Preconception Learned Helplessness as a Cognitive Vulnerability to Lower Maternal Bonding Across the Perinatal Period

Background: Maternal bonding is a key determinant of maternal and infant well-being, yet little is known about preconception factors that shape its development. Learned helplessness (LH), a stable cognitive vulnerability characterized by perceived uncontrollability and diminished efficacy, may predispose women to poorer maternal bonding. This study examined whether preconception LH predicts antenatal and postpartum bonding and whether this association is mediated by antenatal bonding and prenatal affective symptoms. Methods: A sample of 151 euthymic, nulliparous women was followed prospectively from preconception through pregnancy and postpartum, completing questionnaires assessing LH, depressive and anxiety symptoms, and antenatal and postpartum bonding. Analyses used structural equation modeling, linear mixed-effects models, hierarchical regression, and parallel mediation. Results: LH showed high stability from preconception to postpartum (r = 0.71), with no mean-level change, whereas affective symptoms increased. Antenatal bonding predicted postpartum bonding (β = 0.52, p < 0.001). Higher preconception LH predicted lower antenatal bonding (b = −0.20, p = 0.002) and lower postpartum bonding (b = −0.29, p < 0.001), beyond affective symptoms in the corresponding period. The LH–postpartum bonding association was partially mediated by antenatal bonding (β = −0.10, p = 0.005), but not by prenatal depression or anxiety symptoms. Conclusions: Preconception LH reflects a stable cognitive vulnerability linked to poorer maternal bonding. Its association with postpartum bonding was partly mediated by antenatal bonding, but not by prenatal affective symptoms, suggesting that LH’s relevance to postpartum bonding begins when the maternal bond develops during pregnancy. Assessing LH before conception or early in pregnancy may help identify vulnerability to lower bonding, beyond current affective symptoms.

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Publication Details

Journal
Journal of Clinical Medicine
Published
2026-08-18
DOI
https://doi.org/10.3390/jcm15166391
Primary Topic
Maternal Mental Health During Pregnancy and Postpartum
Type
article
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article

Preconception Learned Helplessness as a Cognitive Vulnerability to Lower Maternal Bonding Across the Perinatal Period

Tal Sido, Sharon Florentin, Keren Avirame, Amit Klein et al.
Journal of Clinical Medicine
Maternal Mental Health During Pregnancy and Postpartum
article

Preconception Learned Helplessness as a Cognitive Vulnerability to Lower Maternal Bonding Across the Perinatal Period

Tal Sido, Sharon Florentin, Keren Avirame, Amit Klein, Shiri Ben‐Naim, Inbal Reuveni, Netta Levin, Noa Yakirevich Amir, Adi Klein, Atira Bick, Neta Elbaz Hemo, Tamuz Weinberger, Moriah Azoulay
article en

Abstract

Background: Maternal bonding is a key determinant of maternal and infant well-being, yet little is known about preconception factors that shape its development. Learned helplessness (LH), a stable cognitive vulnerability characterized by perceived uncontrollability and diminished efficacy, may predispose women to poorer maternal bonding. This study examined whether preconception LH predicts antenatal and postpartum bonding and whether this association is mediated by antenatal bonding and prenatal affective symptoms. Methods: A sample of 151 euthymic, nulliparous women was followed prospectively from preconception through pregnancy and postpartum, completing questionnaires assessing LH, depressive and anxiety symptoms, and antenatal and postpartum bonding. Analyses used structural equation modeling, linear mixed-effects models, hierarchical regression, and parallel mediation. Results: LH showed high stability from preconception to postpartum (r = 0.71), with no mean-level change, whereas affective symptoms increased. Antenatal bonding predicted postpartum bonding (β = 0.52, p < 0.001). Higher preconception LH predicted lower antenatal bonding (b = −0.20, p = 0.002) and lower postpartum bonding (b = −0.29, p < 0.001), beyond affective symptoms in the corresponding period. The LH–postpartum bonding association was partially mediated by antenatal bonding (β = −0.10, p = 0.005), but not by prenatal depression or anxiety symptoms. Conclusions: Preconception LH reflects a stable cognitive vulnerability linked to poorer maternal bonding. Its association with postpartum bonding was partly mediated by antenatal bonding, but not by prenatal affective symptoms, suggesting that LH’s relevance to postpartum bonding begins when the maternal bond develops during pregnancy. Assessing LH before conception or early in pregnancy may help identify vulnerability to lower bonding, beyond current affective symptoms.

Journal of Clinical MedicineVol. 15(16)
Tel Aviv University (IL), Hebrew University of Jerusalem (IL), Tel Aviv Sourasky Medical Center (IL), Hadassah Medical Center (IL)
No poverty
Openalex Percentile: Top 7%
Maternal Mental Health During Pregnancy and Postpartum
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