Maternal attachment style and depression associated with childbirth : preliminary results from a european and US cross-cultural study

Background: Insecure attachment style relates to major depression in women, but its relationship to depression associated with childbirth is largely unknown. A new UK-designed measure, the Attachment Style Interview (ASI), has potential for cross-cultural use as a risk marker for maternal disorder.
Aims: To establishthe reliability of the ASI across centres, its stability over a 9-month period, and its associations with context and major or minor depression.
Method: The ASI was used by nine
centres antenatally on 204 women, with 174 followed up 6 months postnataly. Interrater reliability was tested and
ASI was repeated on a subset of 96
women. Affective disorder was assessed
by means of the Structured Clinical
Interview for DSM IV.
Results: Satisfactory interrater
reliability was achieved with relatively high stability rates at follow-up.Insecure attachment related to lower social class position and more negative social context.
Specific associations of avoidant attachment style (angry - dismissive or
withdrawn) with antenatal disorder, and
anxious style (enmeshed or fearful) with postnatal disorder were found.
Conclusions: The ASI can be used reliably in European and US centres as a
measure for risk associated with childbirth. Its use will contribute to theoretically underpinned preventive action for for disorders associated with childbirth.