Date of Award


Document Type


Degree Name

Doctor of Philosophy in Clinical Psychology



First Advisor

Lisa Samstag

Committee Chair and Members

Lisa Samstag, Chair

Philip Wong

Sara Haden


Attachment, Distorted beliefs, Motherhood, Postpartum depression, Self-criticism


Postpartum Depression (PPD) is the most common complication of childbirth, impacting the development of children as well as the wellbeing of mothers and families. Several psychological factors have been found to be associated with PPD, including insecure attachment, self-criticism, dependency, and distorted beliefs about motherhood. However, attachment research has yielded conflicting findings regarding which attachment style is most associated with PPD. Additionally, dependency has been found to be either a protective or a risk factor for PPD in the perinatal population. Further, the cognitive research has not examined factors impacting distorted beliefs about motherhood. Finally, self-criticism, dependency, and distorted beliefs have been shown to mediate the relationship between attachment and depression but had not yet been tested on the perinatal population. This study aimed to address these limitations by integrating attachment, personality characteristics, and distorted beliefs about motherhood on PPD into one overarching model. A Structural Equation Model (SEM) consisting of a sequential double-mediation including these risk factors was tested on an online sample of 537 mothers in the first year postpartum. This model was found to be a good fit and insecure attachment, particularly avoidant attachment, self-criticism, and distorted beliefs about motherhood were significant risk factors for PPD. Self-criticism and distorted beliefs about motherhood partially and sequentially mediated the relationship between attachment and PPD. Additionally, insecure attachment was found to contribute the most to PPD, followed by self-criticism. Distorted beliefs had a negligible effect on PPD. Theoretical and clinical implications are discussed.