Maternal attachment style and prenatal depression: the mediating role of body image
DOI:
https://doi.org/10.12923/pielxxiw-2026-0009Keywords:
pregnancy, body image, attachment styles, prenatal depression, mental healthAbstract
MATERNAL ATTACHMENT STYLE AND PRENATAL DEPRESSION: THE MEDIATING ROLE OF BODY IMAGE
Aim. The aim of this study was to examine the relationship between maternal attachment styles, body dissatisfaction, and prenatal depressive symptoms, with a particular focus on the mediating role of negative body image.
Material and methods. The study included a sample of 215 pregnant women (M = 28.4; SD = 4.5) in their second or third trimester. Participants completed the Attachment Styles Questionnaire (ASQ), the general body dissatisfaction subscale of the Body Attitude Test (BAT), and the Edinburgh Postnatal Depression Scale (EPDS). Mediation analyses were conducted using the PROCESS macro for SPSS with bootstrapping (5,000 resamples).
Results. Security of attachment was negatively correlated with body dissatisfaction and prenatal depressive symptoms, whereas anxious and avoidant attachment styles showed positive correlations. Negative body image fully mediated the relationship between all attachment styles and depressive symptoms.
Conclusions. Negative body image may serve as a key psychological mechanism, which links insecure attachment styles with prenatal depression. Interventions aimed at improving body image may help to reduce the risk of depression in pregnant women,particularly those with insecure attachment patterns.
References
1. Mańkowska A, Steuden S. Samoocena i satysfakcja z wyglądu własnego ciała u kobiet oczekujących narodzin dziecka i bezdzietnych. Polskie Forum Psychologiczne. 2021;26(3):259-276. https://doi.org/10.34767/PFP.2021.03.02
2. Kroska EB, StoweZN. Postpartumdepression. Obstet. Gynecol. Clin. North Am. 2020;47(3):409-419. https://doi.org/10.1016/j.ogc.2020.05.001
3. Ou CH, Hall WA. Anger in the context of postnatal depression: An integrative review. Birth. 2018;45(4):336-346. https://doi.org/10.1111/birt.12356
4. ZacherKjeldsen MM, Bang Madsen K, Liu X, et al.Identifying postpartum depression: Using key risk factors for early detection. BMJ Ment. Health. 2024;27(1):e301206. https://doi.org/10.1136/bmjment-2024-301206
5. Shribalaji S, Vaishnavi AJ, Sharu LB, et al. Postpartum depression and its risk factors: A review. IJSRA. 2024;13(1):977-982. https://doi.org/10.30574/ijsra.2024.13.1.1691
6. Alfahal M, Alfahal MS. Key risk factors contributing to postpartum depression: literature review. IJIRMS. 2024;9(11):700-704. https://doi.org/10.23958/ijirms/vol09-i11/2004
7. Alhusen JL, Hayat MJ, Gross D. A longitudinal study of maternal attachment and infant developmental outcomes. Arch. Womens Ment. Health. 2013;16:521-529. https://doi.org/10.1007/s00737-013-0357-8
8. Mikulincer M, Shaver PR. Attachment orientations and emotion regulation. Current Opinion in Psychology. 2019;25:6-10. https://doi.org/10.1016/j.copsyc.2018.02.006
9. Lutkiewicz K, Bidzan M. Maternal adult attachment and maternal – fetal attachment in the context of romantic relationship quality after premature birth – A cross sectional study. Front. Psychiatry. 2022;13:935871. https://doi.org/10.3389/fpsyt.2022.935871
10. Warfa N, Harper M, Nicolais G, et al. Adult attachment style as a risk factor for maternal postnatal depression: a systematic review.BMC Psychol. 2014;2:1-11. https://doi.org/10.1186/s40359-014-0056-x
11. Nonnenmacher N, Noe D, Ehrenthal JC, et al. Postpartum bonding: the impact of maternal depression and adult attachment style.Arch. Womens Ment. Health. 2016;19:927-935. https://doi.org/10.1007/s00737-016-0648-y
12. Widen EM, Gallagher D. Body composition changes in pregnancy: measurement, predictors and outcomes. Eur. J. Clin. Nutr. 2014;68(6):643-652. https://doi.org/10.1038/ejcn.2014.40
13. Bonev N, Matanova V. Adult attachment representations and body image.Front. Psychol. 2021;12:724329. https://doi.org/10.3389/fpsyg.2021.724329
14. Linde K, Lehnig F, Nagl M, et al. Course and prediction of body image dissatisfaction during pregnancy: a prospective study. BMC Pregnancy Childbirth. 2022;22(1):719. https://doi.org/10.1186/s12884-022-05050-x
15. Goossens L, Van Durme K, Naeye H, et al. Insecure attachment moderates the association between thin internalization and girls’ eating concerns. J. Child. Fam. Stud. 2019;28:3183-3192. https://doi.org/10.1007/s10826-019-01494-6
16. Keramat A, Malary M, Moosazadeh M, et al. Factors influencing stress, anxiety, and depression among Iranian pregnant women: the role of sexual distress and genital self-image. BMC Pregnancy Childbirth. 2021;21:1-12. https://doi.org/10.1186/s12884-021-03575-1
17. Solorzano CS, Porciello G, Violani C, et al. Body image dissatisfaction and interoceptive sensibility significantly predict postpartum depressive symptoms. J. Affect. Disord. 2022;311:239-246. https://doi.org/10.1016/j.jad.2022.05.109
18. Plopa M. Więzi w małżeństwie i rodzinie. Metody badań. Kraków: Oficyna Wydawnicza Impuls; 2008, p. 28.
19. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale. Br. J. Psychiatry. 1987;150(6):782 786. https://doi.org/10.1192/bjp.150.6.782
20. Kossakowska K. Edynburska Skala Depresji Poporodowej–właściwości psychometryczne i charakterystyka. ActaUniversitatisLodziensis. Folia Psychologica. 2013;(17):39-50. https://doi.org/10.18778/1427-969X.17.03
21. Brytek-Matera A, Probst M. Psychometric properties of the Polish version of the Body Attitude Test. Archives of Psychiatry and Psychotherapy. 2014;1:39-46. https://doi.org/10.12740/APP/21445
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