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An overview of attachment theory, and perinatal depression

1 Aug 2014
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The relationship an infant has with their primary caregiver (in Australian society, this is usually the mother) has a profound impact on the infant’s future development. It is now well recognised that experiences in the first weeks and months of life help shape the developing brain; the most important of these experiences is the attachment relationship between the infant and their primary caregiver. 

One of most important tasks of childhood is for the child to develop the ability to express and regulate their emotions; they start to learn to do this from birth with the help of a sensitive and responsive caregiver. The foundation for their future mental health is based on this capacity for emotional regulation.

Secure attachment relationships are fundamental to infant development, providing a foundation for healthy social, emotional and cognitive development. A secure attachment relationship begins with facial mirroring and interaction with the baby and moves on to one that involves opportunities for play, everyday activities and sharing of emotions. These relationships facilitate optimal brain development and stimulate the infant’s curiosity to explore and learn.

The importance of experiences within the attachment relationship for infant behavioural and emotional regulation, and the neurobiological mechanisms underlying the process of attachment, has been a clinical and research focus. Nurturing, contingent, stable, and predictable early experiences promote healthy brain development and the optimal regulation of physiological stress regulation systems.

When early life experiences are full of threat, uncertainty, neglect, or abuse, the infant’s stress management systems are over-activated. This disrupts the architecture of the brain and can contribute to negative health consequences throughout the lifespan. The earliest family relationships are where infants learn how to interact and relate, and this has implications for their sense of connectedness to others and for future participation in society. 

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Achieving a stronger, healthier, more productive future for all Australians begins at the start of life. Although motherhood is a time of great joy and celebration, the experience of new motherhood is, for many mothers, not necessarily what they expected. Many women will struggle with the changes and challenges that come along with accommodating and nurturing a new baby. The unexpected difficulties and challenges that accompany new parenthood can present risks to both mothers’ and fathers’ wellbeing and mental health, as well as to the development and mental health of the infant.

Maternal mental health  has a significant impact on children’s mental health and later life outcomes (O’Hara & Swain, 1996; Gutteling et al, 2005; Weissman et al, 2006). It is estimated that one in seven mothers will be diagnosed with perinatal depression in Australia each year (Deloitte, 2012), which poses significant challenges to both maternal and infant mental health, and the future health and wellbeing of the child (Vos, Flaxman, Naghavi, Lozano, Michaud et al, 2012).

Depression during the childbearing years has the same symptom profile as depression diagnosed at other life stages and occurs across all cultures. 

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2014
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