Perceived Causes of Postnatal Depression

Summary This thesis aims to provide an understanding of the perceived causes of Postnatal Depression (PND). Despite increasing research exploring the aetiology and risk factors for PND, to date, little research has explored how individuals perceive the causes of PND. The first part of this thesis reviews the literature on causal beliefs in adults in clinical, community and general population samples. Thirteen papers were critically appraised to reveal insights into these perceived causes. Beliefs were grouped into four emergent themes: (1) biological; (2) psychological; (3) social; and (4) cultural (including religious). The review identified a need to explore how PND is understood culturally, particularly amongst lay individuals from minority faith and ethnic groups. In accordance with these recommendations, the second part of this thesis is a Q-methodological study of the perceived causes of PND amongst British Muslim women of Arab origin. The sample comprised eleven participants recruited from a community organisation. Participants sorted 50 statements, each detailing a possible cause of PND, according to how much they believed them to be causes of PND. Findings identified two clear and distinct accounts: stress-generation and diathesis-stress, significant in causing PND. Although both accounts were clearly embedded in faith and values, the viewpoints operated with a subtly different interpretation of the role of faith in relation to PND. The third paper provides a reflective commentary on the research process, including a methodological critique of the research project and reflections on the personal impact of the research on the researcher. Contrary to the dominant biomedical model, the thesis highlights the existence of wide-ranging, multi-factorial explanatory models for PND. Eliciting and understanding these causal models can help to engage clients and provide culturally sensitive interventions