Postnatal depression is associated with detrimental life-long and multi-generational impacts on relationship quality.

Sarah Myers,Sarah E Johns

doi:10.7717/peerj.4305

Abstract

Postnatal depression (PND) is known to be associated with a range of detrimental child and adolescent outcomes, resulting from its disruptive impact on mother-child relationship quality. However, until now little has been known about the impact of PND on the longer-term relationships between mothers and their children, and any intergenerational effects this may have. Mother-child relationship quality is of interest from an evolutionary perspective as it plays a role in the accrual of offspring embodied capital, thus affecting offspring quality and offspring’s capacity to subsequently invest in their own children. Relationships with offspring also mediate grandparent-grandchild relations; if PND negatively affects long-term mother–offspring relationship quality, it is also likely to negatively affect grandmaternal investment via reduced grandmother–grandchild relationship quality. Here, we use responses to a retrospective questionnaire study of postmenopausal women, largely from the UK and US, to assess the impact of PND occurring in generation 1 on mother–child relationship quality across the life course of the child (generation 2) with whom it was associated, and also on the relationship quality with grandchildren (generation 3) from that child. Average mother-child relationship quality was lower when the child’s birth was associated with PND. Multi-level regression modelling found that mother-child relationship quality decreased as PND symptom severity increased after controlling for individual effects and a variety of other factors known to influence relationship quality (individual mothers n = 296, mother-child dyads n = 646). Additionally, intergenerational relationships appear to be affected, with PND negatively associated with grandmother-grandchild relations (individual grandmothers n = 125, relations with grandchildren from n = 197 grandmother-parent dyads). That PND has long-term detrimental consequences for mother-child relationships, well beyond adolescence, highlights the need for investment in strategies to prevent PND and its cascade of negative multigenerational effects.

Highlights

Postnatal depression (PND), functionally defined as a major depressive episode occurring within 12 months of giving birth (Stowe, Hostetter & Newport, 2005; Halbreich & Karkun, 2006; Skalkidou et al, 2012), has received a great deal of attention from psychologists due to its association with a range of detrimental outcomes in children (Gelfand & Teti, 1990; Beck, 1998)
PND is thought to have a disruptive impact on mother-infant bonding and attachment (Beck, 1995; Murray et al, 1996; Coyl, Roggman & Newland, 2002; Moehler et al, 2006); postnatally depressed mothers show heightened self-focus (Salmela-Aro et al, 2001), and are more likely to exhibit a range of potentially problematic parenting behaviours
Intergenerational relationships appear to be affected, with grandmaternal self-reported grandmother–grandchild relations more likely to be negatively categorised if PND occurred at the birth of the parent, indicating a hitherto unknown consequence of PND

Summary

Introduction

Postnatal depression (PND), functionally defined as a major depressive episode occurring within 12 months of giving birth (Stowe, Hostetter & Newport, 2005; Halbreich & Karkun, 2006; Skalkidou et al, 2012), has received a great deal of attention from psychologists due to its association with a range of detrimental outcomes in children (Gelfand & Teti, 1990; Beck, 1998). PND is implicated in poorer child behavioural and cognitive outcomes, correlating with, for example, behavioural problems at months (Murray, 1992), reduced interpersonal functioning at months (Stein et al, 1991), behavioural problems at 2 years (Avan et al, 2010), and lower cognitive ability at age four (Cogill et al, 1986). PND is thought to have a disruptive impact on mother-infant bonding and attachment (Beck, 1995; Murray et al, 1996; Coyl, Roggman & Newland, 2002; Moehler et al, 2006); postnatally depressed mothers show heightened self-focus (Salmela-Aro et al, 2001), and are more likely to exhibit a range of potentially problematic parenting behaviours (for a review see O’Hara & McCabe, 2013). The negative effect on parenting is suggested to mediate the relationship between PND and subsequent child development, potentially alongside shared environmental or genetic factors influencing both PND aetiology and child development outcomes (Murray & Cooper, 1997)

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Discussion

Conclusion