Year

1999

Degree Name

Doctor of Clinical Psychology

Department

Department of Psychology

Abstract

This study adopted a developmental-transactional, psychodynamic model of women's psychological approaches to the childbirth transition to maternity, termed the maternal orientation model (Raphael-Leff, 1993), to conceptualise the course and concomitants of the transition. Raphael-Leff proposes three predominant approaches, Facilitator, Regulator and Reciprocator, each of which is characterised by unique constellations of anxieties, defenses and behaviours evident in pregnancy and the early post-partum, and each of which is associated with differential courses of transition, precipitants and of increased vulnerability to distress. In this study a number of hypotheses and exploratory questions were tested. Firstly, the content, discriminant and concurrent validity of one maternal orientation instrument, the Pregnancy Six to Nine Months Questionnaire (P6-9MQ, Raphael-Leff, 1983; Sharp, 1995), were examined. Secondly, the distribution of maternal orientation in an Australian community population was examined. Thirdly, some hypotheses and exploratory questions derived from the model regarding maternal post-partum minor psychiatric symptomatology, minor depressive symptomatology, depression diagnosis and infant-mother synchrony were examined. It was hypothesised that women with Regulator orientations would show more minor psychiatric symptomatology, depressive symptomatology, diagnoses of depression and lower infant-mother synchrony, than women with Facilitator orientations between 6 and 8 weeks post-partum. Maternal orientation was measured after 36 weeks in a community sample of 73 pregnant women attending ante-natal clinics at a major general hospital in Melbourne, Australia. At 6 weeks post-partum, minor psychiatric and depressive symptomatology were measured, and depression diagnosis was assessed in those recording clinically significant depressive symptoms. At 8 weeks, a subset of 10 women provided infant-mother synchrony data. The P6-9MQ was found to have fair content validity but poor discriminant and concurrent validity. The latter result was likely to reflect the poor psychometric properties of the comparison instrument. Maternal orientation was distributed bi-modally, with the dominant groups being the (Collapsed) Facilitator and (Collapsed) Mixed Facilitator/Regulator groups. Because the groups were not well discriminated, planned group comparisons were not made along dependant variables. Instead, patterns of responding to the P6-9MQ by the clinical and non-clinical groups in each dependant variable, were compared. The only variable, along which there was some evidence of different patterns of responding to P6-9MQ items, was depressive symptomatology. Issues such as the conceptualisation and measurement of maternal orientation, the sample demographics and sample size proposed to be associated with null results, are discussed.

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Unless otherwise indicated, the views expressed in this thesis are those of the author and do not necessarily represent the views of the University of Wollongong.