Perceived Parenting Stress Is Related to Cardiac Flexibility in Mothers: Data from the NorBaby Study.

Heart rate variability (HRV) is an indicator of autonomic nervous system activity, and high levels of stress and/or depressive symptoms may reduce HRV. Here, we assessed whether (a) parental stress affected HRV in mothers during the perinatal period and whether this is mediated by bonding and (b) whether antenatal maternal mental states, specifically repetitive negative thinking, depressive symptoms, and pregnancy-related anxiety, have an impact on infant HRV, and lastly, we investigated (c) the relationship between maternal HRV and infant HRV. Data are from the Northern Babies Longitudinal Study (NorBaby). In 111 parent-infant pairs, cardiac data were collected 6 months after birth. In the antenatal period, we used the Pregnancy-Related Anxiety Questionnaire-Revised, the Edinburgh Postnatal Depression Scale, and the Perseverative Thinking Questionnaire; in the postnatal period, we used the Parenting Stress Index and the Maternal Postnatal Attachment Scale. Higher levels of perceived parenting stress but not depressive symptoms were associated with lower HRV in mothers (τ = -0.146), and this relationship was not mediated by maternal bonding. Antenatal maternal mental states were not associated with infant HRV. There was no significant correlation between maternal HRV and infant HRV. Our observational data suggest that perceived stress reduces cardiac flexibility. Future studies should measure HRV and parenting stress repeatedly during the perinatal period.

Do parental cognitions during pregnancy predict bonding after birth in a low-risk sample?

Parental bonding to their infant is important for healthy parent-infant interaction and infant development. Characteristics in the parents affect how they bond to their newborn. Parental cognitions such as repetitive negative thinking, a thinking style associated with mental health issues, and cognitive dispositions, e.g., mood-congruent attentional bias or negative implicit attitudes to infants, might affect bonding. To assess the influence of cognitive factors on bonding, 350 participants (220 pregnant women and their partners) were recruited over two years by midwives at the hospital and in the communal health care services. Participants were followed throughout the pregnancy and until the infant was seven months old as a part of the Northern Babies Longitudinal Study. Both mothers and fathers took part. First, we measured demographics, repetitive negative thinking, attentional bias, and implicit attitudes to infants during pregnancy, as predictors of bonding two months postnatally. Second, we also measured infant regulatory problems, and depressive symptoms at two months postnatally as predictors of parents' perception of infant temperament at five months. Robust regression analyses were performed to test hypotheses. Results showed that mothers and fathers differed on several variables. Parity was beneficial for bonding in mothers but not for fathers. Higher levels of mothers' repetitive negative thinking during pregnancy predicted weaker bonding, which was a non-significant trend in fathers. For fathers, higher education predicted weaker bonding, but not for mothers. Mothers' perception of their infant temperament at five months was significantly affected by bonding at two months, but for fathers, their depressive symptoms were the only significant predictor of perceived infant temperament. In conclusion, for mothers, their relationship with their infant is essential for how they experience their infant, while for fathers their own wellbeing might be the most important factor. Health care providers should screen parents' thoughts and emotions already during pregnancy to help facilitate optimal bonding.

Emotional Infant Face Processing in Women With Major Depression and Expecting Parents With Depressive Symptoms.

Processing of emotional facial expressions is of great importance in interpersonal relationships. Aberrant engagement with facial expressions, particularly an engagement with sad faces, loss of engagement with happy faces, and enhanced memory of sadness has been found in depression. Since most studies used adult faces, we here examined if such biases also occur in processing of infant faces in those with depression or depressive symptoms. In study 1, we recruited 25 inpatient women with major depression and 25 matched controls. In study 2, we extracted a sample of expecting parents from the NorBaby study, where 29 reported elevated levels of depressive symptoms, and 29 were matched controls. In both studies, we assessed attentional bias with a dot-probe task using happy, sad and neutral infant faces, and facial memory bias with a recognition task using happy, sad, angry, afraid, surprised, disgusted and neutral infant and adult faces. Participants also completed the Ruminative Responses Scale and Becks Depression Inventory-II. In study 1, we found no group difference in either attention to or memory accuracy for emotional infant faces. Neither attention nor recognition was associated with rumination. In study 2, we found that the group with depressive symptoms disengaged more slowly than healthy controls from sad infant faces, and this was related to rumination. The results place emphasis on the importance of emotional self-relevant material when examining cognitive processing in depression. Together, these studies demonstrate that a mood-congruent attentional bias to infant faces is present in expecting parents with depressive symptoms, but not in inpatients with Major Depression Disorder who do not have younger children.

Adult attachment style and maternal-infant bonding: the indirect path of parenting stress.

BACKGROUND: The quality of maternal-infant bonding is related to important child outcomes. The literature has assumed that the ability to form relationships is a relatively stable trait, and research studies have suggested that a mother's attachment style in close adult relationships is related to mother-infant bonding. The transition to parenthood is also often stressful, and the adult attachment style may relate to parenting stress in the first year after birth. Such stress could possibly have a negative relationship with the mother-infant bond. In the present study, we examined the associations between maternal adult attachment styles and the quality of mother-infant bonding and whether this relationship is mediated by parenting stress. METHODS: The present study sample comprised 168 women (mean age 31.0 years, SD 4.23 years). Between weeks 31 and 41 of gestation, the anxious and avoidant adult attachment dimensions were measured with the Experiences in Close Relationships questionnaire (ECR). Between 5 and 15 weeks after birth mother-infant bonding and parenting stress were measured with the Maternal Postnatal Attachment Scale (MPAS) and the Parenting Stress Index-Parent Domain (PSI-PD), respectively. RESULTS: Both attachment-related avoidance and attachment-related anxiety correlated significantly and negatively with mother-infant bonding. However, a regression analysis showed that only attachment-related avoidance was a significant predictor of mother-infant bonding when controlling for demographic variables and maternal mental health history. The relationship between the adult attachment style and bonding was mediated by parenting stress. Higher scores on attachment avoidance and anxiety were related to increased stress, which was related to decreased quality of bonding. The overall parent domain and the subscale of competence in the parent-related stress dimension mediated between attachment avoidance and bonding, and the overall parent domain and the subscales of competence and role restriction mediated between attachment anxiety and bonding. There was no direct relationship between the adult attachment style and mother-infant bonding when parenting stress was included as a mediator. CONCLUSIONS: This study illustrates that maternal adult attachment style relates to mother-infant bonding. This relationship was mediated by parenting stress. The results may have implications for the early identification of mothers at risk of having bonding difficulties.

Newborn Behavioral Observation, maternal stress, depressive symptoms and the mother-infant relationship: results from the Northern Babies Longitudinal Study (NorBaby).

BACKGROUND: Families can experience the postpartum period as overwhelming and many report a special need for support. The Newborn Behavioral Observation (NBO) aims to promote a positive parent-infant relationship by sensitising parents to the infant's signals. This article evaluates the NBO as a universal preventive intervention within the regular well-baby clinic service on measures of maternal depressive symptoms, parental stress, the mother-infant relationship and satisfaction/benefit of the postpartum follow-up. METHODS: This investigation is part of a larger longitudinal study comprising 220 women and 130 of their partners recruited between 2015 and 2017. The study had a non-randomised cluster-controlled design with 6 measurement points. This article is based on a sample of 196 women using data from T1 (gestational weeks 13-39), T4 (5-15 weeks postpartum) and T5 (3-9 months postpartum). Participants were allocated to a group receiving the NBO (n = 82) and a care as usual comparison group (n = 114). We measured maternal depressive symptoms and parental stress using the Edinburgh Postnatal Depression Scale (EPDS) and the Parenting Stress Index (PSI). The mother-infant relationship was assessed with the Parental Reflective Functioning Questionnaire (PRFQ), the Maternal Postnatal Attachment Scale (MPAS) and the Maternal Confidence Questionnaire (MCQ). Participants also answered questions about satisfaction/benefit of the postpartum follow-up. RESULTS: A Mann-Whitney U test indicated that participants in the NBO-group learned significantly more than the comparison group from the follow-up about the baby's signals in relation to sleep/sleep patterns, social interaction and crying/fuzziness. Multivariate analyses of covariance (MANCOVA) and repeated measures ANCOVA found no significant differences between the groups for the mother-infant relationship domain and few differences in depressive symptoms and parental stress. The repeated measures ANCOVA found that participants in the NBO-group scored slightly higher on parental stress, although the difference was small. CONCLUSIONS: The results indicate that the NBO-group learned more than the comparison group about reading their child's signals in important everyday situations. However, the benefits of the NBO were limited for depressive symptoms, parental stress and self-reported mother-infant relationship. The study sample was generally well-functioning, and the results indicate that the benefits of the NBO may be limited within a well-functioning sample. TRIAL REGISTRATION: ClinicalTrials, NCT02538497, Registered 2 September 2015.

Early maladaptive schemas as predictors of maternal bonding to the unborn child.

BACKGROUND: The quality of an expectant mother's bonding to the fetus has been shown to be associated with important developmental outcomes. Previous studies suggest that bonding quality is predicted by, for example, social support, psychological well-being, and depression. However, little is known regarding the role of maternal cognition in maternal-fetal bonding. Early maladaptive schemas (EMSs) are negative and stable assumptions about oneself and one's relationships with others that are developed during childhood and adolescence. In the present study, we examined the associations between EMSs and the quality of the bonding to the fetus in expectant mothers. METHODS: The present investigation is part of a larger study in which 220 pregnant women (approximately 12% of the pregnant women in the region) and 130 of their partners were recruited from October 2015 until December 2017. The sample for the current study comprised 165 pregnant women (mean age 30.8 years, SD 4.1 years). The participants completed the Young Schema Questionnaire Short Form 3 (YSQ-S3) between gestational weeks 24 and 37 and the Maternal Antenatal Attachment Scale (MAAS) and the Edinburgh Postnatal Depression Scale (EPDS) between gestational weeks 31 and 41. RESULTS: All EMS domains correlated significantly and negatively with scores for quality of maternal-fetal bonding on the MAAS. Only the Disconnection and Rejection domain correlated significantly and negatively with MAAS scores for intensity of preoccupation with the fetus. The Disconnection and Rejection domain was a significant independent predictor of the quality of maternal-fetal bonding. Symptoms of depression mediated the effect of the EMS domains on the quality of maternal-fetal bonding. The EMS domains Disconnection and Rejection, Impaired Autonomy and Performance, and Impaired Limits showed significant direct effects on bonding quality. CONCLUSIONS: EMSs are related to expectant mothers' self-reported bonding to their fetuses. This association was mediated by the mothers' symptoms of depression. The results may have implications for the early identification of pregnant women at risk of bonding difficulties and encourage more studies on cognitive schemas and mechanisms for maternal-fetal bonding.

The Tromso Infant Faces Database (TIF): Development, Validation and Application to Assess Parenting Experience on Clarity and Intensity Ratings.

Newborns and infants are highly depending on successfully communicating their needs; e.g., through crying and facial expressions. Although there is a growing interest in the mechanisms of and possible influences on the recognition of facial expressions in infants, heretofore there exists no validated database of emotional infant faces. In the present article we introduce a standardized and freely available face database containing Caucasian infant face images from 18 infants 4 to 12 months old. The development and validation of the Tromsø Infant Faces (TIF) database is presented in Study 1. Over 700 adults categorized the photographs by seven emotion categories (happy, sad, disgusted, angry, afraid, surprised, neutral) and rated intensity, clarity and their valance. In order to examine the relevance of TIF, we then present its first application in Study 2, investigating differences in emotion recognition across different stages of parenthood. We found a small gender effect in terms of women giving higher intensity and clarity ratings than men. Moreover, parents of young children rated the images as clearer than all the other groups, and parents rated "neutral" expressions as more clearly and more intense. Our results suggest that caretaking experience provides an implicit advantage in the processing of emotional expressions in infant faces, especially for the more difficult, ambiguous expressions.