Cognitive vulnerability to postnatal depressive symptomatology

Abstract

Understanding the factors involved in the development of postpartum depressive disorders has important implications for the detection of women at risk, and the development of theory‐driven preventative treatments. In the current study, recent innovations in the assessment of idiographic cognitive functioning among adult, non‐pregnant samples were administered to a sample of healthy primiparous women to investigate their predictive utility in the onset of low mood following childbirth. Cognitive biases using autobiographical material, and the degree of self‐devaluation during brief episodes of naturally occurring low mood were assessed in 94 concurrently well women in the third trimester of their first pregnancy. The degree of depressive symptomatology at 2 and 8 weeks postpartum was assessed subsequently. Antenatal self‐devaluative tendencies and a lack of specificity in autobiographical retrieval were not associated with low mood in the initial weeks following delivery, when biological factors are believed to play an important role, but did predict depressive symptoms more distally at 8 weeks after childbirth. This relationship was demonstrated after controlling for educational level, variations in antenatal dysphoria, previous emotional difficulties, neuroticism and the woman's own experience of mothering. The theoretical and clinical implications of the findings are discussed.

Acknowledgements

The research was supported by Lifespan NHS Healthcare Trust and was conducted in part fulfilment of a Doctorate in Clinical Psychology by the first author at the University of East Anglia. We would like to thank Katherine Newman Taylor and Harriet Jondorf for coding transcripts. We are especially grateful to Ros Wells, Research Midwife, for screening infants, and to Chris Whitby, Jen Ferry, Sima McCrae, and to Mr Hackett for supporting the study. We also extend our thanks to all the women who kindly agreed to participate in the research.

Notes

¹The social class composition was broadly comparable with representative samples of primiparous women from the same geographical area (Murray, 1992).

²This variable was positively skewed.

³When the mood scores for the original, unselected sample of 103 women at Time 3 were examined, a rate of 13% depression ‘caseness' was revealed.

⁴In order to simplify the analyses, the single missing Time 2 EPDS score was replaced by the sample mean. The multiple regression analyses were conducted a second time when this data point was excluded, and no effect on the results was observed.