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Underlying persistent psychological difficulties have been found to moderate potential adverse effects of maternal postpartum depression (PPD) on parenting and infant development. The authors examined whether mothers presenting postpartum depressive symptoms showed higher levels of personality pathology and more insecure state of mind regarding attachment compared to nondepressed mothers. Participants (N = 85) were assessed with the Edinburgh Postnatal Depression Scale (EPDS), the Present State Examination, the Adult Attachment Interview, and the Structured Clinical Interview for DSM-IV Axis II. Mothers with high EPDS scores were more likely to have a preoccupied insecure state of mind and to have personality disorder compared with mothers scoring below clinical cutoff. Furthermore, multiple regression analysis showed that personality disorder and AAI classification were independently related to EPDS score, and that these two factors together accounted for 48% of the variance in EPDS score. Findings are discussed in terms of heterogeneity in PPD populations and underline the importance of examining potential coexisting psychological difficulties when studying PPD.

Mentalization or Reflective Functioning (RF), that is, the ability to reflect upon ones' own and others behavior in terms of underlying mental states, plays an important role in parenting behavior and children's socioemotional development. RF has been suggested to be impaired in psychopathology, and thus maternal psychopathology after birth, such as postpartum depression (PPD) and Personality Disorder (PD), may not only affect the mother's socioemotional functioning but also the development of the child. However, little is known about mentalizing abilities of PPD mothers, and mothers with PPD and comorbid PD. Therefore, the aim of this study was to evaluate RF in women presenting symptoms of PPD (n ϭ 13), and women with PPD symptoms and comorbid PD (n ϭ 14) compared with a nonclinical group (n ϭ 52). Women were interviewed with the Adult Attachment Interview (AAI) before birth (nonclinical group), and 9 -12 weeks after birth (clinical groups), and RF was assessed with the Reflective Functioning Scale applied to the AAI. ANCOVA results revealed no significant differences in mean RF abilities among the 3 groups. Possible reasons for the lack of differences in RF between the 3 diagnostic groups are discussed.

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