Maternal psychological well-being is one of many factors that shape the interactions a woman has with her infant. According to Belsky's (1984) Determinants of Parenting Process Model, he suggests that maternal personality and psychological well-being play a significant role in the observation of parenting behaviors. This model was utilized as the overarching framework for this dissertation. The dissertation, in the form of three manuscripts, outlines important factors within the marital relationship that impact postpartum depression, then exploring the moderation of depression by knowledge of infant development in four behavioral scales observed during a mother-infant interaction. Finally, two maternal behaviors that impact child outcomes were utilized as predictors of infant social-emotional and cognitive outcome, while testing for moderation by infant age.Results. In study one, women were more likely to report postpartum depression when they experienced more arguments with family and lower relationship depth. The second study found that knowledge of infant development moderated maternal reports of postpartum depression, thus allowing women with higher knowledge to maintain positive behaviors compared to women with low or average knowledge. The third study indicated that verbal stimulation resulted in higher scores for infant social-emotional and cognitive development, whereas maternal sensitivity was the only variable impacting social-emotional development. The test of moderation by infant age found mothers of older infants did speak more to their older infants, but the differences were minimal.Conclusion. Marital relationships play a significant role in promoting healthy maternal psychological well-being during motherhood. When psychological well-being is compromised via postpartum depression, decreases in maternal behaviors result in lower scores during maternal-child interactions. Maternal sensitivity and verbal stimulation uniquely contributed to infant outcomes. In addition, infant age may impact the observance of these two maternal behaviors resulting in increased or decreased observances based on the infant's age.Thus, use of Belsky's Determinants of Parenting Process Model within this dissertation confirmed the importance of maternal personality and psychological well-being in parenting behaviors. Mothers impacted by postpartum depression suffered a reduction in parenting behaviors, though higher knowledge appeared to buffer these negative effects. Implications for interventions and future work are discussed within each study.

Sammanfattning Syftet med den föreliggande litteraturstudien var dels att beskriva hur faderlig postpartumdepression påverkade familjens livssituation samt att beskriva vilka tecken och riskfaktorer som fanns för faderlig postpartumdepression. Empiriska vetenskapliga artiklar söktes i databasen Medline (PubMed) och fjorton artiklar valdes ut. Artiklarna kvalitetsgranskades avseende urval och bortfall och tabeller över studiernas metod- och resultatbeskrivning sammanställdes. I den föreliggande studiens resultat framkom att en ökad risk för ”parsjuklighet” fanns och även barnen påverkades, då barn till deprimerade fäder i högre grad riskerade att drabbas av temperamentsproblem. Deprimerade fäder upplevde det svårare att hantera sitt barns temperament. Fäderna blev mer irriterade och hade mindre tålamod för barnet vilket gav färre positiva föräldra-barn interaktioner, vilket i sin tur påverkade barnens vokabulära utveckling negativt. I den föreliggande studiens resultat framkom även att fadern kan uppvisa känslomässiga yttringar i form av exempelvis irritation och ilska som tecken på postpartumdepression samt att prenatal depression var en riskfaktor för fadern att drabbas av postpartumdepression. Ingen av de granskade studierna bedömdes ha låg kvalitet och endast två studier bedömdes ha medelkvalitet efter utförd granskning. Författarna till föreliggande studie anser att depression hos fadern bör identifieras och uppmärksammas eftersom tillståndet inte bara kan få konsekvenser för partnern utan även för barnets välbefinnande och utveckling.   Nyckelord: Faderlig postpartumdepression, Familj, Livssituation, Riskfaktorer, Förebygga. / Abstract The purpose of this literature study was partly to describe how paternal postpartum depression effects the life situation of the family and to decribe which signs and risk factors that exist for paternal postpartum depression. Empirical articles were searched in Medline database (PubMed) and fourteen articles were selected. The articles were reviewed for quality regards the selection and dropping. Tables of the articles method and result description was compiled. Result of the present study revealed that an increased risk of "couple morbidity" existed and even the children were affected. Children of depressed fathers were more likely to have temperament problems. Depressed fathers felt difficulties in dealing with their childs temperament. The fathers became more irritable and had less patience for the child which resulted in fewer positive parent-child interactions, which in turn affected the children's vocabulary development negatively. The results of the present study also revealed that the father may display emotional expressions in the form of irritation as well as anger as a sign of postpartumdepression and that prenatal depression was a risk factor for the father to suffer from depression. After performed review none of the selected studies were judged to have low quality and only two studies were judged to have medium quality. The authors of the present study consider that depression in the father should be identified and addressed, since depression not only can have consequences for the partner but also on the child's welfare and development. Keywords: Paternal postpartum depression, Family, Life situation, Risk factors, Prevention.

Psychiatric morbidity in the postpartum period has been a subject of research for years that has been plagued by much controversy. Most of the studies have come from Western countries. Studies that were done in Africa have concentrated on psychotic disorders in in-patients. A pilot study done by Cheetham et al (1981) at King Edward VIII Hospital found a high incidence of 'transient situational disturbances', which required further investigation. AIMS AND OBJECTIVES: 1. To document the spectrum of psychiatric morbidity in an out-patient population of postpartum Zulu women; 2. To define predictive factors which would identify women 'at risk'; 3. To assess the feasibility of 'Western' screening instruments; 4. To investigate whether 'postpartum blues' occurs in Zulu women. RESEARCH DESIGN A prospective, descriptive study was undertaken. Sample Selection: 177 postpartum Zulu women attending the ' Well-Baby' Clinic at King Edward VIII Hospital were randomly selected for inclusion in the study. Methodology: Three questionnaires: The General Health Questionnaire- 30, Pitt's Questionnaire of Anxiety and Depression and The Kennerley Blues Questionnaire were administered to the subjects. A Structured Clinical Interview DSM-III (SCID) was conducted in those women with symptoms. FINDINGS: 1. The majority of the sample were between the ages of 20 and 30 years, unmarried, with a Senior Primary education and a baby of 20 weeks. 2. 45.76% of the sample had a psychiatric diagnosis, with 18.07% having major depression. Other disorders included: adjustment disorders, schizophrenia and dysthymia. 3. Significant variables using Chi-square analysis were: inadequate antenatal care, a negative response from the partner and the absence of cultural rituals. No association was found with demographic and obstetric variables. 4. T-test analysis showed a correlation between the questionnaires and the SCID. 5. 37.3% had experienced 'postpartum blues'. CONCLUSIONS: 1. The spectrum of psychiatric morbidity is affective in nature and similar to other studies. 2. 'Postpartum blues' does occur in Zulu women. 3. Antenatal screening with 'Western' instruments could reduce psychiatric morbidity. 4. The nomenclature of puerperal disorders is inadequate and needs review. 5. More prospective, community-based research is needed, especially in rural Zulu women. / Thesis (M.Med.)-University of Natal, Durban, 1992.

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Bakgrund: Mer än en av tio nyblivna mammor visar tecken på depression efter en förlossning och detta kan ha negativ inverkan på barnets utveckling och föräldraparets relation. I Sverige screenas alla nyblivna mammor för förlossningsdepression då barnet är 6-8 veckor. Nyblivna pappor kan också drabbas av förlossningsdepression men det finns ingen rutin för att screena dem. Syfte: Syftet med föreliggande studie var att undersöka BVC-sjuksköterskors erfarenheter och hantering av förlossningsdepression hos nyblivna föräldrar på BVC. Metod: Studien är baserad på åtta semistrukturerade intervjuer med BVC-sjuksköterskor. Datan analyserades med kvalitativ innehållsanalys med induktiv ansats. Resultat: Av analysen framkom fem kategorier vilka är; svårigheter att identifiera förlossningsdepression, känsla av otillräcklighet, att stödja föräldrarna, användning av screeninginstrument och att observera samt med 13 underkategorier. Konklusion: BVC-sjuksköterskor upplevde att det inte var vanligt med förlossningsdepression hos nyblivna föräldrar. Det var ibland svårt att skilja på förlossningsdepression och depressiva symtom av andra orsaker. Det var viktigt att stötta föräldrarna och förmedla trygghet. BVC- sjuksköterskorna såg EPDS screeningen som positiv och önskade ett screeninginstrument för nyblivna pappor. / Background: Depression after childbirth affects more than one out of ten new mothers and could have a negative impact on the baby’s development and the parents relationship. In Sweden every new mother is screened for postpartum depression when the baby is six to eight weeks. Postpartum depression can also affect new fathers but there is no routine for screening them. Aim: The aim of this study was to examine child health care nurses’ experiences and management of postpartum depression in new parents at child care center. Method: The study was based on eight semi-structured interviews with child health care nurses. The data were analyzed using qualitative content analysis with inductive approach. Results: Five categories appeared from the analysis; difficulties identifying postpartum depression, sense of inadequacy, supporting the parents, using screening instrument and to observe as well as 13 subcategories. Conclusion: Child health care nurses experience postpartum depression as unusual in new parents. It could be difficult to separate postpartum depression from depressive symptoms caused by other factors. They found it important to support the parents and provide comfort. Child health care nurses had positive experiences in using the EPDS screening for mothers and wished for a screening instrument for new fathers.

Postpartum Depression (PPD) affects approximately 15% of Canadian mothers. PPD can have negative and enduring consequences for women and their relationships with their partners and children. Women who have suffered from PPD are 50% more likely to experience depression following delivery of another child. Mindfulness-Based Cognitive Therapy (MBCT) was developed to prevent relapse in recurrent depression. MBCT has been reported to be effective in the treatment of both depression and anxiety among at risk samples from the general and clinical populations. It is not clear whether the approach is a safe and acceptable preventive option to deliver to pregnant women who are at risk for developing PPD. Objectives: The aim of my study was to explore the safety, acceptability, and effectiveness of MBCT for pregnant women who experienced difficult mood after a previous childbirth. Method: I used a mixed methods design and recruited 5 participants from the Victoria community. Participants were at least 18 years of age, native English speakers, pregnant and had experienced difficult mood for at least two consecutive weeks within the first year following the previous delivery of a healthy infant. All participants completed the slightly modified 8-week MBCT program. I administered self-report, quantitative measures at baseline (T1), before and immediately after each group, and postintervention (T2). I collected qualitative data as weekly field notes, through a semi-structured focus group one week following completion of the program, and as comments participants provided on the self-report WC-DM measure. Findings: Quantitative findings suggest program safety; speak to the acceptability of the program; and suggest that MBCT was effective in significantly decreasing anxiety symptomology, decreasing self-reported worry about difficult mood, and increasing wellbeing for pregnant women with a history of difficult postpartum mood. Field notes, focus group data, and comments participants provided on the self-report WC-DM measure contribute to and explain quantitative findings and support MBCT as a safe, acceptable, and effective approach for this population. / Graduate / 0519 / katya@uvic.ca

Background: Antenatal depression is relatively a new area of study compared to postnatal depression and the depth and sophistication of this research is yet developing. For instance, very little is reported on the specific role of the risk factors as moderators and mediators to explain the variability in the magnitude of exposure and the causal pathway for depression during pregnancy. Moderators are those variables that are not modifiable (e.g., ethnicity, and gender), or have qualitative character or nominal in nature, and could also often be antecedent to other independent variables (e.g., behavioural and psychosocial) and depression. Mediators are those variables that may be better able to describe the pathway that connects a predictor to an outcome and intervention can be designed targeting mediators as they are causally related to the outcome. This thesis will address this gap in research and provide empirical evidence to increase the understanding of the role of each identified risk factors that could potentially influence maternal mental health interventions. Methods: In this thesis, I have used the Feelings in Pregnancy and Motherhood (FIP) study. This was a longitudinal study and 649 pregnant women participated in the study. Women were interviewed three times over the course of their pregnancy and the immediate postpartum. Depression status was assessed by the Edinburgh Postnatal Depression Scale (EPDS); sociodemographic characteristics, psychosocial and behavioural information were collected at each time point. Depression status in late pregnancy and postpartum were the two outcomes of interest. Non-modifiable sociodemographic risk factors were considered as moderators. Behavioural and psychosocial variables were considered as mediators. Moderators and mediators were tested through series of regression analysis. Results: In modeling moderating effects in late pregnancy, low income women who were in poor marital relationships (β=1.54; p<0.05) and partnered women (married or common law) who reported having used recreational drugs (β= -1.62; p<0.05) were more likely to be depressed. Young mothers with low social support (β= 1.04; p=0.15) and Aboriginal mothers with low social support (β= 1.12; p=0.17) were also almost significantly noted to have depression symptoms in late pregnancy. In mediating analysis for late pregnancy, psychosocial mediators such as stress, social support, and marital satisfaction, and behavioural factors, such as smoking and recreational drug use exerted partial or full mediating effect for depressive symptoms in women in late pregnancy. In moderating analysis for postpartum, Aboriginal women who had never exercised in late pregnancy were found to be depressed at postpartum compared with non Aboriginal mothers who did not exercise. In looking at mediating effects in postpartum, smoking at late pregnancy exerted full mediating effects for ethnicity and marital satisfaction pathways, and partial mediating effects for age, education, and stress pathways in predicting depression in postpartum period among mothers. Conclusion: Depression, particularly during pregnancy and in postpartum, is a top priority for women themselves, their families, care providers, and society in general. This study found that characteristics of women or their psychosocial or behavioural experiences could have specific effects such as either a mitigating or exacerbating role, or a mediating role, in depression in late pregnancy or in postpartum. This information could be strategically used by clinicians or by health promotion professionals to either target or provide tailored programs to women who might experience depression during pregnancy and postpartum.

Licentiatavhandling (sammanfattning) Stockholm : Karol. inst., 2005. / Härtill 2 uppsatser.

Diss. (sammanfattning) Linköping : Univ., 2003. / Härtill 5 uppsatser.

Thesis (M. Nurs)(Hons.) -- University of Western Sydney, Nepean, 2000. / Bibliography: p. 140-145.