Parental Sensitivity and Responsiveness as Mediators Between Postpartum Mental Health and Bonding in Mothers and Fathers.

Sandra Nakić Radoš

doi:10.3389/fpsyt.2021.723418

Abstract

Background: There is a lack of studies that examine the complex relationship between parental mental health, parental sensitivity and responsiveness, and parent-infant bonding. This study aimed to test whether parental sensitivity and responsiveness were mediators between postpartum mental health (depression, anxiety, and stress) and parent-infant bonding in mothers and fathers.Method: Mothers (n = 427) and fathers (n = 170) of infants aged up to 1-year-old participated in an online study. The parents completed questionnaires on depression (Edinburgh Postnatal Depression Scale, EPDS), anxiety and stress (Depression, Anxiety, and Stress Scale, DASS-21). Parent-infant bonding was measured by Postpartum Bonding Questionnaire (PBQ) that has three components: Impaired bonding (PBQ1), Anxiety about care and parental distress (PBQ2), and Lack of enjoyment and affection with infant (PB3Q). Parental sensitivity was measured as the number of correct recognitions of infant facial expressions (City Infant Faces Database, CIFD). Responsiveness was measured as a self-report with two subscales of responsiveness and non-responsiveness (Maternal Infant Responsiveness Instrument, MIRI).Results: The path analysis showed that the model had a good fit to the data. Parental sex was a significant moderator, indicating different paths in mothers and fathers. In mothers, responsiveness and non-responsiveness were significant mediators between depression symptoms and three dimensions of bonding. In fathers, only non-responsiveness was a significant mediator between anxiety and PBQ3. Although recognizing infant facial expressions directly affected PBQ3 in mothers (but not in fathers), it was not a significant mediator between mental health and bonding.Conclusion: Higher levels of parental mental health problems (depression and anxiety) were associated with lower levels of parental responsiveness, which is, in turn, related to poor parent-infant bonding. Prevention and intervention programs should be offered for both mothers and fathers, focusing on postpartum mental health promotion and enhancing responsiveness in infant care.

Highlights

Maternal sensitivity and responsiveness have been identified as crucial for secure infant attachment
A somewhat reduced range was obtained for depression and anxiety in both mothers and fathers
A full range of observed data was obtained for bonding scores, and the almost whole possible range was obtained for responsiveness and facial expression recognition

Summary

Introduction

Maternal sensitivity and responsiveness have been identified as crucial for secure infant attachment. It refers to the maternal ability to perceive the infant cues and signals, interpret them correctly, and respond to them timely and adequately [2,3,4]. These iterative processes in mother-infant interactions are essential for infant development as infants learn that their actions affect the environment, especially the secure figure, which gives them a sense of efficacy. Based on their conceptual analysis, four aspects of maternal sensitivity have been pointed out These refer to maternal sensitivity as (i) dynamic process, (ii) including reciprocal exchanges between mother and infant, (iii) contingent with infant’s previous behavior, and (iv) including appropriate responses based on specific infant cues. This study aimed to test whether parental sensitivity and responsiveness were mediators between postpartum mental health (depression, anxiety, and stress) and parent-infant bonding in mothers and fathers

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Discussion

Conclusion