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Effects of maternal mental disorders on mother-infant emotional availability in the perinatal period

Aran, Pavitra (2021) Effects of maternal mental disorders on mother-infant emotional availability in the perinatal period. PhD thesis, Murdoch University.

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Background: Maternal depressive symptoms are recognised as a significant risk factor for disturbances to the mother-infant relationship and child developmental outcomes. Less is known about the effects of specific maternal mental disorders, particularly comorbid or severe mental illness, on the mother-infant relationship.

Aims: This dissertation aimed to gather new insights regarding mother-infant interaction quality in the context of maternal mental disorders (Study One and Two) and the assessment of mother-infant interaction quality in research (Study Three) and its application to clinical practice (Study Four).

Methods: Empirical (Study One and Two), psychometric (Study Three), and translational (Study Four) research methods were used. Study One (N = 115) and Study Two (N = 127) involved a longitudinal pregnancy cohort of mother-infant dyads with repeated measurement of maternal disorders (major depression, generalised anxiety, bipolar disorder), symptoms (depressive, anxiety), and antidepressant use over the perinatal period, and assessment of mother-infant interaction quality at six months postpartum using the Emotional Availability Scales (EAS). Study Three (N =342) involved a higher-order factor analysis of EAS data followed by multigroup measurement invariance testing comparing a depressive disorder group to a comparison group not meeting diagnostic criteria. Lastly, Study Four (N =329) employed a translational approach using an online, cross-sectional survey and distributed globally to explore the parent-infant assessment practices and preferences of perinatal and infant mental health (PIMH) clinicians.

Results: Compared to a comparison group, the risk of emotional unavailability was higher among dyads with lifetime major depression and even higher among dyads with a comorbid perinatal generalised anxiety disorder. Compared to no disorder or major depressive disorder, the risk of emotional unavailability was also higher among dyads with bipolar disorders. Psychometric evaluation of the EAS showed comparison group EAS data best fit a unidimensional factor solution and the EAS to be only partially invariant between a depressed and nondepressed group. The translational study indicated a strong endorsement of parent-infant relationship assessments independent of demographic or service characteristics among PIMH clinicians globally. Regardless of service context and framework, most clinicians endorsed a dyadic focus to assessment as their individual preference.

Conclusions. Findings extend existing knowledge regarding parent-infant relationship quality in a mental health context, including assessment practices in research and practice settings and the potential effects of a range of maternal mental disorders on mother-infant emotional availability. Specifically, findings may support the identification of at-risk dyads who may require additional supports or specialised psychological interventions to assist them to improve emotional availability. Ongoing empirical, psychometric, and translational research involving mental health samples are needed to facilitate agreement among researchers and clinicians on optimal measures of parent-infant interaction quality.

Item Type: Thesis (PhD)
Murdoch Affiliation(s): Psychology, Counselling, Exercise Science and Chiropractic
United Nations SDGs: Goal 3: Good Health and Well-Being
Supervisor(s): Galbally, Megan, Lewis, Andrew and Watson, Stuart
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