Antenatal caregiving representations among expectant mothers with severe mental illness: a cross-sectional study

TY - JOUR

T1 - Antenatal caregiving representations among expectant mothers with severe mental illness: a cross-sectional study

AU - Røhder, Katrine

AU - Nyström-Hansen, Maja

AU - Macbeth, Angus

AU - Davidsen, Kirstine Agnete

AU - Brennan, Jessica

AU - George, Carol

AU - Harder, Susanne

AU - Gumley, Andrew

PY - 2019/8/8

Y1 - 2019/8/8

N2 - Objective: The study explores predictors of antenatal caregiving representations among mothers with a history of severe mental illness (SMI). Background: Attachment research has demonstrated that multifactorial assessment of antenatal caregiving representations predicts later maternal behaviour and child attachment. However, the field lacks research among clinical groups. Knowledge of factors influencing caregiving representations during pregnancy can contribute to our understanding of caregiving risk among SMI-mothers and inform intervention decisions. Method: The current study is a cross-sectional subsample of the WARM study. Participants were 65 Danish or Scottish pregnant women with a history of either schizophrenia, bipolar disorder, moderate–severe depression, or non-clinical controls. Caregiving representations, adverse childhood experiences, social support and current symptom severity were assessed during pregnancy. Results: Symptom severity was associated with more non-optimal caregiving representations expecting less parental enjoyment, more difficulties separating from the child, and more feelings of caregiving helplessness. Lack of social support and adverse childhood experiences served as independent predictors of caregiving representations. Parental mental illness during own childhood predicted role reversed expectations. Conclusion: Antenatal caregiving representations can be assessed with a time-efficient self-report measure that assesses caregiving as a multidimensional construct. Prenatal treatment planning should target individual difficulties in undertaking transformation of the caregiving system.

AB - Objective: The study explores predictors of antenatal caregiving representations among mothers with a history of severe mental illness (SMI). Background: Attachment research has demonstrated that multifactorial assessment of antenatal caregiving representations predicts later maternal behaviour and child attachment. However, the field lacks research among clinical groups. Knowledge of factors influencing caregiving representations during pregnancy can contribute to our understanding of caregiving risk among SMI-mothers and inform intervention decisions. Method: The current study is a cross-sectional subsample of the WARM study. Participants were 65 Danish or Scottish pregnant women with a history of either schizophrenia, bipolar disorder, moderate–severe depression, or non-clinical controls. Caregiving representations, adverse childhood experiences, social support and current symptom severity were assessed during pregnancy. Results: Symptom severity was associated with more non-optimal caregiving representations expecting less parental enjoyment, more difficulties separating from the child, and more feelings of caregiving helplessness. Lack of social support and adverse childhood experiences served as independent predictors of caregiving representations. Parental mental illness during own childhood predicted role reversed expectations. Conclusion: Antenatal caregiving representations can be assessed with a time-efficient self-report measure that assesses caregiving as a multidimensional construct. Prenatal treatment planning should target individual difficulties in undertaking transformation of the caregiving system.

KW - Faculty of Social Sciences

KW - Caregiving system

KW - expectant mothers

KW - severe mental illness (SMI)

KW - psychosis

KW - adverse childhood experiences (ACEs)

U2 - 10.1080/02646838.2019.1578868

DO - 10.1080/02646838.2019.1578868

M3 - Journal article

C2 - 30767656

SN - 0264-6838

VL - 37

SP - 370

EP - 383

JO - Journal of Reproductive and Infant Psychology

JF - Journal of Reproductive and Infant Psychology

IS - 4

ER -