Responsibility beliefs, guilt, and self-esteem in postpartum psychosis

Erica Maloney

Research output: ThesisDoctoral Thesis

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Background: Postpartum psychosis (PPP) is a severe psychiatric disorder characterised by a sudden onset usually in the first few weeks after childbirth. Symptoms development is rapid and can have significant consequences for the safety of mother and infant. Typically, the acute psychotic episode is relatively short in duration, however, the literature reports that difficulties persist beyond this time. Research on PPP is underdeveloped and so the psychological mechanisms underlying such experiences are yet to be understood. Cognitive and affective factors including responsibility appraisals, guilt and self-esteem have been linked to psychosis and postpartum mental health difficulties more broadly and may apply to PPP.

Objective: This study aimed to establish whether responsibility beliefs, self-esteem and guilt are linked to PPP following illness compared to clinical and non-clinical postpartum control groups and to what extent these cognitive and affective factors impact on wellbeing.

Method: In a cross-sectional design, 67 women who had experienced PPP, postnatal depression (PND) and no postpartum-related mental health difficulties were recruited via online platforms. They completed an online survey which included measures of responsibility, guilt, self-esteem, and wellbeing.

Results: As hypothesised, results indicated that both PPP and clinical controls experienced elevated responsibility appraisals and guilt and lower self-esteem compared to non-clinical controls. There were no significant differences between PPP and clinical controls on these factors, however, the PPP group experienced significantly poorer wellbeing. Elevated responsibility and guilt and lower self-esteem were related to lower well-being overall, these associations were predicted by group membership only in the case of the PPP group.

Conclusion: Responsibility appraisals, guilt and self-esteem were not found to be specific to women who had experienced PPP, however, all factors were significantly different from controls indicating a potential role for these processes in postpartum mental health. Caution must be taken when interpreting the findings due to the limited sample size. Further research is required to identify psychological mechanisms specific to PPP so that theoretical understanding and clinical supports can be improved.

Original languageEnglish
Awarding Institution
  • Royal Holloway, University of London
  • Luzon, Olga, Supervisor
Award date1 Nov 2022
Publication statusUnpublished - 2022

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