Adaptive and maladaptive dimensions of relatedness and self-definition: Relationship with postpartum depression and anxiety

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Abstract

This study investigated the role of adaptive and maladaptive personality dimensions associated with self-definition and relatedness as measured by the Depressive Experiences Questionnaire (DEQ; Blatt, D’Afflitti, & Quinlan, 1976) in a sample of 244 young mothers. It was hypothesized that only maladaptive personality dimensions related to self-definition and relatedness (i.e., Self-Critical Perfectionism and Dependency), but not adaptive dimensions (i.e., Efficacy and Relatedness), would be associated with severity of depression and anxiety in the postpartum period. In addition, it was hypothesized that Dependency would be more strongly associated with anxiety symptoms, while Self-Critical Perfectionism was expected to be more strongly related to severity of depression.

Results showed that, as expected, Self-Critical Perfectionism, but not Efficacy, was related to depressive feelings in the postpartum period. However, contrary to expectations, Relatedness, but not Dependence, was associated with severity of depression and trait anxiety. Self-Critical Perfectionism was against expectations more strongly related to both severity of depression and anxiety. Results were similar for first-time versus multiparous mothers.

Although further research needs to replicate these findings, results of this study suggest that clinicians should pay attention to personality issues in working with pregnant women or young mothers.

Introduction

Both clinical theory (Cohen and Slade, 2000, Stern, 1995) and research findings (e.g., Hopkins, Marcus, & Campbell, 1984) suggest that the transition to motherhood is a stressful period that may interact with personality vulnerabilities to depression. In particular, the transition to motherhood can be understood as a time when issues of both relatedness and self-definition come to the fore imposing a reassessment of identity and autonomy as well as of close interpersonal relationships, thus putting mothers at increased risk for depression.

One approach to study these issues is offered by theoretical conceptualizations that have distinguished between adaptive and maladaptive dimensions of autonomy/identity and relatedness (e.g., Blatt and Schichman, 1983, Priel and Besser, 1999; for a review see Blatt, 2004). Originally, these models focused on maladaptive dimensions of autonomy and relatedness that is Self-Criticism and Dependency, as vulnerability factors for depression (Arieti and Bemporad, 1978, Blatt, 1974, Blatt et al., 1976). Self-Critical individuals are described as overly preoccupied with self-definition, control and perfection, dependent individuals as preoccupied with fears for abandonment and loss.

Later, Blatt and colleagues (e.g., Blatt and Schichman, 1983, Blatt et al., 1995) expanded their model in terms of a broad model of normal and pathological personality development. They conceptualized normal personality development as the result of a dialectical interaction between two developmental lines, i.e., an introjective line that leads to adaptive and stable feelings of autonomy and identity, and an anaclitic line that leads to the capacity for differentiated and complex interpersonal relationships, whereas psychopathology is considered to be characterized by an overemphasis on or neglect of one of these developmental lines. Thus two clusters of psychopathology can be identified. In the introjective cluster, psychopathology is focused around problems related to identity, autonomy, self-criticism, and guilt, whereas in the anaclitic clusters conflicts concerning interpersonal relationships predominate. In this context, Blatt (e.g., Blatt, 2004, Blatt et al., 1995) coined the notions of relatedness versus dependence to denote adaptive versus maladaptive dimensions of interpersonal relatedness. The less mature level of interpersonal relatedness, dependence, is characterized by strong wishes to be taken care of, feelings of abandonment, and fears for rejection and loss of gratification and support. The more mature level, relatedness, implies a more reciprocal attachment to a particular person.

This theoretical evolution was paralleled by the finding that the Depressive Experiences Questionnaire (DEQ; Blatt et al., 1976), originally designed to measure dependency and self-criticism, also measured adaptive aspects of autonomy and interpersonal relatedness. Using Small Space Analysis (SSA), a theory-driven clustering procedure, Blatt and colleagues (Blatt et al., 1995, Blatt et al., 1996) identified two subfactors, i.e., Relatedness versus Dependency, within the DEQ Dependency factor. Likewise, recent studies suggest that whereas the DEQ Self-Criticism factor assesses a maladaptive level of autonomy and identity, the third DEQ factor, Efficacy, measures a more adaptive level, characterized by expressions of competence and confidence in one’s self and in the future (Blatt, 2004).

Concerning postpartum depression, Priel and Besser, 1999, Priel and Besser, 2000, Besser and Priel, 2003 reported that DEQ Self-Criticism, but not DEQ Dependency, assessed during the third trimester of pregnancy, was associated with depressive symptoms eight weeks postpartum. In fact, Dependency was negatively associated with depressive symptoms, suggesting that this personality dimension might protect against postpartum depression. Similarly, Franche and Mikail, 1999, Franche, 2001 reported that high Self-Criticism and low Dependency were associated with depressive symptomatology and grief in pregnant women with a history of perinatal loss. Thus, high levels of Dependency during pregnancy might be adaptive. Other studies, however, found dependency to be significantly associated with postpartum depressive symptoms (Boyce et al., 1991, Flett et al., submitted, Mongrain et al., 2004).

Thus, more research is needed to investigate the role of these personality dimensions in the postpartum period. First, existing studies only focused on the role of Self-Criticism and Dependency, but not on more adaptive features of autonomy and relatedness. For example, it might be that only the maladaptive form of relatedness is associated with postpartum depressive symptoms, whereas more mature forms of relatedness might protect against postpartum depression. Because the DEQ-Dependency scale, as noted, measures both adaptive and maladaptive aspects of relatedness, existing studies have not investigated this hypothesis.

Second, studies suggest that Dependency is in general more strongly related to anxiety than to depression (e.g., Alford and Gerrity, 1995, Fairbrother and Moretti, 1998, Moore and Blackburn, 1994). Hence, it should perhaps not be surprising that Dependency is not or less related to postpartum depressive symptoms. Because dependent individuals constantly fear rejection and abandonment, and the postpartum period might be a time when these relational worries are intensified, theoretically, one could expect that Dependency is more related to anxiety than to depression in the postpartum period.

Finally, existing studies have exclusively focused on first-time mothers. Although it can be argued that the first pregnancy is likely to impact most on individual vulnerabilities, each new infant can be seen as a new moment in the transition to motherhood (e.g., being the mother of several children instead of just one). Thus, it is an important question whether personality has a different impact on feelings of depression and anxiety in first-time mothers compared to multiparous mothers.

This study is set out to investigate the relationship between personality dimensions associated with relatedness and self-definition and postpartum depressive versus anxiety symptoms in both primiparous and multiparous mothers. Our hypotheses can be summarized as follows:

  • 1.

    Only maladaptive personality dimensions associated with self-definition and relatedness i.e., Self-Criticism and Dependence, are expected to be associated with postpartum symptomatology. The adaptive dimensions, Efficacy and Relatedness, are expected to be unrelated or even negatively related to postpartum symptomatology.

  • 2.

    Self-Criticism will be more strongly related to depressive symptoms in the postpartum period, while Dependency is expected to be more strongly related to anxiety symptoms.

  • 3.

    Finally, we wanted to explore whether Efficacy and Relatedness (adaptive dimensions) and Self-Criticism and Dependence (maladaptive dimensions) were differentially related to severity of depression and anxiety in first-time versus multiparous mothers.

Section snippets

Participants

Participants were 244 mothers. Only mothers with natural pregnancies were included. For 52% of the mothers, it was their first child, 48% of the mothers was multiparous. The mean age of the mothers in the total sample was 30.19 years ( SD = 3.90). They had on average 15.27 (SD  = 2.29) years of education. Their children had a mean age of 7.87 months (SD = 2.72) at the time of testing, and their average birth weight was 3.44 kg (SD = 0.53). The mean period of pregnancy was 39 weeks (SD = 1.65). There

Personality factors and maternal symptomatology: zero-order correlations

Because Means, Standard Deviations, and zero-order correlations were very similar in primiparous and multiparous mothers, we present only results for the total sample in Table 1. As expected, Self-Criticism was significantly more strongly related with severity of depression than Dependency (Hotelling’s t-test for correlated correlations; t = −3.15, p < .01). Both Dependency and Self-Criticism were significantly associated with state and trait anxiety. Contrary to expectations, however,

Discussion

As expected, Self-Criticism was associated with severity of depression in the postpartum period, even controlling for demographic variables and levels of anxiety. These findings are congruent with findings from a number of previous studies (e.g. Franche, 2001, Priel and Besser, 1999, Priel and Besser, 2000). In addition, we found no differences for primiparous versus multiparous mothers. Hence, these results not only add to the robustness of the negative effect of self-criticism on mood in the

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