Paternal depression and anxiety: risk factorsand adverse impact on infant temperament and development

Abstract

Transition to parenthood is a major life event that affects both fathers and mothers. Being a potentially stressful period, it can predispose vulnerable individuals to mental health problems. Compared with maternal studies, there is a dearth of longitudinal research on the psychological impact of transition to fatherhood, particularly with anxiety problems. There are emerging studies demonstrating the adverse consequences of paternal postpartum depression on infant outcomes. It is important to investigate paternal postpartum depression and anxiety and address their relationships with poor infant outcomes which will contribute to the recognition of the problems and the development of early intervention. The current study aimed to contribute to greater knowledge on risk factors of paternal postpartum mental health problems, and their adverse impact on infants, as well as understanding the possible mediating mechanisms underlying such a relationship. A total of 654 couples completed self-report questionnaires at third trimester of pregnancy using validated self-report psychological instruments to evaluate fathers' prenatal mental health. Among them, 255 couples were examined longitudinally at six week postpartum for depression and anxiety symptoms, and fathers were also assessed for marital satisfaction, self-esteem, social support, and postpartum attachment with infants. At six months postpartum, 121couples were again surveyed to assess their infants’ temperament and development. According to established cut-offs, 12.0% and 13.1% of fathers experienced significant postpartum depression and anxiety. No demographic risk factors were found for postpartum depression or anxiety. Multiple regression analyses indicated that low martial satisfaction, low self-esteem, fathers having prenatal anxiety and depression, partners having postpartum depression predicted fathers’ postpartum depression. Low marital satisfaction, low self-esteem, poor social support and fathers having prenatal anxiety were significant risk factors for fathers’ postpartum anxiety. Depressed and anxious fathers reported having less patience and tolerance, pleasure in interaction, and affection and pride with their infants. Paternal postpartum depression was related to reduced infants’ falling reactivity, and poor social and total development in infants; while postpartum anxiety was associated with heightened infants’ distress to limitations, reduced failing reactivity and greater sadness. Baron and Kenny’s criteria was used to investigate whether poor paternal attachment with infants mediated these relationships. Pleasure in interaction partially mediated the relationship between paternal postpartum depression and social as well as total development in infants, whereas affection and pride mediated between fathers' postpartum depression and infants' falling reactivity as well as social development. Affection and pride also served as a partial mediator between fathers' postpartum anxiety and infants’ failing reactivity. Findings revealed that paternal postpartum depression and anxiety are significant mental health problems. Low marital satisfaction, low self-esteem, poor social support, prenatal depression and anxiety, and partners' postpartum depression could contribute to these problems. Postpartum depression and anxiety could reduce fathers' attachment with infants, which adversely impacted infants' temperament and development. The current study also addressed that risk factors for paternal postpartum depression and anxiety were different, and they had distinctive environmental pathways affecting infant outcomes. This provides significant implications for designing timely and effective interventions to improve fathers' well-being and proper father-infant interaction. (499