The relationship between attachment style and postpartum depression

Although an increasing number of studies show an association between adult attachment style and mood disorders, the relationship between adult attachment style and depression associated with childbirth is largely unknown. This study investigated the association between women's attachment style, postpartum depression (PPD), and other risk factors. During the 32nd week of pregnancy, 84 women were interviewed using the Attachment Style Interview. Participants also completed self-report questionnaires about reaction to pregnancy, family relationships, current life stresses, and symptoms of depression and anxiety. At one-month postpartum, they were evaluated for postpartum depressive symptoms using the Mini-International Neuropsychiatric Interview. Eighty-two women completed the second self-report questionnaires and were evaluated for PPD. The data of 76 women were eligible for analysis. PPD was present in 21%. An insecure attachment style was significantly related to depression. A multiple logistic regression analysis showed significant effects for insecure attachment, social economic status, and antenatal depression on PPD. Adding the insecure attachment style factor to the logistic model that predicted PPD increased the area under the curve to 0.87 (95% CI .77-.98; p<.05). The inclusion of attachment styles in assessments of perinatal depressive disorders could improve screening and the design of interventions.