Psychological vulnerability to postnatal depressive symptomatology.
Depressive disorders arising in the postnatal period can affect 10-16% of women
and there is growing evidence for a range of adverse consequences for the mother and
her child long after the symptoms may have remitted. Nevertheless, reliably detecting
women who may be at risk of depression following childbirth continues to be
problematic to health care workers.
Drawing on a diathesis-stress model, the current study used a prospective design
to investigate cognitive factors that might indicate a vulnerability to postnatal
depressive symptomatology. A cohort of nulliparous pregnant women were recruited
from antenatal clinics and parentcraft classes. They were interviewed during the third
trimester of pregnancy when assessments of social support, mood, early experience of
maternal behaviour, and neurotic personality traits were carried out. In addition, three
sets of cognitive measures were included in this interview: the specificity of
autobiographical recall, the nature of self-discrepancies, and self-devaluation.
Ninety-four women without mental health problems at the time of the baseline
assessment were followed up at two weeks and at two months post-delivery, when they
were asked to complete measures relating to their mood.
It was hypothesised that the cognitive characteristics would predict mood score
at 2 months postpartum (Time 3), but not at the earlier follow-up stage of 2 weeks
(Time 2) when biologicaVhormonal factors were believed to playa predominant role in
aetiology. It was also hypothesised that these factors would mediate the relationship
between both early experience and personality style, and postnatal mood.
The results showed that the degree of self-devaluation, and low specificity of
autobiographical recall, predicted depressive symptoms at Time 3, and that selfdevaluation
also mediated the effects of early experience and neuroticism on postnatal
mood. Self-discrepancy scores were not found to be useful in predicting subsequent
levels of depression in the current sample.
The clinical implications of these findings for the detection and prevention of
postnatal depressed mood are discussed.