Factors associated with postpartum depression and abusive behavior in mothers with infants

Aims: This study was conducted to examine factors associated with postpartum depression and abusive behavior in mothers with infants. Methods: Data were collected from baby check-ups in Japan and 413 participants were included in an analysis using: (i) an Original Questionnaire; (ii) the Zung Self-rating Depression Scale (ZSDS); (iii) the Parental Bonding Instrument; and (iv) the Childcare Anxiety Scale ( CAS). Covariance structural analyses were performed to examine interconnections among the Parental Bonding Instrument subscales, CAS subscales ('worry about parenting', 'burden of nursing time', 'difficulty of bonding'), ZSDS, 'fear of being abusive', and 'abusive behavior'. Results: Of the 413 mothers, 14.5% showed higher than moderate levels of depression ( ZSDS >= 50). In covariance structural analyses, 'depression' was strongly influenced by 'worry about parenting' in all variances, but was not associated with 'abusive behavior'. 'Worry about parenting' also had a strong influence on 'fear of being abusive', but did not affect 'abusive behavior'. Low 'maternal care' had most influence on 'difficulty of bonding', and 'difficulty of bonding' only affected 'abusive behavior'. Conclusions: The outcome of this study suggests that excessive worrying related to postpartum depression, 'fear of being abusive', and bonding difficulty are primary predictors of child abuse. Postpartum depression was not a predictor for abusive behavior after exclusion of the impact of bonding difficulties on abusive behavior. Therefore, the correlation between postpartum depression and abusive behavior identified in previous reports may have been influenced by bonding difficulties.