Attention Deficit Hyperactivity Disorder in the perinatal environment: Identifying mothers and infants at risk

Infants who experience attachment insecurity experience greater risk of long-term adverse outcomes (physical, cognitive, social-emotional,
behavioural). Infant attachment security is influenced by early caregiving namely mother-infant relationship quality (MIRQ). Maternal
depressive symptoms and psychosocial risk factors influence MIRQ. A vulnerable cohort are infants whose mothers experience Attention
Deficit Hyperactivity Disorder (ADHD), given demonstrated associations with depression and perinatal (pregnancy and postpartum)
psychosocial risks. Pregnancy is an opportune time for identifying mother-infant dyads at risk of suboptimal MIRQ. Although unborn
infants are indirectly considered within perinatal mental health screening, follow-up care focuses on the mother’s mental health and may
not effectively address the mother-infant relationship nor the infant’s needs.
Perinatal mental health screening has been implemented focused on maternal depressive symptoms. Current Australian guidelines
recommend screening all women for depressive symptoms during the perinatal period using the Edinburgh Postnatal Depression Scale
(EPDS). However, the Interpersonal Sensitivity Measure (IPSM) has been shown to more accurately detect vulnerability to suboptimal MIRQ
than the EPDS. The brief self-report IPSM measures the personality characteristic, interpersonal sensitivity. An advantage of the IPSM is its
early identification of women prone to perinatal depression and mental illness, and mother-infant dyads at-risk of suboptimal MIRQ
antenatally. The IPSM may therefore improve perinatal screening by identifying both maternal mental illness and suboptimal MIRQ.
The current proposal aims to build on previous research to explore the utility of the IPSM in perinatal screening for mothers with ADHD. I
propose that mothers with ADHD are at increased risk of suboptimal MIRQ related to cognitive and executive functioning, and self- and
emotion-regulation, which the IPSM might identify. Additionally, ADHD is a foundation element of the study because of its demonstrated
associations with personality and attachment patterns, and its high comorbidity with mental illnesses with which the IPSM is associated.