Neural pathways of maternal responding: systematic review and meta-analysis.

Functional magnetic resonance imaging (fMRI) has increasingly been employed to establish whether there is a specific brain neural network dedicated to maternal responsiveness. We undertook systematic review and meta-analysis of all studies in which healthy new mothers were exposed to visual stimuli of own versus other infants to determine the quality of evidence for a dedicated maternal neural network. Systematic literature review revealed a pattern of specific neural responses commonly induced by visual infant paradigms. Brain areas consistently reported as activated in mothers in response to own versus unknown infant included the left thalamus, bilateral pre-central gyrus, left limbic lobe, uncus, amygdala and left caudate. These regions are implicated in reward, attention, emotion processing and other core social cognitive skills. Meta-analysis, however, revealed a more limited subset of brain areas activated in mothers specifically in response to their own versus unknown infant and suggested considerable inter-study variability. Further work is needed if functional imaging is to become an objective tool for the assessment of neural pathways associated with distinct patterns of maternal care behaviour. Such a tool would be invaluable in developing biomarkers of neural activity associated with healthy maternal care and for monitoring treatment/intervention effects of costly parenting interventions.

Vocal brain development in infants of mothers with serious mental illness (CAPRI-Voc): study protocol.

INTRODUCTION: Improving the lives of children and adolescents with parental mental illness (CAPRI) remains an urgent political and public health concern for the UK and European Union. Recurrent parental mental illness is believed to lead to fractures in the family, academic and social lives of these children, yet interventions are poorly targeted and non-specific. Part of an interdisciplinary programme of work (the CAPRI Programme; grant number: 682741), CAPRI-Voc aims to achieve two goals: first, to test the feasibility of our longitudinal imaging paradigm in mother-infant pairs where the mother has a diagnosis of severe mental illness. Second, to compare development of vocal processing in these infants with infants in the general population. METHODS AND ANALYSIS: Recruitment of 100 infants of mothers with mental illness, alongside 50 infants of healthy mothers. Both cohorts of infants will undergo functional near infrared spectroscopy (fNIRS) brain imaging at three time points: 9, 12 and 18 months to explore differences between cohorts in their neural responses to vocal stimuli in our language paradigm. Mothers will complete an interview and psychological questionnaires. We shall also complete an infant developmental battery and mother-child interaction play session. Data on recruitment, retention and dropout will be recorded. ETHICS AND DISSEMINATION: It will be made clear that fNIRS is a safe, non-invasive technology widely used in infant clinical and psychological research. We shall reassure mothers that no definitive causal link exists between maternal mental illness and language development in infants, and that individual data will only exist as part of the wider dataset. As the study includes both children and vulnerable adults, all research staff will complete National Health Service (NHS) Safeguarding level 3 training. Dissemination will be via direct feedback to stakeholders, patient and advisory groups, and through presentations at conferences, journal publications and university/NHS trust communications. The study was approved through North West-Greater Manchester West Research Ethics Committee (17/NW/0074) and Health Research Authority (212715).

Epigenetic Transmission of Maternal Behavior: Impact on the Neurobiological System of Healthy Mothers.

Quality of maternal caregiving not only impacts children's development but can also result in heritable changes in gene expression (i.e., in an epigenetic manner). Consequently, when women become mothers, they adopt parenting behavior similar to that they received at family of origin. This transgenerational transmission of maternal behavior may also be associated with changes in the neurobiological system of future mothers. This review aims to highlight the effect quality of perceived parenting has on maternal behavior and the neurobiological system of mothers, specifically the oxytocin system, brain morphology and brain function. This would likely help in finding biomarkers that profile the impact of perceived parenting on mothers, and thus allow identification of mothers who experience poor-quality parenting for intervention.

Bullying among medical and nonmedical students at a university in Eastern Saudi Arabia.

BACKGROUND: Many medical students, junior doctors, and other health-care professionals have been affected by the negative experience of bullying. Research is scarce on bullying experienced by medical and nonmedical students in Saudi Arabia unlike what is found in Western countries. It is unclear whether being a nonmedical student modifies the risk of being bullied. MATERIALS AND METHODS: A cross-sectional study included 400 university students using convenient sampling. The sample comprised 295 students who responded and were stratified into medical (n = 176) and nonmedical (n = 119) groups. Statistical Package for the Social Sciences (SPSS) version 22.0 was used to analyze our data. Normality was measured using the Kolmogorov-Smirnov test. Statistical significance was tested using chi-square test for categorical variables, and t-test for continuous variables. RESULTS: Almost half of the respondents were found to have experienced some bullying, victimization, or other harassment during their medical education. The most common forms of bullying were verbal abuse and undue pressure to produce work (43.8%; n = 77). Nonmedical students experienced more bullying than medical students and were more likely to be female, single, and younger in age. The number of medical students subjected to sexual harassment (1.7%; n = 3) was higher than nonmedical students (0.8%; n = 1). Physical violence was more towards nonmedical (4.2%; n = 5) than medical students (1.1%, n = 2). The rates of bullying continue to be associated with anxiety and depression. CONCLUSIONS: Our data suggest similar bullying rates in the developed world but higher than previously reported in a Saudi study. Bullying or harassment affects both medical and nonmedical students and is associated with high levels of anxiety and depression.

Natural variation in maternal sensitivity is reflected in maternal brain responses to infant stimuli.

Increasing evidence suggests that discrete neural networks that mediate emotion processing are activated when mothers respond to infant's images or cries. Accumulating data also indicate that natural variation in maternal caregiving behavior is related to maternal oxytocin (OT) levels. However, brain activation to infant cues has not been studied comparing mothers at disparate ends of the "maternal sensitivity" spectrum. Based on observed mother-infant play interaction at 4-6 months postpartum in 80 antenatally recruited mothers, 15 mothers with the highest sensitivity (HSMs) and 15 mothers with the lowest sensitivity (LSMs) were followed at 7-9 months using functional magnetic resonance imaging (fMRI) to examine brain responses to viewing videos of their "own" versus an "unknown" infant in 3 affect states (neutral, happy, and sad). Plasma OT measurements were taken from mothers following play interactions with their infant. Compared with LSMs, HSMs showed significantly greater brain activation in right superior temporal gyrus (STG) in response to own versus unknown neutral infant and to own happy versus neutral control. Changes in brain activation were significantly negatively correlated with plasma OT responses in HSMs mothers. Conversely, compared with HSMs, LSMs showed no significant activation difference in response to own infant separately or in contrast to unknown infant. Activation of STG may index sensitive maternal response to own infant stimuli. Sensitive parenting may have its unique profile in relation to brain responses which can act as biomarkers for future intervention studies that enhance sensitivity of maternal care. (PsycINFO Database Record

Does oxytocin modulate variation in maternal caregiving in healthy new mothers?

BACKGROUND: Maternal sensitivity to infant cues and developmental needs may be pivotal for social and cognitive development. Animal and recent human studies emphasise a major role for Oxytocin (OT) in mediating sensitive caregiving but no study has examined the relationship between OT and extreme variation in human maternal sensitivity. METHODS: From 105 expectant mothers, 80 underwent blind-rating of maternal sensitivity at 4-6 months postpartum through free-play interaction with their infants. At 7-9 months postpartum, 30 mothers at extremes of maternal sensitivity: 15 'sensitive mothers' (high sensitivity mothers - HSMs, mean=4.47; SD=0.74) and 15 'less sensitive mothers' (low sensitivity mothers - LSMs, mean=2.13; SD=0.52) underwent plasma OT measurements before and after 10 min infant play. RESULTS: Baseline and post-interaction plasma OT was higher in LSMs than HSMs [F(1, 26)=8.42; p=0.01]. HSMs showed a trend towards significant reduction in plasma OT [t(14)=2.01; p=0.06] following play-interaction; no change was shown by LSMs [t(13)=-0.14; p=0.89]. Conclusion Higher baseline OT levels in healthy LSMs may imply greater stress responses to the demands of caring for an infant, or past deficiencies in own parenting relationship and act as a biomarker for poor parental sensitivity. OT may be acting to reduce stress and anxiety in LSMs consistent with studies of plasma OT and stress in women. By contrast, in HSMs, play interaction with their infants maybe relaxing as indicated by significant reduction in plasma OT from baseline. Ascertainment of mothers in well-defined sensitivity groups might facilitate examination of distinct coping strategies in parents and better understanding of variation in parental caregiving behaviour and its potential for modulation by OT. This article is part of a Special Issue entitled Oxytocin and Social Behav.