title: Postnatal Mother-to-Infant Attachment in Subclinically Depressed Mothers: Dyads at Risk?
abstract: BACKGROUND
  Dyadic interactions between children and depressed mothers have been characterized as less synchronous and with lower maternal sensitivity, fostering an inharmonious, insecure attachment relationship between mother and child. Thus, these children may experience enhanced early life stress and are at higher risk of disturbed socioemotional development. Recently, this association has also been found in women with mild depressive symptoms. However, potential confounding effects of mother's history of own rearing experiences or infant temperament on the link between depressive symptoms and postnatal mother-to-infant attachment have not yet been investigated.
  
  
  METHODS
  Differences in mother-to-infant attachment (e.g. quality of attachment, absence of hostility, and pleasure in interaction) between mothers with and without symptoms of depression 6-8 months postpartum were analyzed in a low-risk community sample (n = 38, 19 per group). Depressive symptomatology was measured with the Beck Depression Inventory (BDI-II) and the Edinburgh Postnatal Depression Scale (EPDS). Depressed mothers indicated mild-to-moderate depressive symptomatology (mean BDI-II 11.26 ± 3.86) but did not fulfill criteria for a major depressive episode and, thus, were referred to as 'subclinically' depressed. Potential confounders, namely maternal history of own rearing experiences and infant temperament, were explored by multivariate AN(C)OVA.
  
  
  RESULTS
  Primiparous mothers with subclinical depression differed significantly from healthy control mothers, i.e. showed poorer mother-to-infant attachment and higher infant-related hostility 6-8 months postpartum. As expected, infant temperament and mother's history of own rearing experiences were both associated with mother-to-infant attachment but did not explain the negative effects of subclinical depression on the mother-infant relationship.
  
  
  CONCLUSIONS
  Given the high prevalence of maternal depression, the current findings give reason for increased concern for the developing mother-child relationship. Therefore, early interventions are needed that focus on the mother-child dyad and target not only clinically but also subclinically depressed mothers.
authors: Department of Child and Adolescent Psychiatry, University Hospital RWTH Aachen, Aachen, Germany.
authors: Hannah F
authors: HF
authors: Behrendt
authors: Kerstin
authors: K
authors: Konrad
authors: Tamme W
authors: TW
authors: Goecke
authors: Roya
authors: R
authors: Fakhrabadi
authors: Beate
authors: B
authors: Herpertz-Dahlmann
authors: Christine
authors: C
authors: Firk
mesh_terms: D000328:Adult; D019052:Depression, Postpartum / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D006801:Humans; D007223:Infant; D007398:Interpersonal Relations; D009034:Mother-Child Relations / Q000523:psychology*; D009035:Mothers / Q000523:psychology*; D009769:Object Attachment; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D013694:Temperament