Exposure to Parents' Negative Emotions as a Developmental Pathway to the Family Aggregation of Depression and Anxiety in the First Year of Life

Asynchronous Involvement of VLPFC and DLPFC During Negative Emotion Processing: An Online Transcranial Magnetic Stimulation Study

The ventrolateral prefrontal cortex (VLPFC) and dorsolateral prefrontal cortex (DLPFC) have been found to play important roles in negative emotion processing. However, the specific time window of their involvement remains unknown. This study addressed this issue in three experiments using single-pulse transcranial magnetic stimulation (TMS). We found that TMS applied over the VLPFC at 400 ms after negative emotional exposure significantly enhanced negative feelings compared to the vertex condition. Furthermore, TMS applied over the DLPFC at both 0 ms and 600 ms after negative emotional exposure also resulted in deteriorated negative feelings. These findings provide potential evidence for the VLPFC-dependent semantic processing (∼400 ms) and the DLPFC-dependent attentional and cognitive control (∼0/600 ms) in negative emotion processing. The asynchronous involvement of these frontal cortices not only deepens our understanding of the neural mechanisms underlying negative emotion processing but also provides valuable temporal parameters for neurostimulation therapy targeting patients with mood disorders.

Impact of trajectories of maternal postpartum depression on infants' socioemotional development

BACKGROUND

We assessed (a) the effects of postpartum depression (PPD) trajectories until 6 months postpartum on infants' socioemotional development (SED) at age 12 months, and (b) the mediating role of maternal self-efficacy (MSE), and the additional effect of postpartum anxiety at age 12 months.

METHODS

We used data from POST-UP trial (n = 1843). PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS) at 1, 3, and 6 months. Infants' SED was assessed at 12 months using the Ages and Stages Questionnaire-Social-Emotional (ASQ-SE). Structural equations were applied to estimate the effect of PPD trajectories on infants' SED and mediation by MSE. The additional effects of postpartum anxiety were assessed with conditional regression.

RESULTS

Higher levels of PPD over time were associated with a lower SED (coefficient for log-EPDS 3.5, 95% confidence interval 2.8; 4.2, e.g., an increase in the EPDS score from 9 to 13 worsens the ASQ-SE by 1.3 points). About half of this relationship was mediated by MSE. Postpartum anxiety had an independent adverse effect on SED.

CONCLUSIONS

PPD and postpartum anxiety have a negative impact on infants' SED. MSE as a mediator may be a potential target for preventive interventions to alleviate the negative effects of maternal psychopathology on infants' SED.

IMPACT

The trajectories of postpartum depression (PPD) from 1 month to 6 months were negatively related to infants' socioemotional development (SED) at age 12 months, underlining the importance of repeated assessment of PPD. Maternal self-efficacy (MSE) mediated the association between PPD and SED, implying MSE could be a potential target for preventive interventions. An additional independent negative effect of postpartum anxiety was identified, implying the assessment of postpartum anxiety also has a surplus value to identify mothers at risk.

Parental Burnout and Prosocial Behavior among Chinese Adolescents: The Role of Empathy

Parental burnout refers to exhaustion caused by the parenting role. This devastating negative emotion can have repercussions for adolescent social development. Nevertheless, much remains unclear about the association between parental burnout and adolescent prosocial behavior and the potential mechanisms underlying this relationship. Based on theoretical and empirical evidence, the current study examined the relationship between parental burnout and adolescent prosocial behavior by using a sequential mediation model that included both parental empathy and adolescent empathy as potential mediators. A total of 488 parent-adolescent dyads (for adolescents: 45.7% men, 54.3% women, Mage = 15.28 ± 1.67 years; for parents: 36.5% fathers, 63.5% mothers, Mage = 41.30 ± 3.79 years) completed questionnaires regarding demographics, social desirability, parental burnout, parental empathy, adolescent empathy, and adolescent prosocial behavior. After controlling for demographic covariates and social desirability, the results showed that parental burnout had a negative effect on adolescent-reported prosocial behavior through parental cognitive empathy and adolescent other-oriented empathy (adolescent cognitive empathy and empathic concern) sequentially. These findings contribute to our understanding of the role of parental burnout as a family environmental factor detrimental to the positive functioning of adolescents through parental reactions to their children's emotions and children's own social competence.

Parent to Offspring Fear Transmission via Modeling in Early Life: A Systematic Review and Meta-Analysis

Infants can acquire fears vicariously by observing parents' fearful reactions to novel stimuli in everyday situations (i.e., modeling). To date, no systematic or meta-analytic review examined the role of modeling in parent-child transmission of fear and avoidance in early life. In our systematic review and meta-analysis, we aimed to investigate the effect of modeling parents' fearful reactions on infants' acquisition of fear and avoidance of novel stimuli and explore the moderation of this effect by child behavioral inhibition (BI) and parent trait anxiety. The search conducted in Web Of Science, Pubmed, Embase, and PsycINFO revealed 23 eligible studies for the systematic review and 19 for the meta-analysis. Eligible studies included published studies that measured infant fear and avoidance (infants aged up to 30 months) of novel stimuli following exposure to parental fearful expressions. Meta-analysis findings revealed a significant causal effect of modeling of parental fear on infants' fear [g = .44] and avoidance of novel stimuli [g = .44]. The findings support moderation by child BI on infant avoidance (not fear) acquisition, with the effects being larger for infants with higher BI. However, this moderation was only found, when including both experimental and correlational studies (p > .05), but not when exclusively including experimental studies (p = .17). This meta-analysis provides support for early parent-to-offspring fear transmission: a causal small to medium effect of parents' fearful reactions was shown on infants' fear and avoidance of novel stimuli. Elucidating parent-to-offspring anxiety transmission pathways can inform us about potential fear reduction and prevention strategies.

Mothers' emotional expressivity in urban and rural societies: Salience and links with young adolescents' emotional wellbeing and expressivity

This research aims to investigate the salience of mothers' emotional expressivity and its links with adolescents' emotional wellbeing and expressivity in an urban society endorsing more individualism and a rural society ascribing to more collectivism. By comparing Chinese urban (N = 283, M age = 14.13) and rural (N = 247, M age = 14.09) adolescents, this research found that urban mothers' expression of positive-dominant and positive-submissive emotions (PD and PS) were more common while expression of negative-dominant (ND) emotions was less common than rural mothers'. PD and PS had significant links with urban and rural adolescents' increased emotional expressivity and self-esteem, however, only significantly related to urban adolescents' decreased depression but not with rural adolescents'. ND had significant links with both urban and rural adolescents' expression of negative emotions, however, only significantly correlated with urban adolescents' less level of self-esteem and rural adolescents' more expression of positive emotions. No significant difference was found in the salience of urban and rural mothers' expression of negative-submissive (NS) emotions, which positively related to both urban and rural adolescents' depression and emotional expressivity. Moreover, we found that adolescents' emotional wellbeing (i.e., self-esteem and depression) mediated the relationship between mothers' emotional expressivity and adolescents' expressivity in both societies. Overall, the study findings document that the salience of mothers' emotional expressivity and its relations with adolescents' emotional adjustment differ between urban and rural societies.

Preventing anxiety in the children of anxious parents - feasibility of a brief, online, group intervention for parents of one- to three-year-olds

BACKGROUND

The evidence suggests an increased risk of developing anxiety problems in children of anxious parents. The current study explored the feasibility and acceptability of an intervention with anxious parents of young children, to inform the possibility of further trials.

METHODS

Participants were recruited through primary and secondary care psychological services and social media. Participants who had a current or recent anxiety disorder and a child aged 12-47 months were included. Assessments of parental and child outcomes occurred at baseline, after the intervention (week-2) and follow-up (week-8). The intervention was delivered in a small group format, in two sessions, one week apart, using videoconferencing.

RESULTS

Out of 32 participants, 30 (94%) attended the full intervention. All found the intervention acceptable and reported it as useful and relevant. There was a reduction in parental depression (MD = 2.63, 95%CI 1.01-4.26), anxiety (MD = 3.93, 95%CI 2.49-5.37) and stress (MD = 4.60, 95% CI 3.02-6.18) and increases in parenting confidence.

CONCLUSIONS

The online group intervention was feasible and acceptable. There were moderate to large effects on parental mental health and no adverse effects on children (decline on outcome measures). This indicates that intervening early in parenting with anxious parents is possible and warrants further investigation to establish prevention efficacy with a larger, controlled trial.

Maternal anxiety and toddler depressive/anxiety behaviors: The direct and moderating role of children's focused attention

Attention mechanisms have a pertinent role in shaping developmental pathways to anxiety and depressive disorders. The current study examined the direct and interactive associations between maternal anxiety symptoms, children's focused attention, and children's anxiety and depression behaviors in early toddlerhood. Participants were 150 mother-child dyads (50 % female) that were assessed at two time points. At 12 months of child age, mothers reported about their anxiety symptoms and children's focused attention. Children's focused attention was also observed and rated from an individual play task. At 18 months of age, mothers reported about children's anxiety and depression behaviors. Focused attention predicted child anxiety and depressive behaviors, with different patterns of associations between observed and reported measures of attention. There was also a significant interaction between maternal anxiety symptoms and observed children's focused attention. A positive association between maternal anxiety symptoms and child anxiety and depression symptoms was evident only for children with above-average levels of observed focused attention during play. Results suggest that different aspects of focused attention play a role in maternal reported anxiety and depression behaviors in early development and may modulate the intergenerational transmission of anxiety.

Lifetime psychopathology in the offspring of parents with anxiety disorders: A systematic review

BACKGROUND

The offspring of parents with Anxiety Disorders (AD) are at high risk for different types of psychopathology, including AD. However, little is known about how parental anxiety during pregnancy and/or the postnatal period might result in alterations in behavior or neurodevelopmental changes in offspring. To examine the effect of parental AD on offspring behavior and neurodevelopment, we conducted a systematic review.

METHODS

Following PRISMA guidelines, we searched the Web of Science, PubMed, and PsycINFO databases.

RESULTS

Forty-seven articles met the inclusion criteria for the systematic review. Prenatal maternal anxiety is related to negative temperament, increased attention to fearful vocalizations, decreased alertness, and impaired psychomotor and cognitive development in early and middle childhood. AD during the postnatal period is associated with greater negative temperament, internalizing symptoms, and anxiety symptoms in early childhood, middle childhood, and adolescence.

CONCLUSION

Our review is the first to demonstrate that prenatal and postnatal AD symptoms impact offspring. Future research should explore the mediating and moderating factors leading to the development of psychopathology in the offspring of parents with AD.

Maternal symptoms of depression and anxiety during the postpartum period moderate infants' neural response to emotional faces of their mother and of female strangers

Affective exchanges between mothers and infants are key to the intergenerational transmission of depression and anxiety, possibly via adaptations in neural systems that support infants' attention to facial affect. The current study examined associations between postnatal maternal symptoms of depression, panic and social anxiety, maternal parenting behaviours, and infants' neural responses to emotional facial expressions portrayed by their mother and by female strangers. The Negative Central (Nc), an event-related potential component that indexes attention to salient stimuli and is sensitive to emotional expression, was recorded from 30 infants. Maternal sensitivity, intrusiveness, and warmth, as well as infant's positive engagement with their mothers, were coded from unstructured interactions. Mothers reporting higher levels of postnatal depression symptoms were rated by coders as less sensitive and warm, and their infants exhibited decreased positive engagement with the mothers. In contrast, postnatal maternal symptoms of panic and social anxiety were not significantly associated with experimenter-rated parenting behaviours. Additionally, infants of mothers reporting greater postnatal depression symptoms showed a smaller Nc to their own mother's facial expressions, whereas infants of mothers endorsing greater postnatal symptoms of panic demonstrated a larger Nc to fearful facial expressions posed by both their mother and female strangers. Together, these results suggest that maternal symptoms of depression and anxiety during the postpartum period have distinct effects on infants' neural responses to parent and stranger displays of emotion.

The effect of perinatal interventions on parent anxiety, infant socio-emotional development and parent-infant relationship outcomes: A systematic review

Background

Infants of parents with perinatal anxiety are at elevated likelihood of experiencing disruption in the parent-infant relationship, as well as difficulties with socio-emotional functioning in later development. Interventions delivered in the perinatal period have the potential to protect the early dyadic relationship and support infants' ongoing development and socio-emotional outcomes. This review primarily aimed to examine the efficacy of perinatal interventions on parent anxiety, infant socio-emotional development/temperament, and parent-infant relationship outcomes. Secondarily, the review sought to understand how interventions focused principally on one member of the dyad affected the outcomes of the other, and which intervention components were common to successful interventions.

Method

Five electronic databases as well as manual search procedures were used to identify randomised controlled trials according to a PICO eligibility criteria framework. Risk of bias assessments were undertaken, and a narrative synthesis was conducted. The review was pre-registered on PROSPERO (CRD42021254799).

Results

Twelve studies were analysed in total, including five interventions focused on the adult, and seven interventions focused on the infant, or the infant's relationship with their parent. Interventions incorporating cognitive behavioural strategies for affective disorders showed reductions in parent anxiety (N = 3), and interventions focusing on altering distorted maternal internal representations showed positive change in parent-child dyadic interactions, and infant outcomes (N = 2). Evidence that interventions focused on one partner of the dyad led to improved outcomes for the other partner was limited. However, evidence was of mixed methodological quality.

Conclusions

It is important to integrate both parents and infants into treatment programmes for perinatal anxiety. Implications for clinical practice and future intervention trials are discussed.

Mental Health of Parents and Their Children: A Longitudinal Study of the Effects of Parents' Negative Affect on Adolescents' Pathological Gaming

Parents' negative affect could lead to the deterioration of the mental state of their adolescent children. According to previous studies, children of parents who have symptoms of depression or anxiety are more likely to have mental problems. As one of the most important issues concerning adolescents with the rapid rise of screen time, the concern for pathological gaming among adolescents continues to intensify. Many studies have demonstrated the remarkable relationships between adolescents' pathological gaming and mental factors, but seldom examined them via longitudinal analysis. With three-year data from adolescents (N = 778) and their parents (N = 685) in South Korea, this study assessed the effects of parents' negative affect (depression and anxiety) on pathological gaming using adolescents' mental factors (i.e., aggression, ADHD, self-control). The results showed the critical role of parents' negative affect on their children's mental health, which finally leads to pathological gaming among adolescents. Depressive parents increased the degree of adolescents' aggression and ADHD, and decreased the degree of adolescents' self-control. Anxious parents increased the degree of adolescents' ADHD. Moreover, both adolescents' aggression and self-control mediated the relationship between parents' depression and adolescents' pathological gaming. Specifically, self-control was one of the most influential factors contributing to pathological gaming among adolescents.

Parental Depression Symptoms and Internalizing Mental Health Problems in Autistic Children

Autistic youth are at risk for internalizing mental health problems such as depression and anxiety. Similarly, parents of autistic youth report higher levels of depression than parents of typically developing children. The goal of this study was to examine bidirectional associations between parent depression symptoms and the internalizing problems of autistic youth in 188 families across four time points (T1-T4; spaced 12 months apart). A cross-lagged panel model revealed that mother (T1 and T2) and father (T1) depression symptoms positively predicted the youth's internalizing problems 12 months later. The youth's internalizing problems at T3 positively predicted maternal depression symptoms at T4. Future research should explore genetic and environmental pathways that link parent depression and internalizing problems in autistic youth.

Parent-to-Child Anxiety Transmission Through Dyadic Social Dynamics: A Dynamic Developmental Model

The intergenerational transmission of psychopathology is one of the strongest known risk factors for childhood disorder and may be a malleable target for prevention and intervention. Anxious parents have distinct parenting profiles that impact socioemotional development, and these parenting effects may result in broad alterations to the biological and cognitive functioning of their children. Better understanding the functional mechanisms by which parental risk is passed on to children can provide (1) novel markers of risk for socioemotional difficulties, (2) specific targets for intervention, and (3) behavioral and biological indices of treatment response. We propose a developmental model in which dyadic social dynamics serve as a key conduit in parent-to-child transmission of anxiety. Dyadic social dynamics capture the moment-to-moment interactions between parent and child that occur on a daily basis. In shaping the developmental trajectory from familial risk to actual symptoms, dyadic processes act on mechanisms of risk that are evident prior to, and in the absence of, any eventual disorder onset. First, we discuss dyadic synchrony or the moment-to-moment coordination between parent and child within different levels of analysis, including neural, autonomic, behavioral, and emotional processes. Second, we discuss how overt emotion modeling of distress is observed and internalized by children and later reflected in their own behavior. Thus, unlike synchrony, this is a more sequential process that cuts across levels of analysis. We also discuss maladaptive cognitive and affective processing that is often evident with increases in child anxiety symptoms. Finally, we discuss additional moderators (e.g., parent sex, child fearful temperament) that may impact dyadic processes. Our model is proposed as a conceptual framework for testing hypotheses regarding dynamic processes that may ultimately guide novel treatment approaches aimed at intervening on dyadically linked biobehavioral mechanisms before symptom onset.

Mental health service use among pregnant and early postpartum women

PURPOSE

To explore the proportion and characteristics of women with a mental disorder who have contact with mental health services during pregnancy and the postnatal period in a maternity service in London.

METHODS

Data from the WEll-being in pregNancy stuDY (WENDY), a prospective cohort study, were used. Women were recruited at their first appointment for antenatal care and assessed for mental disorders using the Structured Clinical Interview DSM-IV Axis I/II Disorders for Research. Clinical, sociodemographic and psychosocial characteristics were collected. Mental health service use data were collected for the period from study entry to 3 months postpartum.

RESULTS

Two hundred women met diagnostic criteria for a mental disorder. Fifty-five (34%) of these had at least one contact with mental health services. Moderate depression (OR 7.44, CI 2.03-27.28, p < 0.01), severe depression (OR 10.5, CI 2.68-41.12, p < 0.01), past psychiatric hospital admission (OR 3.76, CI 1.05-13.44, p < 0.05), symptoms of anxiety (OR 3.95, CI 1.86-8.37, p < 0.001) and perceived low levels of social support (OR 0.43, CI 0.18-1.01, p = 0.05) were associated with an increased likelihood of contact with mental health services in univariate analyses. However, only moderate (OR 5.92, CI 1.31-26.78, p = 0.02) and severe depression (OR 6.04, CI 1.08-33.72, p = 0.04) remained significant in the multivariate regressions analyses.

CONCLUSION

Only a third of women with a diagnosable mental disorder at their first antenatal appointment had any contact with mental health services during pregnancy or up to 3 months postpartum. Further research is warranted to elicit perinatal women's views about the potential barriers to accessing professional mental health care.

A randomized controlled trial of an emotion socialization parenting program and its impact on parenting, children's behavior and parent and child stress cortisol: Tuning in to Toddlers

This paper examines the efficacy of a universally-offered parenting program, Tuning in to Toddlers (TOTS), that aims to improve parent emotion socialization, reduce parent and toddler stress and improve social, emotional, and behavioral functioning in toddlers. Three hundred parents of an 18-36 month old toddler were cluster randomized into intervention or control. Parents in the intervention participated in 6 × 2 h group sessions of TOTS. Baseline and 12-months post-intervention measures were collected using parent-report questionnaires and hair samples from parents and toddlers of systemic cortisol stress. Compared to controls, intervention parents reported significantly greater reductions in difficulties in emotion regulation (difficulty remaining goal directed: 95% CI.10, 1.71, p = .028; lack of access to strategies: 95% CI 0.62, 2.42, p = .001), emotion dismissing (beliefs: 95% CI 2.33,4.82, p < .001; behaviors: 95% CI 0.32, 0.65, p = <.001), greater increase in empathy (95% CI -2.83, -1.50, p < .001), emotion coaching (beliefs: 95% CI -2.56, -0.27, p = .016; behaviors: 95% CI -0.58, -0.24, p = <.001), children's behavior (95% CI 0.19, 2.43, p = .022) and competence (95% CI -1.46, -0.22, p = .008). Significant greater reductions in systemic cortisol were found for intervention but not control children (95% CI 0.01, 0.35, p = .041). Findings provide preliminary support for the use of TOTS as a universal prevention program to improve parent emotion socialization and children's functioning. Trial Registration: Australian and New Zealand Clinical Trials Registry: ACTRN12615000962538.

Depression in childhood: The role of children's exposure to intimate partner violence and maternal mental disorders

BACKGROUND

Intimate partner violence (IPV) is a global problem with high prevalence rates, and is linked to maternal mental disorders (MMD). Children's exposure to IPV (CEIPV) can have impacts on their physical and mental health, including depression.

OBJECTIVE

To analyze the associations between exposure to both CEIPV and MMD and depression in schoolchildren.

PARTICIPANTS AND SETTING

630 mother-child pairs were evaluated in a poor urban district in Recife, Northeast Brazil.

METHODS

A cohort study investigated the effects of IPV during pregnancy, postpartum and six to nine years after delivery. Women were asked about their experience of IPV, their own mental health, and the exposure of their child to violence. The child's mood was reported by the mother, using the Short Mood and Feelings Questionnaire (SMFQ). Ten types of CEIPV, and the age of onset of exposure, were compared with the child's subsequent risk of depression.

RESULTS

IPV was associated with MMD in 31.9% of the women at some period of time. Depressive symptoms were reported in 15.7% of school-age children. All types of CEIPV were associated with depression at school age. Multivariable analyses of exposure to IPV and MMD at different ages showed that exposure to both IPV and MMD in the first year of life had the strongest association with childhood depression (OR = 9.1; 95% CI: 2.4-33.9).

CONCLUSIONS

The frequency of CEIPV and MMD, and the high prevalence of depression at school age, shows the importance of assessing MMD and identifying exposure to IPV in pregnancy and the early years.

Can you teach me not to be angry? Relations between temperament and the emotion regulation strategy distraction in 2-year-olds

Little is known about toddlers' acquisition of specific emotion regulation (ER) strategies, and how early ER is shaped by temperament. This study investigated if 24-month-old German toddlers, predominantly from families with high levels of parental education (N = 96, n = 49 male), learned the ER strategy distraction through observational learning, and its interaction with temperament. Increased use of distraction correlated with reduced negative affect. Use of distraction increased through observational learning. Highly active toddlers tended to use active playing activities to distract themselves in a frustrating situation, whereas toddlers with a less active temperament used calmer activities. Toddlers' learning to apply distraction through observational learning was independent of a match between their own temperament and the model's actions.

Pupil responses to dynamic negative facial expressions of emotion in infants and parents

Observing others' emotions triggers physiological arousal in infants as well as in adults, reflected in dilated pupil sizes. This study is the first to examine parents' and infants' pupil responses to dynamic negative emotional facial expressions. Moreover, the links between pupil responses and negative emotional dispositions were explored among infants and parents. Infants' and one of their parent's pupil responses to negative versus neutral faces were measured via eye tracking in 222 infants (5- to 7-month-olds, n = 77, 11- to 13-month-olds, n = 78, and 17- to 19-month-olds, n = 67) and 229 parents. One parent contributed to the pupil data, whereas both parents were invited to fill in questionnaires on their own and their infant's negative emotional dispositions. Infants did not differentially respond to negative expressions, while parents showed stronger pupil responses to negative versus neutral expressions. There was a positive association between infants' and their parent's mean pupil responses and significant links between mothers' and fathers' stress levels and their infants' pupil responses. We conclude that a direct association between pupil responses in parents and offspring is observable already in infancy in typical development. Stress in parents is related to their infants' pupillary arousal to negative emotions.

Infants Oscillatory Frequencies change during Free-Play

Social interactions are known to be an essential component of infant development. For this reason, exploring functional neural activity while infants are engaged in social interactions will enable a better understanding of the infant social brain. This in turn, will enable the beginning of disentangling the neural basis of social and non-social interactions as well as the influence that maternal engagement has on infant brain function. Maternal sensitivity serves as a model for socio-emotional development during infancy, which poses the question: do interactions between parents and their offspring present altered electrophysiological responses in comparison to the general population if said parents are at risk of mental health disorders? The current research aimed to observe the oscillatory activity of 6-month-old infants during spontaneous free-play interactions with their mother. A 5-minute unconstrained free-play session was recorded between infant-mother dyads with EEG recordings taken from the 6-month-old infants (n = 64). During the recording, social and non-social behaviours were coded and EEG assessed with these epochs. Results showed an increase in oscillatory activity both when an infant played independently or interacted with their mother and oscillatory power was greatest in the alpha and theta bands. In the present 6-month-old cohort, no hemispheric power differences were observed as oscillatory power in the corresponding neural regions (i.e. left and right temporal regions) appeared to mirror each other. Instead, temporal estimates were larger and different from all other regions, whilst the frontal and parietal regions bihemispherically displayed similar estimates, which were larger than those observed centrally, but smaller than those displayed in the temporal locations. The interactions observed between the behavioural events and frequency bands demonstrated a significant reduction in power comparative to the power observed in the gamma band during the baseline event. The present research sought to explore the obstacle of artificial play paradigms for neuroscience research, whereby researchers question how much these paradigms relate to reality. The present manuscript will discuss the strengths and limitations of taking an unconstrained free-play approach.

Joint effects of children's emotional problems and parental depressive symptoms on the occurrence of internet gaming disorder among children and adolescents: A longitudinal study

BACKGROUND AND AIMS

Parental depressive symptoms may aggravate the effects of children's emotional problems on risks for Internet gaming disorder (IGD). Here we examined the joint effects of children's emotional problems and parents' depressive symptoms on the incidence of IGD.

METHODS

A large prospective, population-based cohort tested potential interactions between children's emotional problems, parents' depressive symptoms, and incidence of high risk of IGD (HRIGD). Family dyads (n=2,031) that included children who were non-HRIGD at baseline completed assessments of childhood and parental affective symptomatology. HRIGD was assessed at baseline and 12 months. Relative excess risk due to interaction (RERI) estimated the magnitudes of interactions.

RESULTS

In terms of risk for the development of IGD, parental depression was 1.8 times greater, children's emotional problems were 2.9 times greater, and both risk factors together were 6.1 times greater than the background risk, with the last two findings reaching statistical significance. The expected risk for the development of HRIGD was RR=3.7.

DISCUSSION AND CONCLUSIONS

Children's emotional problems demonstrated a particularly strong relationship with HRIGD. Joint effects of children's emotional problems and depressive symptoms in parents on the incidence of HRIGD were stronger than the sum of the independent effects of each factor. The findings suggest that combining interventions for the treatment of children's emotional problems and parents' depressive symptoms may have extra risk reduction effects on preventing IGD in children and adolescents.

Caregiver Psychological Distress Predicts Temperament and Social-Emotional Outcomes in Infants with Autism Traits

Child temperament and caregiver psychological distress have been independently associated with social-emotional difficulties among individuals with autism. However, the interrelationship among these risk factors has rarely been investigated. We explored the reciprocal interplay between child temperament (surgency, negative affectivity, and self-regulation) and caregiver psychological distress in the development of child internalizing and externalizing symptoms, in a cohort of 103 infants showing early autism traits. Caregivers completed questionnaires when children were aged around 12-months (Time 1 [T1]), 18-months (Time 2 [T2]), and 24-months (Time 3 [T3]). Cross-lagged path models revealed a significant pathway from T1 caregiver psychological distress through lower T2 child self-regulation to subsequently greater T3 child internalizing symptoms. No such caregiver-driven pathway was evident through T2 child negative affectivity or in the prediction of T3 child externalizing symptoms. Further, no support was found for temperament-driven pathways through caregiver psychological distress to child social-emotional difficulties. Child surgency was mostly unrelated to caregiver psychological distress and social-emotional difficulties. These findings implicate the need to support the mental health of caregivers with an infant with autism traits in order to enhance the emotion regulation and social-emotional development of their infants.

Parent and Peer Emotion Responsivity Styles: An Extension of Gottman's Emotion Socialization Parenting Typologies

This theoretical paper introduces six emotion socialization typologies that can be used for designating emotion responsivity styles of parents and peers of children in middle childhood, referred to as Parent and Peer Emotion Responsivity Styles (PPERS). This typology draws on theoretical foundations of meta-emotion and emotion socialization. These typologies are compliment with and extend Gottman's emotion-based parenting styles, as they are organized generally by whether the response is more positive or more negative and whether the response is more emotionally constructive or destructive, but extend the four styles to include whether the parent or peer targets the emotion directly when responding to a child's emotions, or whether they target the emotion-related behavior. On the positive end, there is the Emotion Constructive style, which targets the child's emotions directly. The other two positive styles include Emotion Responsive and Emotion Acceptive, which target the child's emotional behaviors with higher or lower levels of activity. On the negative side, there is the Emotion Destructive style which is employed to target the emotion itself, while the Emotion Punitive and Emotion Dismissive styles target the child's emotion-related behavior with varying levels of activity. Implications for the development and study of these theoretical typologies are discussed.

Infant Emotional Mimicry of Strangers: Associations with Parent Emotional Mimicry, Parent-Infant Mutual Attention, and Parent Dispositional Affective Empathy

Emotional mimicry, the tendency to automatically and spontaneously reproduce others’ facial expressions, characterizes human social interactions from infancy onwards. Yet, little is known about the factors modulating its development in the first year of life. This study investigated infant emotional mimicry and its association with parent emotional mimicry, parent-infant mutual attention, and parent dispositional affective empathy. One hundred and seventeen parent-infant dyads (51 six-month-olds, 66 twelve-month-olds) were observed during video presentation of strangers’ happy, sad, angry, and fearful faces. Infant and parent emotional mimicry (i.e., facial expressions valence-congruent to the video) and their mutual attention (i.e., simultaneous gaze at one another) were systematically coded second-by-second. Parent empathy was assessed via self-report. Path models indicated that infant mimicry of happy stimuli was positively and independently associated with parent mimicry and affective empathy, while infant mimicry of sad stimuli was related to longer parent-infant mutual attention. Findings provide new insights into infants’ and parents’ coordination of mimicry and attention during triadic contexts of interactions, endorsing the social-affiliative function of mimicry already present in infancy: emotional mimicry occurs as an automatic parent-infant shared behavior and early manifestation of empathy only when strangers’ emotional displays are positive, and thus perceived as affiliative.

Respiratory sinus arrhythmia as a dyadic protective factor in the transition to parenthood

Considerable heterogeneity has been observed in couples' adjustment to the transition to parenthood (TTP). One potential yet understudied predictor of emotional adjustment to the TTP is the new parents' capacity for regulation. A widely accepted biological marker of this capacity is respiratory sinus arrhythmia (RSA), which is closely tied to parasympathetic activation. In the present work, we sought to examine the role of tonic RSA and RSA reactivity as possible protective dyadic factors in the TTP. As part of a larger study, we recruited a sample (N = 100) of TTP couples. At 15 weeks postpartum, the couples took part in a lab session during which their RSA was assessed both at rest (tonic RSA) and during four affiliative dyadic interactions (RSA reactivity). Following this session, couples completed daily diaries over a period of 3 weeks, reporting their daily levels of negative affect and stress. A Multivariate Actor Partner Interdependence Model was used to examine the extent to which each partner's RSA predicted their own and their partner's negative affect (NA) level, as well as NA stress-reactivity (i.e., the strength of the within-person stress-affect association). New mothers' tonic RSA predicted their own lower NA level and NA stress-reactivity; both their tonic RSA and RSA reactivity predicted their (male) partners' lower NA level; and finally, new fathers' tonic RSA and RSA reactivity predicted their (female) partners' lower NA stress-reactivity. These results suggest that RSA may serve as a personal and dyadic protective factor.

Toddlers Categorically Perceive Emotional Facial Expressions Along a Happy-Sad Continuum

Adults perceive a continuum of emotional facial expressions categorically rather than continuously. Categorical perception is thought to be adaptive and functional, allowing for inferences that inform behavior. To date, studies have demonstrated categorical perception of some emotional facial expressions in infants. However, a recent study reported that 12-month-olds infants do not perceive facial emotional expressions categorically across a happy-sad continuum. In contrast, toddlers at 3.5 years of age appear to use categorical perception along the happy-sad continuum. Using a novel paradigm that employed the use of a looking-time discrimination task and an explicit identification task, this study measured 26-month-old's identification of faces and ability to discriminate between faces along a happy-sad continuum. Results suggest that 26-month-olds perceive facial expressions categorically along the happy-sad continuum.

The influence of maternal anxiety and depression symptoms on fNIRS brain responses to emotional faces in 5- and 7-month-old infants

Greater relative right (versus left) frontal cortical activation to emotional faces as measured with alpha power in the electroencephalogram (EEG), has been considered a promising neural marker of increased vulnerability to psychopathology and emotional disorders. We set out to explore multichannel fNIRS as a tool to investigate infants' frontal asymmetry responses (hypothesizing greater right versus left frontal cortex activation) to emotional faces as influenced by maternal anxiety and depression symptoms during the postnatal period. We also explored activation differences in fronto-temporal regions associated with facial emotion processing. Ninety-one typically developing 5- and 7-month-old infants were shown photographs of women portraying happy, fearful and angry expressions. Hemodynamic brain responses were analyzed over two frontopolar and seven bilateral cortical regions subdivided into frontal, temporal and parietal areas, defined by age-appropriate MRI templates. Infants of mothers reporting higher negative affect had greater oxyhemoglobin (oxyHb) activation across all emotions over the left inferior frontal gyrus, a region implicated in emotional communication. Follow-up analyses indicated that associations were driven by maternal depression, but not anxiety symptoms. Overall, we found no support for greater right versus left frontal cortex activation in association with maternal negative affect. Findings point to the potential utility of fNIRS as a method for identifying altered neural substrates associated with exposure to maternal depression in infancy.

The Long-Term Impact of Maternal Anxiety and Depression Postpartum and in Early Childhood on Child and Paternal Mental Health at 11-12 Years Follow-Up

BACKGROUND

Postpartum maternal anxiety and depression can affect child development and family functioning. However, the long-term impact of postpartum maternal anxiety and depression on child and paternal mental health is understudied. The present large-scale prospective cohort study is one of the first to investigate whether maternal anxiety and depressive symptoms postpartum and at child age 5-6 years separately and synergistically increase paternal anxiety and depressive symptoms and child emotional problems in early adolescence at age 11-12 years. Secondly, we investigated whether concurrent paternal anxiety and depressive symptoms at child age 11-12 years moderated the association between maternal anxiety and depressive symptoms in the postpartum period and at child age 5-6 years with child emotional problems at age 11-12 years.

METHODS

This study is part of the Amsterdam Born Children and Development (ABCD) cohort study, the Netherlands (N = 2.298). Maternal postpartum anxiety and depressive symptoms were assessed using the State-Trait Anxiety Inventory (STAI) and the Center for Epidemiologic Studies Depression Scale (CES-D) at 13 weeks postpartum. Maternal anxiety and depressive symptoms at child age 5-6 years and parental anxiety and depressive symptoms at 11-12 years were assessed using the Depression Anxiety Stress Scale (DASS-21). Child emotional problems were reported by the child and a teacher using the Strengths and Difficulties Questionnaire (SDQ). Multivariable linear regression was conducted, adjusted for demographic, perinatal/obstetric confounders, and affective symptoms of the other family members at 11-12 years.

RESULTS

Neither maternal anxiety nor depressive symptoms were related to paternal depressive symptoms at child age 11-12 years, while maternal postpartum depressive symptoms, depressive symptoms at 5-6 years and maternal anxiety at 5-6 years were positively related to paternal anxiety at 11-12 years. However, effect sizes were small. Only maternal postpartum depression was positively but weakly associated with more child emotional problems at 11-12 years. Although paternal concurrent affective symptoms were positively related to more child emotional problems in early adolescence, they did not moderate the association between maternal symptoms and child emotional problems.

CONCLUSIONS

Our results indicate that fathers and children seem to be affected only to a small extent by maternal postpartum anxiety or depression.

Fetal and Infant Outcomes in the Offspring of Parents With Perinatal Mental Disorders: Earliest Influences

Mental illness is highly prevalent and runs in families. Mental disorders are considered to enhance the risk for the development of psychopathology in the offspring. This heightened risk is related to the separate and joint effects of inherited genetic vulnerabilities for psychopathology and environmental influences. The early years of life are suggested to be a key developmental phase in the intergenerational psychopathology transmission. Available evidence supports the idea that early exposure to parental psychopathology, during the pregnancy and first postpartum year, may be related to child psychological functioning beyond the postpartum period, up to adulthood years. This not only highlights the importance of intervening early to break the chain of intergenerational transmission of psychopathology but also raises the question of whether early interventions targeting parental mental disorders in this period may alleviate these prolonged adverse effects in the infant offspring. The current article focuses on the specific risk of psychopathology conveyed from mentally ill parents to the offspring during the pregnancy and first postpartum year. We first present a summary of the available evidence on the associations of parental perinatal mental illness with infant psychological outcomes at the behavioral, biological, and neurophysiological levels. Next, we address the effects of early interventions and discuss whether these may mitigate the early intergenerational transmission of risk for psychopathology. The summarized evidence supports the idea that psychopathology-related changes in parents' behavior and physiology in the perinatal period are related to behavioral, biological, and neurophysiological correlates of infant psychological functioning in this period. These alterations may constitute risk for later development of child and/or adult forms of psychopathology and thus for intergenerational transmission. Targeting psychopathology or mother-infant interactions in isolation in the postnatal period may not be sufficient to improve outcomes, whereas interventions targeting both maternal psychopathology and mother-infant interactions seem promising in alleviating the risk of early transmission.

Maternal pre- and postnatal anxiety symptoms and infant attention disengagement from emotional faces

BACKGROUND

Biases in socio-emotional attention may be early markers of risk for self-regulation difficulties and mental illness. We examined the associations between maternal pre- and postnatal anxiety symptoms and infant attention patterns to faces, with particular focus on attentional biases to threat, across male and female infants.

METHODS

A general population, Caucasian sample of eight-month old infants (N = 362) were tested using eye-tracking and an attention disengagement (overlap) paradigm, with happy, fearful, neutral, and phase-scrambled faces and distractors. Maternal self-reported anxiety symptoms were assessed with the Symptom Checklist-90/anxiety subscale at five time points between gestational week 14 and 6 months postpartum.

RESULTS

Probability of disengagement was lowest for fearful faces in the whole sample. Maternal pre- but not postnatal anxiety symptoms associated with higher threat bias in infants, and the relation between maternal anxiety symptoms in early pregnancy and higher threat bias in infants remained significant after controlling for maternal postnatal symptoms. Maternal postnatal anxiety symptoms, in turn, associated with higher overall probability of disengagement from faces to distractors, but the effects varied by child sex.

LIMITATIONS

The small number of mothers suffering from very severe symptoms. No control for the comorbidity of depressive symptoms.

CONCLUSIONS

Maternal prenatal anxiety symptoms associate with infant's heightened attention bias for threat. Maternal postnatal anxiety symptoms, in turn, associate with infant's overall disengagement probability differently for boys and girls. Boys may show enhanced vigilance for distractors, except when viewing fearful faces, and girls enhanced vigilance for all socio-emotional stimuli. Long-term implications of these findings remain to be explored.

Mothers With Postpartum Psychiatric Disorders: Proposal for an Adapted Method to Assess Maternal Sensitivity in Interaction With the Child

About 15% of mothers suffer from postpartum psychiatric disorders, such as depression, anxiety, or psychosis. Numerous studies have shown maternal caregiving behavior to be negatively affected under these circumstances. The current study sets out to shed light on specific caregiving behaviors of affected mothers in the context of parental mental illness at an early stage. There are several methods to assess maternal caregiving behavior in terms of sensitivity. However, all of them have limitations regarding the peculiarities of mothers with postpartum disorders, that is, changes in affect regulation, and the early onset of the disorder postpartum. With the current study, we provide an adapted method to assess maternal sensitivity based on methods recently approved in attachment research. Two groups of mothers, who were either healthy or had different postpartum disorders, were recorded on video during interactions with their infants. Behaviors were rated regarding responsiveness, promptness, appropriateness, intrusiveness, and positive and negative affect. A first analysis revealed an increased number of deficits on all subscales in mothers with postpartum psychiatric disorders as compared to healthy mothers. Depressive mothers with a single diagnosis had lower scores in responsiveness, promptness, and appropriateness and higher scores on intrusiveness as compared to those in healthy mothers. Here, maternal behavior appears more parent-centered, whereas affect seemed to be relatively unharmed. Moreover, as compared to healthy mothers, mothers with comorbid depression and anxiety symptomatology achieved lower scores on responsiveness, appropriateness, and positive affect and higher scores on intrusiveness and negative affect. It is suggested, that increased deficits are related to the severity of illness in mothers with comorbidities. Results on promptness indicate that these mothers are still capable of maintaining higher vigilance to infant cues. Variance in maternal behavior was relatively high in clinical mothers, showing that some of them are well capable of behaving in a sensitive manner toward their child. One strength of our adapted method is that particular aspects of sensitive parent-child interactions are assessed separately. This may shed light on specific behavior patterns of different postpartum psychiatric disorders, which may in turn relate to specific child outcomes. The manual is open for usage, while reliability testing is required.

Maternal Depressive Symptoms During the Pre- and Postnatal Periods and Infant Attention to Emotional Faces

We examined how infants' attentional disengagement from happy, fearful, neutral, and phase-scrambled faces at 8 months, as assessed by eye tracking, is associated with trajectories of maternal depressive symptoms from early pregnancy to 6 months postpartum (decreasing n = 48, increasing n = 34, and consistently low symptom levels n = 280). The sample (mother-infant dyads belonging to a larger FinnBrain Birth Cohort Study) was collected between 5/2013-6/2016. The overall disengagement probability from faces to distractors was not related to maternal depressive symptoms, but fear bias was heightened in infants whose mothers reported decreasing or increasing depressive symptoms. Exacerbated attention to fearful faces in infants of mothers with depressive symptoms may be independent of the timing of the symptoms in the pre- and postnatal stages.