51
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Edvinsson Å, Skalkidou A, Hellgren C, Gingnell M, Ekselius L, Willebrand M, Sundström Poromaa I. Different patterns of attentional bias in antenatal and postpartum depression. Brain Behav 2017; 7:e00844. [PMID: 29201545 PMCID: PMC5698862 DOI: 10.1002/brb3.844] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 07/07/2017] [Accepted: 08/28/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Biased information processing in attention, memory, and interpretation is proposed to be central cognitive alterations in patients with major depressive disorder, but studies in women with peripartum depression are scarce. Because of the many similarities with depression in nonperipartum states as regards symptom profile and risk factors, we hypothesized that women with antenatal and postpartum depression would display attentional bias to negatively and positively valenced words. METHODS One hundred and seventy-seven pregnant and 157 postpartum women were included. Among these, 40 suffered from antenatal depressive disorder and 33 from postpartum depressive disorder. An emotional Stroop task with neutral, positive, negative, and negatively valenced obstetric words was used. RESULTS No significant difference in emotional interference scores was noted between women with antenatal depression and nondepressed pregnant women. In contrast, women with postpartum depression displayed shorter reaction times to both positive (p = .028) and negative (p = .022) stimuli, compared with neutral words. Pregnant women on antidepressant treatment displayed longer reaction times to negatively valenced obstetric words in comparison with untreated depressed women (p = .012), and a trend toward greater interference in comparison with controls (p = .061). CONCLUSIONS In contrast with the hypothesis, we found no evidence of attentional bias to emotionally valenced stimuli in women with untreated peripartum depression. However, the shorter reaction times to emotional stimuli in women with postpartum depression may indicate emotional numbing, which in turn, is a functional impairment that may have repercussions for child development and well-being. Our findings emphasize the need to identify and treat women with postpartum depression at the earliest possible time point to ensure swift recovery and support for the family.
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Affiliation(s)
- Åsa Edvinsson
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Alkistis Skalkidou
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Charlotte Hellgren
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Malin Gingnell
- Department of Psychology Uppsala University Uppsala Sweden
| | - Lisa Ekselius
- Department of Neuroscience, Psychiatry Uppsala University Uppsala Sweden
| | - Mimmie Willebrand
- Department of Neuroscience, Psychiatry Uppsala University Uppsala Sweden
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Letourneau NL, Dennis CL, Cosic N, Linder J. The effect of perinatal depression treatment for mothers on parenting and child development: A systematic review. Depress Anxiety 2017; 34:928-966. [PMID: 28962068 DOI: 10.1002/da.22687] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 07/05/2017] [Accepted: 08/28/2017] [Indexed: 11/10/2022] Open
Abstract
Antenatal and postpartum depression are very common and have significant consequences for mothers and their children. This review examines which antenatal depression (AD) and postpartum depression (PPD) treatment interventions are most efficacious in improving parenting and/or child development. CINAHL, Scopus, Cochrane Systematic Reviews, Cochrane Controlled Trials, Medline (OVID), Embase (OVID), PsychINFO, PsycARTICLES, AMED, and reference lists were searched. Randomized controlled trials (RCTs) and quasi-experimental studies assessing the effect of AD, PPD, or both treatment interventions on parenting and/or child development were included. Meta-analysis was conducted using random effects when possible. Thirty-six trials (within 40 articles) met criteria for review. Interventions include interpersonal psychotherapy (IPT), cognitive behavioural therapy (CBT), peer support, maternal-child interaction guidance, and other interventions, such as massage. For AD, IPT, CBT, and massage produced large effects on parenting (e.g. adjustment and attention toward infant) and child development (e.g. behaviour). For PPD, maternal-child interaction guidance and psychotherapeutic group support produced large effects on parenting (e.g. sense of competence) and child development (e.g. cortisol). However, meta-analysis revealed nonsignificant effects of IPT on maternal-child attachment and CBT on parenting stress. Promising findings exist for IPT, CBT, maternal-child interaction guidance, massage, and psychotherapeutic group support for specific parenting and/or child development outcomes. Additional RCTs using measures already employed in the literature are required to conduct necessary meta-analysis and fully elucidate treatment effects.
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Affiliation(s)
- Nicole L Letourneau
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada.,Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Cindy-Lee Dennis
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.,St. Michael's Hospital, Toronto, ON, Canada
| | - Nela Cosic
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada.,Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Jordana Linder
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada.,Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB, Canada
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Abstract
Crying conveys evidence about an infant's state and neurological health which, when carefully assessed, can provide diagnostic information for parents and clinicians. When crying is inconsolable or judged to be excessive, it can stress parents, disrupt parenting and, in rare cases, place an infant at risk for abuse. Research has revealed physiological and neural responses to crying that may predispose some adults to maltreat infants. Although this work suggests that parental vulnerabilities contribute to insensitive or aggressive reactions, there is a growing recognition that exposure to large doses of crying may be a challenge for all adults. Support programmes that inform parents about infant crying, enhance parenting, and improve parental wellbeing and coping, are under development with promising initial findings.
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Affiliation(s)
- Debra M Zeifman
- Vassar College, Department of Psychological Science, 124 Raymond Avenue, Mailbox 582, Poughkeepsie, NY 12604 USA
| | - Ian St James-Roberts
- Thomas Coram Research Unit, UCL Institute of Education, University College London, 27/28 Woburn Square, London WC1H 0AA, UK
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54
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Letourneau NL, Kozyrskyj AL, Cosic N, Ntanda HN, Anis L, Hart MJ, Campbell TS, Giesbrecht GF. Maternal sensitivity and social support protect against childhood atopic dermatitis. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2017; 13:26. [PMID: 28559916 PMCID: PMC5446757 DOI: 10.1186/s13223-017-0199-4] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 05/17/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Many studies have identified associations between qualities of maternal-child relationships and childhood asthma, but few have examined associations with childhood atopic dermatitis (AD), a common precursor to asthma. Moreover, maternal psychological distress, including prenatal and postnatal depression, anxiety and stress, may increase risk, while social support from partners may reduce risk for childhood AD. We sought to uncover the association between maternal-infant relationship qualities (maternal sensitivity towards infant behavioral signals, controlling behavior, and unresponsiveness) and child AD after accounting for risk (i.e., prenatal and postnatal maternal depression, anxiety and stress) and protective (i.e., social support) factors. METHODS We conducted a secondary analysis of data collected on a subsample of 242 women and their infants enrolled during pregnancy in the ongoing Alberta Pregnancy Outcomes and Nutrition cohort study. Inclusion criteria required mothers to be >16 years of age, English speaking and <22 weeks gestational age at enrollment. Data on depression, anxiety and stress in the prenatal and postnatal periods and physician diagnosis of childhood AD at 18 months were gathered via maternal report. Maternal sensitivity, unresponsiveness and controlling behaviours were assessed via videotaped observations using the Child-Adult Relationship Experimental (CARE)-Index at 6 months of infant age. RESULTS Higher maternal sensitivity, or the inability of the mother to appropriately understand and respond to infant needs based on behavioral signals, predicted reduced odds of AD independent of and in combination with low prenatal and postnatal anxiety and high paternal support. After adjustment, higher maternal controlling behaviours and unresponsiveness also predicted greater odds of AD. CONCLUSIONS Low maternal sensitivity is a risk factor for childhood AD, independently and in combination with perinatal anxiety and low social support. Thus, interventions that improve maternal-infant relationship quality, especially sensitivity, reduce anxiety and improve social support from partners could reduce odds of childhood AD.
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Affiliation(s)
- Nicole L. Letourneau
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4 Canada
- Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB T2N 4N1 Canada
- Child Development Centre, ACHRI Owerko Centre, 3rd Floor, 2888 Shaganappi Trail, Calgary, AB T3B 6A8 Canada
| | - Anita L. Kozyrskyj
- Departments of Pediatrics, Obstetrics & Gynecology, Faculty of Medicine and Dentistry, and School of Public Health, University of Alberta, Edmonton, AB T6G 2R3 Canada
| | - Nela Cosic
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4 Canada
- Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB T2N 4N1 Canada
- Child Development Centre, ACHRI Owerko Centre, 3rd Floor, 2888 Shaganappi Trail, Calgary, AB T3B 6A8 Canada
| | - Henry N. Ntanda
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4 Canada
- Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB T2N 4N1 Canada
- Child Development Centre, ACHRI Owerko Centre, 3rd Floor, 2888 Shaganappi Trail, Calgary, AB T3B 6A8 Canada
| | - Lubna Anis
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4 Canada
- Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB T2N 4N1 Canada
- Child Development Centre, ACHRI Owerko Centre, 3rd Floor, 2888 Shaganappi Trail, Calgary, AB T3B 6A8 Canada
| | - Martha J. Hart
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4 Canada
- Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB T2N 4N1 Canada
- Child Development Centre, ACHRI Owerko Centre, 3rd Floor, 2888 Shaganappi Trail, Calgary, AB T3B 6A8 Canada
| | - Tavis S. Campbell
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4 Canada
| | - Gerald F. Giesbrecht
- Cumming School of Medicine, Department of Pediatrics & Community Health Sciences, University of Calgary, Calgary, AB T2N 4N1 Canada
- Child Development Centre, ACHRI Owerko Centre, 3rd Floor, 2888 Shaganappi Trail, Calgary, AB T3B 6A8 Canada
| | - The APrON Team
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4 Canada
- Cumming School of Medicine, Departments of Pediatrics & Psychiatry, University of Calgary, Calgary, AB T2N 4N1 Canada
- Departments of Pediatrics, Obstetrics & Gynecology, Faculty of Medicine and Dentistry, and School of Public Health, University of Alberta, Edmonton, AB T6G 2R3 Canada
- Department of Psychology, University of Calgary, Calgary, AB T2N 1N4 Canada
- Cumming School of Medicine, Department of Pediatrics & Community Health Sciences, University of Calgary, Calgary, AB T2N 4N1 Canada
- Child Development Centre, ACHRI Owerko Centre, 3rd Floor, 2888 Shaganappi Trail, Calgary, AB T3B 6A8 Canada
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Broberg L, Backhausen M, Damm P, Bech P, Tabor A, Hegaard HK. Effect of supervised exercise in groups on psychological well-being among pregnant women at risk of depression (the EWE Study): study protocol for a randomized controlled trial. Trials 2017; 18:210. [PMID: 28476136 PMCID: PMC5420113 DOI: 10.1186/s13063-017-1938-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 04/11/2017] [Indexed: 11/20/2022] Open
Abstract
Background Pregnant women with depression and/or anxiety prior to pregnancy are at higher risk of preterm birth, breastfeeding problems, postpartum depression, and disruption of the mother-infant attachment. It is well documented that exercise improves psychological well-being in nonpregnant subjects with symptoms of depression. However, in only a few small studies have researchers examined the effect of exercise on symptoms of depression among pregnant women. We hypothesize that physiotherapist-supervised group exercise for pregnant women at risk of antenatal depression increases their psychological well-being. This paper describes the study protocol of a randomized controlled trial (RCT) on a supervised group exercise intervention for pregnant women with a current or previous history of depression and/or anxiety. Methods/design The RCT is being carried out at the Department of Obstetrics, Rigshospitalet, Copenhagen University Hospital, in the period 2016–2019. The inclusion criteria are pregnant women ≥18 years of age with depression and/or anxiety requiring treatment by a psychiatrist or a psychologist within the last 10 years and/or intake of antidepressants in the 3 months prior to conception and/or during pregnancy. The women must have appropriate Danish language skills, be pregnant with a single fetus, give written informed consent, and be at 17–22 gestational weeks when the intervention begins. The primary outcome is psychological well-being (the five-item World Health Organization Well-being Index). Secondary outcomes are symptoms of depression (Edinburgh Postnatal Depression Scale), functional ability (General Health Questionnaire), clinical symptoms of anxiety (State-Trait Anxiety Inventory), sleep quality and sleep disturbances (Pittsburgh Sleep Quality Index), and pregnancy and delivery outcomes. The intervention is supervised group exercise twice weekly for 12 weeks. The control group will receive standard antenatal care. On the basis of sample size calculation, a total of 300 women will be randomly assigned to either the intervention or the control group in a ratio of 1:1. Discussion The trial is expected to contribute to the body of knowledge used in planning antenatal care for pregnant women at risk of depression. Trial registration ClinicalTrials.gov, NCT02833519. Registered on 19 May 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1938-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lotte Broberg
- Research Unit Women's and Children's Health, Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. .,Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Mette Backhausen
- Research Unit Women's and Children's Health, Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Peter Damm
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Per Bech
- Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
| | - Ann Tabor
- Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Center of Fetal Medicine, Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Hanne Kristine Hegaard
- Research Unit Women's and Children's Health, Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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56
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Lucion MK, Oliveira V, Bizarro L, Bischoff AR, Silveira PP, Kauer-Sant'Anna M. Attentional bias toward infant faces – Review of the adaptive and clinical relevance. Int J Psychophysiol 2017; 114:1-8. [DOI: 10.1016/j.ijpsycho.2017.01.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 01/17/2017] [Accepted: 01/18/2017] [Indexed: 12/19/2022]
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57
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Thomas JC, Letourneau N, Bryce CI, Campbell TS, Giesbrecht GF. Biological embedding of perinatal social relationships in infant stress reactivity. Dev Psychobiol 2017; 59:425-435. [PMID: 28220490 DOI: 10.1002/dev.21505] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 01/05/2017] [Accepted: 01/24/2017] [Indexed: 01/24/2023]
Abstract
Whereas significant advances have been made in understanding how exposure to early adversity "gets under the skin" of children to result in long term changes in developmental outcomes, the processes by which positive social relationships become biologically embedded remain poorly understood. The aim of this study was to understand the pathways by which maternal and infant social environments become biologically embedded in infant cortisol reactivity. Two hundred seventy-two pregnant women and their infants were prospectively assessed during pregnancy and at 6 months postpartum. In serial mediation analyses, higher perceived social support from partners during pregnancy was associated with lower infant cortisol reactivity or larger decreases in cortisol in response to a stressor at 6 months of age via lower self-reported prenatal maternal depression and higher mother-infant interaction quality. The findings add to our understanding of how perinatal social relationships become biologically embedded in child development.
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Affiliation(s)
- Jenna C Thomas
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Nicole Letourneau
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Faculties of Nursing and Medicine (Pediatrics and Psychiatry), University of Calgary, Calgary, Alberta, Canada.,Department of Pediatrics and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Crystal I Bryce
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, Arizona
| | - Tavis S Campbell
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Gerald F Giesbrecht
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Faculties of Nursing and Medicine (Pediatrics and Psychiatry), University of Calgary, Calgary, Alberta, Canada
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58
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Field T. Prenatal Depression Risk Factors, Developmental Effects and Interventions: A Review. JOURNAL OF PREGNANCY AND CHILD HEALTH 2017; 4:301. [PMID: 28702506 PMCID: PMC5502770 DOI: 10.4172/2376-127x.1000301] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This narrative review based on a literature search in PubMed and PsycInfo on the two terms prenatal and antenatal depression includes empirical studies, reviews and meta-analyses that have been published during the last 5 years on risk factors, developmental effects and interventions for prenatal depression. Risk factor studies that met criteria feature demographic measures (lower socioeconomic status, less education, non-marital status, non-employment, less social support and health locus of control, unintended pregnancy, partner violence and history of child abuse) and physiological variables (cortisol, amylase, and pro-inflammatory cytokines and intrauterine artery resistance). The negative effects include postpartum depression, paternal depression, and prematurity and low birth weight. Negative effects on infants include greater right frontal EEG, amygdala connectivity, cortical thinning and more difficult temperament. In childhood, externalizing and internalizing problems have been reported. The data on prenatal antidepressants (specifically SSRIs) reveal negative effects including internalizing problems as well as a greater risk for autism spectrum disorder. Prenatal interventions that have been effective include interpersonal psychotherapy, peer support, massage therapy, yoga, tai chi, and aerobic exercise. Potential underlying mechanisms are discussed as well as methodological limitations including homogeneity of samples and lack of randomization to intervention groups. Despite these limitations, the literature highlights the need for prenatal depression screening and intervention.
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Affiliation(s)
- Tiffany Field
- University of Miami/Miller School of Medicine, Fielding Graduate University, USA
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59
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Jia Y, Cheng G, Zhang D, Ta N, Xia M, Ding F. Attachment Avoidance Is Significantly Related to Attentional Preference for Infant Faces: Evidence from Eye Movement Data. Front Psychol 2017; 8:85. [PMID: 28184210 PMCID: PMC5266690 DOI: 10.3389/fpsyg.2017.00085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 01/13/2017] [Indexed: 01/26/2023] Open
Abstract
Objective: To determine the influence of adult attachment orientations on infant preference. Methods: We adopted eye-tracking technology to monitor childless college women's eye movements when looking at pairs of faces, including one adult face (man or woman) and one infant face, with three different expressions (happy, sadness, and neutral). The participants (N = 150; 84% Han ethnicity) were aged 18-29 years (M = 19.22, SD = 1.72). A random intercepts multilevel linear regression analysis was used to assess the unique contribution of attachment avoidance, determined using the Experiences in Close Relationships scale, to preference for infant faces. Results: Women with higher attachment avoidance showed less infant preference, as shown by less sustained overt attentional bias to the infant face than the adult face based on fixation time and count. Conclusion: Adult attachment might be related to infant preference according to eye movement indices. Women with higher attachment avoidance may lack attentional preference for infant faces. The findings may aid the treatment and remediation of the interactions between children and mothers with insecure attachment.
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Affiliation(s)
- Yuncheng Jia
- School of Psychology, Southwest UniversityChongqing, China; Center for Mental Health Education, Southwest UniversityChongqing, China
| | - Gang Cheng
- School of Educational Science, Guizhou Normal University Guiyang, China
| | - Dajun Zhang
- School of Psychology, Southwest UniversityChongqing, China; Center for Mental Health Education, Southwest UniversityChongqing, China
| | - Na Ta
- School of Psychology, Southwest UniversityChongqing, China; Center for Mental Health Education, Southwest UniversityChongqing, China
| | - Mu Xia
- School of Educational Science, Guangxi University for Nationalities Nanning, China
| | - Fangyuan Ding
- School of Psychology, Southwest UniversityChongqing, China; Center for Mental Health Education, Southwest UniversityChongqing, China
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60
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Edwards RC, Hans SL. Prenatal Depressive Symptoms and Toddler Behavior Problems: The Role of Maternal Sensitivity and Child Sex. Child Psychiatry Hum Dev 2016; 47:696-707. [PMID: 26521260 DOI: 10.1007/s10578-015-0603-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Increasing evidence suggests that maternal depression during pregnancy is associated with child behavioral outcomes even after accounting for later maternal depression. The purpose of this study was to examine various mechanisms, including maternal sensitivity, neonatal problems, and concurrent maternal depression, that might explain the association between prenatal maternal depressive symptoms and toddler behavior problems. Young, low income, African American mothers (n = 196) were interviewed during pregnancy and at 24-months postpartum, medical records were collected at the birth, and mother-child interactions were video-recorded at 24 months. Path analyses revealed that the association between prenatal depression and toddler behavior problems was mediated by maternal sensitivity and maternal depressive symptoms at 24 months. No evidence was found for a mediating effect of neonatal problems. Path models examining sex differences suggested that different mediating factors may be important for boys and girls, with boys being particularly susceptible to the effects of maternal sensitivity.
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Affiliation(s)
- Renee C Edwards
- School of Social Service Administration, The University of Chicago, 969 E. 60th Street, Chicago, IL, 60637, USA.
| | - Sydney L Hans
- School of Social Service Administration, The University of Chicago, 969 E. 60th Street, Chicago, IL, 60637, USA
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61
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Hipwell AE, Stepp SD, Moses-Kolko EL, Xiong S, Paul E, Merrick N, McClelland S, Verble D, Keenan K. Predicting adolescent postpartum caregiving from trajectories of depression and anxiety prior to childbirth: a 5-year prospective study. Arch Womens Ment Health 2016; 19:871-82. [PMID: 26971266 PMCID: PMC5018913 DOI: 10.1007/s00737-016-0627-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 02/29/2016] [Indexed: 12/18/2022]
Abstract
Symptoms of depression and anxiety in pregnancy have been linked to later impaired caregiving. However, mood symptoms are often elevated in pregnancy and may reflect motherhood-specific concerns. In contrast, little is known about the effects of prepregnancy depression and anxiety on postpartum caregiving. Understanding these developmental risk factors is especially important when childbearing also occurs during adolescence. The sample comprised 188 adolescent mothers (ages 12-19 years) who had participated in a longitudinal study since childhood. Mothers were observed in face-to-face interaction with the infant at 4 months postpartum, and caregiving behaviors (sensitivity, hostile-intrusive behavior, and mental state talk) were coded independently. Data on self-reported depression and anxiety gathered in the 5 years prior to childbirth were drawn from the large-scale longitudinal study. Parallel process latent growth curve models revealed unique effects of distal anxiety and slow decline in anxiety over time on lower levels of maternal mental state talk after accounting for the overlap with depression development. Depressive symptoms showed significant stability from distal measurement to the postpartum period, but only concurrent postpartum mood was associated with poorer quality of maternal speech. The results highlight specific targets for well-timed preventive interventions with vulnerable dyads.
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Affiliation(s)
| | | | | | | | - Elena Paul
- Department of Psychiatry, University of Pittsburgh Medical Center, USA
| | - Natalie Merrick
- Department of Psychiatry, University of Pittsburgh Medical Center, USA
| | | | - Danielle Verble
- Department of Psychiatry, University of Pittsburgh Medical Center, USA
| | - Kate Keenan
- Department of Psychiatry, University of Pittsburgh Medical Center, USA
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62
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Dudek J, Faress A, Bornstein MH, Haley DW. Infant Cries Rattle Adult Cognition. PLoS One 2016; 11:e0154283. [PMID: 27191845 PMCID: PMC4871531 DOI: 10.1371/journal.pone.0154283] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 04/11/2016] [Indexed: 11/24/2022] Open
Abstract
The attention-grabbing quality of the infant cry is well recognized, but how the emotional valence of infant vocal signals affects adult cognition and cortical activity has heretofore been unknown. We examined the effects of two contrasting infant vocalizations (cries vs. laughs) on adult performance on a Stroop task using a cross-modal distraction paradigm in which infant distractors were vocal and targets were visual. Infant vocalizations were presented before (Experiment 1) or during each Stroop trial (Experiment 2). To evaluate the influence of infant vocalizations on cognitive control, neural responses to the Stroop task were obtained by measuring electroencephalography (EEG) and event-related potentials (ERPs) in Experiment 1. Based on the previously demonstrated existence of negative arousal bias, we hypothesized that cry vocalizations would be more distracting and invoke greater conflict processing than laugh vocalizations. Similarly, we expected participants to have greater difficulty shifting attention from the vocal distractors to the target task after hearing cries vs. after hearing laughs. Behavioral results from both experiments showed a cry interference effect, in which task performance was slower with cry than with laugh distractors. Electrophysiology data further revealed that cries more than laughs reduced attention to the task (smaller P200) and increased conflict processing (larger N450), albeit differently for incongruent and congruent trials. Results from a correlation analysis showed that the amplitudes of P200 and N450 were inversely related, suggesting a reciprocal relationship between attention and conflict processing. The findings suggest that cognitive control processes contribute to an attention bias to infant signals, which is modulated in part by the valence of the infant vocalization and the demands of the cognitive task. The findings thus support the notion that infant cries elicit a negative arousal bias that is distracting; they also identify, for the first time, the neural dynamics underlying the unique influence that infant cries and laughs have on cognitive control.
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Affiliation(s)
- Joanna Dudek
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Ahmed Faress
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Marc H Bornstein
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, United States of America
| | - David W Haley
- Department of Psychology, University of Toronto, Toronto, ON, Canada
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63
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Parsons CE, Young KS, Jegindoe Elmholdt EM, Stein A, Kringelbach ML. Interpreting infant emotional expressions: Parenthood has differential effects on men and women. Q J Exp Psychol (Hove) 2016; 70:554-564. [PMID: 26822551 DOI: 10.1080/17470218.2016.1141967] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Interpreting and responding to an infant's emotional cues is a fundamental parenting skill. Responsivity to infant cues is frequently disrupted in depression, impacting negatively on child outcomes, which underscores its importance. It is widely assumed that women, and in particular mothers, show greater attunement to infants than do men. However, empirical evidence for sex and parental status effects, particularly in relation to perception of infant emotion, has been lacking. In this study, men and women with and without young infants were asked to rate valence in a range of infant facial expressions, on a scale of very positive to very negative. Results suggested complex interaction effects between parental status, sex, and the facial expression being rated. Mothers provided more positive ratings of the happy expressions and more extreme ratings of the intense emotion expressions than fathers, but non-mothers and non-fathers did not. Low-level depressive symptoms were also found to correlate with more negative ratings of negative infant facial expressions across the entire sample. Overall, these results suggest that parental status might have differential effects on men and women's appraisal of infant cues. Differences between fathers' and mothers' perceptions of infant emotion might be of interest in understanding variance in interaction styles, such as proportion of time spent in play.
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Affiliation(s)
- Christine E Parsons
- a Department of Psychiatry , University of Oxford , Oxford , UK.,b Center of Music in the Brain, Centre of Functionally Integrative Neuroscience , Aarhus University , Aarhus , Denmark
| | - Katherine S Young
- a Department of Psychiatry , University of Oxford , Oxford , UK.,b Center of Music in the Brain, Centre of Functionally Integrative Neuroscience , Aarhus University , Aarhus , Denmark.,c Department of Psychology , University of California , Los Angeles , CA , USA
| | - Else-Marie Jegindoe Elmholdt
- b Center of Music in the Brain, Centre of Functionally Integrative Neuroscience , Aarhus University , Aarhus , Denmark
| | - Alan Stein
- a Department of Psychiatry , University of Oxford , Oxford , UK
| | - Morten L Kringelbach
- a Department of Psychiatry , University of Oxford , Oxford , UK.,b Center of Music in the Brain, Centre of Functionally Integrative Neuroscience , Aarhus University , Aarhus , Denmark
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64
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Carnegie R, Shepherd C, Pearson RM, Button KS, Munafò MR, Evans J, Penton-Voak IS. Changing mothers' perception of infant emotion: a pilot study. Arch Womens Ment Health 2016; 19:167-72. [PMID: 26260038 PMCID: PMC5006819 DOI: 10.1007/s00737-015-0565-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 07/30/2015] [Indexed: 11/29/2022]
Abstract
Cognitive bias modification (CBM) techniques, which experimentally retrain abnormal processing of affective stimuli, are becoming established for various psychiatric disorders. Such techniques have not yet been applied to maternal processing of infant emotion, which is affected by various psychiatric disorders. In a pilot study, mothers of children under 3 years old (n = 2) were recruited and randomly allocated to one of three training exercises, aiming either to increase or decrease their threshold of perceiving distress in a morphed continuum of 15 infant facial images. Differences between pre- and post-training threshold were analysed between and within subjects. Compared to baseline thresholds, the threshold for perceiving infant distress decreased in the lowered threshold group (mean difference -1.7 frames, 95 % confidence intervals (CI) -3.1 to -0.3, p = 0.02), increased in the raised threshold group (1.3 frames, 95 % CI 0.6 to 2.1, p < 0.01) and was unchanged in the control group (0.1 frames, 95 % CI -0.8 to 1.1, p = 0.80). Between-group differences were similarly robust in regression models and were not attenuated by potential confounders. The findings suggest that it is possible to change the threshold at which mothers perceive ambiguous infant faces as distressed, either to increase or decrease sensitivity to distress. This small study was intended to provide proof of concept (i.e. that it is possible to alter a mother's perception of infant distress). Questions remain as to whether the effects persist beyond the immediate experimental session, have an impact on maternal behaviour and could be used in clinical samples to improve maternal sensitivity and child outcomes.
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Affiliation(s)
- Rebecca Carnegie
- Centre of Academic Mental Health, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
| | - C Shepherd
- Centre of Academic Mental Health, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - R M Pearson
- Centre of Academic Mental Health, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - K S Button
- Centre of Academic Mental Health, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - M R Munafò
- School of Experimental Psychology, University of Bristol, Bristol, UK
| | - J Evans
- Centre of Academic Mental Health, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - I S Penton-Voak
- School of Experimental Psychology, University of Bristol, Bristol, UK
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65
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Kim P, Strathearn L, Swain JE. The maternal brain and its plasticity in humans. Horm Behav 2016; 77:113-23. [PMID: 26268151 PMCID: PMC4724473 DOI: 10.1016/j.yhbeh.2015.08.001] [Citation(s) in RCA: 170] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 08/03/2015] [Accepted: 08/07/2015] [Indexed: 02/01/2023]
Abstract
This article is part of a Special Issue "Parental Care". Early mother-infant relationships play important roles in infants' optimal development. New mothers undergo neurobiological changes that support developing mother-infant relationships regardless of great individual differences in those relationships. In this article, we review the neural plasticity in human mothers' brains based on functional magnetic resonance imaging (fMRI) studies. First, we review the neural circuits that are involved in establishing and maintaining mother-infant relationships. Second, we discuss early postpartum factors (e.g., birth and feeding methods, hormones, and parental sensitivity) that are associated with individual differences in maternal brain neuroplasticity. Third, we discuss abnormal changes in the maternal brain related to psychopathology (i.e., postpartum depression, posttraumatic stress disorder, substance abuse) and potential brain remodeling associated with interventions. Last, we highlight potentially important future research directions to better understand normative changes in the maternal brain and risks for abnormal changes that may disrupt early mother-infant relationships.
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Affiliation(s)
- Pilyoung Kim
- Department of Psychology, University of Denver, 2155 South Race Street, Denver, CO 80208-3500, United States.
| | - Lane Strathearn
- Department of Pediatrics, University of Iowa, Center for Disabilities and Development, 100 Hawkins Drive 213F CDD, Iowa City, IA 52246-1011, United States.
| | - James E Swain
- Department of Psychiatry, Psychology and Center for Human Growth and Development, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109-2700, United States.
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66
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Braithwaite EC, Murphy SE, Ramchandani PG. Effects of prenatal depressive symptoms on maternal and infant cortisol reactivity. Arch Womens Ment Health 2016; 19:581-90. [PMID: 26940835 PMCID: PMC4963445 DOI: 10.1007/s00737-016-0611-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 02/15/2016] [Indexed: 12/11/2022]
Abstract
Prenatal depression is associated with adverse offspring outcomes, and the prevailing mechanistic theory to account for mood-associated effects implicates alterations of the maternal and foetal hypothalamic-pituitary adrenal (HPA) axes. Recent research suggests that depression may be associated with a failure to attenuate cortisol reactivity during early pregnancy. The aim of the current study is to investigate whether this effect continues into mid and late gestation. A further aim is to test whether maternal prenatal cortisol reactivity directly predicts infant cortisol reactivity. One hundred three pregnant women were recruited during either the second or third trimester. Depressive symptoms were assessed by self-report, and maternal salivary cortisol responses to a stressor (infant distress film) were measured. Approximately 2 months after birth, mothers (n = 88) reported postnatal depression and infant salivary cortisol responses to inoculation were measured. Prenatal depression was not associated with cortisol reactivity to acute stress in mid and late pregnancy. Similarly, neither prenatal depression nor maternal prenatal cortisol reactivity predicted infant cortisol reactivity to inoculation at 2 months. If the effects of prenatal depression on foetal and infant development are mediated by alterations of the maternal and foetal HPA axes, then early pregnancy may be a particularly vulnerable period. Alternatively, changes to HPA reactivity may not be as central to this association as previously thought.
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Affiliation(s)
- Elizabeth C. Braithwaite
- Department of Experimental Psychology, University of Oxford, 9 South Parks Road, Oxford, OX1 3UD UK
| | - Susannah E. Murphy
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX UK
| | - Paul G. Ramchandani
- Centre for Mental Health, Imperial College London, 7th Floor Commonwealth Building, Du Cane Road, London, W12 0NN UK
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67
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Rutherford HJ, Graber KM, Mayes LC. Depression symptomatology and the neural correlates of infant face and cry perception during pregnancy. Soc Neurosci 2015; 11:467-74. [DOI: 10.1080/17470919.2015.1108224] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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68
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Macrae JA, Pearson RM, Lee R, Chauhan D, Bennert K, Burns A, Baxter H, Evans J. THE IMPACT OF DEPRESSION ON MATERNAL RESPONSES TO INFANT FACES IN PREGNANCY. Infant Ment Health J 2015; 36:588-98. [PMID: 26551770 PMCID: PMC4738465 DOI: 10.1002/imhj.21538] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Research has suggested that prenatal depression may be associated with disrupted maternal responses to infant stimuli, with depressed pregnant women not showing the bias toward distressed infants as that observed in nondepressed pregnant women. The current study examined the effects of depression on self‐ reported responses to infant stimuli, in early pregnancy. Women with clinical depression (n = 38), and nondepressed women (n = 67) were recruited from a wider cognitive behavioral therapy trial. They completed Maternal Response Scales in which they were presented with images of distressed, neutral, and happy infant faces, with no time limit. The women rated their responses to these images along three dimensions—wanting to comfort, wanting to turn away, and feelings of anxiety—using Likert scales via a computerized task. There was evidence that women with depression in pregnancy showed different responses than did women without depression. Women with depression were substantially more likely to be in the highest quartile for ratings of wanting to turn away, odds (OR) ratio = 4.15, 95% confidence intervals (CIs) = 1.63–10.5, p = .003, and also were substantially less likely to be in the highest quartile for wanting to comfort a distressed infant face, OR = 0.22, 95% CIs = 0.09–0.54, p < .001. Findings are consistent with there being both a heightened avoidant and a reduced comforting response toward distressed infants in depressed pregnant women, providing some support that depression disrupts maternal preparations at a conscious level.
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Affiliation(s)
| | | | - R Lee
- Exeter University, Bristol
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69
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Maupin AN, Hayes NJ, Mayes LC, Rutherford HJ. The Application of Electroencephalography to Investigate the Neural Bases of Parenting: A Review. PARENTING, SCIENCE AND PRACTICE 2015; 15:9-23. [PMID: 26120286 PMCID: PMC4477836 DOI: 10.1080/15295192.2015.992735] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Angela N. Maupin
- Yale Child Study Center, Yale University, 230 South Frontage Road, New Haven, CT 06520
| | - Nathan J. Hayes
- Yale Child Study Center, Yale University, 230 South Frontage Road, New Haven, CT 06520
| | - Linda C. Mayes
- Yale Child Study Center, Yale University, 230 South Frontage Road, New Haven, CT 06520
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70
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Webb R, Ayers S. Cognitive biases in processing infant emotion by women with depression, anxiety and post-traumatic stress disorder in pregnancy or after birth: A systematic review. Cogn Emot 2014; 29:1278-94. [DOI: 10.1080/02699931.2014.977849] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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71
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Cardi V, Corfield F, Leppanen J, Rhind C, Deriziotis S, Hadjimichalis A, Hibbs R, Micali N, Treasure J. Emotional processing of infants displays in eating disorders. PLoS One 2014; 9:e113191. [PMID: 25463051 PMCID: PMC4251921 DOI: 10.1371/journal.pone.0113191] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 09/25/2014] [Indexed: 11/18/2022] Open
Abstract
AIM The aim of this study is to examine emotional processing of infant displays in people with Eating Disorders (EDs). BACKGROUND Social and emotional factors are implicated as causal and maintaining factors in EDs. Difficulties in emotional regulation have been mainly studied in relation to adult interactions, with less interest given to interactions with infants. METHOD A sample of 138 women were recruited, of which 49 suffered from Anorexia Nervosa (AN), 16 from Bulimia Nervosa (BN), and 73 were healthy controls (HCs). Attentional responses to happy and sad infant faces were tested with the visual probe detection task. Emotional identification of, and reactivity to, infant displays were measured using self-report measures. Facial expressions to video clips depicting sad, happy and frustrated infants were also recorded. RESULTS No significant differences between groups were observed in the attentional response to infant photographs. However, there was a trend for patients to disengage from happy faces. People with EDs also reported lower positive ratings of happy infant displays and greater subjective negative reactions to sad infants. Finally, patients showed a significantly lower production of facial expressions, especially in response to the happy infant video clip. Insecure attachment was negatively correlated with positive facial expressions displayed in response to the happy infant and positively correlated with the intensity of negative emotions experienced in response to the sad infant video clip. CONCLUSION People with EDs do not have marked abnormalities in their attentional processing of infant emotional faces. However, they do have a reduction in facial affect particularly in response to happy infants. Also, they report greater negative reactions to sadness, and rate positive emotions less intensively than HCs. This pattern of emotional responsivity suggests abnormalities in social reward sensitivity and might indicate new treatment targets.
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Affiliation(s)
- Valentina Cardi
- King's College London, Institute of Psychiatry, Department of Psychological Medicine, Section of Eating Disorders, London, United Kingdom
| | - Freya Corfield
- King's College London, Institute of Psychiatry, Department of Psychological Medicine, Section of Eating Disorders, London, United Kingdom
| | - Jenni Leppanen
- King's College London, Institute of Psychiatry, Department of Psychological Medicine, Section of Eating Disorders, London, United Kingdom
| | - Charlotte Rhind
- King's College London, Institute of Psychiatry, Department of Psychological Medicine, Section of Eating Disorders, London, United Kingdom
| | - Stephanie Deriziotis
- King's College London, Institute of Psychiatry, Department of Psychological Medicine, Section of Eating Disorders, London, United Kingdom
| | - Alexandra Hadjimichalis
- King's College London, Institute of Psychiatry, Department of Psychological Medicine, Section of Eating Disorders, London, United Kingdom
| | - Rebecca Hibbs
- King's College London, Institute of Psychiatry, Department of Psychological Medicine, Section of Eating Disorders, London, United Kingdom
| | - Nadia Micali
- University College London, Institute of Child Health, Behavioural and Brain Sciences Unit, London, United Kingdom
| | - Janet Treasure
- King's College London, Institute of Psychiatry, Department of Psychological Medicine, Section of Eating Disorders, London, United Kingdom
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72
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Thompson-Booth C, Viding E, Mayes LC, Rutherford HJV, Hodsoll S, McCrory E. I can't take my eyes off of you: attentional allocation to infant, child, adolescent and adult faces in mothers and non-mothers. PLoS One 2014; 9:e109362. [PMID: 25353640 PMCID: PMC4212970 DOI: 10.1371/journal.pone.0109362] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 09/01/2014] [Indexed: 12/11/2022] Open
Abstract
It has been reported previously that infant faces elicit enhanced attentional allocation compared to adult faces in adult women, particularly when these faces are emotional and when the participants are mothers, as compared to non-mothers [1]. However, it remains unclear whether this increased salience of infant faces as compared to adult faces extends to children older than infant age, or whether infant faces have a unique capacity to elicit preferential attentional allocation compared to juvenile or adult faces. Therefore, this study investigated attentional allocation to a variety of different aged faces (infants, pre-adolescent children, adolescents, and adults) in 84 adult women, 39 of whom were mothers. Consistent with previous findings, infant faces were found to elicit greater attentional engagement compared to pre-adolescent, adolescent, or adult faces, particularly when the infants displayed distress; again, this effect was more pronounced in mothers compared to non-mothers. Pre-adolescent child faces were also found to elicit greater attentional engagement compared to adolescent and adult faces, but only when they displayed distress. No preferential attentional allocation was observed for adolescent compared to adult faces. These findings indicate that cues potentially signalling vulnerability, specifically age and sad affect, interact to engage attention. They point to a potentially important mechanism, which helps facilitate caregiving behaviour.
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Affiliation(s)
- Chloe Thompson-Booth
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Essi Viding
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Linda C. Mayes
- Yale Child Study Center, School of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Helena J. V. Rutherford
- Yale Child Study Center, School of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Sara Hodsoll
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Eamon McCrory
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
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73
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Swain JE, Kim P, Spicer J, Ho SS, Dayton CJ, Elmadih A, Abel KM. Approaching the biology of human parental attachment: brain imaging, oxytocin and coordinated assessments of mothers and fathers. Brain Res 2014; 1580:78-101. [PMID: 24637261 PMCID: PMC4157077 DOI: 10.1016/j.brainres.2014.03.007] [Citation(s) in RCA: 185] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 02/11/2014] [Accepted: 03/07/2014] [Indexed: 12/30/2022]
Abstract
Brain networks that govern parental response to infant signals have been studied with imaging techniques over the last 15 years. The complex interaction of thoughts and behaviors required for sensitive parenting enables the formation of each individual's first social bonds and critically shapes development. This review concentrates on magnetic resonance imaging experiments which directly examine the brain systems involved in parental responses to infant cues. First, we introduce themes in the literature on parental brain circuits studied to date. Next, we present a thorough chronological review of state-of-the-art fMRI studies that probe the parental brain with a range of baby audio and visual stimuli. We also highlight the putative role of oxytocin and effects of psychopathology, as well as the most recent work on the paternal brain. Taken together, a new model emerges in which we propose that cortico-limbic networks interact to support parental brain responses to infants. These include circuitry for arousal/salience/motivation/reward, reflexive/instrumental caring, emotion response/regulation and integrative/complex cognitive processing. Maternal sensitivity and the quality of caregiving behavior are likely determined by the responsiveness of these circuits during early parent-infant experiences. The function of these circuits is modifiable by current and early-life experiences, hormonal and other factors. Severe deviation from the range of normal function in these systems is particularly associated with (maternal) mental illnesses - commonly, depression and anxiety, but also schizophrenia and bipolar disorder. Finally, we discuss the limits and extent to which brain imaging may broaden our understanding of the parental brain given our current model. Developments in the understanding of the parental brain may have profound implications for long-term outcomes in families across risk, resilience and possible interventions. This article is part of a Special Issue entitled Oxytocin and Social Behav.
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Affiliation(s)
- J E Swain
- Department of Psychiatry, University of Michigan, USA; Center for Human Growth and Development, University of Michigan, USA; Department of Psychology, University of Michigan, USA.
| | - P Kim
- Department of Psychology, University of Denver, USA
| | - J Spicer
- Department of Psychiatry, Columbia University, USA
| | - S S Ho
- Department of Psychiatry, University of Michigan, USA
| | - C J Dayton
- Department of Psychiatry, University of Michigan, USA; School of Social Work, Wayne State University, USA
| | - A Elmadih
- Centre for Women׳s Mental Health, Institute of Brain Behaviour and Mental Health, Manchester Academic Health Sciences Centre, University of Manchester, UK
| | - K M Abel
- Centre for Women׳s Mental Health, Institute of Brain Behaviour and Mental Health, Manchester Academic Health Sciences Centre, University of Manchester, UK
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74
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Dorrington S, Zammit S, Asher L, Evans J, Heron J, Lewis G. Perinatal maternal life events and psychotic experiences in children at twelve years in a birth cohort study. Schizophr Res 2014; 152:158-63. [PMID: 24275580 PMCID: PMC3906533 DOI: 10.1016/j.schres.2013.11.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Revised: 10/18/2013] [Accepted: 11/03/2013] [Indexed: 11/04/2022]
Abstract
BACKGROUND International studies indicate that the median prevalence of psychotic experiences in children is 7%. It has been proposed that environmental stress during pregnancy may affect the neurodevelopment of the foetus and lead to a vulnerability in the child to later stressors and psychopathology. AIM In this study we explore the relationship between environmental stress during pregnancy and psychotic experiences in children in the general population at 12 years. METHODS We analysed a birth cohort of 5038 children from the Avon Longitudinal Study of Parents and Children. Environmental stress was measured as life event exposure. Data on life events were collected on women during their pregnancy, whilst psychotic experiences in the offspring were assessed at age 12. RESULTS There was a weak association between maternal exposure to life events and psychotic experiences at twelve years (crude OR 1.10 95% CI 1.02-1.18) per quartile of life event score. This association was not reduced after adjustment for socio-economic status, family history of schizophrenia, maternal education or birth weight but after adjustment for maternal anxiety and depression and smoking in early pregnancy there was no longer any evidence for an association (OR 1.01 95% CI 0.93-1.10). CONCLUSION This study provides some evidence to suggest that stressful life events may affect child psychotic experiences through effects on maternal psychopathology, and possibly physiology, during pregnancy.
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Affiliation(s)
- Sarah Dorrington
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, London SE5 8AF, United Kingdom.
| | - Stan Zammit
- School of Social and Community Medicine, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom; Department of Psychological Medicine & Neurology, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Heath Park, Cardiff CF14 4XN, United Kingdom.
| | - Laura Asher
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom.
| | - Jonathan Evans
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, London SE5 8AF, United Kingdom.
| | - Jonathan Heron
- School of Social and Community Medicine, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom.
| | - Glyn Lewis
- Mental Health Sciences Unit, Faculty of Brain Sciences, University College London, W1W 7EJ, United Kingdom.
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75
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Thompson-Booth C, Viding E, Mayes LC, Rutherford HJV, Hodsoll S, McCrory EJ. Here's looking at you, kid: attention to infant emotional faces in mothers and non-mothers. Dev Sci 2013; 17:35-46. [PMID: 24341972 PMCID: PMC4352331 DOI: 10.1111/desc.12090] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 05/03/2013] [Indexed: 11/29/2022]
Abstract
Infant facial cues play a critical role in eliciting care and nurturance from an adult caregiver. Using an attentional capture paradigm we investigated attentional processing of adult and infant emotional facial expressions in a sample of mothers (n = 29) and non-mothers (n = 37) to determine whether infant faces were associated with greater task interference. Responses to infant target stimuli were slower than adult target stimuli in both groups. This effect was modulated by parental status, such that mothers compared to non-mothers showed longer response times to infant compared to adult faces. Both groups also responded more slowly to emotional faces, an effect that was more marked for infant emotional faces. Finally, it was found that greater levels of mothers' self-reported parental distress was associated with less task interference when processing infant faces. These findings indicate that for adult women, infant faces in general and emotional infant faces in particular, preferentially engage attention compared to adult faces. However, for mothers, infant faces appear to be more salient in general. Therefore, infant faces may constitute a special class of social stimuli. We suggest that alterations in attentional processing in motherhood may constitute an adaptive behavioural change associated with becoming a parent.
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76
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Jones R, Slade P, Pascalis O, Herbert JS. Infant interest in their mother's face is associated with maternal psychological health. Infant Behav Dev 2013; 36:686-93. [PMID: 23962542 DOI: 10.1016/j.infbeh.2013.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 07/17/2013] [Accepted: 07/18/2013] [Indexed: 11/29/2022]
Abstract
Early experience can alter infants' interest in faces in their environment. This study investigated the relationship between maternal psychological health, mother-infant bonding, and infant face interest in a community sample. A visual habituation paradigm was used to independently assess 3.5-month old infants' attention to a photograph of their mother's face and a stranger's face. In this sample of 54 healthy mother-infant pairs, 57% of mothers (N = 31) reported symptoms of at least one of stress response to trauma, anxiety, or depression. Interest in the mother-face, but not stranger-face, was positively associated with the mother's psychological health. In regression analyses, anxiety and depression predicted 9% of the variance in looking to the mother-face. Anxiety was the only significant predictor within the model. No direct associations were found between mother-infant bonding and infants' face interest. Taken together, these findings indicate that infant's visual engagement with their mother's face varies with maternal symptoms of emotional distress, even within a community sample.
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Affiliation(s)
- Rebecca Jones
- Department of Psychology, University of Sheffield, UK
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77
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Gollan JK, Hoxha D, Getch S, Sankin L, Michon R. Affective information processing in pregnancy and postpartum with and without major depression. Psychiatry Res 2013; 206:206-12. [PMID: 23340374 PMCID: PMC5697721 DOI: 10.1016/j.psychres.2012.11.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 10/04/2012] [Accepted: 11/12/2012] [Indexed: 11/25/2022]
Abstract
Adults with clinical depression exhibit systematic errors in their recognition and interpretation of affective stimuli. This study investigated the extent to which depression and phases of pregnancy and postpartum influence affective processing of positive and negative information, and the extent to which affective information processing in pregnancy predicts depressive symptoms in postpartum. Data were collected from 80 unmedicated women, diagnosed with major depressive disorder (MDD) or with no psychiatric disorder and between ages 18 and 44 years, during 32-36 weeks of pregnancy and during 6-8 weeks postpartum. All completed a Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) Axis I review, symptom reports, and a computer task measuring affective information processing. Significant group differences were found in which postpartum women with major depression were less responsive to negative stimuli, with lower ratings of intensity and reactions to negative pictorial stimuli, compared with postpartum healthy women. Also, lower ratings of the intensity and reactions to negative stimuli during pregnancy among depressed women predicted postpartum depression severity, even after controlling for depressive severity and affect ratings in pregnancy. Blunted affective reactivity to negative stimuli is a characteristic of depression that was observed among depressed women during pregnancy and postpartum in our study.
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Affiliation(s)
- Jackie K. Gollan
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States,Correspondence to: Northwestern University, Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, 446 East Ontario Street, Suite 7-204, Chicago, IL 60611, United States. Tel.: +1 312 695 6121; fax: +1 312 965 5010. (J.K. Gollan)
| | - Denada Hoxha
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Sarah Getch
- Northwestern Memorial Hospital, Chicago, IL, United States
| | - Lindsey Sankin
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Ruth Michon
- Northwestern Memorial Faculty Foundation, Chicago, IL, United States
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78
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Kieffer EC, Caldwell CH, Welmerink DB, Welch KB, Sinco BR, Guzmán JR. Effect of the healthy MOMs lifestyle intervention on reducing depressive symptoms among pregnant Latinas. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2013; 51:76-89. [PMID: 22638902 DOI: 10.1007/s10464-012-9523-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Depression during the prenatal and postpartum periods is associated with poor maternal, perinatal and child outcomes. This study examines the effectiveness of a culturally and linguistically tailored, social support-based, healthy lifestyle intervention led by trained community health workers in reducing depressive symptoms among pregnant and early postpartum Latinas. A sample of 275 pregnant Latinas was randomized to the Healthy MOMs Healthy Lifestyle Intervention (MOMs) or the Healthy Pregnancy Education (control) group. More than one-third of participants were at risk for depression at baseline. MOMs participants were less likely than control group participants to be at risk for depression at follow-up. Between baseline and 6 weeks postpartum, MOMs participants experienced a significant decline in depressive symptoms; control participants experienced a marginally significant decline. For MOMs participants, most of this decline occurred during the pregnancy intervention period, a time when no change occurred for control participants. The change in depressive symptoms during this period was greater among MOMs than control participants ("intervention effect"). From baseline to postpartum, there was a significant intervention effect among non-English-speaking women only. These findings provide evidence that a community-planned, culturally tailored healthy lifestyle intervention led by community health workers can reduce depressive symptoms among pregnant, Spanish-speaking Latinas.
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Affiliation(s)
- Edith C Kieffer
- School of Social Work, University of Michigan, 1080 S. University, Room 3770, Box 10, Ann Arbor, MI 48109-1106, USA.
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79
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Pearson RM, O'Mahen H, Burns A, Bennert K, Shepherd C, Baxter H, Chauhan D, Evans J. The normalisation of disrupted attentional processing of infant distress in depressed pregnant women following Cognitive Behavioural Therapy. J Affect Disord 2013; 145:208-13. [PMID: 22884235 DOI: 10.1016/j.jad.2012.07.033] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 06/28/2012] [Accepted: 07/23/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Maternal depression is associated with abnormal processing of infant distress. This may explain why depression disrupts maternal behaviour and ultimately child outcomes. Understanding and improving such processing, in depressed mothers as early as possible is thus important. AIM The focus of the current study was to investigate whether Cognitive Behavioural Therapy (CBT) normalises depressed pregnant women's abnormal attentional processing of infant distress. METHOD Depressed pregnant women participating in a randomised control trial completed a measure of attentional bias for infant distress before and after intervention. Women received either CBT (n=12) or usual care [UC] (n=12) between their first and last trimesters of pregnancy. RESULTS At baseline, depressed women in both arms showed a diminished attentional bias for infant distress compared to a non-depressed comparison group (n=51). Following intervention attentional biases of women who received CBT increased becoming comparable to non-depressed women. In contrast there was no improvement in the UC arm. CONCLUSIONS If replicated, the findings may suggest that CBT during pregnancy improves mother's basic processing of infant stimuli before their child is born. LIMITATIONS The sample size was relatively small and there was some loss to follow up between the pre and post intervention sessions.
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Affiliation(s)
- Rebecca M Pearson
- Academic Unit of Psychiatry, Oakfield House, Oakfield Grove, University of Bristol, Bristol BS8 2BN, UK.
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80
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Abstract
To identify psychosocial variables related to the use of coping strategies by HIV-positive South African women diagnosed during pregnancy, structured interviews were conducted with 224 HIV-positive women at antenatal clinics over a period of 2 years. Two coping styles, active and avoidant coping, were assessed using an adapted version of the Brief COPE. Psychosocial variables associated with changes in coping over time were identified with mixed linear analysis. Increases in active coping were associated with decreasing levels of internalized stigma and depression, increasing self-esteem and positive social support, knowing someone who is living with HIV, being physically healthy and living above the poverty line. Increases in avoidant coping were associated with increasing internalized stigma and depression, lower levels of self-esteem, HIV-knowledge and lower levels of education. Recommendations are made for psychological support services to strengthen women's ability to cope and enhance their health and that of their infants.
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81
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Pearson RM, Melotti R, Heron J, Joinson C, Stein A, Ramchandani PG, Evans J. Disruption to the development of maternal responsiveness? The impact of prenatal depression on mother-infant interactions. Infant Behav Dev 2012; 35:613-26. [PMID: 22982260 DOI: 10.1016/j.infbeh.2012.07.020] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Revised: 06/11/2012] [Accepted: 07/31/2012] [Indexed: 10/27/2022]
Abstract
Both prenatal and postnatal maternal depression are independently associated with an increased risk of adverse infant development. The impact of postnatal depression on infants may be mediated through the effect of depression in reducing maternal responsiveness. However, the mechanisms underlying the effect of prenatal depression are unclear. Using longitudinal data from over 900 mother-infant pairs in a UK birth cohort (ALSPAC), we found that women with high depressive symptom scores during mid pregnancy, but NOT when their infants were 8 months, had a 30% increased risk of low maternal responsiveness when the infant was 12 months compared to women with consistently low depression. This may provide a mechanism to explain the independent association between prenatal depression and poorer infant development.
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Affiliation(s)
- R M Pearson
- School of Social & Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Clifton, Bristol BS8 2BN, United Kingdom.
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82
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Ataya AF, Adams S, Mullings E, Cooper RM, Attwood AS, Munafò MR. Methodological considerations in cognitive bias research: the next steps. Drug Alcohol Depend 2012; 124:191-2. [PMID: 22673198 DOI: 10.1016/j.drugalcdep.2012.02.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Revised: 02/03/2012] [Accepted: 02/07/2012] [Indexed: 11/17/2022]
Abstract
Field and Christiansen (2012) comment on the importance of establishing and understanding the internal reliability of measures of substance-related cognitive bias, and suggest potential reasons for the poor reliability of some task variants. We agree that the impact of using stimuli personalized to the participant on the reliability of cognitive bias tasks is worthy of systematic investigation. However, some tasks may still be inherently less reliable than others. Ultimately, this debate should be framed within the wider debate on the validity of laboratory models and methods used to assess real-world phenomena.
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Affiliation(s)
- Alia F Ataya
- School of Experimental Psychology, University of Bristol, 12a Priory Road, Bristol BS8 1TU, UK.
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83
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Nanzer N, Sancho Rossignol A, Righetti-Veltema M, Knauer D, Manzano J, Palacio Espasa F. Effects of a brief psychoanalytic intervention for perinatal depression. Arch Womens Ment Health 2012; 15:259-68. [PMID: 22610758 DOI: 10.1007/s00737-012-0285-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Accepted: 04/23/2012] [Indexed: 11/24/2022]
Abstract
This pilot study explores the effects of a brief individual psychoanalytic therapy on perinatal depressive symptoms. This intervention is based on the Geneva's mother-infant intervention model. A sample of 129 pregnant women was recruited in Geneva (Switzerland) and screened for depressive symptoms with two instruments: the 'Edinburgh postnatal depression scale' (EPDS) and the 'Dépistage anténatal de la dépression postnatale'. A group of 40 women presenting depressive symptoms (treatment group) participated in a four-session intervention called 'Psychotherapy centred on parenthood (PCP)'. It consists in two antenatal and two postnatal sessions and is focussed on changing problematic representations of parenthood. This treatment group was compared to a control group of 88 women without depressive symptoms and following the usual obstetrical care. The main outcome measure was EPDS at 3 and 6 months after delivery. The 'Global assessment functioning scale' was administered at the end of each therapeutic session. The 'Parent-infant relationship global assessment scale' was administered at the two postnatal sessions in order to explore if PCP was also effective in preventing the potential negative effects of depression on mother-infant relationship. Results show that in the treatment group (N = 31), EPDS scores dropped from 12.8 to 4.8; none of these women met the EPDS cut-off score of 12 at 3 and 6 months postpartum. Mother-infant relationship was well adapted for all 31 dyads at the end of the intervention. These results suggest that PCP is a promising intervention for treating perinatal depression and helping mothers engaging in parenting.
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Affiliation(s)
- Nathalie Nanzer
- Division of Child and Adolescent Psychiatry, University Hospitals of Geneva, Geneva, Switzerland.
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84
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Jackson CA, Henderson M, Frank JW, Haw SJ. An overview of prevention of multiple risk behaviour in adolescence and young adulthood. J Public Health (Oxf) 2012; 34 Suppl 1:i31-40. [PMID: 22363029 DOI: 10.1093/pubmed/fdr113] [Citation(s) in RCA: 114] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The observed clustering, and shared underlying determinants, of risk behaviours in young people has led to the proposition that interventions should take a broader approach to risk behaviour prevention. In this review we synthesized the evidence on 'what works' to prevent multiple risk behaviour (focusing on tobacco, alcohol and illicit drug use and sexual risk behaviour) for policy-makers, practitioners and academics. We aimed to identify promising intervention programmes and to give a narrative overview of the wider influences on risk behaviour, in order to help inform future intervention strategies and policies. The most promising programme approaches for reducing multiple risk behaviour simultaneously address multiple domains of risk and protective factors predictive of risk behaviour. These programmes seek to increase resilience and promote positive parental/family influences and/or healthy school environments supportive of positive social and emotional development. However, wider influences on risk behaviour, such as culture, media and social climate also need to be addressed through broader social policy change. Furthermore, the importance of positive experiences during transition periods of the child-youth-adult phase of the life course should be appropriately addressed within intervention programmes and broader policy change, to reduce marginalization, social exclusion and the vulnerability of young people during transition periods.
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Affiliation(s)
- Caroline A Jackson
- Scottish Collaboration for Public Health Research and Policy, MRC Human Genetics Unit Building, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK.
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85
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Evans J, Melotti R, Heron J, Ramchandani P, Wiles N, Murray L, Stein A. The timing of maternal depressive symptoms and child cognitive development: a longitudinal study. J Child Psychol Psychiatry 2012; 53:632-40. [PMID: 22211468 DOI: 10.1111/j.1469-7610.2011.02513.x] [Citation(s) in RCA: 122] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Maternal depression is known to be associated with impairments in child cognitive development, although the effect of timing of exposure to maternal depression is unclear. METHODS Data collected for the Avon Longitudinal Study of Parents and Children, a longitudinal study beginning in pregnancy, included self-report measures of maternal depression the Edinburgh Postnatal Depression Scale, completed on 6 occasions up to 3 years of age, and IQ of the index child (WISC) measured at aged 8 years. We used these data to assign women to 8 groups according to whether depression occurred in the antenatal, postnatal, preschool period, any combination of these times, or not at all. We compared a model comprising all patterns of depression (saturated model) with models nested within this to test whether there is a relationship between depression and child cognitive development and, if so, whether there is a sensitive period. We then investigated the relationship with child IQ for each model, following adjustment for confounders. RESULTS Six thousand seven hundred and thirty-five of 13,615 children from singleton births (49.5%, of eligible core sample) attended a research clinic at 8 years and completed a WISC with a score ≥ 70. A total of 5,029 mothers of these children had completed mood assessments over the 3 time periods. In unadjusted analyses, all three sensitive period models were as good as the saturated model, as was an accumulation model. Of the sensitive period models, only that for antenatal exposure was a consistently better fit than the accumulation model. After multiple imputation for missing data (to n = 6,735), there was no effect of postnatal depression on child IQ independent of depression at other times [-0.19 IQ points, 95% confidence interval (CI) -1.5 to 1.1 points]. There was an effect of antenatal depression (-3.19 IQ points, 95% CI: -4.33 to -2.06) which attenuated following adjustment (-0.64 IQ points, 95% CI: -1.68 to 0.40). CONCLUSIONS The postnatal period is not a sensitive one for the effect of maternal depression on child cognitive development.
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Affiliation(s)
- Jonathan Evans
- Academic Unit, School of Social & Community Medicine, University of Bristol, Bristol, UK
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86
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Stein A, Murphy S, Arteche A, Lehtonen A, Harvey A, Craske MG, Harmer C. Effects of reboxetine and citalopram on appraisal of infant facial expressions and attentional biases. J Psychopharmacol 2012; 26:670-6. [PMID: 21948858 PMCID: PMC3573684 DOI: 10.1177/0269881111421970] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Difficulties in mother-child interaction are commonly observed in the context of postnatal depression. These difficulties may result in part from the negative cognitive bias present in depression, which may in turn lead to biased negative perceptions of the infant: in particular, these biases encompass the negative appraisal of facial expressions. Given the important role of early mother-child interactions in child development it is vital to investigate potential interventions that might be beneficial in ameliorating the negative cognitive bias. This study aimed to examine the effects of two different antidepressants (reboxetine and citalopram) on the appraisal of infant facial expressions of emotion using a faces rating task, and on attention to infant emotion using an attentional probe. Thirty-nine volunteers were randomly assigned to a double-blind 7-day intervention with either placebo, citalopram or reboxetine. There were significant positive effects on the appraisal of facial expressions; participants assigned to the placebo group rated positive faces less positively than those either in the citalopram or in the reboxetine groups. However, there was no evidence that these drugs had an effect on attentional vigilance. If antidepressants are able to help a mother to perceive her infant's facial expressions as more positive, this may lead to more positive interactions, thereby potentially mitigating the negative effects of depression on infant development. These findings should be treated with caution until replicated in larger and clinical samples.
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Affiliation(s)
- Alan Stein
- Department of Psychiatry, University of Oxford, Oxford, UK.
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87
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Pearson RM, Lightman SL, Evans J. Symptoms of depression during pregnancy are associated with increased systolic blood pressure responses towards infant distress. Arch Womens Ment Health 2012; 15:95-105. [PMID: 22382283 DOI: 10.1007/s00737-012-0269-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Accepted: 02/20/2012] [Indexed: 10/28/2022]
Abstract
A mother's response towards her infant's distress is important for the mother-infant relationship and infant development. There is evidence that maternal responses are impaired in depressed mothers. Further understanding of how depression disrupts maternal responses is important to direct treatment strategies. There is evidence that maternal responses develop during pregnancy. Further understanding of the relationship between depression and maternal responses during pregnancy is therefore important. We have previously found that depression during pregnancy is associated with reduced attentional engagement with infant distress but is unclear whether this is an insensitive or avoidance response. In the current study, we investigated the impact of anhedonic symptoms of depression on pregnant women's autonomic response towards infant distress. We found that women experiencing anhedonic depressive symptoms during pregnancy had significantly larger systolic blood pressure responses towards infant distress (β, 1.6 mmHg, 95 % CI 0.5 to 2.6, p = 0.004) than non-depressed pregnant women. These results suggest that anhedonic symptoms during pregnancy may be associated with increased sympathetic sensitivity. This suggests that depression is not, at a sympathetic level at least, associated with insensitivity to infant distress and rather depression may be associated with an abnormally sensitive response.
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Affiliation(s)
- R M Pearson
- Academic Unit of Psychiatry, University of Bristol, Bristol, UK.
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88
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Noll LK, Mayes LC, Rutherford HJV. Investigating the impact of parental status and depression symptoms on the early perceptual coding of infant faces: an event-related potential study. Soc Neurosci 2012; 7:525-36. [PMID: 22435403 DOI: 10.1080/17470919.2012.672457] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Infant faces are highly salient social stimuli that appear to elicit intuitive parenting behaviors in healthy adult women. Behavioral and observational studies indicate that this effect may be modulated by experiences of reproduction, caregiving, and psychiatric symptomatology that affect normative attention and reward processing of infant cues. However, relatively little is known about the neural correlates of these effects. Using the event-related potential (ERP) technique, this study investigated the impact of parental status (mother, non-mother) and depression symptoms on early visual processing of infant faces in a community sample of adult women. Specifically, the P1 and N170 ERP components elicited in response to infant face stimuli were examined. While characteristics of the N170 were not modulated by parental status, a statistically significant positive correlation was observed between depression symptom severity and N170 amplitude. This relationship was not observed for the P1. These results suggest that depression symptoms may modulate early neurophysiological responsiveness to infant cues, even at sub-clinical levels.
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89
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Foulkes M. Enablers and barriers to seeking help for a postpartum mood disorder. J Obstet Gynecol Neonatal Nurs 2011; 40:450-7. [PMID: 21771070 DOI: 10.1111/j.1552-6909.2011.01264.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To explore the barriers and enablers identified by women experiencing a postpartum mood disorder (PPMD) that preclude and facilitate their help-seeking behaviors for this often devastating illness. DESIGN A qualitative study using a grounded theory approach. SETTING Well-Baby Clinics offered through the Public Health Department, Early Years Centres, Mothercraft, and a Parent Resource Centre in a large Canadian city. PARTICIPANTS Ten women who had either been formally diagnosed as having a PPMD or who self-identified as experiencing a constellation of symptoms indicative of a PPMD. METHODS Interviews that were transcribed verbatim and analyzed using a grounded theory approach as described by Strauss and Corbin. RESULTS The core category of "having postpartum" captured the essence of women's experiences in seeking help for a PPMD. Women identified four main stressors that contributed to their development of a PPMD, two barrier categories, and an enabler category that influenced their help-seeking behaviors. Through navigation of formal and informal help, women were able to begin to reclaim the mothering instincts they had lost to mental illness. CONCLUSIONS Pregnancy, birth, and becoming a mother collectively represent a critical period of physical and emotional upheaval in a woman's life. The need for a holistic care approach that supports the emotional and physical health of the dyad is imperative.
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Affiliation(s)
- Michelle Foulkes
- Child and Adolescent Psychiatry, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
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90
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Arteche A, Joormann J, Harvey A, Craske M, Gotlib IH, Lehtonen A, Counsell N, Stein A. The effects of postnatal maternal depression and anxiety on the processing of infant faces. J Affect Disord 2011; 133:197-203. [PMID: 21641652 PMCID: PMC3161178 DOI: 10.1016/j.jad.2011.04.015] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Revised: 04/21/2011] [Accepted: 04/21/2011] [Indexed: 11/17/2022]
Abstract
BACKGROUND Postnatally depressed mothers have difficulties responding appropriately to their infants. The quality of the mother-child relationship depends on a mother's ability to respond to her infant's cues, which are largely non-verbal. Therefore, it is likely that difficulties in a mother's appraisal of her infants' facial expressions will affect the quality of mother-infant interaction. This study aimed to investigate the effects of postnatal depression and anxiety on the processing of infants' facial expressions. METHOD A total of 89 mothers, 34 with Generalised Anxiety Disorder, 21 with Major Depressive Disorder, and 34 controls, completed a 'morphed infants' faces task when their children were between 10 and 18 months. RESULTS Overall, mothers were more likely to identify happy faces accurately and at lower intensity than sad faces. Depressed compared to control participants, however, were less likely to accurately identify happy infant faces. Interestingly, mothers with GAD tended to identify happy faces at a lower intensity than controls. There were no differences between the groups in relation to sad faces. LIMITATIONS Our sample was relatively small and further research is needed to investigate the links between mothers' perceptions of infant expressions and both maternal responsiveness and later measures of child development. CONCLUSION Our findings have potential clinical implications as the difficulties in the processing of positive facial expressions in depression may lead to less maternal responsiveness to positive affect in the offspring and may diminish the quality of the mother-child interactions. Results for participants with GAD are consistent with the literature demonstrating that persons with GAD are intolerant of uncertainty and seek reassurance due to their worries.
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Affiliation(s)
| | | | - Allison Harvey
- Department of Psychology, University of California, Berkeley, USA
| | - Michelle Craske
- Department of Psychology, University of California, Los Angeles, USA
| | | | | | | | - Alan Stein
- Department of Psychiatry, University of Oxford, UK,Corresponding author at: Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, UK. Tel.: + 44 1865 223 911; fax: + 44 1865 226 384.
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91
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Pearson RM, Lightman SL, Evans J. Attentional processing of infant emotion during late pregnancy and mother-infant relations after birth. Arch Womens Ment Health 2011; 14:23-31. [PMID: 20859644 DOI: 10.1007/s00737-010-0180-4] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Accepted: 09/09/2010] [Indexed: 11/27/2022]
Abstract
The mother-infant relationship has an important influence on maternal mental health and infant development. Evidence suggests that this relationship is enhanced by a mother's sensitive response towards her infant's distress. We proposed that attentional processing of infant distress may indicate individual differences in this response. Research also suggests that maternal responses develop during pregnancy. We therefore hypothesised that more sensitive attentional processing of distressed infant stimuli during late pregnancy will be associated with more successful mother-infant relationships. Healthy pregnant women were recruited through community midwives. An established computerised paradigm measured women's ability to disengage attention from distressed or non-distressed infant faces. From this paradigm, we derived an index of women's attentional bias towards infant distress. Mother-infant relationships were measured using the postpartum bonding questionnaire (PBQ). A complete case sample of 49 women completed the attentional paradigm during late pregnancy and the PBQ 3-6 months after birth. We found that women who showed greater attentional bias towards infant distress during late pregnancy reported more successful mother-infant relationships. For every 50-ms increase on our measure of attentional bias towards infant distress during late pregnancy, the odds ratio for reporting a higher PBQ score, indicative of a weaker relationship, was 0.43 (95% confidence intervals 0.23-0.81, p = 0.01). The results suggest that women's basic attentional processing of infant emotion during pregnancy influences their relationships with their infant. In the future, women's attentional processing of infant emotion could inform early strategies to promote successful mother-infant relationships in vulnerable mothers to be.
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Affiliation(s)
- Rebecca M Pearson
- Academic Unit of Psychiatry, Cotham House, Cotham Hill, Bristol, UK.
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92
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Pearson RM, Lightman SL, Evans J. The impact of breastfeeding on mothers' attentional sensitivity towards infant distress. Infant Behav Dev 2010; 34:200-5. [PMID: 21185606 DOI: 10.1016/j.infbeh.2010.12.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2010] [Revised: 10/06/2010] [Accepted: 12/03/2010] [Indexed: 02/03/2023]
Abstract
BACKGROUND Maternal response towards infant distress has an important impact on infant development. In animals it is established that lactation and pup suckling plays an important role in maintaining maternal responses. Previous research suggests that breastfeeding is associated with sensitive maternal responses in human mothers. However, this may be because women who are more sensitive to their infant choose to breastfeed. The current study investigated the attentional sensitivity towards infant distress in women who went on to breast or formula feed during pregnancy as well as after birth. We hypothesised that differences in breast and formula feeding mothers would only emerge after birth once feeding had commenced. METHOD Women were recruited during pregnancy through community midwives as part of a longitudinal study. 51 women were seen during late pregnancy and between 3 and 6 months after birth (27 were breast and 24 were formula feeding). Sensitivity to infant distress was measured as the extent of women's attentional bias towards infant distress stimuli. RESULTS After birth, we found that our index of attentional bias towards infant distress was 37 ms (0.5 S.D.s) (CI; 6-69, p = 0.021) higher in breastfeeding compared to formula feeding mothers. However, mothers who went on to breastfeed did not show greater attentional bias towards infant distress already during late pregnancy. CONCLUSIONS Our results suggest that the act of breastfeeding may influence mothers' attentional sensitivity towards infant distress. Previous research suggests breastfeeding is indicative of sensitive parenting. The current findings may suggest a mechanism by which breastfeeding and/or associated infant interaction could contribute to this sensitivity.
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Affiliation(s)
- R M Pearson
- Academic Unit of Psychiatry, University of Bristol, Cotham House, Cotham Hill, Bristol, UK.
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