Abstract
Emerging evidence suggests that many women in the postnatal period experience clinically significant levels of anxiety but do not meet full diagnostic criteria for an existing anxiety disorder. In this study, 167 women with infants aged 2 weeks to 12 months were interviewed for current and lifetime history of depression and anxiety disorders using the SCID-I and completed a range of self-report measures measuring psychological risk factors and current depressive and anxiety symptomatology. Qualitative comments provided by women diagnosed with ADNOS (maternally focused worry) were analyzed and themes identified, and independent t-tests and chi-square tests were conducted to compare differences between these women and women with GAD. Results showed (1) there to be almost as many women who met criteria for ADNOS (maternally focused worry) as met criteria for GAD, and (2) that women with maternally focused worry were indistinguishable from women with GAD in terms of anxiety and depressive symptom severity, functional impairment and a range of risk factors. These results highlight the status of maternally focused worry as an under-recognized phenomenon and one in need of further clinical and research attention.
Similar content being viewed by others
References
Affonso DD, Liu-Chiang C-Y, Mayberry LJ (1999) Worry: conceptual dimensions and relevance to childbearing women. Health Care Women Int 20:227–236
American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DC
Barnett BEW, Hanna B, Parker G (1983) Life event scales for obstetric groups. J Psychosom Res 27:313–320
Bates JE, Bennett Freeland CA, Lounsbury ML (1979) Measurement of infant difficultness. Child Dev 50:794–803
Beck AT, Steer RA (1993) Beck anxiety inventory manual, 3rd edn. The Psychological Corporation, Harcourt Brace & Company, San Antonio
Beck AT, Epstein N, Brown G, Steer RA (1988) An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psych 56:893–897
Beck AT, Steer RA, Brown GK (1996) Beck depression inventory manual—2nd edn (BDI-II). The Psychological Corporation, Harcourt Brace & Company, San Antonio
Boyce P, Hickey A, Gilchrist J, Talley NJ (2001) The development of a brief personality scale to measure vulnerability to postnatal depression. Arch Women’s Ment Health 3:147–153
Brockington IF, MacDonald E, Wainscott G (2006) Anxiety, obsessions and morbid preoccupations in pregnancy and the puerperium. Arch Women’s Ment Health 9:253–263
Cohen J (1992) A power primer. Psychol Bull 112:155–159
Cox J (1994) Origins and development of the 10-item Edinburgh Postnatal Depression Scale. In: Cox J, Holden J (eds) Perinatal Psychiatry: Use and Misuse of the Edinburgh Postnatal Depression Scale. London, Gaskell, pp 115–124
Cox JL, Holden JM, Sagovski R (1987) Detection of postnatal depression: development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatry 150:782–786
Curtrona CE (1984) Social support and stress in the transition to parenthood. J Abnorm Psychol 93:378–390
Curtrona CE, Russell DW (1987) The provisions of social relationships and adaptation to stress. Advances in Personal Relationships 1:37–67
First MB, Gibbon M, Spitzer RL, Williams JW (2002) Users guide to the structured clinical interview for DSM-IV-TR axis I disorders—research version—(SCID-I for DSM-IV-TR, November 2002 Revision). Biometrics Research Department, New York State Psychiatric Institute, New York
Gorman LL, O’Hara MW, Figueiredo B, Hayes S, Jacquemain F, Kammerer MH, Klier CM, Rosi S, Seneviratne G, Sutter-Dallay A-L, The TCS-PND Group (2004) Adaptation of the structured clinical interview for DSM-IV disorders for assessing depression in women during pregnancy and post-partum across countries and cultures. Br J Psychiatry 184:s17–s23
Gotlib IH, Whiffen VE, Wallace PM, Mount JH (1991) Prospective investigation of postpartum depression: factors involved in onset and recovery. J Abnorm Psychol 100:122–132
Guedeney A, Kreisler L (1987) Sleep disorders in the first 18 months of life: hypothesis on the role of mother-child emotional exchanges. Infant Ment Health J 8:307–318
Karno M, Golding JM (1988) The epidemiology of obsessive-compulsive disorder in five US communities. Arch Gen Psychiatry 45:1094–1099
Kessler RC, Chiu WT, Demler O, Walters EE (2005) Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry 62:617–627
Kessler RC, Chiu WT, Jin R, Ruscio AM, Shear K, Walters EE (2006) The epidemiology of panic attacks, panic disorder, and agoraphobia in the national comorbidity survey replication. Arch Gen Psychiatry 63:415–424
Lieb R, Becker E, Altamura C (2005) The epidemiology of generalized anxiety disorder in Europe. Eur Neuropsychopharmacol 15:445–452
Matthey S, Barnett B, Howie P, Kavanagh DJ (2003) Diagnosing postpartum depression in mothers and fathers: whatever happened to anxiety? J Affect Disord 74:139–147
Miller RL, Pallant JF, Negri LM (2006) Anxiety and stress in the postpartum: is there more to postnatal distress than depression? BMC Psychiatry 6:12
Murray L (1992) The impact of postnatal depression on infant development. J Child Psychol Psychiat 33:543–561
Murray L, Cooper PJ (1996) The impact of postpartum depression on child development. Int Rev Psychiatr 8:55–63
Murray L, Hipwell A, Hooper R, Stein A, Cooper P (1996) The cognitive development of 5-year-old children of postnatally depressed mothers. J Child Psychol Psychiatry 37:927–935
O’Hara MW, Zekoski EM, Philipps LH, Wright EJ (1990) Controlled prospective study of postpartum mood disorders: comparison of childbearing and nonchildbearing women. J Abnorm Psychol 99:3–15
Olfson M, Broadhead E, Weissman MM, Leon AC, Farber L, Hoven C, Kathol R (1996) Subthreshold psychiatric symptoms in a primary care group practice. Arch Gen Psychiat 53:880–886
Papousek M, Hofacker NV (1995) Persistent crying and parenting: search for a butterfly in a dynamic system. Early Dev Parent 4:209–224
Phillips J, Sharpe L, Matthey S (2007) Rates of depressive and anxiety disorders in a residential mother-infant unit for unsettled infants. Aust N Z J Psychiatry 41:836–842
Pitt B (1968) “Atypical” depression following childbirth. Br J Psychiatry 114:1325–1335
Power MJ, Katz R, McGuffin P, Duggan CF, Lam D, Beck AT (1994) The Dysfunctional Attitudes Scale (DAS): a comparison of forms A and B and proposals for a new subscaled version. J Res Pers 28:263–276
Purdy D, Frank E (1993) Should postpartum mood disorders be given a more prominent or distinct place in the DSM-IV? Depression 1:59–70
Reck C, Struben K, Backenstrass M, Stefenelli U, Reinig K, Fuchs T, Sohn C, Mundt C (2008) Prevalence, onset and comorbidity of postpartum anxiety and depressive disorders. Acta Psychiat Scand 118:459–468
Ross LE, McLean LM (2006) Anxiety disorders during pregnancy and the postpartum period: a systematic review. J Clin Psychiatry 67:1285–1298
Rowe HJ, Fisher JRW, Loh WM (2008) The Edinburgh postnatal depression scale detects but does not distinguish anxiety disorders from depression in mothers of infants. Arch Women’s Ment Health 11:103–108
Warner R, Appleby L, Whitton A, Faragher B (1997) Attitudes toward motherhood in postnatal depression: development of the maternal attitudes questionnaire. J Psychosom Res 43:351–358
Weissman AN (1979) The dysfunctional attitude scale: a validation study. Dissertation, University of Pennsylvania
Wenzel A, Gorman LL, O’Hara MW, Stuart S (2001) The occurrence of panic and obsessive compulsive symptoms in women with postpartum dysphoria: a prospective study. Arch Women’s Ment Health 4:5–12
Wenzel A, Haugen EN, Jackson LC, Robinson K (2003) Prevalence of generalized anxiety at eight weeks postpartum. Arch Women’s Ment Health 6:43–49
Wenzel A, Haugen EN, Jackson LC, Brendle JR (2005) Anxiety symptoms and disorders at eight weeks postpartum. J Anxiety Disord 19:295–311
Whiffen VE (1992) Is postpartum depression a distinct diagnosis? Clin Psychol Rev 12:485–508
Whiffen VE, Gotlib IH (1993) Comparison of postpartum and nonpostpartum depression: clinical presentation, psychiatric history, and psychosocial functioning. J Consult Clin Psych 61:485–494
Zanarini MC, Skodol AE, Bender D, Dolan R, Sanislow C, Schaefer E, Morey LC, Grilo CM, Shea MT, McGlashan TH, Gunderson JG (2000) The collaborative longitudinal personality disorders study: reliability of axis I and II diagnoses. J Personal Disord 14:291–299
Acknowledgements
This work was supported by Karitane and a National Health and Medical Research Council of Australia (NHMRC) Public Health Scholarship.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Phillips, J., Sharpe, L., Matthey, S. et al. Maternally focused worry. Arch Womens Ment Health 12, 409–418 (2009). https://doi.org/10.1007/s00737-009-0091-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00737-009-0091-4