Search

Mothers with insecure attachment styles may have increased difficulty establishing secure attachment with their infant and may experience emotion regulation difficulties in the postpartum period. This study aimed to examine the mediating effect of emotion dysregulation (ED) on the relationship between maternal insecure attachment style and self‐reported attachment to infant in women admitted to a mother‐baby unit. At admission, women completed self‐report questionnaires measuring attachment style, ED, postnatal attachment and postnatal depression (PND) symptoms. Descriptive statistics, correlations, and mediation analyses (PROCESS macro) were conducted. Insecure maternal attachment style was found to predict postnatal attachment through ED. When PND symptoms were accounted for, this model was no longer significant, and instead a serial mediation found that ED predicted PND, which was in turn associated with reduced postnatal attachment quality. This study provides preliminary support for continued research into maternal ED as a predictor of adverse maternal and infant outcomes postnatally. Individuals with attachment insecurity experiencing emotion regulation difficulties may be at an increased risk of developing PND and in turn experiencing adverse mother‐infant attachment outcomes. This has clinical implications for the screening, assessment and treatment of women experiencing mental health or attachment related concerns postnatally.

Additional file 1: Table S1. Descriptive statistics for clinical and parenting outcome measures at admission, discharge and follow-up (nâ =â 75).

Additional file 2: Table S2. Final model fit for latent classes of scores on clinical and parenting outcome measures at admission, discharge and follow-up (nâ =â 75).

Additional file 3: Table S3. Descriptive statistics for clinical and parenting outcome measures by group classification, for each final model (nâ =â 75).

Clinical guidelines recommend that women be asked about their past or current mental health as a routine component of maternity care. The purpose of this research was two-fold: first, to examine whether access to this universal aspect of care is equitable among women who have recently given birth in Australia; second, to examine the clinical effectiveness of this prevention and early intervention approach, in terms of referral rates, service utilisation and maternal mental health and parenting outcomes. A sub-sample of women from the Australian Longitudinal Study on Women’s Health (ALSWH) 1973-1978 Cohort participated in the four studies undertaken to explore these issues. Study One showed that health care provider enquiry into a woman’s current emotional state has been largely embraced during pregnancy and the postpartum in Australia, that much less is occurring in terms of more in depth examinations of maternal psychosocial health, and that there are clear disparities in access to perinatal psychosocial assessment at health-service and socio-demographic levels. Study Two demonstrated that asking women about current mental health is not only a good practice approach but does not seem to inflate referral rates, and that health professionals appropriately taking into account risk factors such as past history will initiate referrals. Subsequent analyses undertaken in Study Three showed that health professional enquiry into past or current mental health is associated with help seeking among women who experienced significant emotional distress during the perinatal period, with the impact of such enquiry on help seeking most apparent when women were also referred by their health care provider for additional support or care. Study Four demonstrated that women who are asked about their emotional health in the second postnatal year have more optimal mental health outcomes than women who are not asked about these issues. However, the most consistent predictors of mental health and parenting outcomes across the first two years postpartum were overall social support, significant stressors in the previous 12 months and delayed help seeking. These studies provide an important contribution to the debate relating to the clinical efficacy of depression ‘screening’ or psychosocial assessment during the perinatal period, and are particularly timely given recent changes in the funding structure for the National Perinatal Depression Initiative in Australia.