Abstract
It is currently unknown whether differences in neural responsiveness to infant cues observed in postpartum affective disturbance are specific to depression/anxiety or are better attributed to a common component of internalizing distress. It is also unknown whether differences in mothers’ brain response can be accounted for by effects of past episodes, or if current neural processing of her child may serve as a risk factor for development of future symptoms. Twenty-four mothers from a community-based sample participated in an fMRI session viewing their 3-month- old infant during tasks evoking positive or negative emotion. They were tracked across the ensuing 15 months to monitor changes in affective symptoms. Past and current episodes of depression and anxiety, as well as future symptoms, were used to predict differences in mothers’ hemodynamic response to their infant in positive compared to negative emotion contexts. Lower relative activation in largely overlapping brain regions involving frontal lobe structures to own infant positive vs. negative emotion was associated with concurrent (3-month) depression diagnosis and prospective (3–18 month) depression and anxiety symptoms. There was little evidence for impacts of past psychopathology (more limited effect of past anxiety and nonsignificant effect of past depression). Results suggest biased maternal processing of infant emotions during postpartum depression and anxiety is largely accounted for by a shared source of variance (internalizing distress). Furthermore, differential maternal responsiveness to her infant’s emotional cues is specifically associated with the perpetuation of postpartum symptoms, as opposed to more general phenotypic or scarring effects of past psychopathology.
Highlights
The transition to motherhood represents a vulnerable time marked by increasing prevalence of affective symptomatology [1,2,3]
We address the following questions: (1) How does maternal neural response to their infant in positive vs. negative emotion situations relate to depression and/or anxiety symptoms in the ensuing 15 months? (2) Are there unique effects associated with current vs. past depression and/or anxiety diagnoses? and (3) Are there unique effects associated with postpartum depression vs. anxiety symptoms? Based on the available literature, we predicted relatively greater neural activation to positive compared to negative infant emotion situations would predict lower levels of postpartum affective symptoms
Lower differential activation was associated with Beck Anxiety Inventory (BAI)[T1-4] only, suggesting effects related to postpartum depression were driven by shared variance with anxiety
Summary
The transition to motherhood represents a vulnerable time marked by increasing prevalence of affective symptomatology [1,2,3]. Underlining the potential overlap [19], documented an association between IFG and insula activation to negative emotion faces and both anxiety and depression symptoms at different postpartum times These findings are consistent with previous anxiety research in non-peripartum populations showing differences in processing valenced stimuli in some of the same regions implicated in both normative maternal response and depression such as the insula, prefrontal cortex, anterior cingulate, and amygdala [20,21,22]. It remains unclear how maternal brain response to own infant across differing emotion contexts may uniquely contribute to anxiety in the postpartum. Self-reported symptoms at each assessment provided an estimate of overall depression and anxiety symptom severity across 3–18 months postpartum
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