Mind the gap: the role of perfectionism in symptoms of common maternal mental health problems & infantile regulatory difficulties during the perinatal period.

Abstract

This thesis submission comprises of two chapters. The first chapter is a systematic review and meta-analysis exploring the association between maternal perfectionism and symptoms of common mental health problems (depression and anxiety) in the perinatal period. In the absence of a prior review and meta-analysis, we aimed to ascertain whether trait perfectionism and/or parenting specific perfectionism was associated with perinatal symptoms of depression and anxiety in mothers, estimating a weighted effect size and additionally exploring possible moderators of timing (pre or post- natal), scales used to measure constructs, infant gender, temperament and age, in this relationship. A total of 14 studies met eligibility criteria for the meta-analysis and were subject to quality assessment and review. Perfectionism as a whole and the perfectionistic concerns sub-factor were found to be moderately correlated with common maternal perinatal mental health difficulties (in particular depression). No moderators reached significance. Findings support a focus on both the early identification of perfectionism and preventative interventions for associated common mental health difficulties in perinatal mothers. Our meta-analysis revealed both methodological and conceptual limitations of included studies and there is a need for further research in this area; with consistent exploration of perfectionistic concerns and strivings factors, as well as anxiety in addition to perinatal depression required.

The second chapter sought to explore the relationships between infantile colic, perfectionism and postnatal mental health difficulties (depression, anxiety and reduced well-being). A cross-sectional design was implemented to explore whether there were associations between prolonged infantile colic, perfectionism and postnatal mental health difficulties, as well as investigate whether perfectionism moderated the relationship between colic and mental health issues. 137 women with infants between the aged of 12-26 weeks and suffering from prolonged infantile colic were recruited through two streams, including online advertisement and placement of posters in community settings. Prevalence of clinical depression was 66.43% and anxiety 89.29% within our sample of women with a baby experiencing prolonged colic, with high comorbidity of both conditions. Hypotheses suggesting that prolonged infantile colic and all types of perfectionism (trait and parenting specific, inclusive of socially prescribed and self-oriented factors) would be correlated with postnatal depression and reduced well-being, were supported. Those in clinical groups for both depression and anxiety were found to have significantly higher scores for socially prescribed perfectionism (perfectionistic concerns). Significantly higher scores for self-oriented perfectionism (perfectionistic strivings) were found only in the clinical anxiety group. The hypotheses that perfectionism (in its different forms), would moderate the relationship between prolonged infantile colic and postnatal mental health difficulties were not supported. Perfectionism was found to have direct effects on postnatal mental health. Clinical and theoretical implications, as well future directions for research are discussed.
Keywords: perfectionism, perinatal, postnatal, mental health, depression, anxiety

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Identifiers

ORCID for Peter Lawrence: orcid.org/0000-0001-6181-433X

ORCID for Jana Kreppner: orcid.org/0000-0003-3527-9083

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