Perinatal mental health, parenting and infant outcomes: Studies on the mechanisms

Abstract

Maternal mental health problems are linked to negative parenting and child outcomes. However, evidence for mechanisms that may explain the undermining influence of psychological problems is less well specified and the influence of possible moderators is relatively unexplored. (Dix & Meunier, 2009). This symposium brings into the discussion intervention as well as longitudinal studies focusing on processes at the cognitive, affective and behavioral level, which may explain the adverse effects of mental health problems in the perinatal period and help to evaluate and select pre- and postnatal intervention targets which are most critical for adaptation to parenthood. The first presentation will report results from three studies (involving over 300 mother-infant dyads) to comment on links among maternal state of mind with respect to attachment, adult separation anxiety, childhood parenting experiences, postnatal psychological distress, parenting confidence and early infant behavior. Results identified attachment and separation anxiety issues as important mechanisms in the development of postnatal difficulties. The second presentation focuses on the impact of anxiety and depression on the development of parental self-efficacy and the moderating role of marital and social support. As part of a longitudinal study, 296 primiparous expecting women were followed from pregnancy (12, 22, 32 weeks) to 3 months postpartum. Controlled for concurrent levels of PSE, state anxiety symptoms (12 weeks) were uniquely associated with prenatal PSE at 32 weeks of pregnancy. Prenatal depressive symptoms were no longer significant when anxiety was taken into account. The association between state anxiety symptoms (32 weeks) and postnatal PSE was mediated by prenatal PSE (32 weeks). Marital and social support showed a compensating effect on postnatal PSE. The third presentation focuses on the role of violated expectations in mediating the effects of parental mental health, marital quality and birth experience on parent-child relationship. The findings are based on a sample of 745 couples, followed from pregnancy to 12 months postpartum, half having conceived via infertility treatment. The effect of marital and mental health problems on parent-child relationship was partly mediated via negatively violated expectations. The role of negative prenatal expectations was also crucial, whereas former infertility had little impact. The fourth presentation presents results from a postnatal intervention (Mom Power) aimed at engaging high-risk families, specifically, low-income mothers with a history of childhood abuse. The intervention addressed potential mediators and moderators in five core domains: attachment-based parenting education, enhancing social support, connecting families to care, practicing self-care skills, and supporting child-parent interaction. Evaluation results on 100 families demonstrated improved parent mental health, and enhanced maternal representations of their children.