A Tricky Object to Classify: Evidence, Postpartum Depression and the <i>DSM</i>‐IV

Godderis, Rebecca

doi:10.1002/jhbs.21590

Cited by 7 publications

(6 citation statements)

References 27 publications

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“…In the mid-1900s, Britain differentiated postpartum psychiatric disorders from nonpuerperal mental illness, but the USA viewed PPD either as harmless, fleeting “baby blues,” or as affective or schizophrenic episodes [ 21 , 22 ]. Seeking a universal definition, clinicians and researchers began advocating for a clinical diagnosis of PPD in order for the condition to be recognized by health care systems [ 23 ]. In the USA, PPD was formally recognized in 1994 as a clinical diagnosis in the Fourth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) to validate the stress some new mothers experience during the postpartum period [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Positive postpartum depression screening practices and subsequent mental health treatment for low-income women in Western countries: a systematic literature review

2017

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Problem statement and significanceLeft undiagnosed and/or untreated, the short-and long-term sequelae of postpartum depression may negatively impact both mother and child. In Western countries, access to mental health care is influenced by socioeconomic factors. The objective of this systematic literature review is to compile factors that hinder and improve access to postpartum depression treatment in low-income women after a positive screen for postpartum depression. The key question of focus is: what are the characteristics associated with access to mental health treatment for low-income women with a positive postpartum depression screen in Western countries?MethodsA PRISMA-based systematic literature review was conducted of studies published in English before February 2016 that looked at treatment for postpartum depression in low-income women who had been identified with the condition. PubMed and EBSCO databases were searched using MESH and key terms and found 100 articles that met the selection criteria. After review by two independent researchers, 18 studies with 17 unique populations were included in the literature review.ResultsTwo independent abstractors searched the included articles for themes surrounding impediments and advantages for low-income women identified with postpartum depression in obtaining mental health treatment. Characteristics of successful mental health treatment included studies that employed the use of a home visitor and those that separated outcomes for women with previous mental health treatment. Themes that emerged as treatment obstacles included cultural barriers, physical barriers, systemic health care barriers, and social barriers.Implications for practiceThis review will help to better inform screening and treatment priorities for those in the medical field who may encounter women experiencing postpartum depression and are not aware of the various barriers to care specific to low-income women. This review will also help policymakers identify specific obstacles that are not addressed in postpartum screening mandate policies which can affect the implementation of these policies.

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Section: Introductionmentioning

confidence: 99%

Positive postpartum depression screening practices and subsequent mental health treatment for low-income women in Western countries: a systematic literature review

2017

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“…Although NIMH Director Insel situates RDoC as both a competitor (Insel 2013) and complement (Insel 2014) to the DSM , RDoC is advertised as a neuroscientific paradigm shift for psychiatry, aiming to redescribe psychopathology from “genome to syndrome.” Whooley (2014) cautions that RDoC might extenuate the decontextualizing of psychopathology, a perspective that appears evident in terminating investigations at the “syndrome” level of analysis. Indeed, it is difficult to discern how clinicians, or those without access to biological data, might be able to maintain participation in category construction (see Godderis 2013). However, it remains unclear to what extent RDoC will supplant the DSM , particularly as new standards must deal with existing infrastructure and power relations (Timmermans and Berg 1997; Timmermans and Epstein 2010).…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, Smith’s (2014) interviews with psychoanalysts detail concerns over medicalization and increasing pressure to prescribe pharmaceuticals. Research from the practice perspective also articulates how professionals produce the DSM , with Godderis (2013) detailing the iterative process of debate between researchers and clinicians leading to the exclusion of postpartum depression from DSM-IV .…”

Section: Introductionmentioning

confidence: 99%

“…Accordingly, while the constructionist perspective critiques the expanding purview of the mental health disciplines and details potential social ramifications, the practice perspective articulates how professionals use the DSM . While some practice perspective studies (e.g., Smith 2014) demonstrate how constructivist concepts (e.g., medicalization) manifest in professional work, other studies (e.g., Godderis 2013; Whooley 2010) pose questions for constructivist perspectives by demonstrating how professionals mitigate the influence of the DSM via selective employment of the text and exercising diagnostic agency.…”

Section: Introductionmentioning

confidence: 99%

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TheDSMand Professional Practice

Halpin

2016

J Health Soc Behav

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How mental illnesses are defined has significant ramifications, given the substantial social and individual repercussions of these conditions. Using actor-network theory, I analyze how mental health professionals use the Diagnostic and Statistical Manual of Mental Disorders (DSM) in their work. Drawing on observations of a neuropsychological laboratory and interviews with 27 professionals (i.e., psychiatrists, psychologists), I investigate how the DSM is used in research, clinical, and institutional work. In research, the DSM influences study design and exclusion/inclusion criteria. In the clinic, the DSM influences how disorders are conceptualized and diagnosed. Institutionally, the DSM aligns the patient-professional encounter to insurance and pharmaceutical interests. I conclude that the DSM operates as multiple, context-specific taxonomies that pervasively influence professional practices, such that all possible actions must orient to DSM criteria, with professionals both a source and an object of institutionalized gaze.

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“…Indeed, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 [5]) defines postpartum depression (PPD) as a major depressive disorder (MDD) with onset in the peri-partum, which includes the period during pregnancy and the four weeks following delivery [5]. However, as it is well-established that women may develop depressive symptoms, and continue to suffer for up to one year postpartum and still remain undiagnosed [6], many researchers and clinicians have argued for, and used, a wider onset specifier (e.g., [7]). Thus, an onset extended to one year postpartum is currently used in most research on maternal perinatal health [8].…”

Section: Introductionmentioning

confidence: 99%

Insecure Attachment and Other Help-Seeking Barriers among Women Depressed Postpartum

Cacciola

Psouni

2020

IJERPH

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When untreated, postpartum depression (PPD) can severely, negatively affect maternal health, child development, and the wellbeing and functioning of the entire family. Yet, despite screening and treatment programs for PPD, many women who experience depression with onset in the postpartum year do not communicate their symptoms. Negative relational experiences early in life, such as not receiving sensitive help and support when needed, often result in so-called insecure attachment styles, and there is evidence that these may contribute to the development and maintenance of PPD. However, the role of insecure attachment styles in non-help-seeking is unknown for this group. Using mixed quantitative and qualitative methodology, we identified help-seeking barriers of women who experienced depression with onset in the postpartum year but who had not sought help for their depression (N = 37), and explored links to their attachment orientations as assessed through both self-reported attachment style and narrative based attachment script assessment. The sample was non-normative regarding attachment, with an over-representation of avoidant attachment styles. Help-seeking barriers varied systematically with the mother’s adult attachment style. Specifically, convictions of a strong self and lack of trust in healthcare professionals constituted a common barrier among women with avoidant attachment styles, while unrealistic expectations about motherhood constituted a barrier for women with secure attachment styles. This new knowledge on how barriers to communicating symptoms and seeking help when suffering from PPD vary systematically with attachment orientation can help formulate individualized, and therefore more efficient, approaches to addressing non-help-seeking behavior in women who suffer in silence.

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A Tricky Object to Classify: Evidence, Postpartum Depression and the DSM‐IV

Cited by 7 publications

References 27 publications

Positive postpartum depression screening practices and subsequent mental health treatment for low-income women in Western countries: a systematic literature review

Positive postpartum depression screening practices and subsequent mental health treatment for low-income women in Western countries: a systematic literature review

TheDSMand Professional Practice

Insecure Attachment and Other Help-Seeking Barriers among Women Depressed Postpartum

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