The role of insecure attachment in the development of problems in mother-child bonding in women with postpartum PTSD symptoms.

Background:
An increasing amount of research is being conducted on the consequences of
postpartum PTSD. Research shows that childbirth-related PTSD symptoms can have
a negative impact on the mother-child relationship (Cook et al., 2018). To
date, however, research has not focussed on the underlying mechanisms. Thus the
question arises, as to whether the problems in the mother-child bond are a
direct result of the postpartum PTSD complaints, or whether other factors also
play a role. As described by Bowlby in 1982, attachment can affect the way one
feels about and interacts with their child. Furthermore, Markin (2013)
describes how women who are diagnosed with a borderline personality disorder
(often based on an attachment disorder) experience more problems in mother-baby
dyads postpartum. The problems in the mother-child bond that are experienced by
women with postpartum PTSD symptoms could therefore be (partly) explained by an
insecure attachment.

Primary hypothesis:
Insecure attachment, in combination with postpartum PTSD symptoms in mothers,
leads to a higher degree of problems in the mother-child bond, than the
aforementioned variables alone (interaction effect insecure attachment X
postpartum PTSD).

Secondary hypotheses:
- Insecure attachment in mothers leads to problems in mother-child bonding
(main effect of insecure attachment).
- Postpartum PTSD symptoms lead to problems in mother-child bonding (main
effect of postpartum PTSD).
- Attachment in mothers is consistent over time.

Primary objective:
Are postpartum PTSD symptoms an independent predictor for impaired mother-child
bonding, or does insecure attachment in mothers, also play a role in this?

Longitudinal questionnaire survey.

The questionnaires will cost participants 45 to 60 minutes to complete.
Participation can take place at home. There is a potential for questions to be
experienced as emotionally demanding. However, we assume that the extent of
this will likely be limited, as participants experiencing psychological
complaints experience these regardless of their participation in the research.
In view of the limited workload associated with respondent participation, we
believe that carrying out the research is justified. The results of the study
can potentially contribute to a better understanding of the relationship
between postpartum PTSD symptoms and problems in mother-child bonding. If our
hypothesis is correct that insecure attachment in mothers plays a role in
mother-child bonding, then the findings could be used to inform preventive
interventions aimed at enhancing mother-child bonding. In the longer term this
could potentially contribute to reducing the risk of childhood psychopathology.