Women are especially prone to depression following childbirth (Brockington & Kumar, 1982; Gotlib, Whiffen, Wallace, & Mount, 1991; Hopkins, Marcus, & Campbell, 1984). The prevalence of postpartum depresssion has been found to range from 7% to 33% (Gotlib, Whiffen, Mount, Milne, & Cody, 1989; O'Hara, Neunaber, & Zekoski, 1984). Several investigators have suggested that maternal depression is associated with early mother-infant problems and with emotional and behavioral problems in children (Caplan, Coghill, Alexandra, Robson, Katz, & Kumar, 1989). Depressed mothers are less active, less playful, and less responsive during face-to-face interactions (Field, Sandberg, Garcia, Vega-Lahr, Goldstein, & Guy, 1985; Cohn, Campbell, Matias, & Hopkins, 1990). At a later age, children of depressed mothers perform less well on the Bayley mental scales, exhibit more negative emotions, and have more emotional and behavioral problems than do children of nondepressed mothers (see Zuckerman & Beardslee, 1987, and Field, 1995, for reviews).
Since postpartum depression seems to have a negative impact on mother-infant interactions and on developmental outcome, it is important to identify mothers who exhibit depressive symptoms. The Beck Depression Inventory (BDI; Beck, Ward, Mendelson, Mock, & Erbaugh, 1961) is the most frequently used self-report instrument for identifying postpartum depression (Field et al., 1985; Gotlib et al., 1991; O'Hara et al., 1982; Pfost, Stevens, & Lum, 1990; Steer, Scholl, & Beck, 1990). The BDI has high convergent validity with psychiatric ratings of depression severity (Beck et al., 1961; Bumberry, Oliver, & McCLure, 1978). Although it has high sensitivity and specificity for detecting clinical depression (Barrera & Garrison-Jones, 1988; Oliver & Simmons, 1984), there is a paucity of research examining extremely low BDI scores.
Mothers with extremely low scores on the BDI (total score = 0, 1, or 2) exhibit more depressed behavior in face-to-face interactions with their infants than do mothers with high scores (an indicator of depression) (Field, Morrow, Healy, Foster, Adelstein, & Goldstein, 1992; see also Lyons-Ruth, Zoll, Connell, & Grunebaum, 1986, for results using the Center for Epidemiological Studies Depression Scale). Several possible explanations for these unexpected findings have been offered, including denial of symptoms, defensiveness, or a need to look good to others (Field et al., 1992). The purpose of the present study was to investigate this phenomenon. Thus, the validity scales of the Minnesota Multiphasic Personality Inventory 2 (MMPI-2) were administered to determine whether low-BDI mothers were "faking good."
The sample consisted of 79 mothers from 14 to 21 years of age (mean = 18.1). based on their BDI total scores, they were divided into three groups: low BDI (scores = 0, 1, 2), nondepressed (scores = 3-9), and depressed (scores [greater than or equal to] 13). The mothers were primarily single (74%), of varying ethnicity (37% African American, 35% Hispanic, and 28% Caucasian), from a low socioeconomic background, and had an average of 10 years of education.
Within 24 hours after delivery, each mother was administered a social history questionnaire, the BDI, and the validity scales of the MMPI-2. All were presented in an interview format to control for differences in reading levels.
Demographic data. Information on age, marital status, ethnicity, and total number of pregnancies was gathered. Socioeconomic status was determined using the Hollingshead Two Factor Index of Social Status.
Beck Depression Inventory. The revised Beck Depression Inventory (Beck, Rush, Shaw, & Emery, 1979; Beck & Steer, 1987) assesses a wide range of symptoms associated with depression. Responses to the 21 items of this self-report inventory are made on a 4-point scale, ranging from 0 to 3 (total scores can range from 0 to 63). …