Date of Award

1-1-2004

Document Type

Thesis

Publisher

Edith Cowan University

Degree Name

Doctor of Philosophy

School

School of Psychology

Faculty

Faculty of Community Services, Education and Social Sciences

First Supervisor

Dr Moira O'Connor

Second Supervisor

Dr Rosie Rooney

Abstract

Although studies have explored the epidemiology of Postnatal Depression (PND) and other mood disorders occurring in the postnatal period, there is some evidence to support the argument that there may be different subsets of women suffering from low mood, around the time of childbirth (Warner, Appleby, Whitton, & Faragher, 1997). Some new mothers may be responding to the inherent, but often understated, stressors of the childbirth experience itself and the period that follows it, linked to dysfunctional maternal attitudes. Others may have pre-existing dysfunctional cognitions before the birth arising from other factors, and therefore already be vulnerable to a mood disorder. Another important factor linked to this, is the time of onset, and the impact of cognitive and affective changes that may occur in the overall process of becoming a mother for the first time. While there has been some research using prospective research methods, measuring cognitions both before, and after, the experience of motherhood to understand better the process by which women become depressed, has not yet been attempted (Boyce & Mason, 1996). This study therefore investigates the role of cognition in new primiparous mothers longitudinally, in an attempt to further our knowledge on these issues. The research begins by following the recommendations of Patton (J 990) to investigate the context in which the main study is to be performed. The literature on mood disorders following childbirth is then reviewed, and the questions arising are documented. The planning stage is then described. This involved both formal and informal interviews with a range of key stakeholders. The main study is prospective, with II particular emphasis on investigating the cognitions of new mothers within II model that incorporates other factors known to be important in depression. The times selected for assessment were the second trimester prior to the birth (Time 1), 10-12 weeks after the birth (Time 2), and a final assessment at six months after the birth (Time 3). In the main study, 158 participants completed a protocol in the presence of a researcher at Time I. AI Time 2, 141 participants remained in the study. At Time 3, 127 participants completed the final protocol. Importantly, the results indicate that women, who are more worried over everyday stressors prior to the birth, are more likely to have higher EPDS scores postnatally. However, women who have higher EPDS scores early in the puerperium are less likely than others who have higher EPDS scores later in the postpartum period to have a past history of mental health problem, dysfunctional maternal attitudes and low self-esteem; prior to the pregnancy. Furthermore, these women are more likely to perceive they are more in control of their lives before the birth, These findings have practical implications for screening and intervention. The accumulation of knowledge that has resulted from this research, and the contribution made to the understanding of cognitive shifts in primiparous mothers, is discussed. Recommendations include review of times of assessment, instruments to provide a more holistic assessment, antenatal intervention, and early motherhood supports .

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