Mothers with postpartum depression with suicidal thoughts and their infant interactions

The joys of motherhood for many women can also lead other new moms to experience postpartum depression and even worse – ideas for committing suicide.

For these women contemplating taking their own lives, the mother-infant relationship and development was a negative experience, with greater mood disturbances, cognitive distortions, low maternal self-esteem, negative perceptions of their effectiveness as a new parent and noticeably less responsiveness to their infants' cues.

Those are the findings of a new two-year study by Ruth Paris, Ph.D., Assistant Professor of Clinical Practice at Boston University's School of Social Work, Rendelle E. Bolton, a graduate student at the BU School of Social Work and M. Katherine Weinberg, Ph.D., a psychologist and an infant development specialist. Their research "Postpartum Depression, Suicidality and Mother-Infant Interactions appears in the September 3rd online edition of Archives of Women's Mental Health. Postpartum depression, they note, occurs in an estimated 19 percent of new mothers and ideas of suicide is considered a common part of this serious mental health problem.

The team worked with clinicians at the Jewish Family and Children's Service Early Connections program, a home-based mother-infant psychotherapy intervention that specializes in the treatment of postpartum depression (PPD) and mood disorders. The program's key goal is to increase the mother's ability to be affectively present in her interaction with the child and to address issues that arise as result of becoming a mother.

The participating women - most of them first-time mothers in their 30s – had a wide range of suicidal thinking, as the study examined the phenomenon of suicidality and its relationship to maternal mood, perceptions and mother-infant interactions.

All the new mothers in the study suffered from depression, isolation and extreme difficulties in parenting infants. They responded to a series of pre-treatment questionnaires, self-report symptom inventories and parenting stress indices. Each of the 32 participants was also observed and videotaped twice – the first to evaluate a structured task-oriented (asking the parent to guide the infant in following a rattle) and later an unstructured interaction (how they interacted with their baby without the use any toys or other props).

To evaluate the clinical levels of the new mothers' maternal mood and psychological functioning, the women were each given the Post Partum Depression Screening Scale that assessed their postpartum psychiatric difficulties. It also included a suicidal thoughts subscale that assessed the degree to which the mother felt her baby would be better off without her, wished she leave this earth, wanted to harm herself, felt that death was the only way out and thought she would be better off dead.

Seventeen of the 32 participants (53 percent) comprised the high suicidality group and the study found that those women were experiencing more sleeping and eating problems along with greater severity in overall struggles attributable to postpartum depression.