Research paperMaternal personality and postnatal bonding disorder in Japan: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study
Introduction
The formation of mother–to–infant bonding —maternal feelings and emotions towards her infant—has been a central focus of obstetric, neonatal, and pediatric nursing care (Bicking Kinsey and Hupcey, 2013). Postnatal bonding disorder has potentially serious effects on the long-term mother–child relationship, including child abuse or neglect (Brockington, 1996). In addition, disordered mother–child relationships are associated with poorer children's neuropsychological, behavioral, emotional, and social development from infancy to adulthood (Behrendt et al., 2019). Therefore, it is important to investigate the factors associated with bonding disorder to early identify and support mothers at higher risk for bonding disorder.
Despite the wealth of knowledge on the effects of maternal psychopathology, such as depressive symptoms, on bonding (Tichelman et al., 2019), the effects of maternal personality have received less attention. Maternal personality—individual differences in characteristic patterns of thinking, feeling and behaving—is associated with postnatal depressive symptoms (Iliadis et al., 2015), parenting style (Prinzie et al., 2009), and child psychological development (Landi et al., 2020). In contrast, there is limited evidence on the association between maternal personality and postnatal bonding disorder. Low persistence, low self-directedness, low cooperativeness (Ohashi et al., 2014), pessimism (Robakis et al., 2015), dysfunctional perfectionism and avoidant personality style (Oddo-Sommerfeld et al., 2016), emotion regulation difficulties (Behrendt et al., 2019), anger trait (Kitamura et al., 2015), and broader autism phenotype (Hirokawa et al., 2019) were predictive of postnatal bonding disorder. These existing studies focused on different personality dimensions anchored in diverse personality models, making the generalization of the results more difficult. Extraversion and neuroticism are two key personality dimensions that have been studied most intensively, as they are shared by different factor models of personality (Digman, 1990). However, to the best of our knowledge, extraversion has not been studied in the context of postnatal bonding, and only one study examined the association between neuroticism and postnatal bonding (Handelzalts et al., 2019). One meta-analytic review examining the associations between parents’ personality and parenting demonstrated that higher extraversion, agreeableness, and conscientiousness, and lower neuroticism were associated with more warmth and behavioral control (Prinzie et al., 2009). Therefore, we hypothesize that these dimensions of maternal personality are associated with postnatal bonding disorder.
Considering the above circumstances, we aimed to examine the associations between maternal personality and postnatal bonding disorder. Extraversion, neuroticism, psychoticism, and lie were used as personality dimensions, which were the subscales of the Eysenck Personality Questionnaire-Revised (EPQ-R) (Eysenck and Eysenck, 1975; Eysenck et al., 1985). As the association between personality and bonding was suggested to be mediated by postnatal depressive symptoms (Oddo-Sommerfeld et al., 2016; Handelzalts et al., 2019), we also focused on the effects of postnatal depressive symptoms on the association with bonding.
Section snippets
Study population
Data were obtained from the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study (TMM BirThree Cohort Study), which has been described elsewhere (Kuriyama et al., 2020). Pregnant women and their family members were contacted in obstetric clinics or hospitals when they scheduled their deliveries, from 2013 to 2017. Approximately 50 obstetric clinics and hospitals in Miyagi Prefecture participated in the recruiting process. Tohoku University Tohoku Medical Megabank Organization
Results
Table 1 shows the characteristics of the study participants. The mean scores (standard deviation) for the short-form EPQ-R subscales were 5.86 (3.28) for extraversion, 5.80 (3.02) for neuroticism, 2.40 (1.57) for psychoticism, and 5.29 (2.37) for lie. Women with bonding disorders were more educated, and more likely to be nulliparous, have negative feelings towards pregnancy and be socially isolated during pregnancy, and had higher EPDS scores one month after delivery.
Table 2 presents the
Discussion
The present study examined the association between maternal personality and postnatal bonding disorder in Japan. Higher extraversion was associated with a decreased risk of bonding disorder, LA, and AR. Higher neuroticism was associated with an increased risk of bonding disorder, but this association disappeared after further adjustment for postnatal depressive symptoms. The association between higher neuroticism and AR remained after further adjustment for postnatal depressive symptoms. Higher
Funding
The TMM BirThree Cohort Study was supported by the Japan Agency for Medical Research and Development (AMED), Japan [grant number, JP20km0105001]. This study was supported by a Grant-in-Aid for Early-Career Scientists (No. 18K17397) from the Ministry of Education, Culture, Sports, Science and Technology, Japan. The funding body played no role in the study's design, implementation, data collection and analysis, or the decision to publish the findings.
Author statement
K.M., F.N., and I.N., developed the study concept and contributed to the study design. K.M. analyzed the data and wrote the manuscript. SK reviewed drafts as an epidemiological and public health specialist. K.M., F.N., M.I., A.N., T.Onuma., T.Obara., and S.K. contributed to data collection. All authors provided critical feedback and approved the final version of the manuscript for submission.
Declaration of Competing Interest
None.
Acknowledgments
The authors wish to express their appreciation to the pregnant women who participated in the TMM BirThree Cohort Study.
References (45)
- et al.
The Eysenck Personality Questionnaire: an examination of the factorial similarity of P, E, N, and L across 34 countries
Pers. Individ. Dif.
(1998) - et al.
State of the science of maternal-infant bonding: a principle-based concept analysis
Midwifery
(2013) Postpartum psychiatric disorders
Lancet
(2004)- et al.
A revised version of the psychoticism scale
Pers. Individ. Dif.
(1985) - et al.
Associations between broader autism phenotype (BAP) and maternal attachment are moderated by maternal postpartum depression when infants are one month old: a prospective study of the Japan environment & children's study
J. Affect. Disord.
(2019) - et al.
The efficacy of interventions aimed at improving post-partum bonding: a review of interventions addressing parent-infant bonding in healthy and at risk populations
J. Neonatal. Nurs.
(2019) - et al.
Discrete category of mother-to-infant bonding disorder and its identification by the Mother-to-Infant Bonding Scale: a study in Japanese mothers of a 1-month-old
Early. Hum. Dev.
(2017) - et al.
Longitudinal effects of dysfunctional perfectionism and avoidant personality style on postpartum mental disorders: pathways through antepartum depression and anxiety
J. Affect. Disord.
(2016) - et al.
The role of extraversion, neuroticism and positive and negative mood in emotional information processing
Pers. Individ. Dif.
(2008) - et al.
Extraversion, social support processes, and stress
Pers. Individ. Dif.
(2002)
Extraversion-Introversion (Eysenck's Theory)
Neuroticism (Eysenck's Theory)
Psychoticism (Eysenck's Theory)
Like mother, like child? Maternal determinants of children's early social-emotional development
Infant. Ment. Health. J.
Motherhood and Mental Health
Neuroticism
Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale
Br. J. Psychiatry.
Psychosocial and psychological interventions for preventing postpartum depression
Cochrane. Database. Syst. Rev.
Personality structure: emergence of the Five-Factor Model
Annu. Rev. Psychol.
Postpartum bonding: the role of perinatal depression, anxiety and maternal-fetal bonding during pregnancy
Arch. Womens. Ment. Health.
Manual of the Eysenck Personality Questionnaire
An association of adult personality with prenatal and early postnatal growth: the EPQ lie-scale
BMC Psychol.
Cited by (9)
The concept analysis of parent-infant bonding during pregnancy and infancy: a systematic review and meta-synthesis
2024, Journal of Reproductive and Infant PsychologyFactors associated with new onset of father-to-infant bonding failure from 1 to 6 months postpartum: an adjunct study of the Japan environment and children’s study
2023, Social Psychiatry and Psychiatric EpidemiologyMaternal postnatal bonding disorder and developmental delays in children: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study
2023, Archives of Women's Mental HealthSocial isolation and postnatal bonding disorder in Japan: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study
2022, Archives of Women's Mental Health