The effects of mentalization and sensitivity of postpartum depression mothers after the circle of security-intensive intervention on the social-emotional development of three-year-old children.

OBJECTIVE

Postpartum depression (PPD) significantly impacts mothers and their children, making relationship-building interventions necessary for prevention. The Circle of Security-Intensive (COS-I) is a specialized approach designed to enhance parental sensitivity and mentalization, with the objective of promoting the child's social-emotional development. This study is based on data from a previously conducted randomized controlled trial and aims to evaluate the effectiveness of COS-I in mothers with postpartum depression (PPD) exhibiting reflective functioning (RF), pre-mentalization (PM), and sensitivity, as determined by a mediation model, following intervention. The hypothesis is that COS-I have a positive effect on a child's social-emotional development. It is predicted that RF, PM, and sensitivity will mediate this effect compared to Treatment-as-usual (Tau).

METHOD: A sample of 44 PPD mothers and their children participated in the model testing. Subsequent to the intervention, at 16-18 months of child age, RF was measured using the Adult Attachment Interview, PM with the Parental Reflective Functioning Questionnaire, and sensitivity with the Mini-Maternal Behavior-Q-Sort. At 36 months of age, the child's social-emotional development was assessed using the Functional Emotional Assessment Scale (FEAS). Baseline socio-demographic and clinical characteristics were controlled for.

RESULTS

At age three, COS-I showed equal FEAS for the children compared to Tau. There were no differences in interventions regarding the mediators (RF, PM, sensitivity). Exploratory analyses suggest that, in children, PM adversely affects their social-emotional development, regardless of intervention.

CONCLUSIONS

This underscores the necessity for more focused attention on PM in mothers with postpartum depression for clinical intervention purposes and improving the efficacy of COS-I on subsequent child development.