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Factors associated with postpartum depression and abusive behavior in mothers with infants
Authors:Hyungin Choi md  Tatsuhisa Yamashita md  phd  Yoshihisa Wada md  phd  Jin Narumoto md  phd  Hiromi Nanri ma  Akihito Fujimori ma  Haruka Yamamoto ma  Susumu Nishizawa md  Daiki Masaki phd  Kenji Fukui md  phd
Affiliation:1. Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine,;2. Kyoto Prefectural Support Center of Child Development and;3. Department of Clinical Psychology, Kyoto Bunkyo University, Kyoto, Japan
Abstract:Aims: This study was conducted to examine factors associated with postpartum depression and abusive behavior in mothers with infants. Methods: Data were collected from baby check‐ups in Japan and 413 participants were included in an analysis using: (i) an Original Questionnaire; (ii) the Zung Self‐rating Depression Scale (ZSDS); (iii) the Parental Bonding Instrument; and (iv) the Childcare Anxiety Scale (CAS). Covariance structural analyses were performed to examine interconnections among the Parental Bonding Instrument subscales, CAS subscales (‘worry about parenting’, ‘burden of nursing time’, ‘difficulty of bonding’), ZSDS, ‘fear of being abusive’, and ‘abusive behavior’. Results: Of the 413 mothers, 14.5% showed higher than moderate levels of depression (ZSDS ≥ 50). In covariance structural analyses, ‘depression’ was strongly influenced by ‘worry about parenting’ in all variances, but was not associated with ‘abusive behavior’. ‘Worry about parenting’ also had a strong influence on ‘fear of being abusive’, but did not affect ‘abusive behavior’. Low ‘maternal care’ had most influence on ‘difficulty of bonding’, and ‘difficulty of bonding’ only affected ‘abusive behavior’. Conclusions: The outcome of this study suggests that excessive worrying related to postpartum depression, ‘fear of being abusive’, and bonding difficulty are primary predictors of child abuse. Postpartum depression was not a predictor for abusive behavior after exclusion of the impact of bonding difficulties on abusive behavior. Therefore, the correlation between postpartum depression and abusive behavior identified in previous reports may have been influenced by bonding difficulties.
Keywords:bonding difficulty  child abuse  covariance structural analysis  parenting stress  postpartum depression
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