Maternal depression: A review of relevant treatment approaches for mothers and infants

Abstract

The negative impact of postpartum depression on the mother-infant relationship and infant development more generally has been well documented. Compared to infants of nondepressed mothers, infants of depressed mothers have been shown to be less securely attached to their caregivers and often have cognitive, emotional, and behavioral deficits that persist well into childhood. Recent evidence has suggested that reduction of maternal depressive symptoms may itself not be sufficient to prevent negative effects on children. Rather, treatments that target the mother-infant relationship may have great potential in providing a buffer against the potentially damaging effects of postpartum depression. Based on our review of several treatment-outcome studies, we conclude that mother-infant psychotherapies and home-based interventions are generally efficacious in their goal of ameliorating detrimental consequences for children of depressed mothers. Nonetheless, the field must continue to investigate the extent to which treatment gains are maintained over time and the mechanisms by which protective effects occur. It is likely that the most efficacious treatment approaches will be those that address the needs of the mother, the infant, and their relationship.

Promoting infant well‐being in the context of maternal depression by supporting the father

“…Depressed mothers' early parenting, specifically their insensitivity to infant cues and inability to provide effective emotional regulation, has been suggested as an important mechanism in the development of insecure or disorganized infant-mother attachment and subsequent reduced social competence and increased behavior disorders (Ashman & Dawson, 2002;Braungart-Rieker, Garwood, Powers, & Wang, 2001;Martins & Gaffan, 2000). A variety of interventions, including clinic-based and home-visiting approaches, have been developed to attempt to provide distressed mothers with effective treatment and support (Cooper & Murray, 1998;Holden, Sagovsky, & Cox, 1989); however, a recent review of treatments found that the reduction in maternal depressive symptoms achieved by home-visiting and psychotherapy programs may not be sufficient to prevent negative effects of maternal depression on children (Nylen, Moran, Franklin, & O'Hara, 2006). By contrast, treatments targeting the mother-infant relationship showed an improvement in attachment security and infant cognitive functioning which, in some cases, occurred without concomitant reduction in depressive symptoms (Nylen et al, 2006).…”

“…A variety of interventions, including clinic-based and home-visiting approaches, have been developed to attempt to provide distressed mothers with effective treatment and support (Cooper & Murray, 1998;Holden, Sagovsky, & Cox, 1989); however, a recent review of treatments found that the reduction in maternal depressive symptoms achieved by home-visiting and psychotherapy programs may not be sufficient to prevent negative effects of maternal depression on children (Nylen, Moran, Franklin, & O'Hara, 2006). By contrast, treatments targeting the mother-infant relationship showed an improvement in attachment security and infant cognitive functioning which, in some cases, occurred without concomitant reduction in depressive symptoms (Nylen et al, 2006).…”

Effects of an Infant-Focused Relationship-Based Hospital and Home Visiting Intervention on Reducing Symptoms of Postpartum Maternal Depression

“…An emerging consensus suggests that promoting the emerging mother-child relationship increases the likelihood of resilient trajectories for both mothers and babies (Als et al, 2003;Beeghly et al, 1995;Browne & Talmi, 2005;. While individual psychotherapy and psychotropic medications have been used effectively to address PPD (National Research Council and Institute of Medicine, 2009), treatments that focus on improving the mother-infant relationship may have greater potential to reduce symptoms (Paris, Bolton, & Spielman, 2011;Forman et al, 2007;Nylen, & Moran, Franklin, & O'Hara, 2006).…”

Assessments of Student–Teacher Relationships in Residential Treatment Center Schools

“…Accumulated evidence clearly demonstrates the importance of early mother-infant and father-infant interactions to development (Armstrong, Fraser, Dadds, & Morris, 2000;BakermansKranenburg et al, 2005;Bates & Dozier, 2002;Lyons-Ruth, Connell, Grunebaum, & Botein, 1990;Nylen, Moran, Franklin, & O'Hara, 2006;Wan & Green, 2009). Ideally, these early interactions forge an attachment that promotes a child's security, safety, and affective regulation (Bowlby, 1982;Schore, 2001) where the child comes to recognize an adult as a reliable source of safety and love (Saakvitne, Tennen, & Affleck, 2003).…”