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Behavioral Sciences
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Perinatal Depressive and Affective Disorders: Assessment, Screening and Treatment
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Perinatal Depressive and Affective Disorders: Assessment, Screening and Treatment

A special issue of Behavioral Sciences (ISSN 2076-328X). This special issue belongs to the section "Psychiatric, Emotional and Behavioral Disorders".

Deadline for manuscript submissions: closed (30 June 2024) | Viewed by 26631

Special Issue Editor

Dr. Franco Baldoni

E-Mail Website
Guest Editor
Department of Psychology, University of Bologna, 40127 Bologna, Italy
Interests: attachment; father; psychosomatics; perinatally; psychotherapy; mentalization; perinatal affective disorders
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The birth of a child is an event that triggers significant changes on an emotional, relational, and existential level, which can expose both parents to adaptation problems and psychological difficulties. Although the scientific literature on post-partum maternal depression has been extensive for decades, only recently has research been dedicated to paternal perinatal depression with the aim of evaluating its clinical manifestations, epidemiology, relationship with maternal depression and its influence on the psychophysical development of the child.

Despite the methodological difficulties encountered in research on men, meta-analyses in this area have shown that fathers suffer from perinatal depression almost as much as mothers but tend to express their difficulties differently. Contemporary research, in fact, has highlighted the need to assess perinatal distress using gender-specific tools for mothers and fathers [1,2]. It is essential to develop new instruments to evaluate a broad range of depressive equivalents in order to increase the sensitivity and specificity of the screening.

Furthermore, given the frequent comorbidity of anxiety disorders with depressive disorders in both parents and the frequent onset of symptoms in the prenatal period, the correct diagnostic definitions should be Paternal Perinatal Affective Disorder (PPAD) in the father and Maternal Perinatal Affective Disorder (MPAD) in the mother.

Prevention and treatment protocols for these disorders are still poorly explored within the field, especially in fathers. In these cases, it is necessary to consider not only the individual difficulties, but also the couple dynamics and the attachment relationship between the partners.

This Special Issue of Behavioral Sciences, entitled “Perinatal Depressive and Affective Disorders: Assessment, Screening and Treatment”, aims to present the latest research in this area.

[1] Walsh, T.B.; Davis, R.N.; Garfield, C. A Call to Action: Screening Fathers for Perinatal Depression. Pediatrics 2020, 145, https://doi.org/10.1542/peds.2019-1193.

[2] Baldoni, F.; Giannotti, M. Perinatal Distress in Fathers: Toward a Gender-Based Screening of Paternal Perinatal Depressive and Affective Disorders. Front. Psychol. 2020, 11, https://doi.org/10.3389/fpsyg.2020.01892.

Prof. Dr. Franco Baldoni
Guest Editor

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Keywords

  • perinatal
  • father
  • mother
  • parents
  • depression
  • affective disorders
  • attachment
  • pregnancy
  • screening
  • assessment
  • treatment
  • prevention

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Published Papers (7 papers)

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Research

Jump to: Review, Other

21 pages, 325 KiB  
Article
“VID-KIDS” Video-Feedback Interaction Guidance for Depressed Mothers and Their Infants: Results of a Randomized Controlled Trial
by Panagiota D. Tryphonopoulos, Deborah McNeil, Monica Oxford, Cindy-Lee Dennis, Jason Novick, Andrea J. Deane, Kelly Wu, Stefan Kurbatfinski, Keira Griggs and Nicole Letourneau
Behav. Sci. 2025, 15(3), 279; https://doi.org/10.3390/bs15030279 - 27 Feb 2025
Viewed by 629
Abstract
VID-KIDS (Video-Feedback Interaction Guidance for Depressed Mothers and their Infants) is a positive parenting programme comprising three brief nurse-guided video-feedback sessions (offered in-person or virtually via Zoom) that promote “serve and return” interactions by helping depressed mothers to be more sensitive and responsive [...] Read more.
VID-KIDS (Video-Feedback Interaction Guidance for Depressed Mothers and their Infants) is a positive parenting programme comprising three brief nurse-guided video-feedback sessions (offered in-person or virtually via Zoom) that promote “serve and return” interactions by helping depressed mothers to be more sensitive and responsive to infant cues. We examined whether mothers who received the VID-KIDS programme demonstrated improved maternal–infant interaction quality. The secondary hypotheses examined VID-KIDS’ effects on maternal depression, anxiety, perceived parenting stress, infant developmental outcomes, and infant cortisol patterns. A parallel group randomized controlled trial (n = 140) compared the VID-KIDS programme to standard care controls (e.g., a resource and referral programme). The trial was registered in the US Clinical Trials Registry (number NCT03052374). Outcomes were assessed at baseline, nine weeks post-randomization (immediate post-test), and two months post-intervention. Maternal–infant interaction quality significantly improved for the intervention group with moderate to large effects. These improvements persisted during the post-test two months after the final video-feedback session. No significant group differences were detected for secondary outcomes. This study demonstrated that nurse-guided video-feedback can improve maternal–infant interaction in the context of PPD. These findings are promising, as sensitive and responsive parenting is crucial for promoting children’s healthy development. Full article
(This article belongs to the Special Issue Perinatal Depressive and Affective Disorders: Assessment, Screening and Treatment)
12 pages, 289 KiB  
Article
Maternal Perinatal Depression, Alexithymia, and Couple Functioning: Which Relationship Exists with Prenatal Attachment
by Sonia Mangialavori, Andrea Fontana, Grazia Terrone, Eleonora Topino, Lucrezia Trani, Valeria Trincia, Giulia Lisi, Giuseppe Ducci and Marco Cacioppo
Behav. Sci. 2024, 14(9), 773; https://doi.org/10.3390/bs14090773 - 2 Sep 2024
Viewed by 1875
Abstract
Background: Prenatal attachment refers to the affective investment that parents develop towards their unborn baby during pregnancy. Studies have identified depressive symptoms, affect dysregulation, and poor marital adjustment as potential risk factors for poor prenatal attachment. However, no research has concurrently examined these [...] Read more.
Background: Prenatal attachment refers to the affective investment that parents develop towards their unborn baby during pregnancy. Studies have identified depressive symptoms, affect dysregulation, and poor marital adjustment as potential risk factors for poor prenatal attachment. However, no research has concurrently examined these factors. This study aims to explore the simultaneous impact of depressive symptomatology, alexithymia, and couple functioning on prenatal attachment to develop a more comprehensive understanding of the factors shaping the emotional bond between expectant mothers and their fetuses. Methods: This cross-sectional study involved 344 women (mean age = 34.1, SD = 4.6) in their last trimester of pregnancy recruited from the National Health System. The participants completed the Edinburgh Postnatal Depression Scale, the Twenty-Item Toronto Alexithymia Scale, the Dyadic Adjustment Scale, and the Maternal Antenatal Attachment Scale. Results: Regression analyses indicated that perinatal depression and alexithymia negatively affected the Quality of Prenatal Attachment, while Dyadic Cohesion served as a protective factor. Conclusions: The results emphasize the need for early identification of perinatal depression and alexithymia, along with targeted interventions aimed at supporting Dyadic Cohesion during pregnancy. These efforts are crucial for fostering positive prenatal attachment and enhancing maternal mental health. Full article
(This article belongs to the Special Issue Perinatal Depressive and Affective Disorders: Assessment, Screening and Treatment)
11 pages, 658 KiB  
Article
Evaluating the Impact of Obsessive-Compulsive Symptoms and Personality Types on Perinatal Depressive Symptoms
by Oana Neda-Stepan, Cătălina Giurgi-Oncu, Andreea Sălcudean, Elena Bernad, Brenda-Cristiana Bernad, Estera Boeriu and Virgil Radu Enătescu
Behav. Sci. 2024, 14(7), 589; https://doi.org/10.3390/bs14070589 - 11 Jul 2024
Cited by 1 | Viewed by 1400
Abstract
Perinatal depression (PPD) presents a significant public health concern, often influenced by psychological and personality factors. This study investigated the impact of personality traits, particularly neuroticism, and obsessive-compulsive disorder (OCD) symptoms on the severity of PPD. The primary aim was to quantify the [...] Read more.
Perinatal depression (PPD) presents a significant public health concern, often influenced by psychological and personality factors. This study investigated the impact of personality traits, particularly neuroticism, and obsessive-compulsive disorder (OCD) symptoms on the severity of PPD. The primary aim was to quantify the contributions of these factors to the risk and severity of PPD to enhance early intervention strategies. A total of 47 pregnant women with depressive symptoms per DSM-5 criteria at “Pius Brinzeu” County Emergency Hospital in Timisoara, Romania, were enrolled in this cross-sectional study, as well as 49 women without depressive symptoms as controls. Personality traits were assessed using the NEO Five-Factor Inventory (NEO-FFI), and OCD symptoms were measured using the Obsessive-Compulsive Inventory (OCI). Depression severity was evaluated using the Edinburgh Postnatal Depression Scale (EPDS). This set of questionnaires were administered antepartum and postpartum. The logistic regression analysis highlighted neuroticism as a significant predictor of PPD severity, with an increase in neuroticism associated with a higher risk of PPD (coefficient = 0.24, p < 0.001). Conversely, openness showed a protective effect (coefficient = −0.13, p = 0.009). Higher OCD symptomatology, particularly ordering and hoarding, were linked with increased depression scores. Specifically, the total OCI score significantly predicted the EPDS score (coefficient = 0.03, p = 0.003). Furthermore, significant increases in EPDS anxiety and depression scores were observed in the perinatal period, indicating worsening of symptoms (anxiety coefficient = 0.51; p < 0.001). The findings suggest that personality traits like neuroticism and OCD symptoms significantly contribute to the severity of PPD. Interventions targeting these specific traits could potentially mitigate the risk and severity of perinatal depression, underscoring the need for personalized treatment plans that consider these psychological dimensions. Full article
(This article belongs to the Special Issue Perinatal Depressive and Affective Disorders: Assessment, Screening and Treatment)
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16 pages, 285 KiB  
Article
Perinatal Loss and Parents’ Grief Amidst the COVID-19 Pandemic: A Mixed-Method Research
by Ciro De Vincenzo, Loredana Cena, Alice Trainini, Chiara Nieddu, Erika Iacona, Lucia Ronconi and Ines Testoni
Behav. Sci. 2024, 14(4), 339; https://doi.org/10.3390/bs14040339 - 18 Apr 2024
Cited by 1 | Viewed by 2465
Abstract
Losing a child is a traumatic event, disrupting life’s natural cycle, profoundly affecting the family system, and causing enduring grief. Perinatal death, including ectopic pregnancies, miscarriages, stillbirths, and neonatal deaths, exacerbates this distress. Additionally, the COVID-19 pandemic has challenged healthcare systems and supporting [...] Read more.
Losing a child is a traumatic event, disrupting life’s natural cycle, profoundly affecting the family system, and causing enduring grief. Perinatal death, including ectopic pregnancies, miscarriages, stillbirths, and neonatal deaths, exacerbates this distress. Additionally, the COVID-19 pandemic has challenged healthcare systems and supporting services available to individuals in need. Thus, this research explores experiences of parents facing perinatal loss in 2020–2021, further focusing on the pandemic’s impact. Using a mixed-methods design with self-reports and qualitative interviews, this paper presents results from the quantitative protocol, involving an update and follow-up of a previous study. It compares measurements across scales: COVID-19: The Impact of Event Scale-Revised; The Prolonged Grief-13; The Parental Assessment of Paternal/Maternal Affectivity; The Dyadic Adjustment Scale (short version); The Daily Spiritual Experiences Scale; and The Inventory of Complicated Spiritual Grief. In the baseline measurement, 45 parents participated (37 mothers and 8 fathers), with 20 (13 mothers and 7 fathers) contributing to the follow-up and 9 engaging in interviews. Baseline results showed higher scores for mothers compared to fathers, with effect sizes ranging from small to medium (ranging from −0.02 to 0.29), though statistical significance was limited due to the small sample size. Multiple regression analysis for distress measures at baseline identified two significant predictors: maternal/paternal affectivity and gestational week. Additionally, positive support from healthcare professionals emerged as a mitigating factor, particularly in relation to Avoidance. A significant reduction in stress measures and parental affectivity was observed at the 6-month follow-up. Qualitative analysis revealed three themes: Shifts in Self-Perception and Post-Loss Growth; Conflicted Relationship with One’s Body; and Negative Impact of COVID-19 vs. Unexpectedly Positive Aspects. In conclusion, the findings emphasize the significance of psychological and psychosocial interventions based on meaning-making processes, along with the importance of spiritual care and empowerment for those navigating perinatal loss. Full article
(This article belongs to the Special Issue Perinatal Depressive and Affective Disorders: Assessment, Screening and Treatment)
14 pages, 673 KiB  
Article
The Association between Cesarean Section Delivery and Child Behavior: Is It Mediated by Maternal Post-Traumatic Stress Disorder and Maternal Postpartum Depression?
by Marie-Andrée Grisbrook, Deborah Dewey, Colleen Cuthbert, Sheila McDonald, Henry Ntanda and Nicole Letourneau
Behav. Sci. 2024, 14(1), 61; https://doi.org/10.3390/bs14010061 - 17 Jan 2024
Cited by 1 | Viewed by 10087
Abstract
Cesarean sections (C-sections) account for up to 21% of births worldwide. Studies have linked delivery via C-section with an increased risk of child behavior problems, such as internalizing and externalizing behaviors. Maternal postpartum depression (PPD) is also linked to child behavioral problems and [...] Read more.
Cesarean sections (C-sections) account for up to 21% of births worldwide. Studies have linked delivery via C-section with an increased risk of child behavior problems, such as internalizing and externalizing behaviors. Maternal postpartum depression (PPD) is also linked to child behavioral problems and may play a mediating role in the association between the mode of delivery and child behavior. Mixed findings between mode of delivery and PPD may be due to a failure to distinguish between C-section types, as unplanned/emergency C-sections are linked to post-traumatic stress disorder (PTSD), which has been linked to PPD. The objectives of this study were to determine whether, (1) compared with spontaneous vaginal delivery (SVD) and planned C-section, unplanned/emergency C-sections are associated with increased child behavior problems at two to three years of age and (2) maternal PTSD and PPD mediate the association between delivery type and child behavior problems. A secondary data analysis was conducted on 938 mother–child dyads enrolled in the Alberta Pregnancy Outcomes and Nutrition (APrON) study. Conditional process modeling was employed. Child behavior was assessed using the Child Behavior Checklist (CBCL) 1.5–5 years, and maternal PPD and PTSD were assessed using the Edinburgh Postnatal Depression Scale (EPDS) and the Psychiatric Diagnostic Screening Questionnaire (PDSQ), respectively. No associations were found between delivery type and child behaviors; however, the indirect effect of emergency C-section on child behaviors was significant via the mediating pathway of maternal PTSD on PPD symptoms. Full article
(This article belongs to the Special Issue Perinatal Depressive and Affective Disorders: Assessment, Screening and Treatment)
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Review

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17 pages, 724 KiB  
Review
Skin-to-Skin Care and Spontaneous Touch by Fathers in Full-Term Infants: A Systematic Review
by Laura Cordolcini, Annalisa Castagna, Eleonora Mascheroni and Rosario Montirosso
Behav. Sci. 2024, 14(1), 60; https://doi.org/10.3390/bs14010060 - 17 Jan 2024
Cited by 3 | Viewed by 3821
Abstract
A series of studies have shown that mothers’ early tactile behaviors have positive effects, both on full-term and preterm infants, and on mothers alike. Regarding fathers, research has focused mostly on paternal skin-to-skin care with preterm infants and has overlooked the tactile behavior [...] Read more.
A series of studies have shown that mothers’ early tactile behaviors have positive effects, both on full-term and preterm infants, and on mothers alike. Regarding fathers, research has focused mostly on paternal skin-to-skin care with preterm infants and has overlooked the tactile behavior effects with full-term newborns on infants’ outcomes and on fathers themselves. The current systematic review considered the evidence regarding paternal tactile behaviors with full-term infants, including skin-to-skin care (SSC) and spontaneous touch (ST), during parent–infant interactions, and differentiated biophysiological, behavioral and psychological variables both in fathers and in infants. We also compared fathers’ and mothers’ tactile behaviors for potential differences. The few available studies suggest that paternal touch—SSC and ST—can have positive effects on fathers and infants alike. They also show that, despite some intrinsic differences, paternal touch is as pleasant as maternal touch. However, given the paucity of studies on the topic, we discuss why this field of research should be further explored. Full article
(This article belongs to the Special Issue Perinatal Depressive and Affective Disorders: Assessment, Screening and Treatment)
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Other

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13 pages, 469 KiB  
Systematic Review
Advanced Maternal Age: A Scoping Review about the Psychological Impact on Mothers, Infants, and Their Relationship
by Monica Ahmad, Cristina Sechi and Laura Vismara
Behav. Sci. 2024, 14(3), 147; https://doi.org/10.3390/bs14030147 - 20 Feb 2024
Cited by 6 | Viewed by 5609
Abstract
The mean age at childbirth in Europe has gradually increased, and it is now around 29 years of age. It has been shown that older maternal age is associated with problems of fertility; in fact, with increasing age, the chance of conceiving diminishes, [...] Read more.
The mean age at childbirth in Europe has gradually increased, and it is now around 29 years of age. It has been shown that older maternal age is associated with problems of fertility; in fact, with increasing age, the chance of conceiving diminishes, and fetal and obstetric complications grow. Research has focused particularly on the biological risks associated with late pregnancy, both for the child and the woman. Less space has been dedicated to the potential psychological and relational benefits of motherhood at an advanced age. The aim of this review was to summarize the existing literature on this issue. Qualitative and quantitative studies were sourced from Pubmed, Science Direct, PsycINFO, and SciELO. The selected works highlight that advanced maternal age can be associated with some advantages for both mothers and their offspring in terms of physical healthcare, parenting styles, and child developmental outcomes. Specifically, the review suggests that older mothers have greater emotional maturity and feel more prepared for motherhood; also, advanced maternal age appears to exert a protective influence on children’s behavioral, social, and emotional functioning, compensating for the biological risks. Full article
(This article belongs to the Special Issue Perinatal Depressive and Affective Disorders: Assessment, Screening and Treatment)
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