Can a Partner's Understanding Help Families Cope with Maternal Depression?

What you need to know

• A father’s ability to understand his partner’s mental states (called “partner reflective functioning”) may help protect against negative effects of maternal depression on the family.
• When fathers had higher partner reflective functioning, maternal depression during pregnancy was less likely to continue postpartum.
• Higher partner reflective functioning in fathers was also associated with less permissive parenting by mothers and better self-regulation in children when mothers experienced prenatal depression.
• Interventions to improve reflective functioning in partners may help support families affected by maternal depression.

The impact of maternal depression on families

Depression during pregnancy and after childbirth is unfortunately common, affecting about 10-20% of women. When a mother experiences depression, it can have ripple effects throughout the family. Past research has found that maternal depression is associated with:

• Increased risk of the mother continuing to experience depression after the baby is born
• More difficulties in the couple’s relationship
• Less responsive and engaged parenting
• Problems with children’s emotional development and behavior

Given how impactful maternal depression can be, researchers wanted to understand what factors might help protect families and reduce these negative outcomes. This study looked at whether a father’s ability to understand and reflect on his partner’s mental states - what researchers call “partner reflective functioning” - could help buffer against some of the effects of maternal depression.

What is reflective functioning?

Reflective functioning refers to the ability to understand that both oneself and others have mental states - thoughts, feelings, beliefs, desires, etc. - that influence behavior. It involves being able to imagine what someone else might be thinking or feeling in a given situation.

For example, high reflective functioning would involve recognizing that your partner seems upset and considering what might be causing those feelings, rather than just reacting to their behavior. Low reflective functioning might involve difficulty understanding why someone is acting a certain way or not considering their perspective.

This study looked specifically at partner reflective functioning - how well fathers were able to reflect on and understand the mental states of their romantic partners (the mothers). The researchers were interested in whether higher partner reflective functioning in fathers could help protect families when mothers experienced depression.

How the study worked

The researchers followed 91 couples in Israel who were expecting their first child. They measured:

• Depression symptoms in both mothers and fathers during pregnancy and at 6 months and 24 months after birth
• Partner reflective functioning in both parents at 6 months after birth
• Parenting style at 24 months after birth
• Children’s self-regulation abilities at 24 months

To measure partner reflective functioning, the researchers conducted interviews asking parents to describe their relationship and reflect on their partner’s thoughts and feelings in various situations. These interviews were then coded by trained raters to assess the level of reflective functioning demonstrated.

The main question was whether higher partner reflective functioning in fathers would weaken the links between maternal depression during pregnancy and negative outcomes later on.

Key findings

The study found several ways that higher partner reflective functioning in fathers seemed to help protect families when mothers experienced prenatal depression:

Continued maternal depression

When fathers had low or average levels of partner reflective functioning, maternal depression during pregnancy was strongly linked to continued depression 2 years after birth. But when fathers had high partner reflective functioning, there was no significant link between prenatal and postnatal maternal depression.

This suggests that when fathers are better able to understand and reflect on their partner’s mental states, it may help prevent depression from persisting long-term in mothers.

Permissive parenting

Maternal depression during pregnancy was associated with more permissive parenting by mothers 2 years later, but only when fathers had low or average partner reflective functioning. With high paternal reflective functioning, there was no link between prenatal depression and later permissive parenting.

Permissive parenting involves being very lenient, with few rules or consequences. While it may stem from fatigue or low confidence associated with depression, it can lead to behavior problems in children. The findings suggest that a reflective, understanding partner may help depressed mothers maintain more effective parenting approaches.

Child self-regulation

The study also looked at children’s effortful control - their ability to manage their attention and behavior. They found that maternal prenatal depression predicted worse effortful control in children, but only when fathers had very low partner reflective functioning.

Interestingly, when fathers had very high reflective functioning, maternal prenatal depression actually predicted better effortful control in children. The researchers suggest this could mean highly reflective fathers are able to compensate and provide extra support for child development when mothers are struggling.

Why partner reflective functioning may help

The researchers propose a few ways that having a reflective, understanding partner could help buffer against the effects of maternal depression:

1. Fathers who can reflect on their partner’s mental states may be better able to provide emotional support and help mothers process negative thoughts/feelings.

2. Reflective partners may be more likely to take on additional childcare/household responsibilities to reduce stress on depressed mothers.

3. Understanding a partner’s perspective could help fathers support, rather than undermine, mothers’ parenting choices.

4. The ability to mentalize about a partner’s needs may allow fathers to provide tailored, effective support during a vulnerable time.

5. Reflective functioning in the couple relationship may promote better overall family dynamics and functioning.

Implications for helping families

These findings suggest that building reflective functioning skills in partners could be a promising way to support families affected by maternal depression. Some potential applications include:

• Screening for reflective functioning abilities in partners of women at risk for perinatal depression
• Incorporating reflective functioning training into prenatal classes and depression prevention programs
• Developing targeted interventions to improve partner reflective functioning
• Including partners in depression treatment and teaching them reflective skills

The researchers note that even moderate increases in reflective functioning could be beneficial. They suggest brief interventions focused on helping partners identify and understand each other’s mental states could potentially have long-lasting benefits for family functioning.

Conclusions

• A father’s ability to understand and reflect on his partner’s mental states appears to help protect families against some negative effects of maternal depression.
• Higher partner reflective functioning in fathers was associated with lower risk of continued maternal depression, less permissive parenting, and better child self-regulation in families where mothers experienced prenatal depression.
• Interventions to improve reflective functioning in partners may be a promising way to support families and promote resilience in the face of maternal depression.
• More research is needed to further explore the mechanisms of how partner reflective functioning helps and develop effective ways to enhance this skill in couples.