Mother–infant bonding impairment across the first 6 months postpartum: the primacy of psychopathology in women with childhood abuse and neglect histories
Open accessAbstract
Our goal was to examine the trajectory of bonding impairment across the first 6 months postpartum in the context of maternal risk, including maternal history of childhood abuse and neglect and postpartum psychopathology, and to test the association between self-reported bonding impairment and observed positive parenting behaviors. In a sample of women with childhood abuse and neglect histories (CA+, n = 97) and a healthy control comparison group (CA-, n = 53), participants completed questionnaires related to bonding with their infants at 6 weeks, 4 months, and 6 months postpartum and psychopathology at 6 months postpartum. In addition, during a 6-month postpartum home visit, mothers and infants participated in a dyadic play interaction subsequently coded for positive parenting behaviors by blinded coders. We found that all women, independent of risk status, increased in bonding with their infant over the first 6 months postpartum; however, women with postpartum psychopathology (depression and posttraumatic stress disorder [PTSD]) showed consistently greater bonding impairment scores at all timepoints. Moreover, we found that, at the 6-month assessment, bonding impairment and observed parenting behaviors were significantly associated. These results highlight the adverse effects of maternal postpartum depression and PTSD on mother-infant bonding in early postpartum in women with child abuse and neglect histories. These findings also shed light on the critical need for early detection and effective treatment of postpartum mental illness in order to prevent problematic parenting and the development of disturbed mother-infant relationships. Results support the use of the Postpartum Bonding Questionnaire as a tool to assess parenting quality by its demonstrated association with observed parenting behaviors.
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Depressed women showed consistently greater impairment in bonding scores at all time points than nondepressed mothers.
“depressed women showed consistently greater impairment in bonding scores at all time points than nondepressed mothers.”
From Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes (2019) · cites this paper as [43]
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Maternal depressed mood moderates the impact of infant sleep on mother–infant bonding
Hairston, I. S., Solnik-Menilo, T., Deviri, D., & Handelzalts, J. E. (2016) · Archives of Women s Mental Health · doi:10.1007/s00737-016-0652-2 · Cited by 51 · see citing works
Traumatic Childbirth Experiences of New Parents: A Meta-Synthesis
Shorey, S., & Wong, P. (2020) · Trauma, Violence, & Abuse · doi:10.1177/1524838020977161 · Cited by 42 · see citing works
Maternal childhood maltreatment and perinatal outcomes: A systematic review
Souch, A. J., Jones, I. R., Shelton, K. H., & Waters, C. S. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.01.062 · Cited by 50 · see citing works
“ACEs Maternal depression: EPDS 7 Seng, 2013 Reported previously Zhang, 2020 China Cross-Sectional Clinical 1825 PW 31.14 154 (8”
BackgroundMethodInfluentialChild-Rearing History and Emotional Bonding in Parents of Preterm and Full-Term Infants
Hall, R. A. S., Hoffenkamp, H. N., Tooten, A., Braeken, J., Vingerhoets, A. J. J. M., & van Bakel, H. J. A. (2014) · Journal of Child and Family Studies · doi:10.1007/s10826-014-9975-7 · Cited by 48 · see citing works
Status of postpartum depression in Turkey: A meta-analysis
Karaçam, Z., Çoban, A., Akbaş, B., & Karabulut, E. (2018) · Health Care For Women International · doi:10.1080/07399332.2018.1466144 · Cited by 47 · see citing works
“Postpartum depression (PPD) is a serious health issue that is most commonly encountered in this period and is one that affects not only the mother but the infant and family as well (Ammermana et al., 2013; Muzik et al., 2013).”
BackgroundKountanis, J. A., Vahabzadeh, C., Bauer, S., Muzik, M., Cassidy, R., Aman, C., MacEachern, M., & Bauer, M. E. (2020) · Journal of Clinical Anesthesia · doi:10.1016/j.jclinane.2019.109658 · Cited by 45 · see citing works
Self-citationTsuchida, A., Hamazaki, K., Matsumura, K., Miura, K., Kasamatsu, H., Inadera, H., Kawamoto, T., Ohya, Y., Kishi, R., Yaegashi, N., et al. (2018) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2018.11.022 · Cited by 44 · see citing works
Talmon, A., Horovitz, M., Shabat, N., Haramati, O. S., & Ginzburg, K. (2019) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2018.12.021 · Cited by 46 · see citing works
Berthelot, N., Lemieux, R., Garon‐Bissonnette, J., & Muzik, M. (2019) · Journal of Midwifery & Women s Health · doi:10.1111/jmwh.13034 · Cited by 45 · see citing works
Self-citationThe prevalence of posttraumatic stress disorder during pregnancy and postpartum period
Khoramroudi, R. (2018) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_272_17 · Cited by 44 · see citing works
“In addition, the average prevalence of PTSD during pregnancy in high‐risk individuals may be affected by special rates reported in several studies.[28,29,37]”
BackgroundInfluentialBreastfeeding Difficulties Predict Mothers’ Bonding with Their Infants from Birth to Age Six Months
Roth, M. C., Humphreys, K. L., King, L. S., Gotlib, I. H., & Robakis, T. K. (2021) · Maternal and Child Health Journal · doi:10.1007/s10995-020-03036-9 · Cited by 42 · see citing works
Dudek, J., Colasante, T., Zuffianò, A., & Haley, D. W. (2018) · Child Development · doi:10.1111/cdev.13182 · Cited by 42 · see citing works
Sachdeva, J., Nagle-Yang, S. M., Gopalan, P. R., Worley, L. L. M., Mittal, L. P., Shirvani, N., Spada, M. L., Albertini, E., Shenai, N., Simas, T. A. M., et al. (2022) · Journal of the Academy of Consultation-Liaison Psychiatry · doi:10.1016/j.jaclp.2022.04.005 · Cited by 42 · see citing works
Tian, X.-Y., Xing, J.-W., Zheng, Q., & Gao, P. (2021) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2021.694443 · Cited by 40 · see citing works
“Given that postpartum women often shoulder the primary responsibility for caring for the baby, persistent depression impairs mother-infant bonding (Muzik et al., 2013; O’Higgins et al., 2013; Lefkovics et al., 2014; Dubber et al., 2015; Tsuchida et al., 2019), which leads to numerous short- and long-term negative cons…”
BackgroundOhara, M., Okada, T., Kubota, C., Nakamura, Y., Shiino, T., Aleksić, B., Morikawa, M., Yamauchi, A., Uno, Y., Murase, S., et al. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-0933-3 · Cited by 39 · see citing works
“In addition, a longitudinal study also showed that bonding impairment in the postpartum period was related to insecure parenting behaviors [6].”
BackgroundReuveni, I., Lauria, M., Monk, C. E., & Werner, E. A. (2020) · Archives of Women s Mental Health · doi:10.1007/s00737-020-01066-4 · Cited by 38 · see citing works
Ahlfs-Dunn, S. M., & Huth‐Bocks, A. C. (2014) · Infant Mental Health Journal · doi:10.1002/imhj.21453 · Cited by 38 · see citing works
“Other studies have found that mothers with PTSD symptoms were more likely to report difficulties bonding with their infants (Muzik et al., 2013), negative perceptions of their infants, and negative perceptions of their relationships and interactions with their infants (J.”
BackgroundRieder, A. D., Roth, S. L., Musyimi, C. W., Ndetei, D. M., Sassi, R. B., Mutiso, V., Hall, G. B., & González, A. (2019) · Developmental Science · doi:10.1111/desc.12833 · Cited by 35 · see citing works
Muzik, M., Brier, Z. M. F., Menke, R. A., Davis, M. T., & Sexton, M. B. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.06.037 · Cited by 36 · see citing works
“The frequency and severity of CM are known to predict increased psychopathology in adult postpartum populations (Choi and Sikkema, 2015; Grekin and O’Hara, 2014; Leigh and Milgrom, 2008; Muzik et al., 2013; Sexton et al., 2015).”
BackgroundSelf-citationQouta, S., Vänskä, M., Diab, S. Y., & Punamäki, R. (2021) · Infant Behavior and Development · doi:10.1016/j.infbeh.2021.101532 · Cited by 37 · see citing works
The Current Concept of Paternal Bonding: A Systematic Scoping Review
Suzuki, D., Ohashi, Y., Shinohara, E., Usui, Y., Yamada, F., Yamaji, N., Sasayama, K., Suzuki, H., Nieva, R. F., da Silva Lopes, K., et al. (2022) · Healthcare · doi:10.3390/healthcare10112265 · Cited by 39 · see citing works
“In previous studies, parents with bonding problems, such as impaired bonding, showed poor interaction with their children [8,9].”
BackgroundWong, K., Stacks, A. M., Rosenblum, K. L., & Muzik, M. (2017) · Merrill-palmer Quarterly · doi:10.13110/merrpalmquar1982.63.1.0054 · Cited by 34 · see citing works
“Subject recruitment has been described in detail in prior reports from the MACY study (e.g., Muzik et al., 2013).”
MethodSelf-citationTester‐Jones, M., O’Mahen, H., Watkins, E. R., & Karl, A. (2015) · Infant Behavior and Development · doi:10.1016/j.infbeh.2015.02.014 · Cited by 34 · see citing works
Teen Mothers' Experience of Intimate Partner Violence
Bekaert, S., & SmithBattle, L. (2016) · Advances in Nursing Science · doi:10.1097/ans.0000000000000129 · Cited by 33 · see citing works
Nagl, M., Steinig, J., Klinitzke, G., Stepan, H., & Kersting, A. (2015) · Archives of Women s Mental Health · doi:10.1007/s00737-015-0573-5 · Cited by 32 · see citing works
“At present, little is known about the effects of expectant mothers’ childhood maltreatment experiences and/or obesity on their pre- or postnatal attachments to their infants (e.g., Muzik et al. 2012), things that might have long-term consequences on a child’s health.”
Busonera, A., Cataudella, S., Lampis, J., Tommasi, M., & Zavattini, G. C. (2017) · Midwifery · doi:10.1016/j.midw.2017.08.011 · Cited by 34 · see citing works
“Since its publication many studies have made use of the PBQ (e.g. Edhborg et al., 2005; Moehler et al., 2006; Hoffenkamp et al., 2012; Muzik et al., 2013; Mitchell et al., 2015; Kerstis et al., 2016; Tikotzky, 2016).”
MethodBabb, J. A., Deligiannidis, K. M., Murgatroyd, C., & Nephew, B. C. (2014) · Behavioural Brain Research · doi:10.1016/j.bbr.2014.03.039 · Cited by 31 · see citing works
Harris, M., MacMillan, H. L., Andrews, K., Atkinson, L. R., Kimber, M., England-Mason, G., & González, A. (2020) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2020.104830 · Cited by 32 · see citing works
Fredland, N., Symes, L., Gilroy, H., Paulson, R. M., Nava, A., McFARLANE, J. M., & Pennings, J. S. (2015) · Journal of Family Violence · doi:10.1007/s10896-015-9702-1 · Cited by 29 · see citing works
“Muzik et al. (2013) findings suggest that the adverse child outcomes are based in problematic mother-infant bonding.”
Marshall, C., Langevin, R., & Cabecinha‐Alati, S. (2022) · International Journal of Child and Adolescent Resilience · doi:10.54488/ijcar.2022.283 · Cited by 34 · see citing works
Rusanen, E., Lahikainen, A. R., Vierikko, E., Pölkki, P., & Paavonen, E. J. (2022) · Child Psychiatry & Human Development · doi:10.1007/s10578-022-01398-5 · Cited by 29 · see citing works
Martin, R. C. B., & Brock, R. L. (2023) · Archives of Women s Mental Health · doi:10.1007/s00737-023-01299-z · Cited by 29 · see citing works
“Second, we obtained multiple reports of parent-infant bonding impairments (at 1 and 6 months postpartum) for a reliable measure of bonding during the first 6 months postpartum, considered the most critical period for establishing a strong bond between parent and infant (Brody 1981; Kinsey & Hupcey 2013; Muzik et al. 2…”
BackgroundPeripartum depression: Early recognition improves outcomes
Howard, M. M., Mehta, N. D., & Powrie, R. O. (2017) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.84a.14060 · Cited by 29 · see citing works
Guyon‐Harris, K. L., Madigan, S. L., Bronfman, E. T., Romero, G. J., & Huth‐Bocks, A. C. (2020) · Journal of Interpersonal Violence · doi:10.1177/0886260520906175 · Cited by 29 · see citing works
“For example, women who report experiencing maltreatment during childhood exhibit decreased maternal sensitivity and engagement and increased anger, control, and intrusiveness during interactions with their young children (e.g., Gustafsson et al., 2012; Hughes & Cossar, 2016; Moehler et al., 2007; Muzik et al., 2013; S…”
BackgroundMinamida, T., Iseki, A., Sakai, H. M., Imura, M., Okano, T., & Tanii, H. (2020) · Infant Mental Health Journal · doi:10.1002/imhj.21866 · Cited by 29 · see citing works
Vesel, J., & Nickasch, B. L. (2015) · Nursing for Women s Health · doi:10.1111/1751-486x.12234 · Cited by 27 · see citing works
Anaemia and depression before and after birth: a cohort study based on linked population data
Xu, F., Roberts, L., Binns, C. W., Sullivan, E., & Homer, C. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1796-6 · Cited by 28 · see citing works
Mathews, T. L., Emerson, M. R., Moore, T. A., Fial, A., & Hanna, K. M. (2019) · Journal of Pediatric Health Care · doi:10.1016/j.pedhc.2019.04.018 · Cited by 28 · see citing works
Khan, M. R., & Renk, K. (2019) · Journal of Child Custody · doi:10.1080/15379418.2019.1575318 · Cited by 29 · see citing works
Bahari, S., Nourizadeh, R., Esmaeilpour, K., & Hakimi, S. (2021) · Issues in Mental Health Nursing · doi:10.1080/01612840.2021.1993388 · Cited by 28 · see citing works
Morelen, D. M., Menke, R. A., Rosenblum, K., Beeghly, M., & Muzik, M. (2016) · Psychopathology · doi:10.1159/000448376 · Cited by 28 · see citing works
Self-citationLara-Cinisomo, S., Zhu, K.-F., Fei, K.-X., Bu, Y., Weston, A. P., & Ravat, U. (2018) · BMC Women's Health · doi:10.1186/s12905-018-0520-5 · Cited by 25 · see citing works
“observed that women with postpartum depressive symptoms experienced greater bonding impairment compared to nondepressed controls at 6 weeks, 4 months and 6 months postpartum [1].”
BackgroundInfluentialSpieker, S. J., Oxford, M. L., Fleming, C. B., & Lohr, M. J. (2018) · Infant Mental Health Journal · doi:10.1002/imhj.21685 · Cited by 27 · see citing works
“Relatedly, several studies found that a history of childhood maltreatment in the absence of postpartum psychopathology did not confer parenting risk (Oh et al., 2016; Muzik et al., 2013; Muzik et al., 2017).”
BackgroundVengadavaradan, A., Bharadwaj, B., Sathynarayanan, G., Durairaj, J., & Rajaa, S. (2019) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2019.01.018 · Cited by 27 · see citing works
Keller, S. M., Doherty, T. S., & Roth, T. L. (2019) · Scientific Reports · doi:10.1038/s41598-019-46539-4 · Cited by 25 · see citing works
Knoblauch, U., Ritschel, G., Weidner, K., Mogwitz, S., Hannig, C., Viergutz, G., & Lenk, M. (2019) · PLoS ONE · doi:10.1371/journal.pone.0224509 · Cited by 26 · see citing works
“It is known that women with childhood traumatization report inadequate dental care in their own childhood [31], often suffer from dental anxiety, perceive dental visits as intimidating [28,29] and more often have issues with motherinfant bonding [32].”
BackgroundSexton, M. B., Davis, M. T., Menke, R., Raggio, G. A., & Muzik, M. (2017) · Psychological Trauma: Theory, Research, Practice, and Policy · doi:10.1037/tra0000272 · Cited by 25 · see citing works
“…system reliably captures meaningful variations in maternal parenting behaviors associated with maternal and child outcomes, with intraclass correlations (ICCs) over .8 (see Muzik et al., 2013; Martinez-Torteya et al., 2014 for more detailed descriptions of the activities, coding system, and ICCs).”
Self-citationEnvironment and early life: Decisive factors for stress-resilience and vulnerability
Hegde, A., & Mitra, R. (2020) · International review of neurobiology · doi:10.1016/bs.irn.2019.12.002 · Cited by 28 · see citing works
Martini, J., Asselmann, E., Weidner, K., Knappe, S., Rosendahl, J., & Garthus‐Niegel, S. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.842410 · Cited by 25 · see citing works
“, avoiding contact with or being emotionally unavailable for the infant) (73, 74).”
BackgroundGuyon‐Harris, K. L., Ahlfs-Dunn, S. M., & Huth‐Bocks, A. C. (2017) · Journal of Family Violence · doi:10.1007/s10896-017-9934-3 · Cited by 24 · see citing works
“This is not surprising given past research documenting that symptoms of PTSD are related to greater parenting difficulties (Muzik et al. 2013; Salloum et al. 2014).”
BackgroundResultInfluentialMuzik, M., Schmicker, M., Alfafara, E. A., Dayton, C. J., Schuster, M., & Rosenblum, K. L. (2014) · Journal of Social Service Research · doi:10.1080/01488376.2014.917451 · Cited by 23 · see citing works
“Thus, not surprisingly, trauma impacts parenting perceptions and cognitions (Muzik et al., 2013) as well as observed parenting behaviors (Bailey, DeOliveira, Wolfe, Evans, & Hartwick, 2012).”
InfluentialSelf-citationMother-infant bonding in the postpartum period and its predictors
Mazúchová, L., Kelčíková, S., Porubská, A., Malinovská, N., & Grendár, M. (2020) · Central European Journal of Nursing and Midwifery · doi:10.15452/cejnm.2020.11.0022 · Cited by 23 · see citing works
“Particular attention and care should be given to this group of women due to their increased susceptibility to the development of psychopathology in the postpartum period (Muzik et al., 2013).”
BackgroundRibaudo, J., Lawler, J. M., Jester, J. M., Riggs, J. L., Erickson, N. L., Stacks, A. M., Brophy‐Herb, H. E., Muzik, M., & Rosenblum, K. L. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.792989 · Cited by 25 · see citing works
“Mothers with PTSD may be emotionally unavailable; experience higher levels of parenting stress; endorse higher levels of aggression toward their children; have increased difficulty reflecting on their child’s needs; have limited empathic responses to their child’s struggles; and display significant difficulties provid…”
BackgroundSelf-citationOxford, M. L., Hash, J. B., Lohr, M. J., Bleil, M. E., Fleming, C. B., Unützer, J., & Spieker, S. J. (2021) · Developmental Psychology · doi:10.1037/dev0001219 · Cited by 22 · see citing works
The Role of Childhood Trauma and PTSD in Postpartum Sleep Disturbance
Swanson, L. M., Hamilton, L., & Muzik, M. (2014) · Journal of Traumatic Stress · doi:10.1002/jts.21965 · Cited by 22 · see citing works
“Further detail regarding the parent study is published elsewhere (Muzik et al., 2013).”
Self-citationToward a framework for best practices and research guidelines for perinatal depression research
Kimmel, M., Bauer, A. E., & Meltzer-Brody, S. E. (2019) · Journal of Neuroscience Research · doi:10.1002/jnr.24425 · Cited by 22 · see citing works
Muzik, M., Umarji, R., Sexton, M. B., & Davis, M. T. (2016) · Maternal and Child Health Journal · doi:10.1007/s10995-016-2197-4 · Cited by 23 · see citing works
“Further, studies have identified associations between CM, maternal psychopathology, and mother-infant bonding and child development, thus increasing the probability of intergenerational transmission of risk (e.g., Martinez-Torteya et al. 2014; Muzik et al. 2013; Sexton et al. 2015).”
BackgroundSelf-citationRepetitive Negative Thinking and Impaired Mother–Infant Bonding: A Longitudinal Study
Schmidt, D., Seehagen, S., Hirschfeld, G. H. F., Vocks, S., Schneider, S., & Teismann, T. (2016) · Cognitive Therapy and Research · doi:10.1007/s10608-016-9823-8 · Cited by 21 · see citing works
“Mother– infant bonding and maternal responsiveness within the mother–infant interaction are known to be of crucial importance for child development (e.g., Muzik et al. 2013; Tester-Jones et al. 2015).”
Background
- Authors
- Muzik, M., Bocknek, E. L., Broderick, A., Richardson, P., Rosenblum, K. L., Thelen, K., & Seng, J. S.
- Affiliations
- University of Michigan (US)
- Corresponding author
- Muzik, Maria
- ORCID
- Venue
- Archives of Women's Mental Health
- Published
- 2012-10-12
- Volume
- 16
- Issue
- 1
- Pages
- 29-38
- ISSN
- 1434-1816 (ISSN-L)
- 1435-1102
- PMC
- PMC4040083
- OpenAlex
- W2085764880
- Cited by
- 293
- References
- 43
- Citations by year
- 2026: 11 · 2025: 19 · 2024: 22 · 2023: 31 · 2022: 28 · 2021: 29 · 2020: 36 · 2019: 23 · 2018: 17 · 2017: 22 · 2016: 21 · 2015: 19 · 2014: 11 · 2013: 4
- FWCI
- 10.51
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Archives of Women s Mental Health (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Michigan Institute for Clinical and Health Research
- National Institute of Mental Health (K23MH080147, MH080147)
- National Center for Research Resources (UL1RR024986)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
- Keywords
- mother-infant bonding, postpartum depression, post-traumatic stress disorder, childhood abuse and neglect, maternal psychopathology, early postpartum period, Postpartum Bonding Questionnaire, parenting quality, mother-infant relationship
- MeSH terms
- Adult, Child Abuse, Female, Follow-Up Studies, House Calls, Humans, Infant, Interviews as Topic, Maternal Behavior, Mother-Child Relations, Mothers, Object Attachment, Psychiatric Status Rating Scales, Psychopathology, Surveys and Questionnaires, Socioeconomic Factors, Stress Disorders, Post-Traumatic, Telephone, Logistic Models, Case-Control Studies, Child of Impaired Parents, Parenting, Postpartum Period
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