Abstract
Approximately 19% of women experience minor or major depression in the first three months following childbirth. Most research suggests that women with withdrawn attachment styles are less likely to be depressed. However, unlike mothers in Western culture, mothers in Japan with withdrawn attachment styles are reported to have greater potential to become depressed. Thus, the aim of this study was to describe the behaviors and situational awareness of Japanese mothers’ with withdrawn attachment styles during pregnancy in order to reveal the specific dynamics underlying the withdrawn style. Interview data were analyzed using qualitative thematic content analysis. Of the 84 women assessed, 12 were determined to have a withdrawn style, and based on the Mini-International Neuropsychiatric Interview, five demonstrated the onset of postpartum depression (PPD). Two themes regarding relationships with partners emerged including: 1) confiding behavior: the importance of what is shared; and 2) need to be heard: wanting sympathy rather than criticism. Additionally, three themes describing mothers’ experiences during the first postnatal month emerged: 1) overwhelming experiences: the childbirth experience; 2) seeking help: behavior changes altered relationships; and 3) experience with the baby. Withdrawn style mothers keep distance from crisis, avoid closeness with others, and opt to manage problems by themselves. However, childbirth and infant care are not easily managed in this style. Mothers who used childbirth to confide in their partners may have reduced the severity of insecurity or developed a more secure style. Healthcare professionals are in the best position to develop good relationships with new mothers and provide support that focuses more on emotional factors and self-esteem levels.
Highlights
19% of women develop postpartum depression (PPD) in the first three months following childbirth (Gavin et al, 2005)
While insecure attachment styles are highly associated with psychological disorders, the secure style is consistently found to be associated with the absence of disorder (Mickelson, Kessler, & Shaver, 1997)
In our previous research examining risk factors reflecting personality structure, we found that the insecure attachment style was significantly related to PPD, and those with withdrawn styles were the most prevalent in the PPD group (Ikeda et al, 2014)
Summary
19% of women develop postpartum depression (PPD) in the first three months following childbirth (Gavin et al, 2005). Insecure schemas influence behavior and confirm this schema because people act in response to these distorted perceptions, inadvertently alienating others and undermining relationships These cognitive schemas pertaining to relationships function largely outside of conscious awareness and can engender feelings of loss and isolation. Individuals with withdrawn style, that are one of the insecure attachment styles, can be characterized by high self-reliance, high constraints on closeness, and low desire for company This is often expressed as desire for privacy and setting clear boundaries with others. Those with withdrawn styles prefer to rely on their own judgments in decision-making and can appear as very practical, rational, and unemotional (Bifulco & Thomas, 2013) Such individuals tend to be socially isolated, which may protect them from becoming depressed (Rholes, Simpson, Campbell, & Grich, 2001)
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