Psychiatry - Theses
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ItemConcurrent treatment of mother-child relationship and mood disturbance within the context of postnatal depression( 2018)Aims. The aim of this study was to investigate the effect of the addition of an attachment-focussed mother and baby component to a standard group interpersonal therapy (IPT) treatment of postnatal depression. Specifically, the research looked at whether an intervention was capable of addressing both the mood disturbance and the relationship between the mother and baby concurrently. Methods. The research involved designing a new IPT protocol, which built on an existing model shown to address mood disturbance in new mothers. Elements of attachment theory and elaboration of the theoretical approach of IPT were used to guide the development of the new IPT-MC protocol. This therapy was then used with a group of mothers who were identified by a Maternal and Child Health Nurse (MCHN) as meeting criteria for major depressive disorder (post-natal onset) and requiring support. The group was compared with a group of mothers who received treatment-as-usual from their MCHN, including referral for GP, psychiatric, or psychological review and treatment as considered necessary. The mood disturbance and relationship changes were measured using a number of maternal self-report and observercoded variables. Results. The results indicated that the amendment of an evidence-based therapy for postnatal depression to include a mother-child focus did not affect the ability of the treatment to address mood disturbance. That is, there were no negative effects demonstrated that reduced its effectiveness, and it appeared to compare with the results of routine trials of IPT for postnatal depression. Due to the lack of exclusion criteria this study did not have the ability to determine whether the IPT-MC itself treated the mood disturbance. Results also indicated that IPT-MC has potential to address mother-child relational issues to a similar extent to existing treatments, and that these benefits can be shown at a moderate follow-up length (three months). IPT-MC improved the mother-child relationship significantly more than the treatment-as-usual condition. Conclusions. Clinical implications and limitations of the study are addressed. Further research extending the numbers and demographic of women involved would be warranted to confirm the findings.