A screening questionnaire for mother-infant bonding disorders

Background: There is a need in primary care for an easily administered instrument to give early indications of disorders in mother-infant relationships. Methods: An 84 item questionnaire was administered to 104 subjects, including normal mothers, depressed mothers with a normal mother-infant relationship and mothers with bonding disorders. A principle component analysis was used to select items for scale construction. Scale scores were compared with interview data. Reliability, sensitivity and specificity of the scales were measured. Findings: 4 factors of clinical relevance were obtained and used to construct 4 scales. The questionnaire was reduced to 25 questions. Scale 1 (impaired bonding) had a sensitivity of 0.93 in detecting mothers with bonding disorder. Scale 2 (rejection and anger) specifically identified mothers with severe disorders. Scale 3 may be useful in anxious mothers. Scale 4 signalled the presence of incipient abuse, requiring urgent intervention. Interpretation: This questionnaire can be used, with the Edinburgh Postnatal Depression Scale, by midwives and health visitors, for the early diagnosis of mother-infant bonding disorders.