Cortisol reactivity to a laboratory stressor predicts increases in depressive symptoms in perinatal and nulliparous women during population-level stress.

BACKGROUND: Research suggests a link between stress and depression, especially in high-risk groups. The perinatal period is known as a time of increased risk for depression and pregnancy has been associated with alterations in cortisol levels; however, limited research has assessed cortisol reactivity during pregnancy. Finally, no studies have yet examined whether cortisol reactivity predicts later depressive symptoms during a population-level stressor, such as the COVID-19 pandemic. METHODS: The current study examined whether cortisol reactivity in perinatal and nulliparous women a year before the onset of COVID-19 predicted increases in depressive symptoms during the initial stage of the pandemic. Participants were 68 women (33 pregnant, Mage = 30.6; 35 nulliparous, Mage = 28.4) who, approximately a year before COVID-19, responded to a depressive symptoms questionnaire and completed a psychosocial stress test, during which they provided salivary cortisol samples. Shortly after the onset of pandemic-related closures (April 2020; postpartum for previously pregnant participants), participants completed follow-up questionnaires assessing current depressive symptoms. RESULTS: Analyses showed that cortisol reactivity at baseline predicted increases in depressive symptoms at follow-up. Perinatal and nulliparous women did not differ in this association. LIMITATIONS: The present study was limited by a moderate sample size and heterogeneity in terms of gestational week, restricting inferences about specific stages of pregnancy. CONCLUSIONS: Our findings suggest that cortisol reactivity to a laboratory stressor is a biomarker of risk for increased depressive symptoms during ecological stress in women. Biomarkers like these increase our understanding of depression risk and may help to identify individuals in need of interventions.

Envisioning motherhood: Mental-state language in caregiving narratives across the perinatal period.

Nancy Suchman's work highlighted the fundamental role of maternal mentalization in maternal addiction, mental health, and caregiving challenges. In this study, we aimed to examine the role of mental-state language (MSL) as a measure of mentalization in prenatal and postnatal narratives and their sentiment in a sample of 91 primarily White mothers from the western United States, followed from the second trimester of pregnancy, through the third trimester, to 4 months postpartum. Specifically, we investigated the use of affective and cognitive MSL in prenatal narratives when mothers visualized caring for their baby and postnatal narratives when mothers compared their prenatal visualization to the current caregiving reality. Results indicated moderate consistency in MSL between the second and third trimesters, but prenatal and postnatal MSL was not significantly correlated. Across all time points, higher use of MSL was related to more positive sentiment, indicating an association between mentalization and positive caregiving representations across the perinatal period. Women used more affective than cognitive MSL in prenatal imagination of caregiving, but this pattern was reversed in their postpartum reflection. Implications on assessing parental mentalization prenatally and considering the relative dominance of affective and cognitive mentalizing are discussed while considering study limitations.

El trabajo de Nancy Suchman subrayó el papel fundamental de la mentalización maternal en la adicción materna, la salud mental y los retos de la prestación de cuidado. En este estudio, nos propusimos examinar el papel del lenguaje del estado mental como una medida de mentalización en las narrativas pre- y postnatales y su sentimiento en un grupo muestra de 91 madres primariamente blancas del oeste de los Estados Unidos, a quienes se les dio seguimiento a partir del segundo trimestre de embarazo, a través del tercer trimestre, hasta 4 meses después del parto. Específicamente, investigamos el uso de lenguaje del estado mental afectivo y cognitivo en las narrativas prenatales cuando las madres visualizaban el cuidado de su bebé, y las narrativas postnatales cuando las madres comparaban su visualización prenatal con la presente realidad de prestación de cuidado. Los resultados indicaron una consistencia moderada en el lenguaje del estado mental entre el segundo y tercer trimestres, pero el lenguaje del estado mental prenatal y postnatal no fue significativamente correlacionado. A los largo de todos los punto temporales, el más alto uso del lenguaje del estado mental se relacionó con un más positivo sentimiento, indicando así una asociación entre la mentalización y las representaciones positivas de la prestación de cuidado a lo largo del período perinatal. Las mujeres usaron más lenguaje del estado mental afectivo que cognitivo en la imaginación prenatal de la prestación de cuidado, pero este patrón se invirtió en sus reflexiones después del parto. Se discuten las implicaciones sobre el tener acceso a la mentalización del progenitor prenatalmente y considerar el relativo dominio del mentalizarse en lo afectivo y cognitivo, al tiempo que se consideran las limitaciones del estudio.

Le travail de Nancy Suchman a mis en lumière le rôle fondamental de la mentalisation maternelle dans l'addiction maternelle, la santé mentale et les défis de la prestation de soins. Dans cette étude nous nous sommes donné pour but d'examiner le rôle du langage d'état mental en tant que mesure de la mentalisation dans les narrations prénatales et postnatales et leur sentiment chez un échantillon de 91 mères dans l'ensemble blanches vivant dans l'ouest des Etats-Unis d'Amériques, et suivies du second trimestre de la grossesse, durant le troisième trimestre jusqu'à 4 mois après la naissance. Plus particulièrement nous nous sommes penchés sur l'utilisation du langage d'état mental affectif et cognitif dans des narrations prénatales lorsque les mères visualisaient les soins à leur bébé, et les narrations postnatales lorsque les mères comparaient leur visualisation prénatale à la réalité actuelle des soins au bébé. Les résultats ont indiqué une cohérence modérée dans le langage d'état mental entre les second et troisième trimestres mais le langage d'état mental prénatal et postnatal n'était pas significativement corrélé. Au travers de tous les points temporels l'utilisation plus grande de langage d'état mental était liée à un sentiment plus positif, indiquant un lien entre la mentalisation et les représentations positives des soins au travers de la période périnatale. Les femmes ont utilisé un langage d'état mentale plus affectif que cognitif dans l'imagination prénatale des soins, mais ce schéma était renversé dans leur réflexion postpartum. Les implications pour l'évaluation de la mentalisation parentale avant la naissance et pour la considération de la domination relative de la mentalisation affective et cognitive sont discutées, tout en considérant les limites de l'étude.

Reflective functioning in mothers with addictions: Differential relationships involving family history of mental illness and substance use.

Parental reflective functioning (RF) is often cited as an important domain in which mothers with addictions struggle in their roles as parents, though the links between addiction and RF remain unclear. Exposure to attachment trauma associated with parental mental illness and substance use is commonly associated with both addiction and lower RF. We thus examined how family history of parental mental illness and substance use may relate to the RF of mothers with addictions. One hundred ninety-four mothers in outpatient substance use treatment completed the Parent Development Interview and provided information about whether their mothers and fathers experienced mental illness or problems with substance use. Univariate ANOVAs revealed an interaction between family history of maternal mental illness and maternal substance use. Among mothers with a history of maternal substance use, those with a history of maternal mental illness had higher RF than those who had no history of maternal mental illness. Among mothers who did not report a family history of maternal mental illness, mothers who had a family history of maternal substance use exhibited significantly lower RF than mothers with no family history of maternal substance use. Exposure to paternal mental illness or substance use was not associated with mothers' RF. These findings highlight the importance of disentangling the contributions of attachment trauma to mothers' RF and utilizing interventions that support mothers' capacity to reflect about how their early experiences of being cared for by a mother with a mental illness or addiction may impact their current caregiving behaviors.

Maternal perinatal anxiety and neural responding to infant affective signals: Insights, challenges, and a road map for neuroimaging research.

Anxiety symptoms are common among women during pregnancy and the postpartum period, potentially having detrimental effects on both mother and child's well-being. Perinatal maternal anxiety interferes with a core facet of adaptive caregiving: mothers' sensitive responsiveness to infant affective communicative 'cues.' This review summarizes the current research on the neural correlates of maternal processing of infant cues in the presence of perinatal anxiety, outlines its limitations, and offers next steps to advance future research. Functional neuroimaging studies examining the neural circuitry involved in, and electrophysiological studies examining the temporal dynamics of, processing infant cues during pregnancy and postpartum are reviewed. Studies have generally indicated mixed findings, although emerging themes suggest that anxiety may be implicated in several stages of processing infant cues- detection, interpretation, and reaction- contingent upon cue valence. Limitations include inconsistent designs, lack of differentiation between anxiety and depression symptoms, and limited consideration of parenting-specific (versus domain-general) anxiety. Future studies should incorporate longitudinal investigation of multiple levels of analysis spanning neural, cognitive, and observed aspects of sensitive caregiving.

Prematurity and Maladaptive Mealtime Dynamics: the Roles of Maternal Emotional Distress, Eating-Related Cognitions, and Mind-Mindedness.

Premature birth and maternal emotional distress constitute risk factors for feeding disorders. This study examined the roles of maternal cognitions in the link between prematurity, emotional distress and mother-infant maladaptive mealtime dynamics in a sample of 134 families (70 preterm, low medical risk; 64 full-term) followed longitudinally. Specifically, maternal cognitions related to eating and health (perception of child vulnerability and concerns about child's eating) and understanding of mental states (interactional mind-mindedness) were considered. A multiple-mediators model was tested, controlling for infants' weight and breastfeeding history. Although prematurity did not directly predict mealtime dynamics, multiple-mediation analyses revealed indirect pathways: mothers of preterm newborns reported higher emotional distress, which subsequently predicted perception of child vulnerability and concerns about child's eating at 6-months; perception of child vulnerability predicted more conflictual mealtime dynamics, whereas concern about child's eating predicted less reciprocal mealtime dynamics at 12-months. Mind-mindedness at 6-months predicted more reciprocal and less conflictual mealtime dynamics but did not act as a mediator. Implications for understanding pathways from prematurity to feeding disorders are discussed.

When do mothers' executive functions contribute to their representations of their child's mind? A contextual view on parental reflective functioning and mind-mindedness.

Parental mentalization refers to parents' capacity to treat their children as having minds of their own and consider the mental states underlying their behaviors. This study examined the roles of mothers' executive functions (EFs), a group of processes supporting self-regulation, in 2 aspects of parental mentalization-spontaneity as measured by mind-mindedness (MM), and complexity as measured by parental reflective functioning (PRF)-while examining child- and family related contextual-moderators. Ninety-nine mothers of 66-month-old preschool children (40 full-term, 59 preterm) completed EFs tasks, were interviewed regarding their child and coparenting, and rated their perception of their child as being difficult (i.e., difficult behavior and negative emotionality). EFs were unrelated to MM. However, EFs were related to PRF when children were rated as more difficult, and when mothers reported high coparenting dissatisfaction; moreover, EFs and PRF were associated among mothers of full-term children, but not in the preterm group. Findings indicate that EFs contribute to the complexity and coherence of maternal mentalization, especially in contexts in which regulation is required for being able to consider the child's mind (difficult child, coparenting dissatisfaction), but not in stressful contexts that are likely to elicit automaticity (prematurity). EFs, however, do not seem to contribute to spontaneous attribution of mental states to the child, when complexity is not considered. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

What's going on in my baby's mind? Mothers' executive functions contribute to individual differences in maternal mentalization during mother-infant interactions.

Maternal mentalization refers to a mother's capacity to understand mental-states of herself and her child and to regard her child as a psychological agent. In mother-infant interactions, this capacity is commonly conceptualized as maternal mind-mindedness, which can be divided into two dimensions: appropriate and nonattuned interpretations of the infants' mental-states. Appropriate mind-mindedness refers to interpretations that seem to be compatible with the infant's behaviors, whereas nonattuned mind-mindedness refers to noncompatible interpretations. The aim of this study was to investigate the cognitive mechanisms that contribute to mind-mindedness. Specifically, we investigated the role of executive functions in appropriate and nonattuned mind-mindedness, and the moderating roles of two infant-related factors, prematurity (as a stressful context) and child temperament (as a context of unpredictability and negative emotionality). To this end, mother-infant free play interactions were coded for mind-mindedness in a sample of 102 mothers and their 6-month-old infants (61 preterm, 41 full-term). When children were 66-months old, mothers completed cognitive tasks that assessed working memory updating, resistance to interference, response inhibition, and shifting. Appropriate mind-mindedness was positively associated with updating, and this link was stronger when infant temperament was rated as more difficult. Furthermore, among mothers of full-term infants, mothers' resistance to interference was negatively associated with nonattuned mind-mindedness. This link was not evident in the stressful context of premature birth. Mothers' response inhibition and shifting were not associated with either of the mind-mindedness dimensions. Implications on understanding variability in maternal mentalization during mother-infant interactions and the roles of executive functions in parenting are discussed.

A two-level hierarchical framework of visual short-term memory.

Over the last couple of decades, a vast amount of research has been dedicated to understanding the nature and the architecture of visual short-term memory (VSTM), the mechanism by which currently relevant visual information is maintained. According to discrete-capacity models, VSTM is constrained by a limited number of discrete representations held simultaneously. In contrast, shared-resource models regard VSTM as limited in resources, which can be distributed flexibly between varying numbers of representations; and a new interference model posits that capacity is limited by interference among items. In this article, we begin by reviewing benchmark findings regarding the debate over VSTM limitations, focusing on whether VSTM storage is all-or-none and on whether object complexity affects capacity. After that, we put forward a hybrid framework of VSTM architecture, arguing that this system is composed of a two-level hierarchy of memory stores, each containing a different set of representations: (1) perceptual memory, a resourcelike level containing analog automatically formed representations of visual stimuli in varying degrees of activation, and (2) visual working memory, in which a subset of three to four items from perceptual memory are bound to conceptual representations and to their locations, thus conveying discrete (digital/symbolic) information which appears quantized. While perceptual memory has a large capacity and is relatively nonselective, visual working memory is restricted in the number of items that can be maintained simultaneously, and its content is regulated by a gating mechanism.

Understanding visual consciousness in autism spectrum disorders.

The paper focuses on the question of what the (visual) perceptual differences are between individuals with autism spectrum disorders (ASD) and typically developing (TD) individuals. We argue against the view that autistic subjects have a deficiency in the most basic form of perceptual consciousness-namely, phenomenal consciousness. Instead, we maintain, the perceptual atypicality of individuals with autism is of a more conceptual and cognitive sort-their perceptual experiences share crucial aspects with TD individuals. Our starting point is Ben Shalom's (2005, 2009) three-level processing framework for explaining atypicality in several domains of processing among autistics, which we compare with two other tripartite models of perception-Jackendoff's (1987) and Prinz's (2000, 2005a, 2007) Intermediate Level Hypothesis and Lamme's (2004, 2006, 2010) neural account of consciousness. According to these models, whereas the second level of processing is concerned with viewer-centered visual representations of basic visual properties and incorporates some early forms of integration, the third level is more cognitive and conceptual. We argue that the data suggest that the atypicality in autism is restricted mainly to the third level. More specifically, second-level integration, which is the mark of phenomenal consciousness, is typical, yet third-level integration of perceptual objects and concepts is atypical. Thus, the basic experiences of individuals with autism are likely to be similar to typical subjects' experiences; the main difference lies in the sort of cognitive access the subjects have to their experiences. We conclude by discussing implications of the suggested analysis of experience in autism for conceptions of phenomenal consciousness.