The Functions of Postpartum Depression

Correlate of PPD

Prenatal and delivery problems:

Postnatal problems:

Unexpected correlations:

Table 2: Studies that found a correlation between infant quality variables and PPD (*PPD assessed by clinical
diagnosis).

The third hypothesis applies to major rather than minor PPD. A minor form of PPD
involving fewer and less severe symptoms is sometimes distinguished from PPD involving a
major depressive episode.² Minor PPD is consistent with the psychological pain hypothesis and
the two proposed functions described earlier. Symptoms of major PPD not well accounted for
by the psychological pain hypothesis—e.g., marked loss of interest in virtually all activities,
psychomotor retardation, significant weight loss, diminished ability to think or concentrate, and
recurrent thoughts of death—may enable the mother to negotiate greater levels of social support,
the third functional hypothesis. In the same way that a valuable employee may attempt to
negotiate a larger salary by threatening to quit, mothers receiving insufficient social support may
attempt to negotiate larger levels of support by threatening to defect from (i.e., quit) the
childrearing endeavor. This hypothesis cannot be adequately tested with the data that are
currently available and it is justified on purely theoretical grounds; as such, it is quite
speculative.

²Virtually all studies of PPD rely on either a clinical diagnosis according to the criteria in the Diagnostic and
Statistical Manual (DSM), International Classification of Diseases (ICD), or on depression instrument scores (e.g.,
Edinburgh Postnatal Depression Scale, Cox et al. 1987) representing a continuum of severity. Minor PPD is
usually not diagnosed separately, but is defined by establishing a lower cutoff for a self-report score, or for
number of symptoms reported.

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