Longitudinal associations between prenatal internalizing symptoms and mindfulness traits with postnatal bonding difficulties.

PURPOSE: Mothers' reported connection, or bond, with their infants develops across the early postnatal period and is relevant to mother and offspring functioning. Little is known, however, about early predictors of bonding difficulties over time. The present study examined prenatal anxiety, depressive symptoms, and trait mindfulness and variation in bonding difficulties in mothers across the first two months postnatal. METHODS: Participants were 120 pregnant women (Mage=31.09 years, SD = 4.81; 80% White). Measures of anxiety, depression, and five facets of mindfulness were administered mid-pregnancy (approximately 20 weeks gestation) and bonding difficulties were assessed every two weeks from approximately 1 to 7 weeks postnatal. RESULTS: Using multilevel modeling to account for within-person repeated assessments, we found an inverted U-shaped pattern across time such that bonding difficulties initially worsened before improving around five weeks postnatal. Prenatal anxiety and depressive symptoms were longitudinally associated with greater bonding difficulties overall and were unrelated to the trajectory of change. The mindfulness facets of acting with awareness and being nonjudging of one's own experience were longitudinally associated with less bonding difficulties overall, weaker initial increases in bonding difficulties, and earlier improvements. CONCLUSIONS: Prenatal anxiety and depression may be risk factors for bonding difficulties that are persistent across the early postnatal period. In contrast, mindfulness tendencies before childbirth, specifically acting with awareness and being nonjudging towards oneself, may support early feelings of bonding over time.

[Formula: see text] Neural and behavioral indicators of cognitive control in preschoolers with and without prenatal opioid exposure.

Prenatal opioid exposure is one consequence of the opioid epidemic, but effects on child development remain poorly understood. There is emerging evidence that children exposed to opioids in utero exhibit elevated emotional and behavioral problems, which may be partially due to alterations in cognitive control. Using multiple methods (i.e., neuropsychological, behavioral, and event-related potential [ERP] assessments), the present study examined differences in emotional, behavioral, and cognitive control difficulties in preschool-aged children with (n = 21) and without (n = 23) prenatal opioid exposure (Mage = 4.30, SD = 0.77 years). Child emotional and behavioral problems were measured with a caregiver questionnaire, indicators of cognitive control were measured using developmentally appropriate behavioral (i.e., delay discounting, Go/No-Go) and neuropsychological (i.e., Statue) tasks, and electroencephalogram was recorded to error and correct responses in a Go/No-Go task. ERP analyses focused on the error-related negativity (ERN), an ERP that reflects error monitoring, and correct-response negativity (CRN), a component reflecting performance monitoring more generally. Opioid exposure was associated with elevated difficulties across domains and a blunted ERN, reflecting altered cognitive control at the neural level, but groups did not significantly differ on behavioral measures of cognitive control. These result replicate prior studies indicating an association between prenatal opioid exposure and behavioral problems in preschool-aged children. Further, our findings suggest these differences may be partially due to children with prenatal opioid exposure exhibiting difficulties with cognitive control at the neural level. The ERN is a potential target for future research and intervention efforts to address the sequelae of prenatal opioid exposure.

Neural reactivity to infant emotion cues during pregnancy: Associations with peripartum anxiety and depressive symptoms.

BACKGROUND: Pregnancy is marked by physiological and psychosocial changes for women, and event-related potentials (ERP) are comfortable and safe for examining brain function across pregnancy. The late positive potential (LPP) ERP, a measure of allocated attention to emotional stimuli, may provide insight into associations between internalizing symptoms and neural processing of infant emotion cues, which may be particularly salient in this life stage. METHODS: We developed a task to examine neural and behavioral responses to infant faces in pregnant women (N = 120, Mage=31.09, SD=4.81), the impact of auditory infant cries on the LPP to faces, and associations between the LPP and anxiety and depressive symptoms. Participants matched distressed, happy, and neutral infant faces and shapes as a comparison condition with interspersed auditory conditions (infant cry sounds vs. white noise) while electroencephalogram data were collected. Participants also completed self-report measures of anxiety and depressive symptoms. RESULTS: Reaction time (RT) was faster for the infant cry vs. white noise condition and when matching shapes vs. infant faces. Depressive symptoms were associated with slower RTs to neutral infant faces. The LPP was enhanced overall to faces vs. shapes, but there was no main effect of auditory condition. Anxiety symptoms were associated with an enhanced LPP to infant distressed faces in the infant cry condition. CONCLUSIONS: Results support these methods for measuring neural and behavioral responses to infant emotional cues in pregnancy and provide evidence that combinations of auditory and visual stimuli may be particularly useful for capturing emotional processes relevant to anxiety.

Neural Predictors of Improvement With Cognitive Behavioral Therapy for Adolescents With Depression: An Examination of Reward Responsiveness and Emotion Regulation.

Earlier depression onsets are associated with more debilitating courses and poorer life quality, highlighting the importance of effective early intervention. Many youths fail to improve with evidence-based treatments for depression, likely due in part to heterogeneity within the disorder. Multi-method assessment of individual differences in positive and negative emotion processing could improve predictions of treatment outcomes. The current study examined self-report and neurophysiological measures of reward responsiveness and emotion regulation as predictors of response to cognitive-behavioral therapy (CBT). Adolescents (14-18 years) with depression (N = 70) completed monetary reward and emotion regulation tasks while electroencephalogram (EEG) was recorded, and self-report measures of reward responsiveness, emotion regulation, and depressive symptoms at intake. Adolescents then completed a 16-session group CBT program, with depressive symptoms and clinician-rated improvement assessed across treatment. Lower reward positivity amplitudes, reflecting reduced neural reward responsiveness, predicted lower depressive symptoms with treatment. Larger late positive potential residuals during reappraisal, potentially reflecting difficulty with emotion regulation, predicted greater clinician-rated improvement. Self-report measures were not significant predictors. Results support the clinical utility of EEG measures, with impairments in positive and negative emotion processing predicting greater change with interventions that target these processes.

Benevolent Childhood Experiences and Childhood Maltreatment History: Examining their Roles in Depressive Symptoms Across the Peripartum Period.

Peripartum depressive symptoms are associated with a range of adverse outcomes for offspring and mothers. Childhood experiences, both negative and positive, may impact peripartum depression risk. Longitudinal studies are needed to examine trajectories of change in depression across the peripartum and predictors of symptoms across time. We examined the associations between women's reports of specific childhood experiences and trajectories of depressive symptoms across the peripartum period. Participants were 208 pregnant women (Mage=30.31, SD=5.45, range=20-45 years) at the prenatal session. Participants completed follow up sessions approximately 1 month and 6 months postpartum. At baseline, participants completed questionnaire measures of benevolent childhood experiences, childhood maltreatment, and depressive symptoms. Greater benevolent childhood experiences were associated with lower depressive symptoms across the peripartum period. The association with postpartum symptoms remained significant even when covarying antepartum depressive symptoms, indicating that benevolent childhood experiences may protect against postpartum depressive symptoms even after accounting for earlier symptoms. We did not find significant associations between childhood maltreatment and depressive symptoms. These findings extend previous research on benevolent childhood experiences by offering insight into unique associations with symptoms across the peripartum period.

Neurobiological changes during the peripartum period: implications for health and behavior.

Pregnancy and the transition to parenthood is an important period marked by dramatic neurobiological and psychosocial changes that may have implications for the health of women and offspring. Although human and non-human animal research suggests that the brain undergoes alterations during the peripartum period, these changes are poorly understood. Here, we review existing research, particularly human neuroimaging and psychophysiological research, to examine changes in brain structure and function during the peripartum period and discuss potential implications for the health of women and offspring. First, we discuss the potential causes of these changes across pregnancy, including physiological and psychosocial factors. Next, we discuss the evidence for structural and functional changes in the brain during pregnancy and into the postpartum period, noting the need for research conducted prospectively across human pregnancy. Finally, we propose potential models of individual differences in peripartum neurobiological changes (i.e. hypo-response, typical response, hyper-response) and emphasize the need to consider trajectories of change in addition to pre-existing factors that may predict maternal adjustment to parenthood. We suggest that the consideration of individual differences in neurobiological trajectories across pregnancy may contribute to a better understanding of risk for negative health and behavior outcomes for women and offspring.