Self-Structure and Postpartum Dejection in First-Time Mothers

An Autoethnographic Examination of Postpartum Depression

PURPOSE

This article examines postpartum depression (PPD) using autoethnography to explore the stigmatization of depression and cultural expectations of motherhood. Because the personal experiences of living with PPD are often absent from primary care literature, this article uses first-person narrative and analysis of intensive mothering to explore the barriers to seeking PPD treatment, the need for increasing physician confidence and comfort using screening tools, and the impact PPD stigma has on patients and their health care.

METHODS

Autoethnography, as a relatively unfamiliar methodology in primary care, is used to illuminate individual experiences of living with PPD. The author details a series of encounters as wife, mother, and patient by narrating what it means to live with the disease. A thematic analysis of the series of first-person narratives was employed to further understand the culture of motherhood and shed light on the stigmatization of PPD.

RESULTS

Four themes emerged from the analysis revealing the pressures surrounding the cultural ideologies of intensive mothering and the stigma of mental illness: essentialism, failure, shame, and avoidance.

DISCUSSION

There is a need to reframe cultural perceptions of motherhood and PPD to positively impact familial interactions and health care encounters for those who live with the illness. The article calls for providing broader diagnostic efforts, more comprehensive care, and engagement with patients in shared decision making around the diagnosis and treatment of PPD.

Identity related to living situation in six individuals with congenital quadriplegia

PURPOSE

This study was a preliminary examination of structural aspects of identity, particularly identity associated with living situation, in individuals who have quadriplegia due to cerebral palsy.

METHOD

A hierarchical classes algorithm (HICLAS) was used to construct idiographic 'identity structure' models for three individuals who are living in an inpatient hospital setting and for three individuals living in community-based group residences.

RESULTS

Indices derived from the models indicate that the identity 'myself as one who has a disability' was structurally superordinate (i.e., resided at a high hierarchical level) for all six participants, suggesting a high level of importance of this identity in participants' sense of self. The models also indicate that while identity associated with one's particular living situation was superordinate for persons living in the hospital, it was not for persons living in community residences.

CONCLUSIONS

While conclusions based on this small sample are necessarily limited, the data suggest that identity associated with living situation might differ in structural centrality, and presumably subjective importance, for persons living in inpatient versus community-based settings.

Domain specific effects of central traits in impression formation

In a procedure similar to that used in Asch's classic studies in 1946, 125 college students (54 men and 71 women, Mage=20.9 yr., SD=4.8) rated their impression of a hypothetical man or woman who was described by seven stimulus traits. This list included one of four central traits which appeared in the middle of the list: warm, cold, serious, or foolish. The dependent measures were factor scores derived from participants' ratings of 20 traits on social desirability and intellectual desirability. As hypothesized, warm and cold, prototypes of social desirability and undesirability, were associated with judgments of social but not intellectual desirability, and serious and foolish, prototypes of intellectual desirability and undesirability, were associated with judgments of intellectual but not social desirability. In addition, there was evidence of a subtle sex bias: ratings of "foolish" women were higher on social desirability than ratings of "foolish" men.