The effect of antepartum depressive and anxiety symptoms on mother-infant interaction: The mediating role of antepartum maternal emotional stress

Anxiety disorders, depression, and emotional stress during the antepartum period are interlinked with adverse child development. The quality of the dyadic interaction seems to play a crucial role in the transmission of these effects. In this study, we explored the mediating effect of antepartum maternal emotional stress (assessed via the Prenatal Emotional Stress Index) regarding the relationship of antepartum maternal depressive (assessed via the Edinburgh Postpartum Depression Scale), anxiety symptoms (assessed via the Stat-Trait-Anxiety-Inventory), and depressive and anxiety disorders (assessed according to the DSM-IV-TR) in the antepartum period on postpartum interactive quality in a longitudinal design. The Face-to-Face-Still-Face Paradigm (FFSF) and the Infant and Caregiver Engagement Phases (ICEP-R) coding system were used to assess the postpartum interactive qualities of the mother-infant dyads. The sample consisted of 59 women, 38 in the clinical and 21 in the control group. We found significant indirect effects of antepartum depressive symptoms and maternal diagnostic status on the mother's neutral engagement and on the latency to the first social positive interactive match during the interaction - effects that were mediated by antepartum stress. Moreover, there was an indirect effect of state anxiety on neutral engagement - mediated by antepartum stress. Therapeutic intervention studies focusing on maternal antepartum regulation of emotional stress and postpartum interactive patterns might be crucial to encounter maladaptive developmental trajectories.

Emotion regulation and cortisol response to the still-face procedure in preterm and full-term infants

In infancy, stress responses and emotion regulation are often coupled. Both are impacted by prematurity, though their relationship to one another in the case of infants born preterm is not fully understood. We investigated emotion regulation behaviours, cortisol reactivity and recovery and coupling between emotion regulation and cortisol reactivity to and recovery from a stressor in preterm infants. 53 preterm and 67 full-term infants with mean (range) gestational age at birth 29⁺³ (24⁺⁰-31⁺⁶) and 39⁺³ (36⁺²-42⁺⁰) weeks respectively were exposed to a socio-emotional stressor, the still-face (SF) paradigm, at 9 months of age (corrected for prematurity). The duration of negative affect and self-comforting behaviours exhibited in response to the SF, coded from a 10-minute video-taped interaction, were compared between groups. Saliva was collected from a subset (20 preterm, 24 term infants) at three timepoints: pre-SF and 20- and 30-minutes post SF. Cortisol concentrations at each timepoint were compared between groups. Associations between behavioural measures and cortisol concentrations were explored. There was no significant difference in duration of self-comforting behaviour between preterm and term infants. Preterm infants spent a significantly smaller proportion of time in a negative affective state compared to term infants (0.18 vs 0.25 s, p = 0.03). Salivary cortisol concentration was significantly higher in the preterm compared to the term group 30 min post SF (2.85 vs 1.77 nmol/L, p = 0.009), though findings were no longer significant after adjusting for time of day of sampling and socioeconomic deprivation. After controlling for time of day, greater negative affect was correlated with higher cortisol concentration 30 min post SF in the full-term (r = 0.58, p = 0.004) but not the preterm group (r = -0.01, p > 0.05). Our findings suggest altered response to an acute stressor in preterm infants, manifesting as a muted emotional response, and a lack of coupling between endocrine and behavioural stress response. Replication studies in larger samples would help to further understand biological stress repose in preterm infants and its relationship to behaviour, time of day and deprivation.

A Pilot Study

The Still-face Paradigm has been widely used for the assessment of emotion regulation in infants, as well as for the study of the mother-child relationship. Given the close bond that dogs have with humans, the purpose of this research was to evaluate, through an exploratory descriptive study, the presence of the Still-face effect in dogs. To this end, a group of Beagle dogs were exposed to three one-minute phases in which first, an unknown experimenter interacted actively and positively with each dog (Interaction). Then, suddenly, she interrupted the interaction and remained passive, with a non-expressive face and without speaking or petting the dog (Still-face). Finally, the experimenter reestablished the interaction (Reunion). Our results showed a decrease in affiliative behaviors in dogs during the Still-face phase according to changes in the human's behavior, a pattern similar to the one previously found in infants. Contrary to expectations, no stress-related behaviors were shown during that phase. A carry-over effect was also observed in the Reunion phase. This study provides information about the human-dog interaction and the effects of its disruption on dogs' behaviors.

Infant affect response in the face-to-face still face among Chinese- and European American mother-infant dyads

Early face-to-face interactions with caregivers allow infants to learn how to express and exchange emotions with others. Within the field, however, the research regarding infant regulatory processes across cultures remains limited. The Double Face-to-Face Still Face (FFSF) paradigm provided an opportunity to examine infant affect in dyadic interactions with European American (EA, n = 54) and Chinese American (CA, n = 48) infants and caregivers. Consistent with our hypothesis that CA infants are less reactive than EA infants, CA infants in our study showed less negative and more neutral affect compared to EA infants. We also examined the number of infants who were unable to complete the full FFSF paradigm due to high levels of distress (e.g., 30-sec of sustained hard cries). Compared to EA infants, more CA infants were unable to complete the paradigm due to negative affect (e.g., sustained cries). Analyses showed an association between mothers' negative affect from the start of the paradigm with infant incompletion of the paradigm. These findings point to cultural differences in infant affect within the FFSF. As well, researchers should consider the characteristics of infants who do not complete the FFSF paradigm as they can provide meaningful data in understanding infant affect and regulation. Taken together, our findings suggest that the Double FFSF paradigm provides a reasonable threshold for distinguishing infants on their ability to regulate during a repeated social stressor.

Social stress regulation in 4-month-old infants: contribution of maternal social engagement and infants' 5-HTTLPR genotype

BACKGROUND

Maternal behavior and infant 5-HTTLPR polymorphism have been linked to infants' social stress reactivity and recovery at different ages. Nonetheless, Gene×Environment (G×E) studies focusing on early infancy are rare and have led to mixed results.

AIM

To investigate the contribution of maternal social engagement and infants' 5-HTTLPR polymorphism in predicting infants' negative emotionality in response to a social stressor, namely maternal unresponsiveness.

STUDY DESIGN

Cross-sectional, G×E study.

SUBJECTS

73 4-month-old infants and their mothers took part to the Face-to-Face Still-Face (FFSF) procedure.

OUTCOME MEASURES

A micro-analytical coding of negative emotionality was adopted to measure infants' reactivity to social stress (Still-Face episode) and infants' recovery after social stress (Reunion episode). Maternal contribution was measured as maternal social engagement during the Play episode. Infants were genotyped as S-carriers or L-homozygotes.

RESULTS

The interplay between maternal social engagement and infants' genotype was found to be predictive of infants' negative emotionality during both Still-Face and Reunion episodes of the FFSF paradigm. The interaction highlighted that maternal social engagement predicted minor negative emotionality during Still-Face and Reunion episodes for S-carrier infants, but not for L-homozygotes.

CONCLUSIONS

Findings extend previous results on adults and children, highlighting that maternal behavior might be a protective factor for stress reactivity and regulation, especially for S-carrier infants who are at risk for heightened stress susceptibility.

Emotional expression and heart rate in high-risk infants during the face-to-face/still-face

In infants, eye constriction-the Duchenne marker-and mouth opening appear to index the intensity of both positive and negative facial expressions. We combined eye constriction and mouth opening that co-occurred with smiles and cry-faces (respectively, the prototypic expressions of infant joy and distress) to measure emotional expression intensity. Expression intensity and heart rate were measured throughout the face-to-face/still-face (FFSF) in a sample of infants with prenatal cocaine exposure who were at risk for developmental difficulties. Smiles declined and cry-faces increased in the still-face episode, but the distribution of eye constriction and mouth opening in smiles and cry-faces did not differ across episodes of the FFSF. As time elapsed in the still face episode potential indices of intensity increased, cry-faces were more likely to be accompanied by eye constriction and mouth opening. During cry-faces there were also moderately stable individual differences in the quantity of eye constriction and mouth opening. Infant heart rate was higher during cry-faces and lower during smiles, but did not vary with intensity of expression or by episode. In sum, infants express more intense negative affect as the still-face progresses, but do not show clear differences in expressive intensity between episodes of the FFSF.

Oxytocin administration alters HPA reactivity in the context of parent-infant interaction

The neuropeptide oxytocin (OT) and the steroid cortisol (CT) have each been implicated in complex social behavior, including parenting, and one mechanism by which OT is thought to exert its pro-social effects is by attenuating hypothalamic-pituitary-adrenal (HPA) response to stress. Yet, no study to date has tested whether OT functions to reduce CT production in the context of the parent-infant attachment. In the current study, we examined the effects of intranasal OT administered to the parent on parent's and infant's CT levels following parent-child interaction that included a social stressor. Utilizing a double-blind, placebo-controlled, within-subject design, 35 fathers and their 5-month-old infants were observed in a face-to-face-still-face paradigm twice, one week apart. Interactions were micro-coded for social synchrony, and salivary CT were repeatedly assessed from parent and child. Results showed that OT increased fathers' overall CT response to the stress paradigm. Furthermore, OT altered infants' physiological and behavioral response as a function of parent-infant synchrony. Among infants experiencing high parent-infant synchrony, OT elevated infant HPA reactivity and increased infant social gaze to the father while father maintained a still-face. On the other hand, among infants experiencing low social synchrony, parental OT reduced the infant's stress response and diminished social gaze toward the unavailable father. Results are consistent with the "social salience" hypothesis and highlight that OT effects on human social functioning are not uniform and depend on the individual's attachment history and social skills. Our findings call to further investigate the effects of OT administration within developmental contexts, particularly the parent-infant relationship.