Predicting Maternal Attachment: The Role of Emotion Regulation and Resilience during Pregnancy

Year 2022, Volume: 6 Issue: 1, 105 - 115, 27.01.2022

Berkan Şahin

https://doi.org/10.30621/jbachs.994182

Cited By: 4

Abstract

Purpose: Evidence suggests that maternal attachment (MA) is both a developmental task of pregnancy and an indicator of compliance with pregnancy and associated with prenatal health. Understanding all aspects of attachment will contribute to improving our understanding of developing preventions.
Methods: The study design was prospective cohort study. The relationship between emotion regulation skills or psychological resilience of pregnant women in the second or third trimester period and postpartum MA was investigated. After written consent was obtained, two interviews were completed with the participants. In the first interview, Difficulties in Emotion Regulation Scale-Brief Form (DERS), Connor–Davidson Resilience Scale (CD-RISC) was applied to all participants. In the second interview, the Maternal Attachment Inventory (MAI) was applied to the participants in the 30-40 days postpartum period.
Results: Of the 120 women recruited, 77 completed two interviews. A negative correlation between MAI scores and DERS scores (p=0.001) and a positive correlation between MAI scores and CD-RISC scores (p<0.001) were found. It was performed multiple linear regression analysis to determine the best predictive factors of the MA and found individuals who breastfeed and individuals with higher resilience have higher MA. Logistic regression analysis performed to determine the best predictive factor of breast-feeding and found individuals with lower difficulties in emotion regulation breastfeed their children.
Conclusion: This study obtained evidence to suggest the psychological benefits of psychological resilience and emotion regulation skills and breast‐feeding for MA. It also found that breast‐feeding and psychological resilience predict MA in the postpartum period and emotion regulation skills predict breastfeeding.

Keywords

Emotion Regulation, Resilience, Breast Feeding, Maternal Attachment

Supporting Institution

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Project Number

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Thanks

The mothers and infants who generously participated in the study are thanked by the author.

References

• Alhusen JL. A literature update on maternal-fetal attachment. J Obstet Gynecol Neonatal Nurs. 2008; 37: 315-28.
• Alhusen JL, Hayat MJ, Gross DA. Longitudinal study of maternal attachment and infant developmental outcomes. Arch Womens Ment Health. 2013; 16: 521-29.
• Askarizadeh G, Fazilatpoor M: The role of cognitive regulation strategies of emotion, psychological hardiness and optimism in the prediction of death anxiety of women in their third trimester of pregnancy. Iranian Journal of Psychiatric Nursing. 2017; 4:50-8.
• Bjureberg J, Ljótsson B, Tull MT, et al. Development and validation of a brief version of the difficulties in emotion regulation scale: the DERS-16. J Psychopathol Behav Assess. 2016; 3: 284-296.
• Bowlby J. Attachment and loss: retrospect and prospect. Am J Orthopsychiatry. 1982; 52: 664.
• Bridges LJ, Denham SA, Ganiban JM. Definitional issues in emotion regulation research. Child Dev. 2004; 75: 340-45.
• Cetisli NE, Arkan G, Top ED. Maternal attachment and breastfeeding behaviors according to type of delivery in the immediate postpartum period. Rev Assoc Med Bras. 2018; 64: 164-69.
• Cinar N, Köse D, Altinkaynak S. The relationship between maternal attachment, perceived social support and breast-feeding sufficiency. J Coll Physicians Surg Pak. 2015; 25: 271-75.
• Connor KM, Davidson JR. Development of a new resilience scale: The Connor‐Davidson resilience scale (CD‐RISC). Depress Anxiety. 2003; 18: 76-82.
• Flykt M, Kanninen K, Sinkkonen J, Punamäki RL. Maternal depression and dyadic interaction: The role of maternal attachment style. Infant Child Dev. 2010; 19: 530-50.
• Gagnon AJ, Stewart DE. Resilience in international migrant women following violence associated with pregnancy. Arch Womens Ment Health. 2014; 17: 303-10.
• Gross JJ, Jazaieri H. Emotion, emotion regulation, and psychopathology: An affective science perspective. Clin Psychol Sci. 2014; 2: 387-401.
• Haddadi P, Besharat MA. Resilience, vulnerability and mental health. Procedia Soc Behav Sci. 2010; 5: 639-42.
• Herguner S, Çiçek E, Annagur A, Herguner A, Ors R. Association of Delivery Type with Postpartum Depression, Perceived Social Support and Maternal Attachment. Dusunen Adam. 2014; 27: 15.
• Karaırmak Ö. Establishing the psychometric qualities of the Connor–Davidson Resilience Scale (CD-RISC) using exploratory and confirmatory factor analysis in a trauma survivor sample. Psychiatry Res. 2010; 179: 350-56.
• Kavlak O, Şirin A. The Turkish version of Maternal Attachment Inventory. International Journal of Human Sciences. 2009; 6: 188-202.
• Kim SH, Kim SH. Factors associated with maternal attachment of breastfeeding mothers. Child Health Nurs Res. 2019; 25: 65-73.
• Kokanalı D, Ayhan S, Devran A, Kokanalı MK, Taşçı Y. Effect of cesarean section on postpartum depression and maternal attachment. J Contemp Med. 2018; 8: 148-52.
• Maas AJB, Vreeswijk CM, Braeken J, Vingerhoets AJ, Van Bakel HJ. Determinants of maternal fetal attachment in women from a community-based sample. J Reprod Infant Psychol. 2014; 32: 5-24.
• Maddi SR. Hardiness: Turning stressful circumstances into resilient growth: Springer science & Business media; 2012.
• Mautner E, Stern C, Deutsch M, et al. The impact of resilience on psychological outcomes in women after preeclampsia: an observational cohort study. Health Qual Life Outcomes. 2013; 11: 194.
• McFarland J, Salisbury AL, Battle CL, Hawes K, Halloran K, Lester BM. Major depressive disorder during pregnancy and emotional attachment to the fetus. Arch Womens Ment Health. 2011; 14: 425.
• Müller ME. A questionnaire to measure mother-to-infant attachment. J Nurs Meas. 1994; 2: 129-41.
• Orr ST, Blazer DG, James SA, Reiter JP. Depressive symptoms and indicators of maternal health status during pregnancy. J Women's Health. 2007; 16: 535-542.
• Pearson R, Cooper R, Penton-Voak I, Lightman S, Evans J. Depressive symptoms in early pregnancy disrupt attentional processing of infant emotion. Psychol Med. 2010; 40: 621-31.
• Roos A, Faure S, Lochner C, Vythilingum B, Stein D. Predictors of distress and anxiety during pregnancy. Afr J Psychiatry. 2013; 16: 118-22.
• Sarıtaş-Atalar D, Gençöz T, Özen A. Confirmatory factor analyses of the difficulties in emotion regulation scale (DERS) in a Turkish adolescent sample. Eur J Psychol Assess. 2015; 31: 12-9.
• Shieh C, Kravitz M, Wang HH. What do we know about maternal-fetal attachment? Kaohsiung J Med Sci. 2001; 17: 448-54.
• Shokoohi-Yekta M, Alavinezhad S, Sajjadi S. Maternal fetal attachment: during and after pregnancy. Rooyesh-e-Ravanshenasi Journal. 2019; 7: 97-118.
• Siddiqui A, Hägglöf B. Does maternal prenatal attachment predict postnatal mother–infant interaction? Early Hum Dev. 2000; 59: 13-25.
• Śliwerski A, Kossakowska K, Jarecka K, Świtalska J, Bielawska-Batorowicz E. The effect of maternal depression on infant attachment: a systematic review. Int J Env Res Pub He. 2020; 17: 2675.
• Tilokskulchai F, Phatthanasiriwethin S, Vichitsukon K, Serisathien Y. Attachment behaviors in mothers of premature infants: a descriptive study in Thai mothers. J Perinat Neonatal Nurs. 2002; 16: 69-83.
• Tobe H, Kita S, Hayashi M, Umeshita K, Kamibeppu K. Mediating effect of resilience during pregnancy on the association between maternal trait anger and postnatal depression. Compr Psychiatry. 2020; 152190: 1-8.
• Walsh J, Hepper EG, Bagge SR, Wadephul F, Jomeen J. Maternal–fetal relationships and psychological health: emerging research directions. J Reprod Infant Psychol. 2013; 31: 490-99.
• Wilkinson RB, Scherl FB. Psychological health, maternal attachment and attachment style in breast‐and formula‐feeding mothers: a preliminary study. J Reprod Infant Psychol. 2006; 24: 5-19.
• Yiğit İ, Yiğit MG. Psychometric properties of Turkish version of difficulties in emotion regulation scale-brief form (DERS-16). Curr Psychol. 2019; 38: 1503-1511.