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Healthcare (Basel). 2016 Aug 2;4(3). pii: E50. doi: 10.3390/healthcare4030050.

Postpartum Bonding Disorder: Factor Structure, Validity, Reliability and a Model Comparison of the Postnatal Bonding Questionnaire in Japanese Mothers of Infants.

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Kitamura Institute of Mental Health Tokyo, Tokyo 151-0063, Japan.
Department of Nursing, Faculty of Health Science Technology, Bunkyo Gakuin University, Tokyo 113-8668, Japan.
Kitamura Institute of Mental Health Tokyo, Tokyo 151-0063, Japan.
Department of Psychiatry, Graduate School of Medicine, Nagoya University, Nagoya 466-8550, Japan.
Graduate School of Health Sciences, Kumamoto University, Kumamoto 860-0976, Japan.
Aso Health Center, Kumamoto Prefecture, Kumamoto 869-2301, Japan.


Negative attitudes of mothers towards their infant is conceptualized as postpartum bonding disorder, which leads to serious health problems in perinatal health care. However, its measurement still remains to be standardized. Our aim was to examine and confirm the psychometric properties of the Postnatal Bonding Questionnaire (PBQ) in Japanese mothers. We distributed a set of questionnaires to community mothers and studied 392 mothers who returned the questionnaires at 1 month after childbirth. Our model was compared with three other models derived from previous studies. In a randomly halved sample, an exploratory factor analysis yielded a three-factor structure: Anger and Restrictedness, Lack of Affection, and Rejection and Fear. This factor structure was cross-validated by a confirmatory factor analysis using the other halved sample. The three subscales showed satisfactory internal consistency. The three PBQ subscale scores were correlated with depression and psychological abuse scores. Their test-retest reliability between day 5 and 1 month after childbirth was measured by intraclass correlation coefficients between 0.76 and 0.83. The Akaike Information Criteria of our model was better than the original four-factor model of Brockington. The present study indicates that the PBQ is a reliable and valid measure of bonding difficulties of Japanese mothers with neonates.


bonding; infant; mother; postnatal; psychometric properties

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