Maternal attachment style and depression associated with childbirth ; preliminary results from a European and US cross-cultural study

Bifulco, Antonia ORCID: https://orcid.org/0000-0001-8316-9706, Figueiredo, Barbara, Guedeney, Nicole, Gorman, Laura L., Hayes, Sandra, Muzik, Maria, Glatigny-Dallay, Elisabeth, Valoriani, Vania, Kammerer, Martin H. and Henshaw, Carol A. (2004) Maternal attachment style and depression associated with childbirth ; preliminary results from a European and US cross-cultural study. The British Journal of Psychiatry, 184 . s31-s37. ISSN 0007-1250 [Article]

Abstract

BACKGROUND:

Insecure attachment style relates to major depression in women, but its relationship to depression associated with childbirth is largely unknown. A new UK-designed measure, the Attachment Style Interview (ASI), has potential for cross-cultural use as a risk marker for maternal disorder.
AIMS:

To establish there liability of the ASI across centres, its stability over a 9-month period, and its associations with social context and major or minor depression.
METHOD:

The ASI was used by nine centres antenatally on 204 women, with 174 followed up 6 months postnatally. Interrater reliability was tested and the ASI was repeated on a subset of 96 women. Affective disorder was assessed by means of the Structured Clinical Interview for DSM-IV.
RESULTS:

Satisfactory interrater reliability was achieved with relatively high stability rates at follow-up. Insecure attachment related to lower social class position and more negative social context. Specific associations of avoidant attachment style (angry-dismissive or withdrawn) with antenatal disorder, and anxious style (enmeshed or fearful) with postnatal disorder were found.
CONCLUSIONS:

The ASI can be used reliably in European and US centres as a measure for risk associated with childbirth. Its use will contribute to theoretically under pinned preventive action for disorders associated with childbirth.

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