Intimate Partner Attachment Style and Antenatal Depression Symptoms in Nulliparas: Results from the ZRNO Study.

ABSTRACT

BACKGROUND: The purpose of this study was to examine the relationship between the important indicators that define mental health functioning during the first pregnancy the level of depression, anxiety and fear of childbirth in the context of nulliparas' intimate partner attachment style type and older generation's emotional support. SUBJECTS AND METHODS: A group of 325 nulliparas in the third trimester of pregnancy were enrolled at the Childbirth preparation program of the University Medical Centre Ljubljana's Division of Gynaecology and Obstetrics. The following instruments were applied Experiences in Close Relationships-Revised, The Edinburgh Depression Scale, two aspects of anxiety - Zung Anxiety Scale and a questionnaire regarding fear of childbirth. Attachment anxiety and avoidance scales were recoded into four categories of a prototypical attachment style secure, fearful, preoccupied and dismissive. Two-way ANOVA and the chi-square test were used for the statistical analysis. RESULTS: All indicators of mental health functioning of our sample of nulliparas differed significantly regarding their partner attachment style. Nulliparas with a fearful, but also with a preoccupied type of attachment, showed less optimal mental health indicators compared to those with a secure/dismissive type of attachment. A significant interactive effect of partner attachment and emotional support from the older generation was found on the level of depression. Partner attachment styles and emotional support from the older generation were found to be statistically dependent. CONCLUSIONS: In our sample a secure attachment seems to represent a protective buffer for the level of depression, even when a lower emotional support of the older generation was included. Screening and intervening on intimate attachment style as a protective factor for antenatal depression and different forms of anxiety is proposed.