Postpartum Depression and Attachment: Long-Term Effects on School-Aged Children

Researchers have demonstrated a strong link between postpartum depression, early mother-child bonding, and the emotional and behavioral development of children. The mental health of the mother after birth and the mother-child bond are well established as crucial factors in a child’s psychosocial development. However, there are only a few studies that have examined the combined influence of postpartum depression in mothers and early bonding experiences on emotional and behavioral problems in middle childhood. A new study shows a significant association between postpartum depression, mother-child bonding, and child difficulties. Notably, secure early bonding can partially buffer the long-term effects of postpartum depression on child development.

How Postpartum Depression, Mother-Child Bonding, and Behavioral Problems in Children are Related

A child’s development and well-being are influenced by various factors, with the mental health of the mother and the mother-child bond playing an important role in social and emotional development. Infants of mothers with postpartum depression often exhibit unpredictable behavior and delayed cognitive development. In addition, maternal depression can hinder the bonding process and increase the risk of insecure attachment and resulting developmental problems. While the short-term effects of postpartum depression on early childhood development and attachment are well documented, less is known about how maternal depression and attachment difficulties jointly affect behavior and psychosocial development in middle childhood.

To fill this gap, a research team led by Associate Professor Daimei Sasayama of the Department of Psychiatry, in collaboration with Professor Hideo Honda of the Department of Child and Adolescent Psychiatry at Shinshu University School of Medicine, Japan, investigated the association between postpartum maternal depression and mother-child attachment, as well as their combined effects on emotional and behavioral problems in children in sixth grade. The study hypothesized that mother-child bonding may mediate the long-term effects of maternal depression on the mental health of the child.

The study included 245 mother-child pairs from Okaya, Japan, with children born between April 2, 2009, and April 1, 2012. The team used the Edinburgh Postnatal Depression Scale (EPDS) and the Mother-to-Infant Bonding Scale-Japanese version (MIBS-J) to assess the mothers’ depressive symptoms and their bonding with their children, respectively. In addition, the children’s difficulties were measured using the Japanese version of the Strengths and Difficulties Questionnaire (SDQ). The EPDS and MIBS-J data were collected from the mothers approximately two weeks to one month after birth as part of postnatal health checks. The SDQ data, which were self-rated and rated by the parents, were collected from the children in sixth grade and their caregivers. Among the caregivers who completed the parent-rated SDQ, 92.2% were mothers, 7.3% were fathers, and one person was another caregiver.

Early Intervention is Important

Based on the data collected, 17.1% of mothers showed postpartum depressive symptoms, which is consistent with national prevalence rates in Japan. These symptoms showed both direct and indirect associations with mother-child attachment and child difficulties. “Interestingly, mother-child attachment was found to mediate 34.6% of the effects of postpartum maternal depression on child difficulties, confirming the study’s hypothesis,” explains Dr. Sasayama. Apart from these factors, the child’s gender was a significant predictor of psychosocial difficulties, with boys scoring higher overall than girls, particularly in the areas of behavior and hyperactivity or inattention.

However, both assessment sources indicated greater difficulties in children whose mothers had postpartum depressive symptoms. These findings underscore the lasting influence of early mother-child bonding experiences on children’s future psychosocial development. This once again underscores the need for early interventions targeting attachment in the context of maternal postpartum depression to promote healthy child development. Future research should prioritize the development of interventions that strengthen postpartum mother-child attachment to reduce long-term psychosocial difficulties in children. Future studies should also investigate which specific depressive symptoms most strongly influence attachment in larger populations and consider genetic data, socioeconomic factors, and other underlying mechanisms to develop targeted interventions to support affected mothers and their families.