Perinatal maternal mental health and disorganised attachment: A critical systematic review

Alexandra G. D. Flowers, Jane A. McGillivray, Megan Galbally, Andrew J. Lewis

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

Background

Disorganised attachment in childhood has been considered an important early marker for the development of socio-emotional and mental health problems. This review critically examines the current evidence and methodology employed to assess the influence of perinatal maternal mental health on disorganised attachment in infancy.

MethodsResultsA search revealed 1 149 articles reporting studies examining predictors of disorganised attachment. An additional 564 grey literature articles were identified via bibliographic searches. After screening for inclusion of maternal mental health measures and use of the Strange Situation Procedure, 28 articles met inclusion criteria.

Few studies robustly examined clinical levels of maternal mental health over time and the potential effects on infant disorganised attachment. Still, the bulk of current evidence does not support a strong positive association between disorganised attachment and low to moderate levels of maternal depression. The relationship between disorganised attachment and chronic and/or severe maternal depression is unclear given the dearth of research into the area. Limited research has examined other mental health disorders, with one study suggesting borderline personality disorder is associated with disorganised attachment. A level of bias in the literature was evident, with many studies recruiting non-clinical samples and excluding those with significant mental health concerns.

ConclusionsMost non-significant findings were reported in non-clinical samples, while most positive findings were reported in clinical samples, suggesting that severity of mental disorder may be a critical factor. Further research on the relationship between disorganised attachment and chronic and severe maternal depression, psychotic, trauma, bipolar, and personality disorders is required.

Original languageEnglish
Pages (from-to)300-316
Number of pages17
JournalClinical Psychologist
Volume22
Issue number3
DOIs
Publication statusPublished - Nov 2018
Externally publishedYes

Cite this

Flowers, Alexandra G. D. ; McGillivray, Jane A. ; Galbally, Megan ; Lewis, Andrew J. / Perinatal maternal mental health and disorganised attachment : A critical systematic review. In: Clinical Psychologist. 2018 ; Vol. 22, No. 3. pp. 300-316.
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abstract = "BackgroundDisorganised attachment in childhood has been considered an important early marker for the development of socio-emotional and mental health problems. This review critically examines the current evidence and methodology employed to assess the influence of perinatal maternal mental health on disorganised attachment in infancy.MethodsResultsA search revealed 1 149 articles reporting studies examining predictors of disorganised attachment. An additional 564 grey literature articles were identified via bibliographic searches. After screening for inclusion of maternal mental health measures and use of the Strange Situation Procedure, 28 articles met inclusion criteria.Few studies robustly examined clinical levels of maternal mental health over time and the potential effects on infant disorganised attachment. Still, the bulk of current evidence does not support a strong positive association between disorganised attachment and low to moderate levels of maternal depression. The relationship between disorganised attachment and chronic and/or severe maternal depression is unclear given the dearth of research into the area. Limited research has examined other mental health disorders, with one study suggesting borderline personality disorder is associated with disorganised attachment. A level of bias in the literature was evident, with many studies recruiting non-clinical samples and excluding those with significant mental health concerns.ConclusionsMost non-significant findings were reported in non-clinical samples, while most positive findings were reported in clinical samples, suggesting that severity of mental disorder may be a critical factor. Further research on the relationship between disorganised attachment and chronic and severe maternal depression, psychotic, trauma, bipolar, and personality disorders is required.",
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Perinatal maternal mental health and disorganised attachment : A critical systematic review. / Flowers, Alexandra G. D.; McGillivray, Jane A.; Galbally, Megan; Lewis, Andrew J.

In: Clinical Psychologist, Vol. 22, No. 3, 11.2018, p. 300-316.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Perinatal maternal mental health and disorganised attachment

T2 - A critical systematic review

AU - Flowers, Alexandra G. D.

AU - McGillivray, Jane A.

AU - Galbally, Megan

AU - Lewis, Andrew J.

PY - 2018/11

Y1 - 2018/11

N2 - BackgroundDisorganised attachment in childhood has been considered an important early marker for the development of socio-emotional and mental health problems. This review critically examines the current evidence and methodology employed to assess the influence of perinatal maternal mental health on disorganised attachment in infancy.MethodsResultsA search revealed 1 149 articles reporting studies examining predictors of disorganised attachment. An additional 564 grey literature articles were identified via bibliographic searches. After screening for inclusion of maternal mental health measures and use of the Strange Situation Procedure, 28 articles met inclusion criteria.Few studies robustly examined clinical levels of maternal mental health over time and the potential effects on infant disorganised attachment. Still, the bulk of current evidence does not support a strong positive association between disorganised attachment and low to moderate levels of maternal depression. The relationship between disorganised attachment and chronic and/or severe maternal depression is unclear given the dearth of research into the area. Limited research has examined other mental health disorders, with one study suggesting borderline personality disorder is associated with disorganised attachment. A level of bias in the literature was evident, with many studies recruiting non-clinical samples and excluding those with significant mental health concerns.ConclusionsMost non-significant findings were reported in non-clinical samples, while most positive findings were reported in clinical samples, suggesting that severity of mental disorder may be a critical factor. Further research on the relationship between disorganised attachment and chronic and severe maternal depression, psychotic, trauma, bipolar, and personality disorders is required.

AB - BackgroundDisorganised attachment in childhood has been considered an important early marker for the development of socio-emotional and mental health problems. This review critically examines the current evidence and methodology employed to assess the influence of perinatal maternal mental health on disorganised attachment in infancy.MethodsResultsA search revealed 1 149 articles reporting studies examining predictors of disorganised attachment. An additional 564 grey literature articles were identified via bibliographic searches. After screening for inclusion of maternal mental health measures and use of the Strange Situation Procedure, 28 articles met inclusion criteria.Few studies robustly examined clinical levels of maternal mental health over time and the potential effects on infant disorganised attachment. Still, the bulk of current evidence does not support a strong positive association between disorganised attachment and low to moderate levels of maternal depression. The relationship between disorganised attachment and chronic and/or severe maternal depression is unclear given the dearth of research into the area. Limited research has examined other mental health disorders, with one study suggesting borderline personality disorder is associated with disorganised attachment. A level of bias in the literature was evident, with many studies recruiting non-clinical samples and excluding those with significant mental health concerns.ConclusionsMost non-significant findings were reported in non-clinical samples, while most positive findings were reported in clinical samples, suggesting that severity of mental disorder may be a critical factor. Further research on the relationship between disorganised attachment and chronic and severe maternal depression, psychotic, trauma, bipolar, and personality disorders is required.

KW - antenatal depression

KW - child development

KW - disorganised attachment

KW - perinatal mental health

KW - postnatal depression

KW - INFANT-MOTHER ATTACHMENT

KW - RANDOMIZED CONTROLLED-TRIAL

KW - BORDERLINE PERSONALITY

KW - POSTNATAL DEPRESSION

KW - INTERGENERATIONAL TRANSMISSION

KW - POSTPARTUM DEPRESSION

KW - UNRESOLVED STATES

KW - BEHAVIOR

KW - SYMPTOMS

KW - PSYCHOPATHOLOGY

U2 - 10.1111/cp.12145

DO - 10.1111/cp.12145

M3 - Review article

VL - 22

SP - 300

EP - 316

JO - The Clinical Psychologist

JF - The Clinical Psychologist

SN - 1328-4207

IS - 3

ER -