects against depressive symptoms postpartum.
abstract: The transition to motherhood is a time of elevated risk for clinical depression. Dispositional optimism may be protective against depressive symptoms; however, the arrival of a newborn presents numerous challenges that may be at odds with initially positive expectations, and which may contribute to depressed mood. We have explored the relative contributions of antenatal and postnatal optimism regarding maternity to depressive symptoms in the postnatal period. Ninety-eight pregnant women underwent clinician interview in the third trimester to record psychiatric history, antenatal depressive symptoms, and administer a novel measure of optimism towards maternity. Measures of depressive symptoms, attitudes to maternity, and mother-to-infant bonding were obtained from 97 study completers at monthly intervals through 3 months postpartum. We found a positive effect of antenatal optimism, and a negative effect of postnatal disconfirmation of expectations, on depressive mood postnatally. Postnatal disconfirmation, but not antenatal optimism, was associated with more negative attitudes toward maternity postnatally. Antenatal optimism, but not postnatal disconfirmation, was associated with reduced scores on a mother-to-infant bonding measure. The relationships between antenatal optimism, postnatal disconfirmation of expectations, and postnatal depression held true among primigravidas and multigravidas, as well as among women with prior histories of mood disorders, although antenatal optimism tended to be lower among women with mental health histories. We conclude that cautious antenatal optimism, rather than immoderate optimism or frank pessimism, is the approach that is most protective against postnatal depressive symptoms, and that this is true irrespective of either mood disorder history or parity. Factors predisposing to negative cognitive assessments and impaired mother-to-infant bonding may be substantially different than those associated with depressive symptoms, a finding that merits further study.
authors.affiliation: Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, 401 Quarry Road, MC 5723, Stanford, CA, 94305, USA. trobakis@stanford.edu.
authors.forename: Thalia K
authors.initials: TK
authors.lastname: Robakis
authors.affiliation: Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, 401 Quarry Road, MC 5723, Stanford, CA, 94305, USA.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Williams
authors.affiliation: Department of Obstetrics and Gynecology, Stanford University School of Medicine, 770 Welch Road, Suite 201, Stanford, CA, 94304, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Crowe
authors.affiliation: Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, 401 Quarry Road, MC 5723, Stanford, CA, 94305, USA.|Palo Alto University, 1791 Arrastradero Road, Palo Alto, CA, 94304, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Kenna
authors.affiliation: Palo Alto University, 1791 Arrastradero Road, Palo Alto, CA, 94304, USA.
authors.forename: Jamie
authors.initials: J
authors.lastname: Gannon
authors.affiliation: Department of Psychiatry and Behavioral Science, Stanford University School of Medicine, 401 Quarry Road, MC 5723, Stanford, CA, 94305, USA.
authors.forename: Natalie L
authors.initials: NL
authors.lastname: Rasgon
mesh_terms: D000328:Adult; D001290:Attitude; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D019052:Depression, Postpartum / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008016:Life Change Events; D008425:Maternal Behavior; D008603:Mental Health; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D009769:Object Attachment; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires
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