INTERPERSONAL PSYCHOTHERAPY FOR POSTPARTUM DEPRESSION

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The major purpose of the proposed research is to evaluate interpersonal psychotherapy (IPT) as a treatment for postpartum depression. The second purpose is to evaluate the effect of IPT on (a) women's adjustment in their relationships with their spouses, children, families, and friends, (b) the women's responsiveness to their infants, and (c) the infants' affective expression and emotional regulation. The third purpose is to determine the rate of recurrence of depression in successfully treated women over an 18 month period following the end of treatment. The fourth purpose is to evaluate a clinical-social model of depression recurrence in successfully treated women. A sample of 104 postpartum depressed women will be randomly assigned to immediate or delayed (a waiting list control) IPT. Treatment will consist of 12 to 16 sessions (over 12 weeks) with a private therapist. Assessments of women before, during, and after therapy with several measures of depression and social adjustment will be undertaken to determine the value of treatment. Following the treatment trial all women will be followed for 18 months with self-report or interview assessments of depression and social adjustment occurring every three months. Assessments of children will take place at post-therapy and at two years of age. We expect that women receiving interpersonal psychotherapy will evidence significantly lower levels of depression, higher levels of social adjustment than women in the waiting list control condition, and be more responsive to their infants. We also expect that approximately 40% to 50% of successfully treated women will experience a recurrence of their depression during the 18 month follow-up period. We expect that previous history of depression and other psychiatric disorders will be associated with increased risk of depression recurrence. The proposed research should lay the groundwork for later studies to (a) prevent depression recurrence in women successfully treated for postpartum depression and (b) to improve the social adjustment of young children by reducing their exposure to maternal depression. The final purpose of this proposed research is to evaluate the contribution of maternal depression in the first two years of children's lives to their adjustment at age two. Finally, we expect that children whose mothers were chronically depressed during their first two years of life will show poorer adjustment at two years of age.