Dimensions of depressive symptomatology in mothers derived from factor analyses.

PURPOSE: Subtypes of depression have been under studied in women during the peripartum period and the year after childbirth and delivery. Due to heterogeneity of depression, researchers have attempted to identify phenotypes of maternal and postpartum depression based on key symptoms that may represent underlying genes and biological etiology (Leuchter et al. Dialog Clinic Neurosci 16(4):525, 2014). METHODS: The current study collected self-report data from 587 women and utilized exploratory and confirmatory factor analyses (CFA) to identify subtypes of depression symptoms across two measures. RESULTS: Findings of the study showed that: (1) using the Beck Depression Inventory (BDI-II) and the Postpartum Depression Screening Scale (PDSS), a five-factor solution best fit the data in our sample of mothers with infants aged 4-14 months. The factors included: anxiety/thought disorder; cognitive depression; suicide; somatic/neurovegetative; and sleep [χ2 (454, N = 587) = 1102.61, p < 0.001, comparative fit index (CFI) = 0.93, Tucker Lewis index (TLI) = 0.92, root mean square error of approximation (RMSEA) = 0.05]; and (2) the following factors significantly positively predicted interview-based diagnosis of depression: cognitive symptoms of depression and sleep [χ2 (482, N = 587) = 1170.40, p < 0.001, TLI = 0.91, CFI = 0.93, RMSEA = 0.05]. CONCLUSIONS: Future research could assess the clinical benefits of screening for maternal mood disorders.

Associations between maternal depression and mother and infant oxytocin receptor gene (OXTR_rs53576) polymorphisms.

Polymorphisms in the oxytocin receptor gene, OXTR_rs53576, have been linked to differences in maternal sensitivity and depressive symptoms. Although some studies suggest the A allele confers risk for mood disorders, individuals homozygous for the G allele may exhibit greater sensitivity to both positive and negative social experiences, including in the mother-infant dyad. Given the bi-directional nature of mother-infant influences on maternal mood, we tested the association between both mothers' and infants' OXTR_rs53576 genotype and maternal depression, as assessed through a self-report inventory. Although Beck Depression Inventory (BDI-II) scores were significantly higher for GG in comparison to AG/AA mothers, and for mothers of GG in comparison to AG/AA infants, an ANCOVA revealed that after sociodemographic risk factors had been controlled, infants', but not mothers', OXTR genotype predicted maternal depression scores, with no significant interaction between the two. The effect of infant OXTR on maternal depression was not explained by maternal reports of difficult infant temperament. We propose that GG infants have an enhanced capacity for processing both positive and negative socially meaningful contextual information, first amplifying and then differentially perpetuating negative affectivity in mothers who exhibit depressive characteristics.

Psychometric properties of the postpartum depression screening scale beyond the postpartum period.

Accurate postpartum depression screening measures are needed to identify mothers with depressive symptoms both in the postpartum period and beyond. Because it had not been tested beyond the immediate postpartum period, the reliability and validity of the Postpartum Depression Screening Scale (PDSS) and its sensitivity, specificity, and predictive value for diagnoses of major depressive disorder (MDD) were assessed in a diverse community sample of 238 mothers of 4- to 15-month-old infants. Mothers (N = 238; M age = 30.2, SD = 5.3) attended a lab session and completed the PDSS, the Beck Depression Inventory-II (BDI-II), and a structured clinical interview (SCID) to diagnose MDD. The reliability, validity, specificity, sensitivity, and predictive value of the PDSS to identify maternal depression were assessed. Confirmatory factor analysis supported the construct validity of five but not seven content subscales. The PDSS total and subscale scores demonstrated acceptable to high reliability (α = 0.68-0.95). Discriminant function analysis showed the scale correctly provided diagnostic classification at a rate higher than chance alone. Sensitivity and specificity for major depressive disorder (MDD) diagnosis were good and comparable to those of the BDI-II. Even in mothers who were somewhat more diverse and had older infants than those in the original normative study, the PDSS appears to be a psychometrically sound screener for identifying depressed mothers in the 15 months after childbirth.

A Privileged Status for Male Infant-Directed Speech in Infants of Depressed Mothers? Role of Father Involvement.

Prior research showed that 5- to 13-month-old infants of chronically depressed mothers did not learn to associate a segment of infant-directed speech produced by their own mothers or an unfamiliar nondepressed mother with a smiling female face, but showed better-than-normal learning when a segment of infant-directed speech produced by an unfamiliar nondepressed father signaled the face. Here, learning in response to an unfamiliar nondepressed father's infant-directed speech was studied as a function both of the mother's depression and marital status, a proxy measure of father involvement. Infants of unmarried mothers on average did not show significant learning in response to the unfamiliar nondepressed father's infant-directed speech. Infants of married mothers showed significant learning in response to male infant-directed speech, and infants of depressed, married mothers showed significantly stronger learning in response to that stimulus than did infants of nondepressed, married mothers. Several ways in which father involvement may positively or negatively affect infant responsiveness to male infant-directed speech are discussed.

Face Preferences for Infant- and Adult-Directed Speakers in Infants of Depressed and Nondepressed Mothers: Association with Infant Cognitive Development.

Face preferences for speakers of infant-directed and adult-directed speech (IDS and ADS) were investigated in 4- to 13.5-month-old infants of depressed and non-depressed mothers. Following 1-min of exposure to an ID or AD speaker (order counterbalanced), infants had an immediate paired-comparison test with a still, silent image of the familiarized versus a novel face. In the test phase, ID face preference ratios were significantly lower in infants of depressed than non-depressed mothers. Infants' ID face preference ratios, but not AD face preference ratios, correlated with their percentile scores on the cognitive (Cog) scale of the Bayley Scales of Infant & Toddler Development (3rd Edition; BSID III), assessed concurrently. Regression analyses revealed that infant ID face preferences significantly predicted infant Cog percentiles even after demographic risk factors and maternal depression had been controlled. Infants may use IDS to select social partners who are likely to support and facilitate cognitive development.

Maternal depression and the learning-promoting effects of infant-directed speech: Roles of maternal sensitivity, depression diagnosis, and speech acoustic cues.

The hypothesis that the associative learning-promoting effects of infant-directed speech (IDS) depend on infants' social experience was tested in a conditioned-attention paradigm with a cumulative sample of 4- to 14-month-old infants. Following six forward pairings of a brief IDS segment and a photographic slide of a smiling female face, infants of clinically depressed mothers exhibited evidence of having acquired significantly weaker voice-face associations than infants of non-depressed mothers. Regression analyses revealed that maternal depression was significantly related to infant learning even after demographic correlates of depression, antidepressant medication use, and extent of pitch modulation in maternal IDS had been taken into account. However, after maternal depression had been accounted for, maternal emotional availability, coded by blind raters from separate play interactions, accounted for significant further increments in the proportion of variance accounted for in infant learning scores. Both maternal depression and maternal insensitivity negatively, and additively, predicted poor learning.

Infants of chronically depressed mothers learn in response to male, but not female, infant-directed speech.

Previous research using a conditioned-attention paradigm demonstrated that 4-month-old infants of depressed mothers (a) failed to acquire associations when a segment of their mothers' infant-directed (ID) speech signaled the presentation of a smiling face but (b) did acquire associations when a segment of an unfamiliar nondepressed mother's ID speech signaled the face (P. S. Kaplan, J. -A. Bachorowski, M. J. Smoski, & W. J. Hudenko, 2002). In the present study, 5- to 13-month-old infants of depressed mothers failed to acquire associations when either their own mothers' (Experiment 1) or an unfamiliar nondepressed mother's (Experiments 1 and 2) ID speech signaled a face. However, these infants acquired associations when a segment of an unfamiliar nondepressed father's ID speech served as the signal (Experiment 2). One possible explanation of these results is that infants of depressed mothers selectively "tune out" ID speech from their mothers and from other, nondepressed, women.

Role of Clinical Diagnosis and Medication Use in Effects of Maternal Depression on Infant-Directed Speech.

Infant-directed (ID) speech was recorded from mothers as they interacted with their 4- to 12-month-old infants. Hierarchical regression analyses revealed that two variables, age of the mother and mother's diagnosed depression, independently accounted for significant proportions of the variance in the extent of change in fundamental frequency (ΔF0). Specifically, depressed mothers produced ID speech with smaller ΔF0 than did nondepressed mothers, and older mothers produced ID speech with larger ΔF0 than did younger mothers. Mothers who were taking antidepressant medication and who were diagnosed as being in at least partial remission produced ID speech with mean ΔF0 values that were comparable to those of nondepressed mothers. These results demonstrate explicit associations between major depressive disorder and an acoustic attribute of ID speech that is highly salient to young infants.

Depression Diagnoses and Fundamental Frequency-Based Acoustic Cues in Maternal Infant-Directed Speech.

F0-based acoustic measures were extracted from a brief, sentence-final target word spoken during structured play interactions between mothers and their 3- to 14-month-old infants, and were analyzed based on demographic variables and DSM-IV Axis-I clinical diagnoses and their common modifiers. F0 range (ΔF0) was negatively correlated with infant age and number of children. ΔF0 was significantly smaller in clinically depressed mothers and mothers diagnosed with depression in partial remission, relative to non-depressed mothers, mothers diagnosed with depression in full remission, and those diagnosed with depressive disorder not otherwise specified. ΔF0 was significantly lower in mothers experiencing their first major depressive episode relative to mothers with recurrent depression. Deficits in ΔF0 were specific to diagnosed clinical depression, and were not well predicted by elevated self-report scores only, or by diagnosed anxiety disorders. Mothers with higher ΔF0 had infants with reportedly larger productive vocabularies, but depression was unrelated to vocabulary development. Implications for cognitive-linguistic development are discussed.

Maternal depression and expressive communication in one-year-old infants.

To separate effects of maternal depression on infant cognitive versus language development, 1-year-olds were assessed using the revised Bayley Scales of Infant and Toddler Development (BSID-III). Percentile scores on the Bayley Expressive Communication (EC) subscale were significantly negatively correlated with maternal self-report scores on the Beck Depression Inventory (BDI-II). However, mothers' BDI-II scores did not correlate with infant percentile scores on the general cognitive (COG) or receptive communication (RC) subscales. Boys had significantly lower percentile scores than girls on the RC and EC scales, but did not differ on the Cog scale. Gender and maternal depression did not significantly interact on any of the scales. These findings suggest problems with expressive communication precede, and may at least partially account for, apparent deficits in general cognitive development.

A developmental decline in the learning-promoting effects of infant-directed speech for infants of mothers with chronically elevated symptoms of depression.

Infants of mothers who varied in symptoms of depression were tested at 4 and 12 months of age for their ability to associate a segment of an unfamiliar non-depressed mother's infant-directed speech (IDS) with a face. At 4 months, all infants learned the voice-face association. At 12 months, despite the fact that none of the mothers were still clinically depressed, infants of mothers with chronically elevated self-reported depressive symptoms, and infants of mothers with elevated self-reported depressive symptoms at 4 months but not 12 months, on average did not learn the association. For infants of mothers diagnosed with depression in remission, learning at 12 months was negatively correlated with the postpartum duration of the mother's depressive episode. At neither age did extent of pitch modulation in the IDS segments correlate with infant learning. However, learning scores at 12 months correlated significantly with concurrent maternal reports of infant receptive language development. The roles of the duration and timing of maternal depressive symptoms are discussed.

An associative learning deficit in 1-year-old infants of depressed mothers: role of depression duration.

The effectiveness of infant-directed speech (IDS) produced by non-depressed mothers for promoting the acquisition of voice-face associations was investigated in 1-year-old children of depressed mothers in a conditioned-attention paradigm. Prior research suggested that infants of mothers with comparatively longer-duration depressive episodes exhibit poorer learning in response to non-depressed mothers' IDS, but duration of depression was confounded with infant age. In the current study, 1-year-old infants of currently depressed mothers with relatively longer-duration depressive episodes (i.e., perinatal onset) showed significantly poorer learning than 1-year-olds of currently depressed mothers with relatively shorter duration depressive episodes (non-perinatal onset). This was true despite the fact that there were no measurable differences in the severity of depression, level of social functioning, or antidepressant medication use between the two groups. These findings add support to the hypothesis that there is an experience-based change in responsiveness to female IDS in infants of depressed mothers during the first year of life.

Maternal Sensitivity and the Learning-Promoting Effects of Depressed and Non-Depressed Mothers' Infant-Directed Speech.

The hypothesis that aspects of current mother-infant interactions predict an infant's response to maternal infant-directed speech (IDS) was tested. Relative to infants of non-depressed mothers, those of depressed mothers acquired weaker voice-face associations in response to their own mothers' IDS in a conditioned-attention paradigm, although this was partially attributable to demographic differences between the two groups. The extent of fundamental frequency modulation (DeltaF(0)) in maternal IDS was smaller for infants of depressed than non-depressed mothers, but did not predict infant learning. However, Emotional Availability Scale ratings of maternal sensitivity, coded from videotapes of mothers and infants engaged in a brief play interaction, were significant predictors of infant learning, even after maternal depression, its demographic correlates, and antidepressant medication use had been taken into account. These findings are consistent with a role for experience-dependent processes in determining IDS's effects on infant learning.

Infant-directed speech produced by fathers with symptoms of depression: effects on infant associative learning in a conditioned-attention paradigm.

Infant-directed (ID) speech produced by fathers who varied in their number of self-reported symptoms of depressed was analyzed for differences its ability to promote infant voice-face associative learning. Infants of fathers with elevated scores on the Beck Depression Inventory-II (BDI-II) showed significantly poorer learning than did infants of fathers with non-elevated BDI-II scores when their fathers' ID speech served as a conditioned stimulus for a face reinforcer in a conditioned-attention paradigm. Fathers with elevated BDI-II scores produced ID speech with marginally significantly lower F0 variability than fathers with non-elevated BDI-II scores. However, F0-related cues were uncorrelated with infant learning. Overall, fathers' ID speech contained significantly less F0 modulation than did mothers' ID speech. These findings show that paternal depression, like maternal depression, adversely affects infant learning in a conditioned-attention paradigm.

Infants of depressed mothers, although competent learners, fail to learn in response to their own mothers' infant-directed speech.

Depressed mothers use less of the exaggerated prosody that is typical of infant-directed (ID) speech than do nondepressed mothers. We investigated the consequences of this reduced perceptual salience in ID speech for infant learning. Infants of nondepressed mothers readily learned that their mothers' speech signaled a face, whereas infants of depressed mothers failed to learn that their mothers' speech signaled the face. Infants of depressed mothers did, however, show strong learning in response to speech produced by an unfamiliar nondepressed mother. These outcomes indicate that the reduced perceptual salience of depressed mothers' ID speech could lead to deficient learning in otherwise competent learners.