Development of the Parent-to-Infant Bonding Scale: Validation in Swedish Mothers and Fathers in Community and Clinical Contexts.

Valid measurement instruments are needed to investigate the impact of parental bonding on child health development. The aim was to develop and validate a self-report questionnaire, the Parent-to-Infant Bonding Scale (PIBS) to measure bonding in both mothers and fathers. Internal consistency and construct validity were analysed using data from Swedish parents from both clinical (N = 182), and community (N = 122) population samples. Overall, good or acceptable internal consistency of the PIBS appeared. Convergent validity (against the Postpartum Bonding Questionnaire, analysed in the clinical sample) and discriminant validity (against the mental health constructs of depressive symptoms and anxiety) were demonstrated. The results support the PIBS as a measure of maternal and paternal bonding in community and clinical populations. Assessments of criterion validity in these populations are desirable. The similarities in PIBS measurement properties between the parent groups suggest its usefulness for comparisons between mothers and fathers, and for future investigations of unique and interactive impacts of maternal and paternal bonding on child outcomes using community and clinical cohorts.

The importance of high-quality partner support for reducing stress during pregnancy and postpartum bonding impairments.

The current study investigated the extent to which interparental support reduced pregnancy stress and subsequent postpartum bonding impairments with infant. We hypothesized that receiving higher quality partner support would be associated with decreased maternal pregnancy-related concerns, and less maternal and paternal pregnancy stress which, in turn, would predict fewer parent-infant bonding impairments. One hundred fifty-seven cohabiting couples completed semi-structured interviews and questionnaires once during pregnancy and twice postpartum. Path analyses with tests of mediation were employed to test our hypotheses. Higher quality support received by mothers was associated with lower maternal pregnancy stress which, in turn, predicted fewer mother-infant bonding impairments. An indirect pathway of equal magnitude was observed for fathers. Dyadic pathways also emerged such that higher quality support received by fathers was associated with lower maternal pregnancy stress which reduced mother-infant bonding impairments. Similarly, higher quality support received by mothers reduced paternal pregnancy stress and subsequent father-infant bonding impairments. Hypothesized effects reaching statistical significance (p < .05) were small to moderate in magnitude. These findings have important theoretical and clinical implications in demonstrating the critical role of both receiving and providing high-quality interparental support to reduce pregnancy stress and subsequent postpartum bonding impairments for mothers and fathers. Results also highlight the utility of investigating maternal mental health in the couple context.

Towards Preventative Psychiatry: Concurrent and Longitudinal Predictors of Postnatal Maternal-Infant Bonding.

Maternal-infant bonding is important for children's positive development. Poor maternal-infant bonding is a risk factor for negative mother and infant outcomes. Although researchers have examined individual predictors of maternal-infant bonding, studies typically do not examine several concurrent and longitudinal predictors within the same model. This study aimed to evaluate the unique and combined predictive power of cross-sectional and longitudinal predictors of maternal-infant bonding. Participants were 372 pregnant women recruited from an Australian hospital. Data were collected from mothers at antenatal appointments (T0), following their child's birth (T1), and at a laboratory assessment when their child was 5-11-months-old (T2). Poorer bonding at T2 was predicted at T0 by younger maternal age, higher education, and higher antenatal depressive symptoms. Poorer bonding at T2 was predicted at T1 by younger maternal age, higher education, and higher postnatal depressive symptoms. Poorer bonding at T2 was predicted at T2 by younger maternal age, higher education, higher postnatal depression symptoms, higher concurrent perceived social support, and more difficult infant temperament, when controlling for child age at T2. To promote positive maternal-infant bonding, global and targeted interventions in the perinatal period may benefit from targeting maternal psychopathology, perceived lack of social support, and coping with difficult infant temperament.

Postpartum bonding and association with depressive symptoms and prenatal attachment in women with fear of birth.

BACKGROUND: Co-morbidity is prevalent in women with fear of birth. Depressive symptoms and lack of prenatal attachment might influence the postpartum bonding between the mother and the new-born. AIM: To examine the underlying dimensions of the Postpartum Bonding Questionnaire and to investigate associations between depressive symptoms, prenatal attachment and postpartum bonding in women with fear of birth. METHODS: A longitudinal study comprising 172 women with fear of birth. Data were collected by questionnaires in mid- and late pregnancy and two months after birth. The Edinburgh Postnatal Depressive Scale, Prenatal Attachment Inventory and Postpartum Bonding Questionnaire were investigated. RESULTS: Two factors of the Postpartum Bonding Questionnaire were identified: Factor 1 mirrored caring activities and the women's perceptions of motherhood, whereas Factor 2 reflected negative feelings towards the baby. The Postpartum Bonding Questionnaire was negatively correlated with the Prenatal Attachment Inventory and positively with The Edinburgh Postnatal Depressive Scale. Women with fear of birth and depressive symptoms both during pregnancy and postpartum showed the highest risk of impaired bonding after birth. Primiparity and being single were also associated with impaired bonding. CONCLUSION: A focus on women's mental health during pregnancy is necessary in order to avoid the negative effects of impaired bonding on the infant. Depressive symptoms could be concurrent with fear of birth and, therefore, it is important to determine both fear of birth and depressive symptoms in screening procedures during pregnancy. Caregivers who meet women during pregnancy need to acknowledge prenatal attachment and thereby influence adaptation to motherhood.

Alexithymic traits and parental postpartum bonding: Findings from the FinnBrain Birth Cohort Study.

In the postpartum period, some parents experience problems in bonding with the infant, which can lead to difficulties in adjusting to the parental caregiving role. Alexithymia, through deficits in emotional processing, could potentially be associated with problems in parental postpartum bonding. In the current study, this association has been explored in a large population-based sample of mothers and fathers, and to our knowledge, this is the first study to investigate this association. The study population (n = 2,671) was part of the FinnBrain Birth Cohort study and included 1,766 mothers and 905 fathers who returned The Postpartum Bonding Questionnaire (PBQ) at three months postpartum and the 20-item Toronto Alexithymia Scale (TAS-20) at six months postpartum. Correlation analyses and hierarchical regression modeling, adjusted for selected background factors, were performed separately for mothers and fathers. The alexithymia dimension "Difficulty Identifying Feelings" (DIF) in mothers and fathers, and additionally dimensions of "Difficulty Describing Feelings" (DDF) and "Externally Oriented Thinking" (EOT) in fathers were associated with weaker postpartum bonding, when related background factors were controlled for. To our knowledge this was the first study to investigate the relationship between parents' alexithymic traits and postpartum bonding within a large birth cohort study population. The main finding was that especially higher levels of maternal DIF and paternal EOT were associated with weaker postpartum bonding. Longitudinal studies are needed to establish the potential causality of this relationship.

The Application of Connectome-Based Predictive Modeling to the Maternal Brain: Implications for Mother-Infant Bonding.

Maternal bonding early postpartum lays an important foundation for child development. Changing brain structure and function during pregnancy and postpartum may underscore maternal bonding. We employed connectome-based predictive modeling (CPM) to measure brain functional connectivity and predict self-reported maternal bonding in mothers at 2 and 8 months postpartum. At 2 months, CPM predicted maternal anxiety in the bonding relationship: Greater integration between cerebellar and motor-sensory-auditory networks and between frontoparietal and motor-sensory-auditory networks were associated with more maternal anxiety toward their infant. Furthermore, greater segregation between the cerebellar and frontoparietal, and within the motor-sensory-auditory networks, was associated with more maternal anxiety regarding their infant. We did not observe CPM prediction of maternal bonding impairments or rejection/anger toward the infant. Finally, considering 2 and 8 months of data, changes in network connectivity were associated with changes in maternal anxiety in the bonding relationship. Our results suggest that changing connectivity among maternal brain networks may provide insight into the mother-infant bond, specifically in the context of anxiety and the representation of the infant in the mother's mind. These findings provide an opportunity to mechanistically investigate approaches to enhance the connectivity of these networks to optimize the representational and behavioral quality of the caregiving relationship.

Prenatal expectations and other psycho-social factors as risk factors of postnatal bonding disturbance.

The mother's bond to her baby starts to develop during pregnancy, and it is related to the baby's attachment. We study how the mother's prenatal expectations of her unborn baby, the mother's adult relationships, and postnatal psycho-social factors (stress, depression, and anxiety) are related to the risk of bonding disturbance. The study comprised 1398 mothers and their unborn babies assessed both during pregnancy and when the babies were 3 months old (47.7% girls). The mother's risk of bonding disturbance was investigated using Brockington's Postpartum Bonding Questionnaire. According to the results, 71 (5.1%) of all the mothers in the study had a risk of a bonding disturbance. In a final adjusted logistic regression model, the most important risk factors were the mother's inability to form positive expectations about relationships with the baby during the third trimester of pregnancy (AOR = 7.78, p ≤ .001), maternal postnatal stress (AOR = 4.95, p ≤ .001) and maternal postnatal depression (AOR = 3.46, p ≤ .01). The results challenge healthcare professionals to screen pregnant mothers to identify at-risk groups for post-partum bonding disturbances. Intervention programs to prevent the development of bonding disturbances, and thus their possible serious consequences for children's development, should be considered.

La unión afectiva entre la madre y su bebé comienza a desarrollarse durante el embarazo y está relacionado a la afectividad del bebé. Estudiamos cómo las expectativas prenatales que la madre tenía de su bebé aún no nacido, las relaciones adultas de la madre, así como los factores sicosociales (estrés, depresión y ansiedad) están relacionados con la alteración de la unión afectiva. El estudio incluyó a 1,398 madres y sus no nacidos bebés evaluados ambos durante el embarazo y cuando los bebés tenían tres meses de nacidos (47.7% niñas). El riesgo de la madre de alteraciones en la unión afectiva fue investigado usando el Cuestionario Brockington sobre la Unión Afectiva Posterior al Parto. De acuerdo con los resultados, 71 (5.1%) de todas las madres en el estudio presentaban un riesgo de alteración de la unión afectiva. En un modelo final de regresión logístico ajustado, los más importantes factores de riesgo fueron la inhabilidad de la madre de formar expectativas positivas acerca de las relaciones con el bebé durante el tercer trimestre del embarazo (AOR = 7.78, p < .001), el estrés materno postnatal (AOR = 4.95, p < .001) y la depresión materna postnatal (AOR = 3.46, p < .01). Los resultados presentan un reto a los profesionales del cuidado de la salud para examinar a mujeres embarazadas con el fin de identificar grupos bajo riesgo de alteraciones en la unión afectiva posterior al parto. Se deben considerar programas de intervención para prevenir el desarrollo de alteraciones en la unión afectiva y, por tanto, posibles serias consecuencias para el desarrollo de los niños.

Le lien de la mère avec son bébé commence à se développer durant la grossesse, et est lié à l'attachement du bébé. Nous étudions la manière dont les attentes prénatales que la mère se fait de son bébé à naître, les relations adultes de la mère, et les facteurs postnatals psycho-sociaux (stress, dépression, anxiété) sont liés au risque de trouble du lien. L'étude a compris 1398 mères et leurs bébé à naître évalués à la fois durant la grossesse et quand les bébés avaient trois mois (47,7% de filles). Le risque de trouble du lien de la mère a fait l'objet de l'étude, au moyen du Questionnaire du Lien Postpartum de Brockington. Selon les résultats, 71 (soit 5,1%) de toutes les mères de l'étude avaient un risque de trouble du lien. Dans un modèle de régression logistique ajusté final les facteurs de risque les plus importants étaient l'incapacité de la mère à former des attentes positives sur les relations avec le bébé durant le troisième trimestre de la grossesse (AOR - 7,78, p ≤,001), le stress postnatal maternel (AOR = 4,95, p ≤,001) et la dépression postnatale maternelle (AOR = 3,46, p ≤,01). Les résultats défient les professionnels de la santé de dépister les mères enceintes afin d'identifier les groupes à risque de troubles du lien postpartum. Des programmes d'intervention destinés à prévenir le développement de troubles du lien ainsi que leurs conséquences sévères pour le développement des enfants devraient être considérés.

Reliability and validity of the German version of the Maternal-Fetal Attachment Scale.

OBJECTIVES: In understanding early disturbances in the mother-child relationship, maternal-fetal attachment has become an important concept. To date no study has investigated the reliability and validity of the German version of the Maternal Fetal Attachment Scale (MFAS). The present study aimed to close this gap. METHODS: Questionnaires were completed in a sample of 324 women [third trimester (T1), first week postpartum (T2), and 4 months postpartum (T3)]. In addition to the MFAS (T1), the following measures were assessed: the questionnaire of partnership (T1), the postpartum bonding questionnaire (T2), the Edinburgh Postnatal Depression Scale (T1-T3), the State Trait Anxiety Inventory (T1-T3), and the pregnancy related anxiety questionnaire (T1-T3). Factor structure was analyzed using a principal component analysis (PCA) with varimax rotation. Internal and convergent validities were calculated. RESULTS: In contrast to the original version with five subscales, PCA yielded a three-factor solution, consisting of the three independent dimensions "anticipation", "empathy", and "caring", explaining 34.9% of the variance together. Good internal reliabilities were found for the total MFAS scale. Maternal-fetal attachment showed a significant negative correlation with postpartum bonding impairment. While no correlations were found with depression, general anxiety and pregnancy-related anxiety during pregnancy, maternal-fetal attachment was significantly related to aspects of partnership quality. In the postpartum period, maternal attachment showed a strong negative correlation with maternal anxiety. CONCLUSIONS: Our results suggest that the German version of the MFAS is a reliable and valid questionnaire to measure the emotional relationship of the mother to the unborn child during pregnancy.

Assessment of psychometric properties of the Postpartum Bonding Questionnaire (PBQ) in Spanish mothers.

The Postpartum Bonding Questionnaire (PBQ) was developed to assess mother-infant bonding disturbances in the postpartum period. The aim of this study was to examine the psychometric properties of the Spanish version of the PBQ in a sample of Spanish postpartum women. Eight hundred forty mothers were recruited in the postpartum visit (4-6 weeks after delivery): 513 from a gynecology unit (forming the general population sample) and 327 mothers from a perinatal psychiatry program (forming the clinical sample). All women were assessed by means of the Edinburgh Postnatal Depression Scale (EPDS) and the PBQ. Neither the original four-factor structure nor alternative structures (Reck et al. 2006; Wittkowski et al. 2010) were replicated by the confirmatory factor analyses. An exploratory factor analysis showed a four-factor solution. The Schmid-Leiman transformation found a general factor that accounted for 61% of the variance of the PBQ. Bonding impairment showed higher associations with depressive symptomatology in both samples. The Spanish version of the PBQ showed adequate psychometric properties for use with clinical and general populations of Spanish postpartum women. The results suggest that the PBQ could be summarized by a general factor and confirm the utility of the use of the total score for detecting bonding impairment.

Postpartum-Specific Anxiety and Maternal-Infant Bonding: A Predictive Validity Study amongst Italian Women.

The role of anxiety is unknown in relation to postpartum bonding, unlike the well-known detrimental effect that postpartum depression has on the relationship between a mother and child. This study investigates how anxiety affects mother-infant bonding after childbirth, comparing the Italian version of the Postpartum Specific Anxiety Scale (PSAS-IT) with generalized measures of anxiety. Examining 324 non-randomly-selected participants responding to various scales, including the Edinburgh postnatal depression scale (EPDS), generalized anxiety disorder (GAD), postpartum-specific anxiety scale (PSAS-IT), postpartum bonding questionnaire (PBQ), and baby care questionnaire (BCQ-2), initial results suggest a link between certain postpartum anxiety symptoms and attachment problems. Surprisingly, anxiety measured with the PSAS has no direct influence on attachment; however, it is a strong predictor of bonding, even when maternal age, general anxiety, and depression are taken into account, explaining 3% of the variance in scores (ß = 0.26, p < 0.001). This emphasizes the importance of early identification and intervention of postpartum anxiety in promoting bonding between mother and child.

Maternal postpartum bonding impairment and increased substance use to cope with pandemic-related stress.

Substance use rates, particularly among women, increased substantially during the COVID-19 pandemic. Psychological and economic risks disproportionately experienced by women were associated with increase in substance use patterns during the pandemic. Using substances (i.e., tobacco, alcohol, cannabis) to cope with stress is well-documented; what is less known are protective factors that were associated with less substance use during the pandemic. We examined whether mothers of young children (N = 96) who reported postpartum bonding impairment before the start of the pandemic reported greater substance use during the pandemic as a means to cope. Results from linear regression analyses found that mothers who reported higher levels of pre-pandemic mother-infant bonding impairments reported greater use of alcohol and other substances as a means to cope with pandemic stressors. These findings suggest that social connections might be a strategy to reduce substance use as a maladaptive coping behavior, especially during widespread crises such as the recent pandemic or for mothers of young children. In particular, promoting postpartum bonding through interventions might help to reduce substance use among new mothers.

Infantile atopic dermatitis and maternal-infant bonding: a mixed methods study.

BACKGROUND: Childhood atopic dermatitis can have a negative effect on caregivers' quality of life and stress levels due to the burdensome nature of its treatment. Given that the condition often emerges in infancy, atopic dermatitis-related stress also carries the potential to negatively affect the developing mother-infant bond. While it is plausible that atopic dermatitis has a negative impact on maternal-infant bonding, these relationships have not been studied directly. In light of this gap, the current study investigated the association between infantile atopic dermatitis and the maternal-infant bond using a mixed-method design. METHODS: Mothers of infants (< 19 months) with atopic dermatitis were recruited from social media and medical clinics between October 2021 and May 2022. Mothers with infants unaffected by inflammatory skin conditions were also recruited to serve as a control group. Participants were asked to complete questionnaires related to their demographics, child's health, and mother-infant bond. Multiple linear regression analyses were used to assess bonding quality among cases and controls. A subset of cases were also asked to participate in semi-structured interviews focused on infantile atopic dermatitis and the maternal-infant bond. RESULTS: The final sample consisted of 32 cases and 65 controls. Scores on the impaired bonding and risk of abuse subscales did not significantly differ between cases and controls. However, mothers of infants with atopic dermatitis did report lower levels of caregiving anxiety (b = - 1.47, p < 0.01) and pathological anger/rejection (b = - 1.74, p = 0.02) relative to controls. Qualitative findings suggest that the topical therapies required to manage atopic dermatitis may strengthen the bond between some mothers and infants. CONCLUSION: Findings suggest that atopic dermatitis does not have a negative impact on maternal-infant bonding and may actually improve bonds in some cases. In light of this finding, clinicians may leverage the potentially positive impact of atopic dermatitis-related caregiving on the maternal-infant bond to encourage caregivers to remain adherent to their child's topical treatments.

Relationship of premenstrual syndrome with postpartum depression and mother-infant bonding.

PURPOSE: This study was conducted to investigate the relationship between pre-pregnancy premenstrual syndrome (PMS) history with postpartum depression and mother-infant bonding. DESIGN AND METHODS: The sample of this descriptive and cross-sectional study included 322 mothers. Data were collected using the Premenstrual Syndrome Scale (PMSS), Edinburgh Postnatal Depression Scale (EPDS), and Brockington Postpartum Bonding Questionnaire (BPBQ). FINDINGS: There were positive statistically significant correlations between PMSS total and subscale scores and EPDS scores and BPBQ. In addition, there were statistically significant positive correlations between EPDS score scores and BPBQ. IMPLICATIONS FOR NURSING PRACTICE: Especially by achieving success in PMS management in the pre-pregnancy period, the risk of postpartum depression development can be prevented, and healthy development of mother-infant bonding can be achieved.

Factor structure of the Postpartum Bonding Questionnaire: Configural invariance and measurement invariance across postpartum time periods.

BACKGROUND: Despite the research and clinical significance of the Postpartum Bonding Questionnaire (PBQ), its psychometric properties have not been studied intensively. The goodness-of-fit of proposed factor models of the PBQ is poor. Configural and measurement invariance have never been reported. METHODS: As a secondary analysis of the previous paper (Ohashi et al., 2016), we analysed the PBQ data at 5 days and 1 month after childbirth among 247 mothers of a singleton. We created 9 parcels of PBQ items to perform confirmatory factor analysis (CFA). We also examined configural and measurement invariances of the PBQ factor structure between the two observation times. RESULTS: The CFI of the 3-factor model of the PBQ was .936 and .968 for 5 days and 1 month after childbirth, respectively. Configural, measurement (metric, scalar, and residual), and structural (factor variance and factor covariance) invariances were accepted. The mean of only 'anger and restrictedness' factor was scored higher at 1 month than 5 days after childbirth. CONCLUSION: The 3-factor model of the PBQ was good in its fit with the data as well as robust in its measurement between the two observation time periods.

External Validation and Test-Retest Reliability of Postpartum Bonding Questionnaire in Spanish Mothers.

The aim of the present study was to validate the Spanish Postpartum Bonding Questionnaire (PBQ) against external criteria of bonding disorder, as well as to establish its test-retest reliability. One hundred fifty-six postpartum women consecutively recruited from a perinatal mental health outpatient unit completed the PBQ at 4-6 weeks postpartum. Four weeks later, all mothers completed again the PBQ and were interviewed using the Birmingham Interview for Maternal Mental Health to establish the presence of a bonding disorder. Receiver operating characteristic curve analysis revealed an area under the curve (AUC) value for the PBQ total score of 0.93, 95% CI [0.88, 0.98], with the optimal cut-off of 13 for detecting bonding disorders (sensitivity: 92%, specificity: 87%). Optimal cut-off scores for each scale were also obtained. The test-retest reliability coefficients were moderate to good. Our data confirm the validity of PBQ for detecting bonding disorders in Spanish population.

Translation, validation and factor structure of the Tamil version of the Postpartum Bonding Questionnaire (PBQ-T).

BACKGROUND: The Postpartum Bonding Questionnaire was developed in English for the purpose of screening for bonding disorders among postpartum mothers. There was a felt need for a Tamil translation of the self-rated instrument. METHODS: The Postpartum Bonding Questionnaire was translated into Tamil (PBQ-T). Two hundred and fifty mother-infant dyads were administered the PBQ-T along with the Stafford Interview. The Stafford Interview was studied by two independent psychiatrists to arrive at a diagnosis of bonding disorders in the mothers. The Edinburgh Postnatal Depression Scale (EPDS) and Bangalore Maternal Behaviour Scale (BMBS) were used for rating depressive symptoms and caregiver reported behaviour of the mother towards the infant. We also did a factor analysis to find the factor structure of the PBQ-T. RESULTS: A 19-item PBQ-T that has five factors grouped into three subscales. The five factors are General Bonding (F1A), Frustration (F1B), Anxiety (F2), Feeling trapped (F3A) and Aggression/ Rejection dimensions (F3B) loading onto three subscales 1, 2 and 3. Total PBQ-T scores were best used to detect 'any disorder of bonding' (cut-off 5/6). Subscale 1 (cut-off 2/3) was useful in detection of mild disorders of bonding, subscale 2 (cut-off 2/3) for infant-focused anxiety and subscale 3 (cut-off 0/1) for Anger/ Rejection. Mothers with bonding disorders had greater psychological distress. Caregiver report of mother's behaviour (BMBS) could detect anxiety and anger/ rejection but not the lack of emotional bond. CONCLUSION: A 19-item Tamil version of the PBQ is useful in screening for disorders of mother-infant bonding among healthy postpartum mothers.

Psychometric properties of the Postpartum Bonding Questionnaire and correlates of mother-infant bonding impairment in Italian new mothers.

OBJECTIVE: impaired maternal bonding is a risk factor for problems with infant well-being and development. The investigation of perinatal variables related to disorders of the mother-infant relationship as well as the administration of reliable and valid screening tools to new mothers in the postpartum can help identify early signs of a disturbed mother-child relationship. The Postpartum Bonding Questionnaire (PBQ) has been shown to be a valid screening instrument, but its dimensional structure is still controversial. An analysis of the literature demonstrated the need for research into the perinatal correlates of the quality of mother-newborn bonding as measured by the PBQ, and for information about the reliability and validity of the Italian version of the questionnaire. AIM: to (a) carry out preliminary analysis of the psychometric properties of an Italian version of the PBQ and (b) explore how mother-infant disturbances are related to relevant perinatal psychological variables. DESIGN: the research design consisted of a prenatal and a postnatal phase. SETTING: prenatal education classes delivered in public and private institutions. PARTICIPANTS: 123 pregnant Italian women were recruited from prenatal education classes. MEASUREMENTS: in the prenatal period participants completed a questionnaire measuring maternal-fetal attachment; at the postnatal assessment (3 months postpartum) participants completed the Italian PBQ together with measures of mother-infant attachment, the couple's adjustment and maternal psychological well-being. Exploratory factor analysis was used to investigate the factor structure of the PBQ. Internal consistencies were evaluated using Cronbach's alpha. Nomological validity was assessed via Pearson correlations. FINDINGS: a three-factor model provided the most meaningful representation of the PBQ data, with one factor reflecting annoyance and anger towards the infant, another reflecting detachment and rejection and the third reflecting anxiety about infant care. Internal consistencies were good. Impaired mother-infant bonding was negatively correlated with prenatal and postnatal mother-infant attachment and couple adjustment, as well as being positively correlated with maternal depressive symptoms. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: the Italian PBQ is a reliable, valid screening instrument and can be used for research, including transcultural comparisons in perinatal psychiatry. It can also be used clinically to detect signs of a disordered mother-child relationship. Knowledge of the variables generally associated with mother-infant bonding problems combined with data from postpartum administration of the PBQ could be used in midwifery to develop preventive programmes based on the specific needs of new mothers.

The Japanese version of the Postpartum Bonding Questionnaire: Examination of the reliability, validity, and scale structure.

OBJECTIVE: The purpose of this study was to develop the Japanese version of the Postpartum Bonding Questionnaire (PBQ) to gather data on Japanese mothers for comparison with other cultures and to examine the scale structure of the PBQ among Japanese mothers. METHODS: We administered the PBQ to a cross-section of 244 mothers 4 weeks after delivery and again 2 weeks later to 199 mothers as a retest to examine reliability. We used exploratory factor analysis to evaluate the factor structure of the PBQ. Correlations with the Mother-to-Infant Bonding Scale (MIBS), the Maternal Attachment Inventory (MAI), Edinburgh Postnatal Depression Scale (EPDS), and sociodemographic variables were calculated for validation. RESULTS: The 14-item version of the PBQ extracted by exploratory analysis consisted of four factors: 'impaired bonding', 'rejection and anger', 'anxiety about care', and 'lack of affection'. We found significant correlations of the total scores of the PBQ and the 14-item version of the PBQ positively with the MIBS and negatively with the MAI. Moderate significant correlations with total scores were also found with the EPDS. Total scores for primiparous and depressed mothers were higher than those for multiparous mothers and mothers without depression. CONCLUSION: The results of this study demonstrated the reliability and validity of the PBQ and the 14-item version of the PBQ in Japanese mothers 4 weeks after delivery.

Birth-related, psychosocial, and emotional correlates of positive maternal-infant bonding in a cohort of first-time mothers.

OBJECTIVE: to describe the development of a shortened 10-item version of the Postpartum Bonding Questionnaire (S-PBQ) and examine the relationship between birth-related, psychosocial, and emotional factors and maternal-infant bonding. DESIGN: cross-sectional interview study. SETTING: women having their first baby in Pennsylvania, USA. PARTICIPANTS: we interviewed 3005 women in their third trimester and at one month post partum who were enroled in the First Baby Study. MEASUREMENTS AND FINDINGS: for the S-PBQ, we completed factor analysis and examined instrument properties. We examined the relationship between birth-related, psychosocial, and emotional factors and maternal-infant bonding using adjusted linear regression models. The S-PBQ demonstrated acceptable internal reliability (Cronbach׳s α=0.67). Analysis revealed a socio-economic bias such that women who were older, more educated, not living in poverty, and married reported lower bonding scores. Maternal-infant bonding was significantly negatively correlated with maternal stress, maternal pain, and post partum depression, and positively correlated with partner support with the infant, and social support. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: For researchers who wish to measure maternal-infant bonding but are in need of a relatively short scale, the 10 item S-PBQ may be a useful alternative to the original version. However, it is important that researchers measuring maternal-infant bonding also investigate socio-economic bias in their studies and adjust for this effect as needed. Our results also indicate that clinicians should be aware of life stressors that may impact the maternal-infant relationship, in order that intervention may be provided to improved health outcomes for mothers, infants, and families.