A Screening Questionnaire for mother-infant bonding disorders

Brockington, I. F.; Oates, J.; George, S.; Turner, D.; Vostanis, P.; Sullivan, M.; Loh, C.; Murdoch, C.

doi:10.1007/s007370170010

Cited by 600Maternal Mental Health During Pregnancy and PostpartumAttachment and Relationship DynamicsPsychoanalysis and Psychopathology Research

A Screening Questionnaire for mother-infant bonding disorders

Brockington, I. F., Oates, J., George, S., Turner, D., Vostanis, P., Sullivan, M., Loh, C., Murdoch, C.·2001·Archives of Women's Mental Health

DOI 10.1007/s007370170010

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The PBQ comprises 25 items, all assessed using a six-point Likert scale of frequency reflecting elements of emotions, behaviours, and cognitions relating to the infant.
“The PBQ is similarly nuanced, comprising 25-items, all assessed using a six-point Likert scale of frequency reflecting elements of emotions, behaviours, and cognitions relating to the infant.”
From Associations between maternal psychological distress and mother-infant bonding: a systematic review and meta-analysis (2023) · cites this paper as Brockington et al., 2001
The PBQ is the most frequently used and validated questionnaire to assess maternal bonding difficulties.
“However, the PBQ is the most frequently used and validated questionnaire to assess maternal bonding difficulties.”
From Longitudinal associations between prenatal internalizing symptoms and mindfulness traits with postnatal bonding difficulties. (2025) · cites this paper as Brockington et al. 2001

Detection of Postnatal Depression: Development of the 10-item Edinburgh Postnatal Depression Scale
Cox, J. L., Holden, J. M., & Sagovsky, R. (1987) · British Journal of Psychiatry · doi:10.1192/bjp.150.6.782 · Cited by 14,183 · see citing works
Motherhood and mental health
Brockington, I., & Guédeney, A. (1999) · Infant Observation · doi:10.1080/13698039908400552 · Cited by 309 · see citing works
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The prevalence of posttraumatic stress disorder in pregnancy and after birth: a systematic review and meta-analysis
Yildiz, P. D., Ayers, S., & Phillips, L. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.10.009 · Cited by 768 · see citing works
Postpartum psychiatric disorders
Brockington, I. (2004) · The Lancet · doi:10.1016/s0140-6736(03)15390-1 · Cited by 605 · see citing works
Self-citation
The Postpartum Bonding Questionnaire: a validation
Brockington, I. F., Fraser, C., & Wilson, D. (2006) · Archives of Women's Mental Health · doi:10.1007/s00737-006-0132-1 · Cited by 568 · see citing works
“It was both surprising and disappointing that the principal component analysis (reported in Brockington et al, 2001 ) did not yield a separate anger factor.”
BackgroundMethodResultInfluentialSelf-citation
Maternal depressive symptoms in the postnatal period are associated with long-term impairment of mother–child bonding
Moehler, E., Brunner, R., Wiebel, A., Reck, C., & Resch, F. (2006) · Archives of Women's Mental Health · doi:10.1007/s00737-006-0149-5 · Cited by 445 · see citing works
“The current findings are highly relevant, because impaired mother–infant bonding has been regarded as a risk factor for the whole spectrum of mother–child relationship disturbances including child abuse ( Brockington et al, 2001 ).”
BackgroundMethodInfluential
Postpartum bonding: the role of perinatal depression, anxiety and maternal–fetal bonding during pregnancy
Dubber, S., Reck, C., Müller, M., & Gawlik, S. (2015) · Archives of Women's Mental Health · doi:10.1007/s00737-014-0445-4 · Cited by 400 · see citing works
“…prenatal maternal bonding; to assess postpartummaternal bonding the Maternal Postpartum Attachment Scale (MPAS) by Condon and Corkindale (1998), the Postpartum Bonding Questionnaire (PBQ; Brockington et al. 2001) and the Motherto-Infant Bonding Scale (MIBS; Taylor et al. 2005) were administered.”
BackgroundMethod
Mother–infant bonding impairment across the first 6 months postpartum: the primacy of psychopathology in women with childhood abuse and neglect histories
Muzik, M., Bocknek, E. L., Broderick, A., Richardson, P., Rosenblum, K. L., Thelen, K., & Seng, J. S. (2013) · Archives of Women's Mental Health · doi:10.1007/s00737-012-0312-0 · Cited by 293 · see citing works
“The Postpartum Bonding Questionnaire (PBQ; Brockington et al. 2001) is a self-report questionnaire designed to assess a mother’s emotional connection to her infant as well as her feelings about herself as a parent in the early weeks and months postpartum.”
BackgroundMethodInfluential
State of the science of maternal–infant bonding: A principle-based concept analysis
Bicking Kinsey, C., & Hupcey, J. E. (2013) · Midwifery · doi:10.1016/j.midw.2012.12.019 · Cited by 287 · see citing works
“Studies consistently differentiated depression and anxiety from maternal–infant bonding (Brockington et al., 2001; Klier, 2006; Moehler et al., 2006; Reck et al., 2006).”
BackgroundInfluential
The German version of the Postpartum Bonding Instrument: Psychometric properties and association with postpartum depression
Reck, C., Klier, C. M., Pabst, K., Stehle, E., Stefenelli, U., Struben, K., & Backenstraß, M. (2006) · Archives of Women s Mental Health · doi:10.1007/s00737-006-0144-x · Cited by 236 · see citing works
“# Brockington et al (2001) 270 C. Reck et al”
Influential
Netmums: a phase II randomized controlled trial of a guided Internet behavioural activation treatment for postpartum depression
O'Mahen, H. A., Richards, D. A., Woodford, J., Wilkinson, E., McGinley, J., Taylor, R. S., & Warren, F. C. (2014) · Psychological Medicine · doi:10.1017/s0033291713002092 · Cited by 201 · see citing works
“Effectiveness outcomes were estimated with the Edinburgh Postnatal Depression Scale (EPDS), Generalized Anxiety Disorder-7, Work and Social Adjustment Scale, Postnatal Bonding Questionnaire, and Social Provisions Scale.”
Method
Three self-report questionnaires of the early mother-to-infant bond: reliability and validity of the Dutch version of the MPAS, PBQ and MIBS
van Bussel, J. C. H., Spitz, B., & Demyttenaere, K. (2010) · Archives of Women's Mental Health · doi:10.1007/s00737-009-0140-z · Cited by 199 · see citing works
“For these reasons, several instruments have been developed to assist obstetricians, paediatricians and primary-care professionals in detecting disorders in the early emotional bond between a mother and her newborn infant (Brockington et al. 2001; Condon and Corkindale 1998; Fleming et al. 1988; Kumar and Hipwell 1996;…”
BackgroundMethodInfluential
Mother-child bonding at 1 year; associations with symptoms of postnatal depression and bonding in the first few weeks
O’Higgins, M., Roberts, I. S. J., Glover, V., & Taylor, A. (2013) · Archives of Women's Mental Health · doi:10.1007/s00737-013-0354-y · Cited by 201 · see citing works
Childhood Abuse History, Posttraumatic Stress Disorder, Postpartum Mental Health, and Bonding: A Prospective Cohort Study
Seng, J. S., Sperlich, M. I., Low, L. K., Ronis, D. L., Muzik, M., & Liberzon, I. (2013) · Journal of Midwifery & Women s Health · doi:10.1111/j.1542-2011.2012.00237.x · Cited by 205 · see citing works
A Japanese version of Mother-to-Infant Bonding Scale: factor structure, longitudinal changes and links with maternal mood during the early postnatal period in Japanese mothers
Yoshida, K., Yamashita, H., Conroy, S., Marks, M., & Kumar, C. (2012) · Archives of Women's Mental Health · doi:10.1007/s00737-012-0291-1 · Cited by 191 · see citing works
“Brockington et al. (2001) developed the Postpartum Bonding Questionnaire (PBQ), which is a self-rating questionnaire.”
BackgroundMethod
The effect of post‐natal symptoms of post‐traumatic stress and depression on the couple's relationship and parent–baby bond
Parfitt, Y., & Ayers, S. (2008) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646830802350831 · Cited by 196 · see citing works
“Test–retest reliability was 0.95, 0.95, 0.93 and 0.77 for the four sub-scales (Brockington, Fraser, & Wilson, 2006; Brockington et al., 2001).”
MethodInfluential
Predictors of postnatal mother-infant bonding: the role of antenatal bonding, maternal substance use and mental health
Rossen, L., Hutchinson, D., Wilson, J., Burns, L., A Olsson, C., Allsop, S., J Elliott, E., Jacobs, S., Macdonald, J. A., & Mattick, R. P. (2016) · Archives of Women's Mental Health · doi:10.1007/s00737-016-0602-z · Cited by 187 · see citing works
“Furthermore, anxiety showed no correlation with maternal-fetal bonding in low or high obstetrical risk women (Mercer and Ferketich 1990) and has not been considered a major component of bonding disorders commonly seen postpartum (Brockington et al. 2001).”
Background
Maternal bonding in mothers with postpartum anxiety disorder: the crucial role of subclinical depressive symptoms and maternal avoidance behaviour
Tietz, A., Zietlow, A., & Reck, C. (2014) · Archives of Women s Mental Health · doi:10.1007/s00737-014-0423-x · Cited by 188 · see citing works
Some early indicators for depressive symptoms and bonding 2 months postpartum – a study of new mothers and fathers
Edhborg, M., MATTHIESEN, A. ‐., Lundh, W., & Widström, A.-M. (2005) · Archives of Women s Mental Health · doi:10.1007/s00737-005-0097-5 · Cited by 180 · see citing works
“Brockington et al. (2001) also performed a factor analysis and four subscales were developed.”
BackgroundMethodInfluential
Association between parental depressive symptoms and impaired bonding with the infant
Kerstis, B., Aarts, C., Tillman, C., Persson, H., Engström, G., Edlund, B., Öhrvik, J., Sylvén, S., & Skalkidou, A. (2016) · Archives of Women's Mental Health · doi:10.1007/s00737-015-0522-3 · Cited by 165 · see citing works
Associations between maternal psychological distress and mother-infant bonding: a systematic review and meta-analysis
O’Dea, G. A., Youssef, G. J., Hagg, L. J., Francis, L. M., Spry, E. A., Rossen, L., Smith, I., Teague, S. J., Mansour, K., Booth, A., et al. (2023) · Archives of Women's Mental Health · doi:10.1007/s00737-023-01332-1 · Cited by 161 · see citing works
“Taken together, this suggests that the MIBS may be assessing different facets of mother-infant bonding than the MPAS or PBQ, which may then correlate less strongly with maternal depression or psychological distress.”
ResultInfluential
Impact of postpartum depressive and anxiety symptoms on mothers’ emotional tie to their infants 2–3 months postpartum: a population-based study from rural Bangladesh
Edhborg, M., Nasreen, H. E., & Kabir, Z. N. (2011) · Archives of Women s Mental Health · doi:10.1007/s00737-011-0221-7 · Cited by 159 · see citing works
“Factor analysis of the Postpartum Bonding Questionnaire To our knowledge, the PBQ has not been used in lowincome countries.”
Method
A randomised control trial for the effectiveness of group interpersonal psychotherapy for postnatal depression
Mulcahy, R., Reay, R. E., Wilkinson, R. B., & Owen, C. A. (2009) · Archives of Women s Mental Health · doi:10.1007/s00737-009-0101-6 · Cited by 154 · see citing works
“Furthermore, given that mother–infant bonding has been shown to be a risk factor for a spectrum of mother–child relationship problems (Boyle and Pickles 1997; Brockington et al. 2001), this remains an important area of research.”
Background
Severe disorders of the mother–infant relationship: definitions and frequency
Brockington, I. F., Aucamp, H. M., & Fraser, C. (2006) · Archives of Women's Mental Health · doi:10.1007/s00737-006-0133-0 · Cited by 144 · see citing works
Self-citation
The functional neuroanatomy of the evolving parent–infant relationship
Parsons, C. E., Young, K. S., Murray, L., Stein, A. L., & Kringelbach, M. L. (2010) · Progress in Neurobiology · doi:10.1016/j.pneurobio.2010.03.001 · Cited by 141 · see citing works
“There are a number of measures currently used to assess the emotional aspects of the caregiver’s bond to an infant, including: Parental Bonding Questionnaire (Brockington et al., 2001; Papousek and Papousek, 1983), Parenting Stress Questionnaire (Loyd and Abidin, 1985), and self-report (e.g., Wojnar, 2004).”
Background
An evaluation of two bonding questionnaires: a comparison of the Mother-to-Infant Bonding Scale with the Postpartum Bonding Questionnaire in a sample of primiparous mothers
Wittkowski, A., Wieck, A., & Mann, S. (2007) · Archives of Women s Mental Health · doi:10.1007/s00737-007-0191-y · Cited by 147 · see citing works
“Brockington et al. (2001) suggest cut-off scores to identify problematic bonding of 12 for Scale 1, 17 for Scale 2, 10 for Scale 3 and 3 for Scale 4.”
BackgroundMethodInfluential
Maternal–Infant Bonding and Its Relationships with Maternal Depressive Symptoms, Stress and Anxiety in the Early Postpartum Period in a Polish Sample
Lutkiewicz, K., Bieleninik, Ł., Cieślak, M., & Bidzan, M. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17155427 · Cited by 130 · see citing works
“Factor 3 includes 4 questions (a cut-off score of 9) that aims to identify maternal–infant anxiety and factor 4 includes two questions (a cut-off score of 2) to identify incipient abuse and dangerous behaviors from the mother toward the child [8].”
BackgroundMethod
Measuring bonding or attachment in the parent-infant-relationship: A systematic review of parent-report assessment measures, their psychometric properties and clinical utility
Wittkowski, A., Vatter, S., Muhinyi, A., Garrett, C., & Henderson, M. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101906 · Cited by 121 · see citing works
Postpartum bonding: the impact of maternal depression and adult attachment style
Nonnenmacher, N., Noe, D., Ehrenthal, J. C., & Reck, C. (2016) · Archives of Women s Mental Health · doi:10.1007/s00737-016-0648-y · Cited by 127 · see citing works
“The PBQ was originally developed as a self-report measure for the screening of bonding disorders (Brockington et al. 2001).”
Breastfeeding and the mother–infant relationship—A review
JANSEN, J., de Weerth, C., & Riksen‐Walraven, J. M. (2008) · Developmental Review · doi:10.1016/j.dr.2008.07.001 · Cited by 126 · see citing works
“…for use in a clinical setting, such as the bonding scale of the Parental Stress Index (PSI: Abidin, 1986) or the Postpartum Bonding Instrument (PBI: Brockington et al., 2001), are designed toward diagnosing potential failure in maternal bond formation, but are unable to quantify the maternal bond…”
BackgroundMethod
Postpartum Maternal Sleep, Maternal Depressive Symptoms and Self-Perceived Mother–Infant Emotional Relationship
Tikotzky, L. (2014) · Behavioral Sleep Medicine · doi:10.1080/15402002.2014.940111 · Cited by 121 · see citing works
Psychopathology and parenting: An examination of perceived and observed parenting in mothers with depression and PTSD
Muzik, M., Morelen, D. M., Hruschak, J. L., Rosenblum, K. L., Bocknek, E. L., & Beeghly, M. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.08.035 · Cited by 119 · see citing works
“12 The Postpartum Bonding Questionnaire (PBQ) (Brockington et al., 2001), assessed”
BackgroundMethod
Birth-related, psychosocial, and emotional correlates of positive maternal–infant bonding in a cohort of first-time mothers
Kinsey, C. B., Baptiste-Roberts, K., Zhu, J., & Kjerulff, K. H. (2014) · Midwifery · doi:10.1016/j.midw.2014.02.006 · Cited by 117 · see citing works
Effects of maternal depressive symptomatology during pregnancy and the postpartum period on infant–mother attachment
Ohoka, H., Koide, T., Goto, S., Murase, S., Kanai, A., Masuda, T., Aleksić, B., Ishikawa, N., 古村, 香., & Ozaki, N. (2014) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.12171 · Cited by 117 · see citing works
“Bonding disorder has been acknowledged as an important problem in perinatal psychiatry.(1,2) However, it has not been recognized as a nosological category either in the ICD-10 or the DSM-IV.”
Background
Maternal bond and mother–child interaction in severe postpartum psychiatric disorders: Is there a link?
Hornstein, C., Trautmann‐Villalba, P., Hohm, E., Rave, E. J., Wortmann-Fleischer, S., & Schwarz, M. (2006) · Archives of Women s Mental Health · doi:10.1007/s00737-006-0148-6 · Cited by 116 · see citing works
“Due to the fact that Risk of abuse is not associated with any form of bonding disorders ( Brockington et al, 2001 ) we excluded scale 4 from further analyses.”
BackgroundMethodInfluential
Impact of maternal depressive symptoms and infant temperament on early infant growth and motor development: Results from a population based study in Bangladesh
Nasreen, H.-E., Nahar Kabir, Z., Forsell, Y., & Edhborg, M. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.09.013 · Cited by 104 · see citing works
“The mother’s bonding with the infant at 2–3 months postpartum was assessed by three sub-scales of the postpartum bonding questionnaire (PBQ) (Brockington et al., 2001): impaired bonding (12 items), rejection and anger towards the infant (7 items), and anxiety about care (4 items).”
Method
Untreated perinatal paternal depression: Effects on offspring
Gentile, S., & Fusco, M. L. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.02.064 · Cited by 100 · see citing works
Associations Between Breastfeeding and Mother–Infant Relationships: A Systematic Review
Peñacoba, C., & Catalá, P. (2019) · Breastfeeding Medicine · doi:10.1089/bfm.2019.0106 · Cited by 103 · see citing works
“In relation to self-report measures, although there is no consensus, the Postpartum Bonding Questionnaire (PBQ) 51 and the MAI 17 have been recommended.”
Assessment of psychometric properties of the postpartum bonding questionnaire (PBQ) in Spanish mothers
Garcia-Esteve, L., Torres, A., Lasheras, G., Palacios-Hernández, B., Farré-Sender, B., Subirà, S., Valdés, M., & Brockington, I. F. (2016) · Archives of Women s Mental Health · doi:10.1007/s00737-015-0589-x · Cited by 99 · see citing works
“Postpartum Bonding Questionnaire (Brockington et al. 2001) This instrument was used to assess mother-infant bonding.”
BackgroundMethodResultInfluentialSelf-citation
Maternal childhood trauma, postpartum depression, and infant outcomes: Avoidant affective processing as a potential mechanism
Choi, K. W., Sikkema, K. J., Vythilingum, B., Geerts, L., Faure, S., Watt, M. H., Roos, A., & Stein, D. J. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.01.004 · Cited by 100 · see citing works
Quick, simple measures of family relationships for use in clinical practice and research. A systematic review
Pritchett, R., Kemp, J., Wilson, P., Minnis, H., Bryce, G., & Gillberg, C. (2010) · Family Practice · doi:10.1093/fampra/cmq080 · Cited by 94 · see citing works
Effectiveness of hospital-based video interaction guidance on parental interactive behavior, bonding, and stress after preterm birth: A randomized controlled trial.
Hoffenkamp, H. N., Tooten, A., Hall, R. A. S., Braeken, J., Eliëns, M. P. J., Vingerhoets, A. J. J. M., & van Bakel, H. J. A. (2014) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0038401 · Cited by 92 · see citing works
“Abbreviations questionnaires: My Baby and I Questionnaire (MBI): enjoyment/responsiveness MBI-ER; Yale Inventory of Parental Thoughts and Actions (YIPTA): compulsive checking YIPTA-CC, affiliative behavior YIPTA-AB, attachment representations YIPTA-AR; Postpartum Bonding Questionnaire (PBQ) PBQ-Sum.”
Method
Pre-natal Attachment and Parent-To-Infant Attachment: A Systematic Review
Trombetta, T., Giordano, M., Santoniccolo, F., Vismara, L., Vedova, A. M. D., & Rollè, L. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.620942 · Cited by 103 · see citing works
Breastfeeding Duration and Early Parenting Behaviour: The Importance of an Infant-Led, Responsive Style
Brown, A., & Arnott, B. (2014) · PLoS ONE · doi:10.1371/journal.pone.0083893 · Cited by 91 · see citing works
“Sleep deprivation [35] and infant crying [36] are associated with increased risk of postnatal depression and maternal feelings of loss of control or identity [37].”
Background
The role of posttraumatic stress and depression symptoms in mother-infant bonding
Radoš, S. N., Matijaš, M., Anđelinović, M., Čartolovni, A., & Ayers, S. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.03.006 · Cited by 90 · see citing works
Perceived and observed mother–child interaction at time of hospitalization and release in postpartum depression and psychosis
Noorlander, Y., Bergink, V., & den Berg, M. P. L. (2008) · Archives of Women s Mental Health · doi:10.1007/s00737-008-0217-0 · Cited by 90 · see citing works
“Furthermore, previous research has demonstrated that this scale is not associated with any form of bonding disorders (Brockington et al. 2001).”
The Role of Infant Sleep in Intergenerational Transmission of Trauma
Hairston, I. S., Waxler, E., Seng, J. S., Fezzey, A., Rosenblum, K. L., & Muzik, M. (2011) · SLEEP · doi:10.5665/sleep.1282 · Cited by 89 · see citing works
THE CEYLON MEDICAL JOURNAL
Frcp, C. G., & de Silva, J. (2013) · Cited by 89 · see citing works
Perceived parenting stress in the course of postpartum depression: the buffering effect of maternal bonding
Reck, C., Zietlow, A.-L., Müller, M., & Dubber, S. (2016) · Archives of Women's Mental Health · doi:10.1007/s00737-015-0590-4 · Cited by 81 · see citing works
Mother–infant bonding disorders in patients with postnatal depression: The Postpartum Bonding Questionnaire in clinical practice
Klier, C. M. (2006) · Archives of Women s Mental Health · doi:10.1007/s00737-006-0150-z · Cited by 83 · see citing works
“We present here two case vignettes which illustrate the importance of using both The Edinburgh Postnatal Depression Scale (EPDS) (Cox et al, 1987) and The Postpartum Bonding Questionnaire (PBQ) ( Brockington et al, 2001; Klier & Muzik, 2004).”
BackgroundMethodInfluential
Maternal postnatal psychiatric symptoms and infant temperament affect early mother-infant bonding
Nolvi, S., Karlsson, L., Bridgett, D. J., Pajulo, M., Tolvanen, M., & Karlsson, H. (2016) · Infant Behavior and Development · doi:10.1016/j.infbeh.2016.03.003 · Cited by 82 · see citing works
Couple comorbidity and correlates of postnatal depressive symptoms in mothers and fathers in the first two weeks following delivery
Anding, J. E., Röhrle, B., Grieshop, M., Schücking, B., & Christiansen, H. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.10.033 · Cited by 80 · see citing works
Maternal Rejection of the Young Child: Present Status of the Clinical Syndrome
Brockington, I. (2011) · Psychopathology · doi:10.1159/000325058 · Cited by 80 · see citing works
Self-citation
Associations of postpartum mother-infant bonding with maternal childhood maltreatment and postpartum mental health: a cross-sectional study
Lehnig, F., Nagl, M., Stepan, H., Wagner, B., & Kersting, A. (2019) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-019-2426-0 · Cited by 80 · see citing works
The establishment of a mother-baby inpatient psychiatry unit in India: Adaptation of a Western model to meet local cultural and resource needs
Chandra, P. S., Desai, G., Reddy, D., Thippeswamy, H., & Saraf, G. (2015) · Indian Journal of Psychiatry · doi:10.4103/0019-5545.166621 · Cited by 78 · see citing works
“Based on ratings of PBQ and Objective Bonding instrument, mother‑infant bonding problems that needed specific interventions were noted in 98 (40”
MethodInfluential
Defining Attachment and Bonding: Overlaps, Differences and Implications for Music Therapy Clinical Practice and Research in the Neonatal Intensive Care Unit (NICU)
Ettenberger, M., Bieleninik, Ł., Epstein, S., & Elefant, C. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18041733 · Cited by 79 · see citing works
“To be able to admit for example: “I feel angry with my baby”, “I regret having this baby” or “I feel like hurting my baby” (examples from the Postpartum Bonding Questionnaire [65]), are certainly affirmations that can be challenging to acknowledge.”
BackgroundInfluential
Mother–infant bonding in the postpartum period: assessment of the impact of pre-delivery factors in a clinical sample
Farré-Sender, B., Torres, A., Gelabert, E., Andrés, S., Roca, A., Lasheras, G., Valdés, M., & García-Esteve, L. (2018) · Archives of Women's Mental Health · doi:10.1007/s00737-017-0785-y · Cited by 57 · see citing works
Links between maternal postpartum depressive symptoms, maternal distress, infant gender and sensitivity in a high-risk population
Sidor, A., Kunz, E., Schweyer, D., Eickhorst, A., & Cierpka, M. (2011) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/1753-2000-5-7 · Cited by 75 · see citing works
POSTPARTUM BONDING DIFFICULTIES AND ADULT ATTACHMENT STYLES: THE MEDIATING ROLE OF POSTPARTUM DEPRESSION AND CHILDBIRTH‐RELATED PTSD
Hairston, I. S., Handelzalts, J. E., Assis, C., & Kovo, M. (2018) · Infant Mental Health Journal · doi:10.1002/imhj.21695 · Cited by 75 · see citing works
“A score higher than 10 on the general factor reflects “some kind of bonding disorder,” a score above 16 on the Anger/Rejection scale reflects a “severe bonding disorder,” and a score above 11 on the Infant-Focused Anxiety scale indicates high levels of anxiety (Brockington, Fraser, & Wilson, 2006; Brockington et al.,…”
Background
Antenatal Depression and Maternal-Fetal Attachment
Honjo, S., Arai, S., Kaneko, H., Ujiie, T., Murase, S., Sechiyama, H., Sasaki, Y., Hatagaki, C., Inagaki, E., Usui, M., et al. (2003) · Psychopathology · doi:10.1159/000075189 · Cited by 75 · see citing works
Risk factors for impaired maternal bonding when infants are 3 months old: a longitudinal population based study from Japan
Nakano, M., Upadhyaya, S., Chudal, R., Skokauskas, N., Luntamo, T., Sourander, A., & Kaneko, H. (2019) · BMC Psychiatry · doi:10.1186/s12888-019-2068-9 · Cited by 78 · see citing works
“Maternal bonding (PBQ) low level of impaired maternal bonding.”
BackgroundMethodInfluential
Effects of Lavender Tea on Fatigue, Depression, and Maternal‐Infant Attachment in Sleep‐Disturbed Postnatal Women
Chen, S., & Chen, C. (2015) · Worldviews on Evidence-Based Nursing · doi:10.1111/wvn.12122 · Cited by 74 · see citing works
Long-term outcomes of participants in a perinatal depression early detection program
Reay, R. E., Matthey, S., Ellwood, D. A., & Scott, M. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.07.035 · Cited by 73 · see citing works
“Disruptions in the mother–infant bond are of serious concern because of their implication in the development of complex relationship problems, including child neglect and abuse (Brockington et al., 2001).”
Background
Mother-infant bonding is not associated with feeding type: a community study sample
Hairston, I. S., Handelzalts, J. E., Lehman-Inbar, T., & Kovo, M. (2019) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-019-2264-0 · Cited by 69 · see citing works
The Impact of Premature Childbirth on Parental Bonding
Hoffenkamp, H. N., Tooten, A., Hall, R. A. S., Croon, M. A., Braeken, J., Winkel, F. W., Vingerhoets, A. J. J. M., & van Bakel, H. J. A. (2012) · Evolutionary Psychology · doi:10.1177/147470491201000311 · Cited by 68 · see citing works
“In addition, all parents were asked to complete the Postpartum Bonding Questionnaire (PBQ; Brockington et al., 2001) 1 month postpartum.”
BackgroundInfluential
The association between prenatal maternal anxiety disorders and postpartum perceived and observed mother-infant relationship quality
Nath, S., Pearson, R. M., Moran, P., Pawlby, S., Molyneaux, E., Challacombe, F. L., & Howard, L. M. (2019) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2019.102148 · Cited by 68 · see citing works
The Impact of Parental Role Distributions, Work Participation, and Stress Factors on Family Health-Related Outcomes: Study Protocol of the Prospective Multi-Method Cohort “Dresden Study on Parenting, Work, and Mental Health” (DREAM)
Kress, V., Steudte‐Schmiedgen, S., Kopp, M., Förster, A., Altus, C., Schier, C., Wimberger, P., Kirschbaum, C., von Soest, T., Weidner, K., et al. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.01273 · Cited by 66 · see citing works
“Parent-to-infant-bonding Postpartum Bonding Questionnaire (PBQ; Brockington et al., 2001; Reck et al., 2006) x x x x x x x”
Background
Maternal perinatal depressive symptoms trajectories and impact on toddler behavior – the importance of symptom duration and maternal bonding
Fransson, E., Sörensen, F., Kallak, T. K., Ramklint, M., Eckerdal, P., Heimgärtner, M., Krägeloh‐Mann, I., & Skalkidou, A. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.04.003 · Cited by 65 · see citing works
“Furthermore, a stratified linear regression analysis was used to correct for the influence of concurrent depression on bonding scores (PBQ).”
Influential
Repetitive transcranial magnetic stimulation treats postpartum depression
Garcia, K. S., Flynn, P., Pierce, K. J., & Caudle, M. (2010) · Brain Stimulation · doi:10.1016/j.brs.2009.06.001 · Cited by 63 · see citing works
“Wilcoxon signed-ranks test was used to examine changes in mother-infant bonding from pretreatment to posttreatment as measured by the PBQ.36,37”
MethodInfluential
The Early Mother-to-Child Bond and Its Unique Prospective Contribution to Child Behavior Evaluated by Mothers and Teachers
Fuchs, A., Möhler, E., Reck, C., Resch, F., & Kaess, M. (2016) · Psychopathology · doi:10.1159/000445439 · Cited by 64 · see citing works
Discrete category of mother-to-infant bonding disorder and its identification by the Mother-to-Infant Bonding Scale: A study in Japanese mothers of a 1-month-old
Matsunaga, A., Takauma, F., Tada, K., & Kitamura, T. (2017) · Early Human Development · doi:10.1016/j.earlhumdev.2017.04.008 · Cited by 62 · see citing works
Why does perfectionism confer risk for depressive symptoms? A meta-analytic test of the mediating role of stress and social disconnection
Smith, M. M., Sherry, S., Vidovic, V., Hewitt, P. L., & Flett, G. L. (2020) · Journal of Research in Personality · doi:10.1016/j.jrp.2020.103954 · Cited by 65 · see citing works
Longitudinal Study of music Therapy’s Effectiveness for Premature infants and their caregivers (LongSTEP): protocol for an international randomised trial
Ghetti, C., Bieleninik, Ł., Hysing, M., Kvestad, I., Assmus, J., Romeo, R., Ettenberger, M., Arnon, S., Vederhus, B. J., Söderström Gaden, T., et al. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-025062 · Cited by 62 · see citing works
“The PBQ is a parent-rated screening instrument for disorders of the early mother-infant relationship consisting of 25 statements on a 6-point Likert scale (each 0–5; sum score ranging from 0 to 125; high=problematic), addressing problems in the mother–infant relationship based on weakened bonding; rejection and anger;…”
BackgroundMethod
Early infant temperament shapes the nature of mother-infant bonding in the first postpartum year
Takács, L., Šmolík, F., Kaźmierczak, M., & Putnam, S. P. (2020) · Infant Behavior and Development · doi:10.1016/j.infbeh.2020.101428 · Cited by 61 · see citing works
Mother-to-Infant Bonding in Women with Postpartum Psychosis and Severe Postpartum Depression: A Clinical Cohort Study
Gilden, J., Molenaar, N. M., Smit, A. K., Hoogendijk, W. J. G., Rommel, A., Kamperman, A. M., & Bergink, V. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9072291 · Cited by 60 · see citing works
“Bonding was measured with the Postpartum Bonding Questionnaire (PBQ) [30].”
MethodInfluential
The effectiveness of video interaction guidance in parents of premature infants: A multicenter randomised controlled trial
Tooten, A., Hoffenkamp, H. N., Hall, R. A. S., Winkel, F. W., Eliëns, M. P. J., Vingerhoets, A. J. J. M., & van Bakel, H. J. A. (2012) · BMC Pediatrics · doi:10.1186/1471-2431-12-76 · Cited by 57 · see citing works
“Bonding problems will be measured with the Postpartum Bonding Questionnaire (PBQ) [67] and the quality of the parent-infant interaction will be measured with the EAS [72].”
Method
Birth Experience Mediates the Association Between Fear of Childbirth and Mother-Child-Bonding Up to 14 Months Postpartum: Findings From the Prospective Cohort Study DREAM
Seefeld, L., Weise, V., Kopp, M., Knappe, S., & Garthus-Niegel, S. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.776922 · Cited by 50 · see citing works
“Mother-child-bonding was assessed using the German version of the frequently used Postpartum Bonding Questionnaire [PBQ; (61, 62)] which screens for bonding disorders and contains 25 items on the four subscales “impaired bonding,” “rejection and anger,” “anxiety about care,” and “risk of abuse.”
Method
Mother-child bonding is associated with the maternal perception of the child's body odor
Croy, I., Mohr, T., Weidner, K., Hummel, T. R., & Junge‐Hoffmeister, J. (2018) · Physiology & Behavior · doi:10.1016/j.physbeh.2018.09.014 · Cited by 55 · see citing works
Impairment of Mother-Infant Relationship
Siu, B. W. M., Ip, P., Chow, H. M.-T., Kwok, S. S.-P., Li, O. L., Koo, M. L., Cheung, E. F. C., Yeung, T. M. H., & Hung, S. (2010) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e3181d14154 · Cited by 55 · see citing works
“The PBQ is a 25-item self-rating questionnaire with 4 scales designed for detecting impairments of the mother-infant relationship as perceived by the mother (e.g., “I regret having this baby,” “My baby annoys me”) (Brockington et al., 2001).”
BackgroundMethodInfluential
Maternal anxiety disorders prior to conception, psychopathology during pregnancy and early infants’ development: a prospective-longitudinal study
Martini, J., Wittich, J., Petzoldt, J., Winkel, S., Einsle, F., Siegert, J., Höfler, M., Beesdo‐Baum, K., & Wïttchen, H. (2013) · Archives of Women s Mental Health · doi:10.1007/s00737-013-0376-5 · Cited by 55 · see citing works
A pilot randomised controlled trial to evaluate the feasibility and acceptability of the Baby Triple P Positive Parenting Programme in mothers with postnatal depression
Tsivos, Z.-L., Calam, R. M., Sanders, M. R., & Wittkowski, A. (2014) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104514531589 · Cited by 55 · see citing works
“It has good internal consistency (0.79; Wittkowski, Williams, & Wieck, 2010) and high test–retest reliability on total scale scores (0.95; Brockington et al., 2001).”
BackgroundInfluential
The association of attachment style, postpartum PTSD and depression with bonding- A longitudinal path analysis model, from childbirth to six months
Handelzalts, J. E., Levy, S., Molmen-Lichter, M., Ayers, S., Krissi, H., Wiznitzer, A., & Peled, Y. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.10.068 · Cited by 55 · see citing works
The Japanese version of the Postpartum Bonding Questionnaire: Examination of the reliability, validity, and scale structure
Suetsugu, Y., Honjo, S., Ikeda, M., & Kamibeppu, K. (2015) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2015.02.008 · Cited by 55 · see citing works
Cohort profile: the Biology, Affect, Stress, Imaging and Cognition (BASIC) study on perinatal depression in a population-based Swedish cohort
Axfors, C., Bränn, E., Henriksson, H. E., Hellgren, C., Kallak, T. K., Fransson, E., Lager, S., Iliadis, S. I., Sylvén, S. M., Papadopoulos, F. C., et al. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-031514 · Cited by 54 · see citing works
The role of maternal mental health, infant temperament, and couple’s relationship quality for mother-infant bonding
Tolja, R., Radoš, S. N., & Anđelinović, M. (2020) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646838.2020.1733503 · Cited by 54 · see citing works
Contact between mother, child and partner and attitudes towards breastfeeding in relation to mode of delivery
Carlander, A. K., Edman, G., Christensson, K., Andolf, E. G., & Wiklund, I. E. (2010) · Sexual & Reproductive Healthcare · doi:10.1016/j.srhc.2009.10.001 · Cited by 53 · see citing works
“Two self-rating instruments have recently been developed to assess maternal bonding; a self-rating questionnaire to assess the feelings of a mother towards her newborn infant namely The Mother-to-Infant Bonding Scale [4] and the screening questionnaire for mother–infant bonding disorders, The Postpartum Bonding Questi…”
Method
A psychiatric mother-baby day hospital for pregnant and postpartum women
Howard, M., Battle, C. L., Pearlstein, T. B., & Rosene‐Montella, K. (2006) · Archives of Women s Mental Health · doi:10.1007/s00737-006-0135-y · Cited by 49 · see citing works
“Evaluation consists of a semi-structured clinical assessment and administration of the Edinburgh Postnatal Depression Scale (EPDS; Cox et al, 1987), the Postpartum Bonding Instrument (Brockington et al, 2001) and a demographic questionnaire.”
Method
Child-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
Instrumentos de avaliação do vínculo entre mãe e bebê
Perrelli, J. G. A., Zambaldi, C. F., Cantilino, A., & Sougey, É. B. (2014) · Revista Paulista de Pediatria · doi:10.1590/0103-0582201432318 · Cited by 51 · see citing works
Risk And Resilience Factors Influencing Postpartum Depression And Mother-Infant Bonding During COVID-19
Kornfield, S. L., White, L. K., Waller, R. E., Njoroge, W., Barzilay, R., Chaiyachati, B. H., Himes, M. M., Rodriguez, Y., Riis, V. M., Simonette, K., et al. (2021) · Health Affairs · doi:10.1377/hlthaff.2021.00803 · Cited by 48 · see citing works
Short-term Music Therapy for Families With Preterm Infants: A Randomized Trial
Gaden, T. S., Ghetti, C., Kvestad, I., Bieleninik, Ł., Stordal, A. S., Assmus, J., Arnon, S., Elefant, C., Epstein, S., Ettenberger, M., et al. (2022) · PEDIATRICS · doi:10.1542/peds.2021-052797 · Cited by 50 · see citing works
Perceived mother‐infant relationship difficulties in postnatal depression
Loh, C., & Vostanis, P. (2004) · Infant and Child Development · doi:10.1002/icd.347 · Cited by 47 · see citing works
Self-citation
Outcomes for women admitted to a mother and baby unit: a systematic review
Wittkowski, A., & Gillham, R. (2015) · International Journal of Women s Health · doi:10.2147/ijwh.s69472 · Cited by 49 · see citing works
“Similar progress was recorded over admission with both a staff-completed scale (Bethlem Mother–Infant Interaction Scale [BMIS])(42) and self-report scale (Postpartum Bonding Questionnaire).(40,43) At admission, participants with postpartum depression rated their bonding as more problematic than participants with postp…”
Method
Longitudinal effects of dysfunctional perfectionism and avoidant personality style on postpartum mental disorders: Pathways through antepartum depression and anxiety
Oddo-Sommerfeld, S., Hain, S., Louwen, F., & Schermelleh-Engel, K. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.11.040 · Cited by 46 · see citing works
“Our effect sizes generally correspond with those found in other studies in the context of peripartum studies (see Choe et al. (2014) and Raposa et al.”
BackgroundResult
Parental Sensitivity and Responsiveness as Mediators Between Postpartum Mental Health and Bonding in Mothers and Fathers
Radoš, S. N. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.723418 · Cited by 45 · see citing works
Impact of perinatal different intrauterine environments on child growth and development in the first six months of life - IVAPSA birth cohort: rationale, design, and methods
Bernardi, J. R., Ferreira, C. F., Nunes, M., da Silva, C. H., Bosa, V. L., Silveira, P. P., & Goldani, M. Z. (2012) · BMC Pregnancy and Childbirth · doi:10.1186/1471-2393-12-25 · Cited by 46 · see citing works
“points labelled “always”, “very often”, “quite often”, “sometimes”, “rarely” and “never” [77].”
Effects of a prenatal mindfulness program on longitudinal changes in stress, anxiety, depression, and mother–infant bonding of women with a tendency to perinatal mood and anxiety disorder: a randomized controlled trial
Pan, W., Lin, L.-C., Kuo, L.-Y., Chiu, M.-J., & Ling, P. (2023) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-023-05873-2 · Cited by 44 · see citing works
“Each item is rated on a 6-point Likert scale (0 = always and 5 = never), and the PBQ includes four subscales: reflect impaired bonding (12 items), rejection and anger (7 items), anxiety about care (4 items), and risk of abuse (2 items) [40].”
Background
An examination of the psychometric properties and factor structure of the Post‐partum Bonding Questionnaire in a clinical inpatient sample
Wittkowski, A., Williams, J., & Wieck, A. (2009) · British Journal of Clinical Psychology · doi:10.1348/014466509x445589 · Cited by 44 · see citing works
“Measures The 25-item PBQ (Brockington et al., 2001; Brockington, Fraser et al., 2006) is scored on a six-point scale from 0 (‘always’) to 5 (‘never’), with some items being reverse scored.”
BackgroundMethodResultInfluential
Postpartum Bonding Disorder: Factor Structure, Validity, Reliability and a Model Comparison of the Postnatal Bonding Questionnaire in Japanese Mothers of Infants
Ohashi, Y., Kitamura, T., Sakanashi, K., & Tanaka, T. (2016) · Healthcare · doi:10.3390/healthcare4030050 · Cited by 44 · see citing works
“used a patient population, while our study used a community population [15].”
BackgroundMethodInfluential
Fear of childbirth during pregnancy: associations with observed mother-infant interactions and perceived bonding
Challacombe, F. L., Nath, S., Trevillion, K., Pawlby, S. J., & Howard, L. M. (2020) · Archives of Women s Mental Health · doi:10.1007/s00737-020-01098-w · Cited by 43 · see citing works
Maternal Bonding in Early Infancy Predicts Childrens' Social Competences in Preschool Age
Joas, J., & Möhler, E. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.687535 · Cited by 43 · see citing works
Maternal romantic attachment, and antenatal and postnatal mother–infant attachment in a sample of Polish women
Chrzan‐Dętkoś, M., & Łockiewicz, M. (2015) · European Journal of Developmental Psychology · doi:10.1080/17405629.2015.1036024 · Cited by 42 · see citing works
“PBQ by Brockington et al. (2001) was used to screen for the mother–infant bonding, or postnatal maternal attachment, which is the term we use in this paper, following Redshaw and Martin’ suggestions (2013).”
MethodResult

The Postpartum Bonding Questionnaire: a validation
Brockington, I. F., Fraser, C., & Wilson, D. (2006) · Archives of Women's Mental Health · doi:10.1007/s00737-006-0132-1 · Cited by 568 · see citing works
Self-citation
An evaluation of two bonding questionnaires: a comparison of the Mother-to-Infant Bonding Scale with the Postpartum Bonding Questionnaire in a sample of primiparous mothers
Wittkowski, A., Wieck, A., & Mann, S. (2007) · Archives of Women s Mental Health · doi:10.1007/s00737-007-0191-y · Cited by 147 · see citing works
Clinical features of bonding disorders in Japanese mothers derived from the Stafford interview
Nishikii, Y., Suetsugu, Y., Yamashita, H., & Yoshida, K. (2025) · BMC Women s Health · doi:10.1186/s12905-025-03795-z · Cited by 2 · see citing works
Impact of bonding questionnaires in an assessment of maternal–infant bonding: A review of the literature
Mason, M. (2015) · Journal of Health Visiting · doi:10.12968/johv.2015.3.8.432 · Cited by 1 · see citing works
A new Mother-to-Infant Bonding Scale: links with early maternal mood
Taylor, A., Atkins, R., Kumar, R., Adams, D., & Glover, V. (2005) · Archives of Women’s Mental Health · doi:10.1007/s00737-005-0074-z · Cited by 481 · see citing works

Authors: Brockington, I. F., Oates, J., George, S., Turner, D., Vostanis, P., Sullivan, M., Loh, C., & Murdoch, C.
Affiliations: University of Birmingham (GB)
The Open University (GB)
ORCID: Brockington, I. F.
Oates, J.
Vostanis, P.
Venue: Archives of Women's Mental Health
Publisher: Springer Science and Business Media LLC
Published: 2001-03-15
Volume: 3
Issue: 4
Pages: 133-140
ISSN: 1434-1816 (ISSN-L)
1435-1102
DOI: 10.1007/s007370170010
OpenAlex: W2060591994
Cited by: 600
References: 2
Citations by year: 2026: 42 · 2025: 48 · 2024: 48 · 2023: 55 · 2022: 54 · 2021: 56 · 2020: 44 · 2019: 41 · 2018: 33 · 2017: 15 · 2016: 19 · 2015: 26 · 2014: 24 · 2013: 20 · 2012: 18
FWCI: 2.60
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Archives of Women s Mental Health (publishedVersion)
Leicester Research Archive (University of Leicester) (submittedVersion)
Open Research Online - ORO (The Open University) (submittedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords: mother-infant bonding, screening questionnaire, scale development, maternal depression, maternal anxiety, child abuse, early diagnosis, midwives, health visitors, Edinburgh Postnatal Depression Scale

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A Screening Questionnaire for mother-infant bonding disorders

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