Major depression as a predictor of the intergenerational transmission of attachment security: Findings from a pregnancy cohort study

Megan Galbally; Stuart J. Watson; Anne Tharner; Maartje Luijk; Gaynor Blankley; Kelli K. MacMillan; Josephine Power; Andrew J. Lewis

doi:10.1177/00048674211060749

Major depression as a predictor of the intergenerational transmission of attachment security: Findings from a pregnancy cohort study

Megan Galbally^*, Stuart J. Watson, Anne Tharner, Maartje Luijk, Gaynor Blankley, Kelli K. MacMillan, Josephine Power, Andrew J. Lewis

^*Corresponding author for this work

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Abstract

Objective: Understanding the relationship between attachment and mental health has an important role in informing management of perinatal mental disorders and for infant mental health. It has been suggested that experiences of attachment are transmitted from one generation to the next. Maternal sensitivity has been proposed as a mediator, although findings have not been as strong as hypothesised. A meta-analysis suggested that this intergenerational transmission of attachment may vary across populations with lower concordance between parent and infant attachment classifications in clinical compared to community samples. However, no previous study has examined major depression and adult attachment in pregnancy as predictors of infant–parent attachment classification at 12 months postpartum. Methods: Data were obtained on 52 first-time mothers recruited in early pregnancy, which included 22 women who met diagnostic criteria for current major depression using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders. The Adult Attachment Interview was also administered before 20 weeks of pregnancy. A history of early trauma was measured using the Childhood Trauma Questionnaire and maternal sensitivity was measured at 6 months postpartum using the observational measure of the Emotional Availability Scales. Infant–parent attachment was measured using the Strange Situation Procedure at 12 months. Results: Overall, we found no significant association between the Adult Attachment Interview and the Strange Situation Procedure classifications. However, a combination of maternal non-autonomous attachment on the Adult Attachment Interview and major depression was a significant predictor of insecure attachment on the Strange Situation Procedure. We did not find that maternal sensitivity mediated parental and infant attachment security in this sample. Conclusion: While previous meta-analyses identified lower concordance in clinical samples, our findings suggest women with major depression and non-autonomous attachment have a greater concordance with insecure attachment on the Strange Situation Procedure. These findings can guide future research and suggest a focus on depression in pregnancy may be important for subsequent infant attachment.

Original language	English
Pages (from-to)	1006-1016
Number of pages	11
Journal	Australian and New Zealand Journal of Psychiatry
Volume	56
Issue number	8
Early online date	29 Nov 2021
DOIs	https://doi.org/10.1177/00048674211060749
Publication status	Published - Aug 2022

Bibliographical note

Funding Information:
The authors would like to thank those who have supported the development of MPEWS including Michael Permezel, Marinus van IJzendoorn and Marian Bakermans-Kranenburg. The authors also thank staff, students and volunteers on the MPEWS study as well as study co-ordinators: Nicole Brooks and Tina Vaiano for their contribution to MPEWS. Thank you to Deane Dozier for her assistance with coding the AAIs. We are also sincerely grateful to the study participants who have contributed a substantial amount of time to participating in this study. The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This study is supported through the 2012 National Priority Founding Round of Beyondblue in a 3-year research grant (ID 519240), a 2015 National Health and Medical Research Council (NHMRC) project grant for 5 years (APP1106823) and a 2015 RANZJP Pat, Toni and Peter Kinsman Research Scholarship awarded to Dr Josephine Power. Financial support has also been obtained from the Academic Research and Development Grants, Mercy Health and Centre for Mental Health and Well-Being, Deakin University.

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This study is supported through the 2012 National Priority Founding Round of Beyondblue in a 3-year research grant (ID 519240), a 2015 National Health and Medical Research Council (NHMRC) project grant for 5 years (APP1106823) and a 2015 RANZJP Pat, Toni and Peter Kinsman Research Scholarship awarded to Dr Josephine Power. Financial support has also been obtained from the Academic Research and Development Grants, Mercy Health and Centre for Mental Health and Well-Being, Deakin University.

Publisher Copyright:
© The Royal Australian and New Zealand College of Psychiatrists 2021.

Funding

The authors would like to thank those who have supported the development of MPEWS including Michael Permezel, Marinus van IJzendoorn and Marian Bakermans-Kranenburg. The authors also thank staff, students and volunteers on the MPEWS study as well as study co-ordinators: Nicole Brooks and Tina Vaiano for their contribution to MPEWS. Thank you to Deane Dozier for her assistance with coding the AAIs. We are also sincerely grateful to the study participants who have contributed a substantial amount of time to participating in this study. The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This study is supported through the 2012 National Priority Founding Round of Beyondblue in a 3-year research grant (ID 519240), a 2015 National Health and Medical Research Council (NHMRC) project grant for 5 years (APP1106823) and a 2015 RANZJP Pat, Toni and Peter Kinsman Research Scholarship awarded to Dr Josephine Power. Financial support has also been obtained from the Academic Research and Development Grants, Mercy Health and Centre for Mental Health and Well-Being, Deakin University. The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This study is supported through the 2012 National Priority Founding Round of Beyondblue in a 3-year research grant (ID 519240), a 2015 National Health and Medical Research Council (NHMRC) project grant for 5 years (APP1106823) and a 2015 RANZJP Pat, Toni and Peter Kinsman Research Scholarship awarded to Dr Josephine Power. Financial support has also been obtained from the Academic Research and Development Grants, Mercy Health and Centre for Mental Health and Well-Being, Deakin University.

Funders	Funder number
AAIS
Michael Permezel, Marinus van IJzendoorn
Marian Bakermans-Kranenburg
Deakin University
National Health and Medical Research Council	APP1106823, 519240, 1106823

Keywords

attachment
Depression
maternal sensitivity
trauma

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1177/00048674211060749

Major depression as a predictor of the intergenerational transmission of attachment securityFinal published version, 257 KBLicence: Article 25fa Dutch Copyright Act

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@article{2f2e58dfe9564f6c9135ce9a04aaf4b3,

title = "Major depression as a predictor of the intergenerational transmission of attachment security: Findings from a pregnancy cohort study",

abstract = "Objective: Understanding the relationship between attachment and mental health has an important role in informing management of perinatal mental disorders and for infant mental health. It has been suggested that experiences of attachment are transmitted from one generation to the next. Maternal sensitivity has been proposed as a mediator, although findings have not been as strong as hypothesised. A meta-analysis suggested that this intergenerational transmission of attachment may vary across populations with lower concordance between parent and infant attachment classifications in clinical compared to community samples. However, no previous study has examined major depression and adult attachment in pregnancy as predictors of infant–parent attachment classification at 12 months postpartum. Methods: Data were obtained on 52 first-time mothers recruited in early pregnancy, which included 22 women who met diagnostic criteria for current major depression using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders. The Adult Attachment Interview was also administered before 20 weeks of pregnancy. A history of early trauma was measured using the Childhood Trauma Questionnaire and maternal sensitivity was measured at 6 months postpartum using the observational measure of the Emotional Availability Scales. Infant–parent attachment was measured using the Strange Situation Procedure at 12 months. Results: Overall, we found no significant association between the Adult Attachment Interview and the Strange Situation Procedure classifications. However, a combination of maternal non-autonomous attachment on the Adult Attachment Interview and major depression was a significant predictor of insecure attachment on the Strange Situation Procedure. We did not find that maternal sensitivity mediated parental and infant attachment security in this sample. Conclusion: While previous meta-analyses identified lower concordance in clinical samples, our findings suggest women with major depression and non-autonomous attachment have a greater concordance with insecure attachment on the Strange Situation Procedure. These findings can guide future research and suggest a focus on depression in pregnancy may be important for subsequent infant attachment.",

keywords = "attachment, Depression, maternal sensitivity, trauma",

author = "Megan Galbally and Watson, \{Stuart J.\} and Anne Tharner and Maartje Luijk and Gaynor Blankley and MacMillan, \{Kelli K.\} and Josephine Power and Lewis, \{Andrew J.\}",

note = "Funding Information: The authors would like to thank those who have supported the development of MPEWS including Michael Permezel, Marinus van IJzendoorn and Marian Bakermans-Kranenburg. The authors also thank staff, students and volunteers on the MPEWS study as well as study co-ordinators: Nicole Brooks and Tina Vaiano for their contribution to MPEWS. Thank you to Deane Dozier for her assistance with coding the AAIs. We are also sincerely grateful to the study participants who have contributed a substantial amount of time to participating in this study. The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This study is supported through the 2012 National Priority Founding Round of Beyondblue in a 3-year research grant (ID 519240), a 2015 National Health and Medical Research Council (NHMRC) project grant for 5 years (APP1106823) and a 2015 RANZJP Pat, Toni and Peter Kinsman Research Scholarship awarded to Dr Josephine Power. Financial support has also been obtained from the Academic Research and Development Grants, Mercy Health and Centre for Mental Health and Well-Being, Deakin University. Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This study is supported through the 2012 National Priority Founding Round of Beyondblue in a 3-year research grant (ID 519240), a 2015 National Health and Medical Research Council (NHMRC) project grant for 5 years (APP1106823) and a 2015 RANZJP Pat, Toni and Peter Kinsman Research Scholarship awarded to Dr Josephine Power. Financial support has also been obtained from the Academic Research and Development Grants, Mercy Health and Centre for Mental Health and Well-Being, Deakin University. Publisher Copyright: {\textcopyright} The Royal Australian and New Zealand College of Psychiatrists 2021.",

year = "2022",

month = aug,

doi = "10.1177/00048674211060749",

language = "English",

volume = "56",

pages = "1006--1016",

journal = "Australian and New Zealand Journal of Psychiatry",

issn = "0004-8674",

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T1 - Major depression as a predictor of the intergenerational transmission of attachment security

T2 - Findings from a pregnancy cohort study

AU - Galbally, Megan

AU - Watson, Stuart J.

AU - Tharner, Anne

AU - Luijk, Maartje

AU - Blankley, Gaynor

AU - MacMillan, Kelli K.

AU - Power, Josephine

AU - Lewis, Andrew J.

N1 - Funding Information: The authors would like to thank those who have supported the development of MPEWS including Michael Permezel, Marinus van IJzendoorn and Marian Bakermans-Kranenburg. The authors also thank staff, students and volunteers on the MPEWS study as well as study co-ordinators: Nicole Brooks and Tina Vaiano for their contribution to MPEWS. Thank you to Deane Dozier for her assistance with coding the AAIs. We are also sincerely grateful to the study participants who have contributed a substantial amount of time to participating in this study. The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This study is supported through the 2012 National Priority Founding Round of Beyondblue in a 3-year research grant (ID 519240), a 2015 National Health and Medical Research Council (NHMRC) project grant for 5 years (APP1106823) and a 2015 RANZJP Pat, Toni and Peter Kinsman Research Scholarship awarded to Dr Josephine Power. Financial support has also been obtained from the Academic Research and Development Grants, Mercy Health and Centre for Mental Health and Well-Being, Deakin University. Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This study is supported through the 2012 National Priority Founding Round of Beyondblue in a 3-year research grant (ID 519240), a 2015 National Health and Medical Research Council (NHMRC) project grant for 5 years (APP1106823) and a 2015 RANZJP Pat, Toni and Peter Kinsman Research Scholarship awarded to Dr Josephine Power. Financial support has also been obtained from the Academic Research and Development Grants, Mercy Health and Centre for Mental Health and Well-Being, Deakin University. Publisher Copyright: © The Royal Australian and New Zealand College of Psychiatrists 2021.

PY - 2022/8

Y1 - 2022/8

N2 - Objective: Understanding the relationship between attachment and mental health has an important role in informing management of perinatal mental disorders and for infant mental health. It has been suggested that experiences of attachment are transmitted from one generation to the next. Maternal sensitivity has been proposed as a mediator, although findings have not been as strong as hypothesised. A meta-analysis suggested that this intergenerational transmission of attachment may vary across populations with lower concordance between parent and infant attachment classifications in clinical compared to community samples. However, no previous study has examined major depression and adult attachment in pregnancy as predictors of infant–parent attachment classification at 12 months postpartum. Methods: Data were obtained on 52 first-time mothers recruited in early pregnancy, which included 22 women who met diagnostic criteria for current major depression using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders. The Adult Attachment Interview was also administered before 20 weeks of pregnancy. A history of early trauma was measured using the Childhood Trauma Questionnaire and maternal sensitivity was measured at 6 months postpartum using the observational measure of the Emotional Availability Scales. Infant–parent attachment was measured using the Strange Situation Procedure at 12 months. Results: Overall, we found no significant association between the Adult Attachment Interview and the Strange Situation Procedure classifications. However, a combination of maternal non-autonomous attachment on the Adult Attachment Interview and major depression was a significant predictor of insecure attachment on the Strange Situation Procedure. We did not find that maternal sensitivity mediated parental and infant attachment security in this sample. Conclusion: While previous meta-analyses identified lower concordance in clinical samples, our findings suggest women with major depression and non-autonomous attachment have a greater concordance with insecure attachment on the Strange Situation Procedure. These findings can guide future research and suggest a focus on depression in pregnancy may be important for subsequent infant attachment.

AB - Objective: Understanding the relationship between attachment and mental health has an important role in informing management of perinatal mental disorders and for infant mental health. It has been suggested that experiences of attachment are transmitted from one generation to the next. Maternal sensitivity has been proposed as a mediator, although findings have not been as strong as hypothesised. A meta-analysis suggested that this intergenerational transmission of attachment may vary across populations with lower concordance between parent and infant attachment classifications in clinical compared to community samples. However, no previous study has examined major depression and adult attachment in pregnancy as predictors of infant–parent attachment classification at 12 months postpartum. Methods: Data were obtained on 52 first-time mothers recruited in early pregnancy, which included 22 women who met diagnostic criteria for current major depression using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders. The Adult Attachment Interview was also administered before 20 weeks of pregnancy. A history of early trauma was measured using the Childhood Trauma Questionnaire and maternal sensitivity was measured at 6 months postpartum using the observational measure of the Emotional Availability Scales. Infant–parent attachment was measured using the Strange Situation Procedure at 12 months. Results: Overall, we found no significant association between the Adult Attachment Interview and the Strange Situation Procedure classifications. However, a combination of maternal non-autonomous attachment on the Adult Attachment Interview and major depression was a significant predictor of insecure attachment on the Strange Situation Procedure. We did not find that maternal sensitivity mediated parental and infant attachment security in this sample. Conclusion: While previous meta-analyses identified lower concordance in clinical samples, our findings suggest women with major depression and non-autonomous attachment have a greater concordance with insecure attachment on the Strange Situation Procedure. These findings can guide future research and suggest a focus on depression in pregnancy may be important for subsequent infant attachment.

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KW - Depression

KW - maternal sensitivity

KW - trauma

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JO - Australian and New Zealand Journal of Psychiatry

JF - Australian and New Zealand Journal of Psychiatry

IS - 8

ER -

Major depression as a predictor of the intergenerational transmission of attachment security: Findings from a pregnancy cohort study

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

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