Maternal depression impacts child psychopathology across the first decade of life: Oxytocin and synchrony as markers of resilience

Contributions of music therapy and of prenatal singing to maternal mental health, maternal attachment, and neonatal behavior

BACKGROUND

Listening to music during pregnancy is associated with better neonatal behavior; however, contributions of prenatal singing to neonatal behavior are still unknown. Also, contributions of acoustic propagation of maternal humming inside the womb on fetal and neonatal behavior are still not understood.

METHODS

Low obstetric risk pregnant women (N = 24) were sequentially allocated into three groups: 1) control group (CG) without prenatal singing; 2) music therapy group (MTG); and 3) vocal training group (VTG). Depression, Anxiety and Stress Scales (DASS) and Antenatal Maternal Attachment Scales were applied at 32 GW and also at 37 GW. DASS, Postnatal Maternal Attachment Scales, and Neonatal Behavioral Assessment Scale (NBAS) were applied between one week and one month after birth.

RESULTS

For MTG: prenatal attachment was improved at 37 GW; newborns range of state was higher when compared with CG newborns; lower scores of anxiety and of stress assessed at 37 GW were associated with higher neonatal autonomic regulation; after birth, lower maternal levels of depression were associated with newborns' higher social orientation. For VTG: anxiety assessed at 37 GW associated negatively with social orientation; after birth, DASS total score associated negatively with autonomic regulation.

CONCLUSION

MTG seems to favor prenatal attachment, and neonatal range of state. Apparently prenatal singing (present at both MTG and VTG) improves the association between maternal mental health and newborns' social and self-regulatory competencies.

Diurnal changes of salivary oxytocin in healthy and psychiatric adolescents

Oxytocin, a neuropeptide with implications for interpersonal relationships and psychopathology, remains relatively unexplored in adolescence, particularly in acute mental health states. While studies examined baseline levels and reactivity patterns in salivary oxytocin, no study has tested diurnal patterns of oxytocin in the context of youth mental health. The current study examines diurnal rhythms of salivary oxytocin in 34 adolescent patients admitted to a psychiatric inpatient ward, as compared to 33 healthy peers. Samples were collected at four daily time-points across two consecutive days (8 a.m., 12 p.m., 4 p.m., 8 p.m.). Patients underwent psychiatric assessments and completed self-report questionnaires prior to the study and again at discharge. Results revealed significant differences between patients and healthy controls, indicating elevated overall salivary oxytocin production in the patient group. No significant differences were found among patients at the admission and discharge sampling. A consistent diurnal pattern emerged across participants that showed oxytocin elevation toward evening. Diurnal oxytocin levels correlated with measures of emotion regulation and anxiety. Findings are the first to describe the diurnal rhythms of oxytocin in youth and suggest that diurnal oxytocin may serve as additional biomarker of psychopathology. Future research is needed to assess processes that may lead to change in patients' diurnal oxytocin patterns.

Intranasal oxytocin increases breast milk oxytocin, but has a reduced effect in depressed mothers: A randomized controlled trial

Oxytocin (OT) plays pivotal roles in stress regulation, mother-infant bonding, and breastfeeding, all of which are adversely impacted by postnatal depression (PND). In a double-blind, randomized controlled trial, we assessed endogenous OT concentrations first in the breast milk of new mothers at baseline, and second following the administration of exogenous OT compared to a placebo delivered via a nasal spray.

METHOD

Participants were mothers (N = 62, aged 23-42 years) and their infants (aged 3-9 months). Each mother underwent screening for PND symptoms using the Edinburgh Postnatal Depression Scale (EPDS). N = 26 mothers scored above the cut-off point (≥9) on the EPDS, and N = 36 mothers scored below. Breast milk samples, collected during breastfeeding, were assayed for OT content.

RESULTS

Baseline endogenous OT concentration in breast milk was not associated with maternal low mood. Exogenous OT administration was associated with a significant increase in breast milk OT, but with reduced effect in mothers experiencing symptoms of PND compared to control mothers.

CONCLUSIONS

Future studies should test if breast milk OT exhibits a protective role against the developmental disadvantages of maternal PND on children. The current findings may reflect a possible disruption of the interaction between the central and peripheral OT pathways during breastfeeding in mothers experiencing symptoms of PND. These insights shed new light on the potential biological mechanisms involved in the transference of mental health vulnerabilities from mothers to infants.

Oxytocin as a Biomarker of Differential Effects to SPACE vs. CBT Treatment of Child Anxiety Disorders

OBJECTIVE

Two lines of research, on outcome moderators and on novel treatment targets, seek to improve the overall efficacy of child anxiety treatment, with mixed results. We propose that an integration of both lines of research can lead to improved treatment efficacy. In a first proof of concept of this approach, we studied whether the interaction between baseline levels and targeted changes in peripheral oxytocin (OT) can predict differential responses to two childhood anxiety treatments.

METHOD

A total of 124 mother-child dyads participated in the study. Children's salivary OT levels were measured at baseline and again, immediately after an experimental dyadic interaction in the lab. Dyads were subsequently randomized to receive one of two treatments, differing in their targets: SPACE (Supportive Parenting for Anxious Childhood Emotions) and CBT (cognitive-behavioral therapy). Treatment outcomes were assessed using the Childhood Anxiety Related Emotional Disorders scale, reported by both mother and child.

RESULTS

The findings suggest that in SPACE, where the mother is the main agent of change, higher baseline levels of child OT, coupled with increases in OT following a positive mother-child interaction, predicted greater treatment efficacy. By contrast, in CBT, where the child is the main agent of change, higher baseline levels of child OT, coupled with a decrease in OT following the interaction, predicted greater treatment efficacy.

CONCLUSIONS

The findings highlight the importance of the integration between moderators and targets of treatments for progress toward improving treatment efficacy through precision medicine.

Early Family Conflict and Behavioral Outcomes in Children from Low-Income Families: The Indirect Effects of Parental Depression and Parenting Practices

Family conflict has been demonstrated as a risk factor impacting children's mental health and behaviors; however, the mechanisms underlying these connections are unclear. Focusing on 1622 children from low-income families (51.4% boys, 38.3% White, 35.5% Hispanic/Latino, 22.1% African American, 4.1% other), the current study examines the role that maternal depression and parenting behaviors play in the associations between family conflict in early childhood and children's internalizing and externalizing behaviors in early adolescence. Family conflict was positively associated with maternal depression at age 3 and detached parenting at age 5; however, maternal depression was linked to increased child internalizing and externalizing behaviors, and detached parenting was associated with decreased behavioral outcomes. Maternal depression at age 3 and intrusive parenting at age 5 successively mediated the association between family conflict and child externalizing. Multi-group analysis indicated different indirect paths of parenting behaviors in boys and girls. Specifically, in boys, the indirect effect of detached parenting on the links between family conflict and externalizing and internalizing behaviors was sustained. In girls, maternal depression and intrusive parenting sequentially explained the link between family conflict and externalizing behaviors. The findings highlighted the importance of addressing family well-being and parenting support, especially for children from low-income families.

Language use in depressed and non-depressed mothers and their adolescent offspring

BACKGROUND

Approximately 10% of mothers experience depression each year, which increases risk for depression in offspring. Currently no research has analysed the linguistic features of depressed mothers and their adolescent offspring during dyadic interactions. We examined the extent to which linguistic features of mothers' and adolescents' speech during dyadic interactional tasks could discriminate depressed from non-depressed mothers.

METHODS

Computer-assisted linguistic analysis (Linguistic Inquiry and Word Count; LIWC) was applied to transcripts of low-income mother-adolescent dyads (N = 151) performing a lab-based problem-solving interaction task. One-way multivariate analyses were conducted to determine linguistic features hypothesized to be related to maternal depressive status that significantly differed in frequency between depressed and non-depressed mothers and higher and lower risk offspring. Logistic regression analyses were performed to classify between dyads belonging to the two groups.

RESULTS

The results showed that linguistic features in mothers' and their adolescent offsprings' speech during problem-solving interactions discriminated between maternal depression status. Many, but not all effects, were consistent with those identified in previous research using primarily written text, highlighting the validity and reliability of language behaviour associated with depressive symptomatology across lab-based and natural environmental contexts.

LIMITATIONS

Our analyses do not enable to ascertain how mothers' language behaviour may have influenced their offspring's communication patterns. We also cannot say how or whether these findings generalize to other contexts or populations.

CONCLUSION

The findings extend the existing literature on linguistic features of depression by indicating that mothers' depression is associated with linguistic behaviour during mother-adolescent interaction.

Maternal mind-mindedness and infant oxytocin are interrelated and negatively associated with postnatal depression

Previous studies show that maternal mind-mindedness positively impacts children's social development. In the current studies, we examine the relation between mind-mindedness during parent-child interaction, oxytocin (OT), and postnatal depression in a sample of mothers (N = 62, ages 23-44) and their infant (ages 3-9 months). In Study 1, infant salivary OT was positively correlated with mothers' appropriate mind-related comments, and negatively correlated (at trend level) with maternal depression scores. Mothers experiencing symptoms of depression used fewer appropriate mind-related comments than controls. Study 2 was a double-blind, placebo-controlled, experimental study, in which the same women who participated in Study 1 were administered nasal OT. This did not significantly influence levels of mind-mindedness. Study 2 warrants a larger trial to investigate the effect of OT on mind-mindedness further. Study 1 is the first to demonstrate an association between maternal mind-mindedness and variation in children's OT levels. Since both OT and mind-mindedness have been repeatedly implicated in processes of maternal-infant attachment, this association highlights the centrality of mothers' caregiving representations in facilitating the parent-child relationship and children's early development.

Maternal psychopathology is differentially associated with adolescent offspring neural response to reward given offspring ADHD risk

Reinforcement sensitivity is a hypothesized attention-deficit/hyperactivity disorder (ADHD) intermediate phenotype but its role in transgenerational transmission of ADHD-linked psychopathology risk is largely unknown. We examined, in a carefully phenotyped, N = 123 sample of adolescents (Mage = 15.27 years, SD = 0.984; 61.78% boys), whether (1) parental psychopathology is differentially associated with fMRI-indexed neural response to reward receipt and (2) both maternal and paternal psychopathology are associated with neural response to reward; across adolescents at-risk for and not at-risk for ADHD. Indices of parental psychopathology were differentially associated with adolescent offspring neural response to reward such that across measures, parental psychopathology was negatively or not associated with offspring superior frontal gyrus (SFG) response to reward receipt in adolescents at-risk for ADHD, but parental psychopathology was positively associated with offspring SFG response in adolescents not at-risk. Further, across measures, greater maternal psychopathology was associated with blunted adolescent SFG response to reward in adolescents at-risk for ADHD whereas greater maternal externalizing problems were linked to enhanced adolescent SFG response in adolescents not at-risk. Across measures, paternal psychopathology was not associated with adolescent response to reward, in either group. ADHD risk confers differential reward-related susceptibility to the effects of parental psychopathology. Results also show this association is nonspecific in terms of parental psychopathology type but is specific to maternal psychopathology.

Maternal prenatal depressive symptoms and child brain responses to affective touch at two years of age

BACKGROUND

Touch is an essential form of mother-child interaction, instigating better social bonding and emotional stability.

METHODS

We used diffuse optical tomography to explore the relationship between total haemoglobin (HbT) responses to affective touch in the child's brain at two years of age and maternal self-reported prenatal depressive symptoms (EPDS). Affective touch was implemented via slow brushing of the child's right forearm at 3 cm/s and non-affective touch via fast brushing at 30 cm/s and HbT responses were recorded on the left hemisphere.

RESULTS

We discovered a cluster in the postcentral gyrus exhibiting a negative correlation (Pearson's r = -0.84, p = 0.015 corrected for multiple comparisons) between child HbT response to affective touch and EPDS at gestational week 34. Based on region of interest (ROI) analysis, we found negative correlations between child responses to affective touch and maternal prenatal EPDS at gestational week 14 in the precentral gyrus, Rolandic operculum and secondary somatosensory cortex. The responses to non-affective touch did not correlate with EPDS in these regions.

LIMITATIONS

The number of mother-child dyads was 16. However, by utilising high-density optode arrangements, individualised anatomical models, and video and accelerometry to monitor movement, we were able to minimize methodological sources of variability in the data.

CONCLUSIONS

The results show that maternal depressive symptoms during pregnancy may be associated with reduced child responses to affective touch in the temporoparietal cortex. Responses to affective touch may be considered as potential biomarkers for psychosocial development in children. Early identification of and intervention in maternal depression may be important already during early pregnancy.

Parent-child interactive behavior in a German sample of parents with and without a mental illness: model replication and adaption of the Coding Interactive Behavior system

Studies using observational measures often fail to meet statistical standards for both reliability and validity. The present study examined the psychometric properties of the Coding Interactive Behavior (CIB) System within a German sample of parent-child dyads. The sample consisted of 149 parents with and without a mental illness and their children [n experimental group (EG) = 75, n control group (CG) = 74] who participated in the larger Children of Mentally Ill Parents at Risk Evaluation (COMPARE) study. The age of the children ranged from 3 to 12 years (M = 7.99, SD = 2.5). Exploratory factor analysis supported a five-factor model of the CIB with items describing 1) parental sensitivity/reciprocity, 2) parental intrusiveness, 3) child withdrawal, 4) child involvement, and 5) parent limit setting/child compliance. Compared to international samples, the model was reduced by two independent dyadic factors. Testing for predictive validity identified seven items with predictive power to differentiate parental group membership. The CIB factors did not seem to be sufficiently sensitive to illustrate differences in interaction within a sample of parents with various mental illnesses. To apply the CIB to the described sample or similar ones in the future, additional measurement instruments may be necessary.

Breast milk oxytocin and s-IgA modulate infant biomarkers and social engagement; The role of maternal anxiety

Breastfeeding has long been known to improve infants' health and mental development and to enhance the mother-infant bond, but much less research focused on the biological composition of breast milk and its associations with the infant's biomarkers and social development. In this exploratory study, we measured oxytocin (OT) and secretory immunoglobulin-A (s-IgA), the most abundant antibody in breast milk, and evaluated their associations with the same biomarkers in infant saliva and, consequently, with infant social engagement behavior. Fifty-five mother-infant dyads were home-visit and OT and s-IgA were assessed from breast milk and from infant saliva before and after a free-play interaction. Infant social behavior was coded offline using the Coding Interactive Behavior (CIB) and maternal anxiety self-reported. A path model revealed that mother's breast milk s-IgA impacted child social engagement via its links with child OT. In parallel, maternal breast milk OT was linked with infant social behavior through its association with the infant's immunity. This path was moderated by maternal anxiety; only in cases of high anxiety breast milk OT was positively connected to infant s-IgA. Our study, the first to measure OT and s-IgA in both breast milk and infant saliva in relation to observed social behavior, underscores the need for much further research on the dynamic interplay between breast milk composition, infant biomarkers, maternal mental health, and infant social outcomes. Results may suggest that biological systems in breast milk integrate to prepare infants to function in their social ecology through bio-behavioral feedback loops that signal the degree of stress in the environment.

Does parental mental health mediate the association between parents' perceived stress and parent-infant bonding during the early COVID-19 pandemic?

BACKGROUND

The spread of the COVID-19 virus was declared a pandemic in March 2020. New restrictions such as 'lockdowns' and 'social distancing' created challenges for individuals' work-life balance, financial situation, family life, and physical and mental health. The global population's stress levels rose in response to these changes, leading to a widespread deterioration of mental health. One group particularly affected was parents of infants and very young children. Poor parental mental health may disrupt parent-infant bonding, with negative consequences for infant well-being and development.

AIMS

To consider parent-infant bonding in relation to parents' perceived stress and psychological distress during the first lockdown, and to examine whether associations of stress with parent-infant bonding were mediated by parental mental health.

METHODS

DREAMCORONA (n = 738: 471 mothers and 267 partners) is a sub-study of the prospective German cohort study 'DREAM'. The SPSS modelling tool PROCESS was used to assess whether parental mental health mediated the relationship between parents' perceived stress response to the COVID-19 pandemic and parent-infant bonding, while controlling for covariates.

RESULTS

Higher levels of parental stress were strongly associated with higher levels of depression, anxiety, and aggression symptoms for both parents. In addition, there was a significant relationship between parents' self-reported stress levels and parent-infant bonding. This relationship was mediated by symptoms of depression and anxiety for fathers and by symptoms of anger-hostility for both parents.

CONCLUSION

Increased parental stress during the early pandemic was associated with poorer parent-infant bonding. This has important implications for the management of any future public health crises.

Oxytocin as a transdiagnostic biomarker of well-being in severe mental illness during the Covid-19 pandemic

Individuals with severe mental illness (SMI) have been found to suffer a greater decline in psychological well-being compared to the general population in times of stress. The present study aimed to examine clinical and endocrine resilience factors of psychological well-being in SMI patients during the Covid-19 pandemic.

METHODS

After Covid-19 crisis outburst in Israel 112 participants, 69 outpatients, and 43 inpatients and day treatment patients were recruited. Outpatients signed an online informed consent and filled in questionnaires regarding their level of mental health symptoms (OQ-45), fear of Covid-19 (FCV), and psychological well-being (PWB). Inpatients answered the same questionnaires and in addition, went through a positive social interaction paradigm while providing three saliva samples to measure their s-IgA and oxytocin (OT) levels.

RESULTS

A strong negative correlation was found in the whole sample between reported mental health symptoms, fear of Covid-19, and well-being. Hierarchical regression did not find additional contribution of the fear of the pandemic in predicting well-being beyond the impact of symptomatology. For inpatients (N = 39) only, hierarchical regression found that oxytocin, but not s-IgA could explain 5% of the variance of well-being (R2 = 0.05) in individuals with SMI regardless of their mental health symptoms (R2 = 0.46) and their marital status (R2 = 0.21).

CONCLUSIONS

OT is suggested as a possible independent biological resilience factor of well-being in times of major stress among SMI patients. It is still unknown whether OT is a mediator that contributes to well-being or a biological marker that indicates the degree of beneficial social interactions.

Human sweat contains oxytocin

BACKGROUND

Oxytocin (OT) has been detected in various body fluids, including blood, urine, saliva, breastmilk, and spinal fluid. Consistent with models that regard skin as a social organ and in line with studies demonstrating that skin cells express both OT and its receptor, our study sought to examine the presence of OT in human sweat.

METHODS

Overall, 553 individuals participated in a pilot study and three experiments. Firstly, 50 participants provided sweat after engaging in various sports for different durations. Secondly, 26 participants provided sweat from forehead, upper-chest, forearm, and underarm, including 11 in natural setting and 15 following OT administration and a 30-minute exercise. Thirdly, of 435 volunteers, 97 provided sufficient axillary sweat for assaying. Of these, 84 participated in a naturalistic experiment that involved saliva and sweat collection in response to physical activity in either solitary or social settings. OT and testosterone (TS) were assayed in sweat and saliva.

RESULTS

Intense activity for at least 25 min was required to produce sufficient sweat for OT analysis. Highest OT levels were found in axillary sweat compared to sweat from the forehead, upper-chest, and forearm. Salivary OT and TS increased after both solitary and social physical activity; however, higher sweat OT was found after solitary sports. Post-hoc preliminary findings indicate that highly extroverted individuals exercising in solitary environments showed the highest sweat OT levels.

CONCLUSIONS

Findings demonstrate, for the first time, the presence of OT in human sweat and show the feasibility of its measurement. Much further research is required to illuminate how sweat OT is impacted by personality and social context and to uncover the role of the skin in OT production.

Father contribution to human resilience

Fathers have been an important source of child endurance and prosperity since the dawn of civilization, promoting adaptation to social rules, defining cultural meaning systems, teaching daily living skills, and providing the material background against which children developed; still, the recent reformulation in the role of the father requires theory-building. Paternal caregiving is rare in mammals, occurring in 3-5% of species, expresses in multiple formats, and involves flexible neurobiological accommodations to ecological conditions and active caregiving. Here, we discuss father contribution to resilience across development. Our model proposes three tenets of resilience - plasticity, sociality, and meaning - and discussion focuses on father-specific contributions to each tenet at different developmental stages; newborn, infant, preschooler, child, and adolescent. Father's style of high arousal, energetic physicality, guided participation in daily skills, joint adventure, and conflict resolution promotes children's flexible approach and social competence within intimate bonds and social groups. By expanding children's interests, sharpening cognitions, tuning affect regulation, encouraging exploration, and accompanying the search for identity, fathers support the sense of meaning, enhancing the human-specific dimension of resilience. We end by highlighting pitfalls to paternal contribution, including absence, abuse, rigidity, expectations, and gender typing, and the need to formulate novel theories to accommodate the "involved dad."

The impact of peer-delivered cognitive behavioral therapy for postpartum depression on infant emotion regulation

BACKGROUND

Postpartum depression (PPD) affects up to one in five and negatively affects mothers, birthing parents, and their infants. The impact of PPD exposure on infant emotion regulation (ER) may be particularly harmful given its associations with later psychiatric problems. It remains unclear if treating maternal PPD can improve infant ER.

OBJECTIVE

To examine the impact of a nine-week peer-delivered group cognitive behavioral therapy (CBT) intervention on infant ER assessed across physiological and behavioral levels.

METHODS

Seventy-three mother-infant dyads were enrolled in a randomized controlled trial from 2018 to 2020. Mothers/birthing parents were randomized to the experimental group or waitlist control group. Measures of infant ER were collected at baseline (T1) and nine weeks later (T2). Infant ER was assessed using two physiological measures (frontal alpha asymmetry (FAA) and High Frequency-Heart Rate Variability (HF-HRV)), and parental-report of infant temperament.

RESULTS

Experimental group infants displayed more adaptive changes in both physiological markers of infant ER from T1 to T2 (FAA (F(1,56) = 4.16, p = .046) and HF-HRV (F(1,28.1) = 5.57, p = .03)) than those in the waitlist control group. Despite improvements in maternal PPD, no differences were noted in infant temperament from T1 to T2.

LIMITATIONS

A limited sample size, potential lack of generalizability of our results to other populations, and an absence of long-term data collection.

CONCLUSIONS

A scalable intervention designed for those with PPD may be capable of adaptively improving infant ER. Replication in larger samples is needed to determine if maternal treatment can help disrupt the transmission of psychiatric risk from mothers/birthing parents to their infants.

Prosocial behavior and psychopathology: An 11-year longitudinal study of inter- and intraindividual reciprocal relations across childhood and adolescence

The current study investigated whether prosocial behavior and emotional problems, peer problems, conduct problems, and hyperactivity and inattention problems were long-term longitudinally and bidirectionally related at inter- and or intra-individual levels from early childhood through mid-adolescence. Parents in the United Kingdom reported their child's prosocial behavior and multidimensional psychopathology at ages 3, 5, 7, 11, and 14 years (N = 16,984, 51% male, 83% White). Four random intercepts cross-lagged panel models were fitted. Higher levels of earlier prosocial behavior were associated with greater than expected decrements in psychopathology. At an intraindividual, within-person level, prosocial behavior was negatively bidirectionally associated with peer, conduct, and hyperactivity and inattention problems. Also at an intraindividual, within-person level, prosocial behavior was unidirectionally protective against emotional problems. At an interindividual level, prosocial behavior and each dimension of psychopathology were negatively associated. Therefore, engaging in prosocial behavior can reduce psychopathological symptoms over time (and vice versa), and youth who are more prosocial also tend to experience fewer psychopathological symptoms. Intraindividual associations were small while interindividual associations were moderate to large. Implications for theory, future research, and evidence-based interventions are discussed.

The role of the oxytocin system in the resilience of patients with breast cancer

Breast cancer is a grave traumatic experience that can profoundly compromise patients' psychological resilience, impacting their overall quality of life. The oxytocin system represents one of the essential neurobiological bases of psychological resilience and plays a critical role in regulating resilience in response to social or traumatic events during adulthood. Oxytocin, through its direct interaction with peripheral or central oxytocin receptors, has been found to have a significant impact on regulating social behavior. However, the precise mechanism by which the activation of peripheral oxytocin receptors leads to improved social is still not completely comprehended and requires additional research. Its activation can modulate psychological resilience by influencing estrogen and its receptors, the hypothalamic-pituitary-adrenal axis, thyroid function, 5-hydroxytryptamine metabolism levels, and arginine pressure release in breast cancer patients. Various interventions, including psychotherapy and behavioral measures, have been employed to improve the psychological resilience of breast cancer patients. The potential effectiveness of such interventions may be underpinned by their ability to modulate oxytocin release levels. This review provides an overview of the oxytocin system and resilience in breast cancer patients and identifies possible future research directions and interventions.

Dynamic Associations among Caregiver Romantic Satisfaction, Depressive Symptoms, and School-aged Child Problem Behavior

Parental mental health and social relationships are related to children's problem behaviors in a complex way, but the intricate nuances of such effects remain understudied. Within the context of a prospectively followed, randomized controlled trial of a parenting intervention (the Family Check-Up), the current study investigated reciprocal relations among primary caregiver romantic satisfaction, depressive symptoms and children's externalizing behaviors during the school-age period using a sample of low-income families from diverse racial/ethnic backgrounds. Primary caregiver self-reported romantic satisfaction and depressive symptoms, and caregiver- and teacher-reported child externalizing behavior problems were measured at child ages 7.5, 8.5, and 9.5. To prevent against bias for the inclusion of couples in longer- versus shorter-term relationships in the literature, primary caregivers with different romantic partners across waves of the study were included. Leveraging complex modeling to more thoroughly understand dynamic associations among interparental romantic satisfaction, depressive symptoms, and child problem behavior, nested model comparisons among five models were conducted to assess which model best fit the data in the control and intervention groups separately. For the control group, within a looped, clockwise paths model, child externalizing behaviors positively predicted caregiver depressive symptoms one year later, and caregiver depressive symptoms predicted lower levels of caregiver romantic satisfaction one year later. However, for the intervention group, child externalizing behavior was not related to caregiver depressive symptoms nor to romantic satisfaction across waves. The findings highlight many avenues for prevention and intervention to support positive family processes.

Maternal negative affect moderates behavioral and physiological synchrony in Latinx and Black mother-child dyads

Positive behavioral synchrony (PBS) between mothers and children involves the bidirectional exchange of verbal and nonverbal communication. Respiratory sinus arrhythmia (RSA) synchrony reflects the concordance between mother-child physiological states. Both PBS and RSA synchrony can be undermined by psychopathology symptoms. Latinx and Black families may experience contextual stressors that contribute to heightened symptoms of psychopathology, yet minimal research has examined relations between psychopathology symptoms with PBS and RSA synchrony in these families. The present study assessed associations between maternal depressive and child internalizing symptoms, mother and child negative affect (NA), and PBS and RSA synchrony in a sample of 100 Latina and Black mothers (M_age  = 34.48 years, SD = 6.39 years) and their children (M_age  = 6.83 years, SD = 1.50 years). Dyads engaged in a video-recorded stress task where RSA was collected continuously. Videos were later coded for PBS and mother and child NA. Mothers reported on their depressive and child's internalizing symptoms. Maternal NA was associated with weak PBS and negative RSA synchrony. Neither depressive and internalizing symptoms nor child NA were associated with PBS or RSA synchrony. Results highlight the potency of maternal NA on behavioral and physiological synchrony in Latinx and Black families.

Caregivers' Experiences During the COVID-19 Pandemic and Their Children's Behavior

The COVID-19 pandemic has financial and emotional impacts on families. We explored how caregivers' financial strain and mental health are associated with changes in their young children's behavior during the pandemic. We additionally considered whether having a sense of purpose moderated these associations. Caregivers (n = 300) in the emergency department of a children's hospital were surveyed anonymously about changes to their employment (e.g., reduced/increased hours and job loss), ability to pay for expenses and whether their child's behavior had changed. Aligned with the Family Stress Model, caregivers' financial strain was associated with poor mental health, inconsistent sleep routines, and changes in children's problematic and prosocial behaviors. A sense of purpose buffered some of these relationships. Families are differently affected by the pandemic and our findings underscore the need for supporting caregivers' mental health and connecting them with resources.

Maternal perinatal depression and child neurocognitive development: A relationship still to be clarified

Pregnancy frequently is associated with emotional conditions such as anxiety and depression. Perinatal depression has an incidence of around 12%. Only recently researcher put the attention on the effects of pre- and postpartum psychopathology on infant neurocognitive development. Neurobiology studies indicate that perinatal maternal depression can significantly affect the structure and function of children's prefrontal cortex and modulate the development of cognitive abilities from intrauterine life. On the topic, the scientific literature appears ambiguous, reporting mixed results. Some studies have found no significant differences in developmental outcomes between prenatal and postpartum exposure to maternal depression, others have suggested a greater burden of depression in pregnancy than in postpartum, and still others have emphasized the role of chronicity of symptoms rather than the period of onset. Few studies have examined the effects of different developmental trajectories of maternal depression on children's neurocognitive outcomes. The assessment of maternal health has for years been limited to postpartum depression often neglecting the timing of onset, the intensity of symptoms and their chronicity. These aspects have received less attention than they deserve, especially in relation to the effects on children's neurocognitive development. The aim of this Perspective was to highlight inconsistencies and gaps that need to be filled in the approach to the study of this problem. Given the wide heterogeneity of data in the current literature, further studies are needed to clarify these interactions. This Perspective provides an overview of current progress, future directions, and a presentation of the authors' views on the topic.

Parental Pre and Postnatal Depression: The Longitudinal Associations with Child Negative Affectivity and Dysfunctional Mother–Child Feeding Interactions

Background: Many studies have shown the influence of maternal perinatal depression on a child’s emotional and behavioral regulation ability; yet there is scarce research on the impact of the father’s perinatal depression on the caregiver–infant relationship and the child’s development. Methods: Through a longitudinal study, we investigated maternal and paternal depression and its association with infants’ emotionality and mother–infant feeding interactions The sample was constituted of 136 first-time parents (68 couples, and their full-term babies at 3 and 6 months old). At T1 (28th week of pregnancy), T2 (three months old), and T3 (at six months age) parents responded to the Edinburgh Postpartum Depression Scale. At Times 2 and 3, mothers and fathers completed the Infant Behavior Questionnaire, and recorded mother–infant interactions were coded by means of the Feeding Scale. Results: Statistical analyses indicated stability of maternal and paternal depression over time. Correlations emerged between mother’s higher depression scores, negative affective state during interactions at three months age, infant food refusal and mother–infant interactional conflict at six months age. Paternal higher depressive scores were associated with the mother–child interactional conflict. To finish, higher parental depression scores were related with infant negative emotionality. Conclusion: The current study confirms the relevance of embracing a cumulative risk model to support the child’s development with early caregiver-child interventions.

The Differential Impact of Parenting on Adolescent Externalizing Behaviors in the Context of Maternal Stress

The effectiveness of parenting on child outcomes may be dependent on other contextual factors. To date, few studies have focused on the potential moderating effect of maternal stress on the relationship between parenting and youth externalizing behaviors. This study extends prior work by assessing how the relationship between parenting and youth outcomes varies by the presence of maternal stress, while focusing on the developmental period of adolescence and two dimensions of parenting, parental knowledge and maternal warmth. Data were collected from 278 Mother-adolescent dyads (M_{adolescent age} = 14.05; 53.2% females; 61.9% minority) on maternal stress, maternal warmth and parental knowledge, and youth aggression and delinquency. Multi-level regression models found significant two-way interactions between parental knowledge and maternal stress on aggression and between maternal warmth and maternal stress on both outcomes. Parental knowledge was associated with lower aggression in the context of high maternal stress, but warmth only attenuated the risk of youth outcomes among low maternal stress. This study highlights the importance of considering how contextual factors impact the relationship between parenting and youth externalizing behaviors.

Maternal gender discrimination and child emotional and behavioural problems: A population-based, longitudinal cohort study in the Czech Republic

BACKGROUND

Gender discrimination may be a novel mechanism through which gender inequality negatively affects the health of women and girls. We investigated whether children's mental health varied with maternal exposure to perceived gender discrimination.

METHODS

Complete longitudinal data was available on 2,567 mother-child dyads who were enrolled between March 1, 1991 and June 30, 1992 in the European Longitudinal Cohort Study of Pregnancy and Childhood-Czech cohort and were surveyed at multiple time points between pregnancy and child age up to 15 years. The Strengths and Difficulties Questionnaire (SDQ) was administered at child age 7, 11, and 15 years to assess child emotional/behavioural difficulties. Perceived gender discrimination was self-reported in mid-pregnancy and child age 7 and 11 years. Multilevel mixed-effects linear regression of SDQ scores were estimated. Mediation was tested using structural equation models.

FINDINGS

Perceived gender discrimination, reported by 11.2% of mothers in mid-pregnancy, was related to increased emotional/behavioural difficulties among children in bivariate analysis (slope = 0.24 [95% confidence interval (CI): 0.15, 0.32], p<0.0001) and in the fully adjusted model (slope = 0.18 [95% CI: 0.09, 0.27], p<0.0001). Increased difficulties were evident among children of mothers with more depressive symptoms (slope = 0.04 [95% CI: 0.03, 0.05], p<0.0001), boys (slope = 0.26 [95% CI: 0.19, 0.34], p<0.0001), first children (slope = 0.16 [95% CI: 0.09, 0.23], p<0.0001), and families under financial hardship (slope = 0.09 [95% CI: 0.04, 0.14], p<0.0001). Effects were attenuated for married mothers (slope-0.12 [95% CI: -0.22, -0.01], p<0.05]. Maternal depressive symptoms and financial hardship mediated about 37% and 13%, respectively, of the total effect of perceived gender discrimination on SDQ scores.

INTERPRETATION

Perceived gender discrimination among child-bearing women in family contexts was associated with more mental health problems among their children and adolescents, extending prior research showing associations with maternal mental health problems. Maternal depressive symptoms and, to a lesser extent, financial hardship both partially mediated the positive relationship between perceived gender discrimination and child emotional/behavioural problems. This should be taken into consideration when measuring the societal burden of gender inequality and gender-based discrimination. Moreover, gender-based discrimination affects more than one gender and more than one generation, extending to boys in the household even moreso than girls, highlighting that gender discrimination is everyone's issue. Further research is required on the intergenerational mechanisms whereby gender discrimination may lead to maternal and child mental health consequences.

FUNDING

Bill and Melinda Gates Foundation; Ministry of Education, Youth and Sports, Czech Republic and European Structural and Investment Funds.

Online intervention to prevent postnatal depression and anxiety in Chilean new mothers: Protocol for a feasibility trial

Symptoms of postpartum depression and anxiety in new mothers are prevalent and negatively impact maternal emotional wellbeing and infant development. Barriers to accessing treatment prevent women from receiving mental health care, a situation that has worsened due to the COVID-19 pandemic. mHealth interventions hold the potential to support women during the transition to parenthood despite these barriers and to promote the use of preventive interventions. This study uses a mixed methods design to assess the feasibility and preliminary effectiveness of a psychoeducational, guided mHealth intervention to prevent postpartum mental health difficulties in women who receive care in primary health centers in Chile. The study will contribute to evidence-based research on the effectiveness of mHealth interventions for new mothers from an understudied cultural background. The findings will also enable the development of a larger randomized controlled trial to assess the effectiveness of the intervention, which, if effective, could significantly contribute to the emotional wellbeing of women and their families.

Infant Stimulation Induced a Rapid Increase in Maternal Salivary Oxytocin

Oxytocin (OT) is a neuropeptide involved in human social behaviors and reproduction. Non-invasive OT levels in saliva have recently roused interest as it does not require a specialized medical setting. Here, we observed one woman’s basal serum and saliva OT from pregnancy to 1 year postpartum to track OT concentration changes over this period. We examined the changes in salivary OT levels over time in response to maternal physiological and behavioral responses. The fluctuation of saliva OT levels is well correlated with serum OT during pregnancy and breastfeeding. However, while salivary OT increased rapidly during direct interaction (social interaction tests) with the infant and/or when the mother was watching her own infant’s video (video tests), no increase was observed in serum. We used social interaction and video tests on a group of mothers (nine mothers for social interaction and six for the video test) to clarify these single-subject results. In both tests, the mothers had increased OT in their saliva but not serum. Our study may suggest that salivary samples reflect not only the physical but also the emotional state and that saliva samples may be useful for monitoring women’s OT levels during pre- and postpartum periods. Further studies with larger sample numbers are necessary to confirm the rapid changes in salivary OT levels in response to maternal physiological and behavioral responses.

Association of Food Insecurity with Mental Health Outcomes in Parents and Children

BACKGROUND

Food insecurity affects 13.7 million US households and is linked to poor mental health. Families shield children from food insecurity by sacrificing their nutritional needs, suggesting parents and children experience food insecurity differentially.

OBJECTIVE

To identify the associations of food insecurity and mental health outcomes in parents and children DATA SOURCES: PubMed, Embase, Web of Science, and PsycInfo STUDY ELIGIBILITY CRITERIA: We included original research published in English from January 1990 to June 2020 that examined associations between food insecurity and mental health in children or parents/guardians in the United States.

STUDY APPRAISAL AND SYNTHESIS METHODS

Two reviewers screened studies for inclusion. Data extraction was completed by one reviewer and checked by a second. Bias and confounding were assessed using the Agency for Healthcare Research and Quality RTI Item Bank. Studies were synthesized qualitatively, grouped by mental health outcome, and patterns were assessed. Meta-analyses were not performed due to high variability between studies.

RESULTS

We included 108 studies, assessing 250,553 parents and 203,822 children in total. Most studies showed a significant association between food insecurity and parental depression, anxiety, and stress, and between food insecurity and child depression, externalizing/internalizing behaviors, and hyperactivity.

LIMITATIONS

Most studies were cross-sectional and many were medium- or high-risk for bias or confounding.

CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS

Food insecurity is significantly associated with various mental health outcomes in both parents and children. The rising prevalence of food insecurity and mental health problems make it imperative that effective public health and policy interventions address both problems.

Intrinsic Connectivity and Family Dynamics: Striatolimbic Markers of Risk and Resilience in Youth at Familial Risk for Mood Disorders

BACKGROUND

Few studies to date have characterized functional connectivity (FC) within emotion and reward networks in relation to family dynamics in youth at high familial risk for bipolar disorder (HR-BD) and major depressive disorder (HR-MDD) relative to low-risk youth (LR). Such characterization may advance our understanding of the neural underpinnings of mood disorders and lead to more effective interventions.

METHODS

A total of 139 youth (43 HR-BD, 46 HR-MDD, and 50 LR) aged 12.9 ± 2.7 years were longitudinally followed for 4.5 ± 2.4 years. We characterized differences in striatolimbic FC that distinguished between HR-BD, HR-MDD, and LR and between resilience and conversion to psychopathology. We then examined whether risk status moderated FC-family dynamic associations. Finally, we examined whether baseline between-group FC differences predicted resilence versus conversion to psychopathology.

RESULTS

HR-BD had greater amygdala-middle frontal gyrus and dorsal striatum-middle frontal gyrus FC relative to HR-MDD and LR, and HR-MDD had lower amygdala-fusiform gyrus and dorsal striatum-precentral gyrus FC relative to HR-BD and LR (voxel-level p < .001, cluster-level false discovery rate-corrected p < .05). Resilient youth had greater amygdala-orbitofrontal cortex and ventral striatum-dorsal anterior cingulate cortex FC relative to youth with conversion to psychopathology (voxel-level p < .001, cluster-level false discovery rate-corrected p < .05). Greater family rigidity was inversely associated with amygdala-fusiform gyrus FC across all groups (false discovery rate-corrected p = .017), with a moderating effect of bipolar risk status (HR-BD vs. HR-MDD p < .001; HR-BD vs. LR p = .005). Baseline FC differences did not predict resilence versus conversion to psychopathology.

CONCLUSIONS

Findings represent neural signatures of risk and resilience in emotion and reward processing networks in youth at familial risk for mood disorders that may be targets for novel interventions tailored to the family context.

Characteristics of maternal depression and children's functioning: A meta-analytic review

Maternal depression is associated with cognitive, emotional, and behavioral problems in offspring, but the substantial heterogeneity of depression precludes a full understanding of these associations. Variation in course of depression, characterized by severity or chronicity, may be related differentially to children's development. The current meta-analytic review examined the relations of these characteristics of maternal depression to children's developmental outcomes. Twenty-nine studies were identified and reviewed; the majority (93%) of studies reported a negative association between some aspect of maternal depression and children's adjustment. Separate meta-analyses revealed significant effect sizes for severity (Fisher's z = -.243) and chronicity (adjusted Fisher's z = -.337) of maternal depression and children's cognitive or behavioral functioning. Findings are synthesized across features of maternal depression; methodological limitations within the empirical literature are discussed; and recommendations for future research are suggested. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Machine learning prediction models for postpartum depression: A multicenter study in Japan

AIM

Postpartum depression (PPD) and perinatal mental health care are of growing importance worldwide. Here we aimed to develop and validate machine learning models for the prediction of PPD, and to evaluate the usefulness of the recently adopted 2-week postpartum checkup in some parts of Japan for the identification of women at high risk of PPD.

METHODS

A multicenter retrospective study was conducted using the clinical data of 10 013 women who delivered at ≥35 weeks of gestation at 12 maternity care hospitals in Japan. PPD was defined as an Edinburgh Postnatal Depression Scale score of ≥9 points at 4 weeks postpartum. We developed prediction models using conventional logistic regression and four machine learning algorithms based on the information that can be routinely collected in daily clinical practice. The model performance was evaluated using the area under the receiver operating characteristic curve (AUROC).

RESULTS

In the machine learning models developed using clinical data before discharge, the AUROCs were similar to those in the conventional logistic regression models (AUROC, 0.569-0.630 vs. 0.626). The incorporation of additional 2-week postpartum checkup data into the model significantly improved the predictive performance for PPD compared to that without in the Ridge regression and Elastic net (AUROC, 0.702 vs. 0.630 [p < 0.01] and 0.701 vs. 0.628 [p < 0.01], respectively).

CONCLUSIONS

Our machine learning models did not achieve better predictive performance for PPD than conventional logistic regression models. However, we demonstrated the usefulness of the 2-week postpartum checkup for the identification of women at high risk of PPD.

Investigating default mode network connectivity disruption in children of mothers with depression

BACKGROUND

Exposure to maternal major depressive disorder (MDD) bears long-term negative consequences for children's well-being; to date, no research has examined how exposure at different stages of development differentially affects brain functioning.

AIMS

Utilising a unique cohort followed from birth to preadolescence, we examined the effects of early versus later maternal MDD on default mode network (DMN) connectivity.

METHOD

Maternal depression was assessed at birth and ages 6 months, 9 months, 6 years and 10 years, to form three groups: children of mothers with consistent depression from birth to 6 years of age, which resolved by 10 years of age; children of mothers without depression; and children of mothers who were diagnosed with MDD in late childhood. In preadolescence, we used magnetoencephalography and focused on theta rhythms, which characterise the developing brain.

RESULTS

Maternal MDD was associated with disrupted DMN connectivity in an exposure-specific manner. Early maternal MDD decreased child connectivity, presenting a profile typical of early trauma or chronic adversity. In contrast, later maternal MDD was linked with tighter connectivity, a pattern characteristic of adult depression. Aberrant DMN connectivity was predicted by intrusive mothering in infancy and lower mother-child reciprocity and child empathy in late childhood, highlighting the role of deficient caregiving and compromised socio-emotional competencies in DMN dysfunction.

CONCLUSIONS

The findings pinpoint the distinct effects of early versus later maternal MDD on the DMN, a core network sustaining self-related processes. Results emphasise that research on the influence of early adversity on the developing brain should consider the developmental stage in which the adversity occured.

Intranasal oxytocin administration improves mood in new mothers with moderate low mood but not in mothers with elevated symptoms of postnatal depression: A randomised controlled trial

BACKGROUND

Oxytocin (OT) is a neuropeptide hormone that has anxiolytic and antidepressant effects, and positive effects on social affiliation and behaviour, particularly in parenting and attachment relationships. In women with postnatal depression (PND), each of these are reduced. This study investigated if OT administration reduces low mood in new mothers with PND and across the low mood spectrum.

DESIGN

A double-blind, placebo-controlled, randomised controlled-trial, within-subjects, cross-over design was conducted.

PARTICIPANTS

Mothers (N = 58) between 3 and 9 months postpartum. Participants were screened for traits of PND on the Edinburgh Postnatal Depression Scale (EPDS) and assigned into 2 groups: probable PND cases (N = 26, scoring ≥9) and controls (N = 32, scoring ≤9).

METHOD

Participants rated their current mood on the Positive and Negative Affect Scale (PANAS) at Baseline (before nasal administration), Condition 1 (after first OT/Placebo administration) and Condition 2 (after second OT/Placebo administration).

RESULTS

OT administration did not affect mood in women with PND scores above the cut-off point but significantly reduced negative mood in those scoring below the cut-off point. To explore if a subgroup was driving this, we compared participants with mild, moderate and severe scores on the EPDS. OT administration significantly reduced negative mood in women with moderate low mood scores on the EPDS.

LIMITATIONS

PND was assessed by the EPDS, rather than a clinical diagnosis.

CONCLUSION

These results illustrate individual differences in response to OT administration and suggest that OT administration may offer treatment benefit to new mothers who report moderate sub-clinical levels of depression.

Parent-Child Synchrony After Early Childhood: A Systematic Review

Parent-child synchrony, or the coordination of biological and behavioral processes between parent and child, is thought to promote healthy relationships and support youth adjustment. Although extensive work has been conducted on parent-child synchrony during infancy and early childhood, less is known about synchrony in middle childhood and adolescence and the contextual factors that impact synchrony, particularly physiological synchrony. This is a systematic and qualitative review of 37 studies of behavioral and physiological synchrony in parent-child interactions after early childhood (parents with youth ages 5-18). Behavioral and physiological synchrony were typically identified in youth and their parents beyond early childhood and related to positive outcomes; however, research on father-child synchrony is rarer with mixed findings. Multiple factors are associated with synchrony, including parent and youth psychological symptoms and disorders, parenting factors, such as over-controlling parenting, and parent characteristics, such as interparental aggression and conflict. Few studies have examined behavioral and physiological synchrony simultaneously and longitudinally, limiting our ability to understand the relationship between types of synchrony and later adjustment. Available studies suggest that the context, such as presence of psychopathology or exposure to trauma, influences whether synchrony is associated with positive or negative outcomes. This review highlights the need for additional research to understand the relationship between types of synchrony and the long-term effects and contextual factors that impact youth outcomes.

Mindful awareness as a mechanism of change for natural childbirth in pregnant women with high fear of childbirth: a randomised controlled trial

BACKGROUND

Mindfulness-Based Childbirth and Parenting (MBCP) is effective in increasing natural childbirth in pregnant women with high fear of childbirth (FOC) as compared to enhanced care as usual (ECAU). We aimed to examine through which pathway of action MBCP reaches this effect, based on a model of approaching or avoiding the challenges related to childbirth.

METHODS

One hundred eleven pregnant women with high FOC were measured pre- and post-intervention on FOC (emotion pathway), catastrophic beliefs about labour pain (cognition pathway) and mindful awareness (attention pathway). A multiple mediation model was used to examine through which pathway the mechanism of change operated in relation to approach (i.e., natural childbirth) versus avoidance (i.e., self-requested caesarean section).

RESULTS

It was found that greater mindful awareness (18% R2 = 0.18, F[1107] = 22.77, p < 0.0001) was the only significant mechanism of change operating through the attentional pathway leading to natural childbirth. More specifically, nonreactivity to inner experience (a facet of mindful awareness) showed to be the strongest mechanism of change. More extensive meditation practice was positively associated with natural childbirth; however, the number of completed MBCP sessions was not associated with the outcome.

CONCLUSIONS

An increase in mindful awareness was the strongest mechanism of change for better adaptation to the challenges of childbirth. Decreases in neither FOC nor catastrophic beliefs about labour pain were identified as mechanisms of change. Additionally, the more one meditated, the more one was inclined towards a natural childbirth. MBCP enhances adaptation to the challenges of childbirth and less use of obstetric interventions in the presence of high FOC.

TRIAL REGISTRATION

The Netherlands Trial Register (NTR; 4302 ).

Family Factors Associated with Hands-On Play and Screen Time During the COVID-19 Pandemic

Background

Parent-child interactions are crucial for child development. The COVID-19 pandemic has negatively affected mental health and increased parenting challenges impacting parent-child functioning.

Objective

This study examined parent factors related to more and less enriching child activities during the pandemic through Bronfenbrenner's Ecological Systems framework.

Methods

A convenience sample of parents (N = 708), primarily mothers (n = 610; 87.4%) aged 35.59 years old (SD = 5.59; range = 21-72), with children ages 2-8 years completed an online questionnaire between April 14-June 1, 2020. Participants mostly resided in Canada, had an income of > $100,000, and identified as White (82.4%). Parent-child activities were measured as total weekly time and combined time across activities within two categories: hands-on play and screen time. Bivariate correlations informed blockwise linear regression models.

Results

For families with childcare needs, parental anxiety was associated with higher total hands-on play, combined hands-on play, and combined screen time. Families without childcare needs indicated parenting stress was associated with lower total hands-on play and combined hands-on play, and higher supervised screen time. Family structure and indices of socioeconomic status were also predictive of activities across childcare needs and child ages.

Conclusions

To promote high-quality parent-child interactions and positive developmental outcomes during the pandemic, childcare needs and parent wellbeing should be supported, while evidence-based guidelines for child screen time should be further researched in this context.

Perinatal depression screening and prevention: Descriptive findings from a multicentric program in the South of Italy

INTRODUCTION

Perinatal depression (PD) is a cluster of clinical depressive symptoms occurring globally during pregnancy or after childbirth, with a prevalence of 11.9%. Risk factors for PD among pregnant women may include personality traits of neuroticism, low personal resilience, higher anxiety, avoidance in close relationships, as well as dysfunctional coping strategies.

METHODS

We report on descriptive findings of a screening/prevention program aimed to detect depressive symptoms and associated risk factors in a large sample of women (N = 1,664) accessing the gynecological departments of the Regione Puglia (South of Italy) from July to November 2020. Pregnant women were assessed in their third trimester of pregnancy (T0), after childbirth (T1), and those at risk for PD within 1 year from delivery (T2-T4); The Edinburgh Postnatal Depression Scale (EPDS) has been employed for the screening of PD over time as well as other standardized measures for neuroticism, resilience, coping strategies, and quality of life.

RESULTS

Of 1,664, n = 1,541 were tested at T1, and 131 scored ≥ 12 at EPDS (14.6 ± 2.95), showing a higher risk for PD. They were followed over time at 1, 6, and 12 months after childbirth (T2-T4), and 15 of them scored ≥ 12 (EPDS) at T4. Women with a higher risk of PD also reported higher levels of neuroticism, lower levels of personal resilience, more anxiety and avoidance in close relationships, higher employment of dysfunctional coping strategies (e.g., denial, self-blame, etc.), and lower quality of life (0.0008 < all p < 0.0001).

CONCLUSION

This study confirmed the benefit of screening programs for the early detection of PD among pregnant women. We may suggest a set of risk factors to be considered in the clinical assessment of PD risk as well as the promotion of similar programs to improve depressive outcomes and pathways to care for PD on the basis of a more accurate assessment and referral.

Roles of Oxytocin in Stress Responses, Allostasis and Resilience

Oxytocin has been revealed to work for anxiety suppression and anti-stress as well as for psychosocial behavior and reproductive functions. Oxytocin neurons are activated by various stressful stimuli. The oxytocin receptor is widely distributed within the brain, and oxytocin that is released or diffused affects behavioral and neuroendocrine stress responses. On the other hand, there has been an increasing number of reports on the role of oxytocin in allostasis and resilience. It has been shown that oxytocin maintains homeostasis, shifts the set point for adaptation to a changing environment (allostasis) and contributes to recovery from the shifted set point by inducing active coping responses to stressful stimuli (resilience). Recent studies have suggested that oxytocin is also involved in stress-related disorders, and it has been shown in clinical trials that oxytocin provides therapeutic benefits for patients diagnosed with stress-related disorders. This review includes the latest information on the role of oxytocin in stress responses and adaptation.

Family Functioning in the Time of COVID-19 Among Economically Vulnerable Families: Risks and Protective Factors

The ongoing COVID-19 crisis has been particularly harmful to economically vulnerable families with young children. We surveyed 247 low-income mothers and fathers from 142 families in the United States about changes in their family life following the economic and social restrictions imposed by the pandemic. We examined the associations between pandemic-related risk factors such as economic stressors (e.g., loss of job) and social stressors (e.g., exposure to the virus) on family functioning (e.g., parents' mental health, parent engagement, and children's socioemotional behaviors) and the degree to which coparenting support and parents' positivity protected families from the negative effects of these stressors on their wellbeing. We found both positive and negative associations. Mothers and fathers who reported more economic stressors since the pandemic also observed that their children behaved more prosocially and that fathers experienced more mental health difficulties during the pandemic. Mothers and fathers who reported more social stressors reported that they were less engaged with their children and their children exhibited more behavior problems compared to before the pandemic. We also found that mothers and fathers who reported feeling more positive also reported feeling less depressed and stressed during the pandemic and observed that their children had more prosocial behaviors compared to before the pandemic. Compared to before the pandemic, mothers and fathers who reported a more supportive coparenting relationship also reported more parent engagement and observed more prosocial behaviors in their children. In terms of protective factors, high levels of parent positivity during the pandemic protected mothers (less mental health difficulties) whereas high levels of coparenting support protected fathers (less mental health difficulties) from the negative effects of economic stress on their mental health during the pandemic. These findings highlight family processes that could promote resilience in mothers and fathers in the face of pandemic-related economic and social stressors.

Health of Immigrant Children: The Role of Immigrant Generation, Exogamous Family Setting, and Family Material and Social Resources

Although the children of first-generation immigrants tend to have better health than the native population, the health advantage of the children of immigrant families deteriorates over generations. It is, however, poorly understood where on the generational health assimilation spectrum children with one immigrant and one native parent (i.e., exogamous families) lie, to what extent family resources explain health assimilation, and whether the process of assimilation varies across health conditions. We seek to extend our understanding of the process of health assimilation by analyzing the physical and mental health of immigrant generations, assessing the role of exogamous family arrangements, and testing the contributions of family material and social resources to children's outcomes. We use register-based longitudinal data on all children residing in Finland, born in 1986-2000, and alive in 2000; these data are free of reporting bias and loss to follow-up. We estimate the risk of receiving inpatient and outpatient care for somatic conditions, psychopathological disorders, and injuries by immigrant generation status. Our results show evidence of a negative health assimilation process, with both first- and second-generation immigrant children having a higher prevalence of physical problems and particularly mental health problems than native children that is only partially explained by family resources. We find that the children of exogamous families are at especially high risk of developing psychopathological disorders. These results provide strong support for the hypothesis that children of exogamous families constitute a specific health risk group and that the impact on children's health of family social and material resources seems to be secondary to other unobserved factors.

Neglecting Maternal Depression Compromises Child Health and Development Outcomes, and Violates Children's Rights in South Africa

The intention of the South African Children’s Act 38 of 2005 is to provide guarantees for the protection and promotion of optimum health and social outcomes for all children. These guarantees are the provision of basic nutrition, basic health care and social services, optimal family or parental care, as well as protection from maltreatment, neglect and abuse services. However, despite these guarantees, child and maternal mortality remain high in South Africa. The literature identifies maternal depression as a common factor that contributes to negative health and social outcomes for both mothers and their children. Despite the availability of easy-to-use tools, routine screening for maternal depression is not carried out in public health services, which is the source of services for the majority of women in South Africa. The results are that the mothers miss out on being diagnosed and treated for maternal depression, which results in negative child outcomes, such as malnutrition, as well as impacts on mental, social and physical health, and even death. The long-term impacts of untreated maternal depression include compromised child cognitive development, language acquisition and deviant behaviors and economic disadvantage in later life. The author concludes that the neglect of screening for, and treatment of maternal depression therefore violates the constitutional rights of the affected children, and goes against the spirit of the Constitution. The author recommends that maternal and child health services integrate routine screening for maternal depression, which will not only satisfy the Constitutional mandate, but also improve the health and developmental outcomes of the children and reduce child mortality.

Scoping Review of the Associations Between Perinatal Substance Use and Perinatal Depression and Anxiety

OBJECTIVE

To evaluate published literature on the associations between perinatal substance use (PSU), perinatal depression and anxiety (PDA), and known maternal-newborn outcomes.

DATA SOURCES

We conducted a systematic search of health-related databases, including PubMed, CINAHL, MEDLINE, and Embase. Search terms included maternal mental health, substance use, postpartum, opioid, alcohol, methamphetamine, addiction, dependence, pregnancy, depression, and anxiety.

STUDY SELECTION

We included English-language, peer-reviewed reports of primary research and systematic reviews that were published between 2010 and 2020 and focused on PSU and PDA. We excluded commentaries, nonsystematic reviews, and articles on maternal mental health other than PDA. Fourteen of 379 articles met the inclusion criteria.

DATA EXTRACTION

We used the Joanna Briggs Institute Review Guidelines to guide extraction of the following data: author(s), year of publication, type of study, country of origin, study sample, targeted substance(s), mental health, key findings, and recommendation(s).

DATA SYNTHESIS

In studies of PSU, researchers identified a strong association with PDA. Likewise, researchers investigating PDA found a strong association with PSU. Findings from these articles suggest an increasing risk for PSU with increasing severity of PDA, depending on the specific substances of use. Findings also indicated that women with polysubstance use have greater odds for comorbid perinatal mental health conditions. A relationship between PSU and PDA and adverse newborn outcomes, such as low birth weight, was found.

CONCLUSION

There is a paucity of published research on co-occurring PSU and PDA. However, polysubstance use appears to be associated with the greatest risk for PDA. It is essential to address PSU and PDA together to better understand the effects on maternal and infant outcomes.

Social dialogue triggers biobehavioral synchrony of partners' endocrine response via sex-specific, hormone-specific, attachment-specific mechanisms

Social contact is known to impact the partners' physiology and behavior but the mechanisms underpinning such inter-partner influences are far from clear. Guided by the biobehavioral synchrony conceptual frame, we examined how social dialogue shapes the partners' multi-system endocrine response as mediated by behavioral synchrony. To address sex-specific, hormone-specific, attachment-specific mechanisms, we recruited 82 man–woman pairs (N = 164 participants) in three attachment groups; long-term couples (n = 29), best friends (n = 26), and ingroup strangers (n = 27). We used salivary measures of oxytocin (OT), cortisol (CT), testosterone (T), and secretory immuglobolinA (s-IgA), biomarker of the immune system, before and after a 30-min social dialogue. Dialogue increased oxytocin and reduced cortisol and testosterone. Cross-person cross-hormone influences indicated that dialogue carries distinct effects on women and men as mediated by social behavior and attachment status. Men's baseline stress-related biomarkers showed both direct hormone-to-hormone associations and, via attachment status and behavioral synchrony, impacted women's post-dialogue biomarkers of stress, affiliation, and immunity. In contrast, women's baseline stress biomarkers linked with men's stress response only through the mediating role of behavioral synchrony. As to affiliation biomarkers, men's initial OT impacted women's OT response only through behavioral synchrony, whereas women's baseline OT was directly related to men's post-dialogue OT levels. Findings pinpoint the neuroendocrine advantage of social dialogue, suggest that women are more sensitive to signs of men's initial stress and social status, and describe behavior-based mechanisms by which human attachments create a coupled biology toward greater well-being and resilience.

Maternal depressive symptoms, poverty, and young motherhood increase the odds of early depressive and anxiety disorders for children born prematurely

Children born preterm, compared to term, are at risk for behavioral problems. However, the prevalence and predictors of internalizing disorders among children born preterm are unclear. The purpose of this study was to identify the prevalence of depressive and anxiety disorders at 2 years of age among children born preterm and determine the extent to which poverty, maternal depressive symptoms, or young motherhood increase the likelihood of these disorders. Mothers and their infants (N = 105) were recruited from two neonatal intensive care units affiliated with a major U.S. university. A sociodemographic questionnaire, the Patient Health Questionnaire‐9, and the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition scale scores from the Preschool Child Behavior Checklist were used to measure primary variables. We examined mothers’ family satisfaction and quality of caregiving as well as children's degree of prematurity, morbidity, gender, cognitive functioning, and motor function as covariates. Fifteen percent of children met criteria for an anxiety disorder and another 15% for depression. Maternal depressive symptoms increased the odds of children developing both anxiety and depression, whereas young motherhood was associated with child anxiety and poverty with child depression. Results indicate the need for mental health assessment of children born preterm during their first 2 years of life and the importance of early therapeutic and tangible support to vulnerable mothers and children.

The association of oxytocin with major depressive disorder: role of confounding effects of antidepressants

Major depressive disorder is a genetic susceptible disease, and a psychiatric syndrome with a high rate of incidence and recurrence. Because of its complexity concerning etiology and pathogenesis, the cure rate of first-line antidepressants is low. In recent years, accumulative evidences revealed that oxytocin act as a physiological or pathological participant in a variety of complex neuropsychological activities, including major depressive disorder. Six electronic databases (Web of Science, PubMed, Scopus, Google Scholar, CNKI, and Wanfang) were employed for researching relevant publications. At last, 226 articles were extracted. The current review addresses the correlation of the oxytocin system and major depressive disorder. Besides, we summarize the mechanisms by which the oxytocin system exerts potential antidepressant effects, including regulating neuronal activity, influencing neuroplasticity and regeneration, altering neurotransmitter release, down regulating hypothalamic-pituitary-adrenal axis, anti-inflammatory, antioxidation, and genetic effects. Increasing evidence shows that oxytocin and its receptor gene may play a potential role in major depressive disorder. Future research should focus on the predictive ability of the oxytocin system as a biomarker, as well as its role in targeted prevention and early intervention of major depressive disorder.

Mothers' neural response to valenced infant interactions predicts postpartum depression and anxiety

It is currently unknown whether differences in neural responsiveness to infant cues observed in postpartum affective disturbance are specific to depression/anxiety or are better attributed to a common component of internalizing distress. It is also unknown whether differences in mothers’ brain response can be accounted for by effects of past episodes, or if current neural processing of her child may serve as a risk factor for development of future symptoms. Twenty-four mothers from a community-based sample participated in an fMRI session viewing their 3-month- old infant during tasks evoking positive or negative emotion. They were tracked across the ensuing 15 months to monitor changes in affective symptoms. Past and current episodes of depression and anxiety, as well as future symptoms, were used to predict differences in mothers’ hemodynamic response to their infant in positive compared to negative emotion contexts. Lower relative activation in largely overlapping brain regions involving frontal lobe structures to own infant positive vs. negative emotion was associated with concurrent (3-month) depression diagnosis and prospective (3–18 month) depression and anxiety symptoms. There was little evidence for impacts of past psychopathology (more limited effect of past anxiety and nonsignificant effect of past depression). Results suggest biased maternal processing of infant emotions during postpartum depression and anxiety is largely accounted for by a shared source of variance (internalizing distress). Furthermore, differential maternal responsiveness to her infant’s emotional cues is specifically associated with the perpetuation of postpartum symptoms, as opposed to more general phenotypic or scarring effects of past psychopathology.

Social Behavior as a Transdiagnostic Marker of Resilience

The recent shift from psychopathology to resilience and from diagnosis to functioning requires the construction of transdiagnostic markers of adaptation. This review describes a model of resilience that is based on the neurobiology of affiliation and the initial condition of mammals that mature in the context of the mother's body and social behavior. The model proposes three tenets of resilience-plasticity, sociality, and meaning-and argues that coordinated social behavior stands at the core sustaining resilience. Two lines in the maturation of coordinated social behavior are charted, across animal evolution and throughout human development, culminating in the mature human reciprocity of empathy, mutuality, and perspective-taking. Cumulative evidence across ages and clinical conditions and based on our behavioral coding system demonstrates that social reciprocity, defined by plasticity at the individual, dyadic, and group levels, denotes resilience, whereas the two poles of disengagement/avoidance and intrusion/rigidity characterize specific psychopathologies, each with a distinct behavioral signature. Attention to developmentally sensitive markers and to the dimension of meaning in human sociality may open new, behavior-based pathways to resilience.

Maternal Depression and Mother-Child Oxytocin Synchrony in Youth with Anxiety Disorders

The neuropeptide oxytocin (OT) plays a central role in the regulation of affiliative bonds and anxiety. However, the degree to which its levels are synchronized between interaction partners has not yet been assessed. Physiological synchrony assessed using other peripheral measures (e.g., heart rate, etc.) has been tied to positive outcomes for the individual and the dyad. The present study examined OT synchrony in the context of child anxiety and maternal depression by examining mother-child dyads. Mothers and their children with anxiety disorders participated in a behavioral interaction task. Changes in OT levels and mother-child OT synchrony before and after the interaction, as well as their moderation by maternal depression, were assessed. Ninety-eight youth with anxiety disorders (ages 10 to 17) and their mothers underwent psychiatric evaluation, and mothers rated their own depressive symptoms and their children's behavior problems. Salivary OT was assayed from mother and child before and after the task. Behavioral coding showed that interactions were characterized by high behavioral synchrony between mothers and their children, and both individuals displayed higher levels of positive vs. negative affect during the interactions. Mothers and their children also showed decreases in OT levels after the interaction. As hypothesized, OT synchrony increased following the task, but only dyads in which mothers showed high levels of depressive symptoms showed this increase. As hypothesized, lower levels of OT-synchrony were associated with higher levels of child internalizing symptoms. The findings suggest that positive interactions may be beneficial for youth with anxiety disorders with mothers with depression.