Mental health articles

Effect of perinatal mental illness on the infant and family As has been discussed in earlier chapters, the infant is extremely dependent on the sensitivity and responsiveness of her primary caregivers. Depression and/or significant social or personal adversity interferes with social functioning and emotional availability, and may make parents less contingent and sensitive in interaction with their babies. Australian studies (for example, McMahon, Barnett, Kowalenko, Tennant & Don, 2001) have found a close association between maternal mood and unsettled infant behaviour in their sample of women admitted to residential parent-craft hospitals. Their study confirms the interactional nature of relationship difficulties in this period, that is, mothers are also dependent to an extent on the responses they receive or perceive from their infants for a sense of their own competence and effectiveness as parents. Post-natal mood disorder can interfere with accurate interpretation of infant cues and increase the risk of depressive or negative attribution of infant behaviour and responses. Both the parent and the infant bring strengths and vulnerabilities to the new relationship and the ‘fit’ between them in the context of other supports and stressors determines how the new relationship develops. Several studies have now indicated that maternal depression, especially in combination with other risk factors, can decrease the security of infant attachment at 12 months and affect the infant’s social and short-term cognitive development. Cooper and Murray (1997) conducted a longitudinal study examining the effect of PND on infant development in a low-risk British sample. They found that maternal depression at two months post-partum did affect the sensitivity and attunement of mothers to their babies, who used less affirming language and were more negating of their infants’ experience. This had an effect on cognitive development at 18 months. Social and personal adversity had an effect on the security of infant attachment. Other researchers (for example, Kurstjens & Wolke, 2001) found a significant effect on cognitive development in boys associated with chronicity of maternal depression—particularly in low-socioeconomic-status families, or in infants with other perinatal risk factors. Boys may also be more vulnerable generally to the effect of maternal depression (Hay, 1997). Post-natal psychiatric illness also affects partners and the quality of the marital interaction. Because lack of a supportive partner is a clear risk factor for post-natal mental illness, the direction of these associations is not always clear. Rarely, men are also diagnosed as suffering the range of perinatal psychiatric disorders that occur in women. More significantly, men were found to be at much greater risk of depression post-partum if their partner was also depressed. Lovestone and Kumar (1993) found depression in male partners followed admission of their spouse to a mother–baby unit. The effect of parental mental illness on other children in the family also needs to be considered.

Tags: infant, mental illness