Maladaptive personality styles in a clinical sample of women with postpartum depression

Abstract Background : Personality traits are associated with the onset and course of postpartum depression. The impact of maladaptive personality traits on mother-child bonding and parenting is less studied. Therefore, the aims of this study are to investigate: a) the frequency of maladaptive personality styles in women with postpartum depression; b) the association between personality styles and the course of maternal psychopathology; and c) the association between personality styles and mother-child bonding and parenting competence. Methods : We examined n=123 patients of a mother-baby unit with the Personality Style and Disorder Inventory (PSSI) at admission and instruments assessed maternal psychopathological symptoms (BSI), mother-child bonding (PBQ), and parenting sense of competence (PSOC) at admission and discharge. Results : Maladaptive personality styles were frequent. Women with postpartum depression had higher scores on the schizoid, avoidant, obsessive-compulsive, negativistic, dependent, borderline, depressive, and self-forgetting PSSI scales than women of the general population. The presence of maladaptive personality styles was associated with higher psychopathology, impaired mother-child bonding, and lower parenting sense of competence at admission. From admission to discharge, women showed significant improvements on psychopathology, bonding and parenting irrespective of the presence of maladaptive personality styles. However, mothers with maladaptive personality styles still had higher psychopathology and impaired mother-child bonding at discharge compared to mothers with normal PSSI scores. Limitations : Data is based upon a clinical sample of women hospitalized in a mother-child unit. Results are not representative for all women with postpartum depression. Conclusions : Our results underline the need for early identification of maladaptive personality styles and for the adequate treatment and monitoring of women with postpartum depression. It can be anticipated that women suffering from maladaptive personality styles will need ongoing care to prevent long-term negative outcomes.