A Clinician's Guide to Maintaining and Enhancing Close Relationships by Harvey John H. Wenzel Amy

Author:Harvey, John H.,Wenzel, Amy.
Language: eng
Format: epub
Tags: Behavioral Sciences
Publisher: Taylor & Francis Ltd
Published: 2001-11-01T05:00:00+00:00

THE PARENTAL RELATIONSHIP

Her family’s history of psychopathology may relate to a woman’s risk for postpartum depression (Campbell et al., 1992; Nilsson & Almgren, 1970; O’Hara, Neunaber, & Zekoski, 1984; Watson et al., 1984; for opposing findings, see Kumar & Robson, 1984; O’Hara, Schlechte, Lewis, & Varner, 1991). Reasons for the link between family history of psychopathology and postpartum depression are likely to include a genetic component as well as an environmental one. This section focuses on the environmental links between women’s relationships with their parents and her risk for postpartum depression. Research suggests that women’s reports of childhood parental loss, parental separation, or parental conflict are not related to a diagnosis of postpartum depression (Paykel et al., 1980; Watson et al., 1984). However, a recent study incorporating a large sample of pregnant women found links between their ratings of parental care during childhood and postpartum depression (Gotlib et al., 1991). Pregnant women who described their early parental relationships as less caring were more likely to experience a postpartum depressive episode. These studies suggest that women’s perceptions of early parental care may be related to postpartum depression, yet early parental loss and separation may not.

Although attachment research suggests that loss of an attachment object, such as a parent, will have consequences for the child’s future relationships, the aforementioned findings indicate that such a loss may not predict adult maternal depression in the postpartum period. Perhaps parental loss did not destroy these women’s childhood attachment organizations because they had other caregivers who provided them with a secure attachment base. However, the significant relationship between parental care and postpartum depression suggests a link between women’s childhood attachment organization and their mood disturbance following childbirth. If these women’s parents were present but did not provide sufficient emotional care for them, they may not have formed secure attachments in childhood. On becoming the parent of an infant, these women may have worried that, like their parents, they would be inadequate caregivers for their children. Indeed, studies of postpartum depression have linked parenting stress to levels of depressive symptomatology (see the partner relationship and the mother-infant relationship sections in this chapter). Not surprisingly, some researchers have recommended that postpartum depression be understood with an attachment framework (Whiffen & Johnson, 1998).

Accordingly at least one group intervention for postpartum depression has included a session during which women discuss their own experiences of being mothered and how this experience has influenced their current relationships with their infants (Clark et al., 1991). Because this group included several components including partner and infant participation, it is unclear what specific effect the mothering discussion had on the women’s functioning and adjustment. An empirically supported individual treatment for depression, Interpersonal Psychotherapy (IPT), is based on the premise that disturbances in an individual’s early attachments contribute to later depression (Klerman, Weissman, Rounsaville, & Chevron, 1984). Evidence suggests that IPT may be an effective treatment for women experiencing depression during the puerperium (O’Hara, Stuart, Gorman, & Wenzel, 2000; Spinelli, 1997; Stuart & O’Hara, 1995). Subsequent

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