Neurophysiological sensitivity in early childhood: EEG aperiodic slope moderates the association between maternal anxiety and child internalizing symptoms

BackgroundPostpartum maternal anxiety and depression can affect child development and family functioning. However, the long-term impact of postpartum maternal anxiety and depression on child and paternal mental health is understudied. The present large-scale prospective cohort study is one of the first to investigate whether maternal anxiety and depressive symptoms postpartum and at child age 5–6 years separately and synergistically increase paternal anxiety and depressive symptoms and child emotional problems in early adolescence at age 11–12 years. Secondly, we investigated whether concurrent paternal anxiety and depressive symptoms at child age 11–12 years moderated the association between maternal anxiety and depressive symptoms in the postpartum period and at child age 5–6 years with child emotional problems at age 11–12 years.MethodsThis study is part of the Amsterdam Born Children and Development (ABCD) cohort study, the Netherlands (N = 2.298). Maternal postpartum anxiety and depressive symptoms were assessed using the State-Trait Anxiety Inventory (STAI) and the Center for Epidemiologic Studies Depression Scale (CES-D) at 13 weeks postpartum. Maternal anxiety and depressive symptoms at child age 5–6 years and parental anxiety and depressive symptoms at 11–12 years were assessed using the Depression Anxiety Stress Scale (DASS-21). Child emotional problems were reported by the child and a teacher using the Strengths and Difficulties Questionnaire (SDQ). Multivariable linear regression was conducted, adjusted for demographic, perinatal/obstetric confounders, and affective symptoms of the other family members at 11–12 years.ResultsNeither maternal anxiety nor depressive symptoms were related to paternal depressive symptoms at child age 11–12 years, while maternal postpartum depressive symptoms, depressive symptoms at 5–6 years and maternal anxiety at 5–6 years were positively related to paternal anxiety at 11–12 years. However, effect sizes were small. Only maternal postpartum depression was positively but weakly associated with more child emotional problems at 11–12 years. Although paternal concurrent affective symptoms were positively related to more child emotional problems in early adolescence, they did not moderate the association between maternal symptoms and child emotional problems.ConclusionsOur results indicate that fathers and children seem to be affected only to a small extent by maternal postpartum anxiety or depression.

Maternal depressive and anxiety symptoms and the risk of attention deficit hyperactivity disorder symptoms in offspring aged 17: Findings from the Raine Study

Anxiety and depression are highly prevalent in youth and can cause significant distress and functional impairment. The presence of maternal anxiety and depression are well-established risk factors for child internalizing psychopathology, yet the responsible mechanisms linking the two remain unclear. We examined the potential mediating and moderating roles of EEG frontal alpha asymmetry (FAA) in the intergenerational transmission of internalizing symptoms in a longitudinal sample of N = 323 mother-child dyads. Self-report maternal internalizing symptoms were evaluated at child age 3 years and 5 years, child EEG at 5 years, and parent-report child internalizing symptoms at age 7 years. Mediation was evaluated via bootstrapped ( N = 5000) confidence intervals. We found significant associations among maternal internalizing (anxiety, depressive) symptoms at child ages 3 and 5 years, child FAA at age 5 years, and child internalizing symptoms at age 7 years. There was a significant mediation effect, whereby greater maternal anxiety and depressive symptoms at age 3 years were significantly associated with greater relative right FAA in children at age 5 years, which, in turn, was significantly associated with greater child internalizing symptoms at age 7 years ( ps <.001). There was no moderating effect of FAA on the association between maternal internalizing symptoms at age 5 years and child internalizing symptoms at age 7 years. Greater right frontal asymmetry may be a neurophysiological mechanism that mediates the intergenerational transmission of internalizing symptoms.

Anxiety and depression are highly prevalent in youth and can cause significant distress and functional impairment. The presence of maternal anxiety and depression are well-established risk factors for child internalizing psychopathology, yet the responsible mechanisms linking the two remain unclear. We examined the potential mediating and moderating roles of EEG frontal alpha asymmetry (FAA) in the intergenerational transmission of internalizing symptoms in a longitudinal sample of N = 323 mother-child dyads. Self-report maternal internalizing symptoms were evaluated at child age 3 years and 5 years, child EEG at 5 years, and parent-report child internalizing symptoms at age 7 years. Mediation was evaluated via bootstrapped (N = 5,000) confidence intervals. We found significant associations among maternal internalizing (anxiety, depressive) symptoms when their children were ages 3 and 5 years, child FAA at age 5 years, and child internalizing symptoms at age 7 years. There was a significant mediation effect, whereby greater maternal anxiety and depressive symptoms at age 3 years were significantly associated with FAA (greater relative right cortical activation) in children at age 5 years, which, in turn, was significantly associated with greater child internalizing symptoms at age 7 years (ps < .001). There was no moderating effect of FAA on the association between maternal internalizing symptoms at age 5 years and child internalizing symptoms at age 7 years. Greater right frontal asymmetry may be a neurophysiological mechanism that mediates the intergenerational transmission of internalizing symptoms.

To investigate the emotional problems (depressive and anxiety symptoms) of mothers of children with autism spectrum disorder (ASD) and explore the role of the mother's socioeconomic status (SES) and the core symptoms of the child on the mother's emotional problems.This cross-sectional survey was performed in 180 mothers of children with ASD in Chang Sha city of China. The 7-item Generalized Anxiety Disorder Scale (GAD-7) and the 9-item Patient Health Questionnaire (PHQ-9) were used to assess the anxiety and depressive symptoms of the mothers of the autistic children. The education level and annual family income, as well as occupation, were be selected as components of the mother's SES. Autism Behaviour Checklist (ABC) and Social Responsiveness Scale (SRS) were used for the evaluation of the core symptoms of the children. A general information questionnaire was also used. The ordinal regression was used to examine the effect of the SES and children's core symptoms on maternal emotional problems.The valid response rate was 92.7% (167 of 180 questionnaires were returned). Of the mothers studied, 72.5% and 80.2% had depressive and anxiety symptoms, respectively, and 67.1% suffered from both symptoms. Mother's SES was observed to be unrelated to maternal anxiety symptoms (P >.05). Only 1 component of the SES (junior high school education level) was related to depressive symptoms (OR = 0.31, 95% CI 0.12–0.80). SRS score under 115 (OR = 0.38, 95% CI 0.16–0.93) of autistic children was a protective factor against maternal anxiety symptoms. The borderline and mild behavioral problems (OR = 0.43, 95% CI 0.19–0.99; OR = 0.45, 95% CI 0.22–0.94, respectively) of autistic children were protective factors against maternal depressive symptoms.Mothers of autistic children generally exhibited high levels of anxiety and depressive symptoms. The core symptoms of the autistic children were observed to be strongly associated with both maternal anxiety and depressive symptoms. Improvements in the core symptoms of children with ASD may help reduce maternal anxiety and depressive symptoms to some extent.

The unpredictability of maternal sensory signals in caregiving behavior has been recently found to be linked with infant neurodevelopment. The research area is new, and very little is yet known, how maternal anxiety and depressive symptoms and specific parental characteristics relate to the unpredictable maternal care. The aims of the current study were to explore how pre- and postnatal maternal anxiety and depressive symptoms and self-regulation capacity associate with the unpredictability of maternal sensory signals. The study population consisted of 177 mother-infant dyads. The unpredictability of the maternal sensory signals was explored from the video-recorded mother-infant free play situation when the infant was 8 months of age. Pre- and postnatal anxiety and depressive symptoms were measured by questionnaires prenatally at gwks 14, 24, 34, and 3 and 6 months postpartum. Maternal self-regulation capacity, a trait considered to be stable in adulthood, was assessed using adult temperament questionnaire when the infant was 12 months of age. We found that elevated prenatal maternal anxiety symptoms associated with higher unpredictability in the maternal care while depressive symptoms were unrelated to the unpredictability of maternal care. Moreover, the association was moderated by maternal self-regulation capacity, as higher anxiety symptoms during pre-and postnatal period were associated more unpredictability among the mothers with low self-regulation capacity. The combination of higher amount of maternal anxiety symptoms and lower self-regulation capacity seems to constitute specific risk for the unpredictable maternal care.

There is limited evidence on the impact of parental mental health problems on offspring's educational outcomes. We investigated the impact of maternal anxiety and depressive symptoms, as well as paternal emotional problems on the educational outcomes of their adolescent and young adult offspring. We used data from a longitudinal birth cohort recruited between 1989 and 1991 in Australia (the Raine Study). The Depression, Anxiety and Stress Scale was used to assess maternal depressive and anxiety symptoms, and a self-reported question was used to measure paternal mental health problems. Both were assessed when the offspring was aged 10 years. Outcomes included offspring's self-reported education attainment-not completing year 10 at age 17, not attending tertiary education at ages 17 and 22 and primary caregiver's reports of offspring's academic performance at age 17. A total of 1033, 1307 and 1364 parent-offspring pairs were included in the final analysis exploring the association between parental mental health problems and offspring's academic performance at school, completing year 10 and attending tertiary education, respectively. After adjusting for potential confounders, the offspring of mothers with anxiety symptoms were 3.42 times more likely than the offspring of mothers without anxiety symptoms to have poor or below-average academic performance (odds ratio = 3.42; 95% confidence interval = [1.31, 8.92]) and more than 2 times more likely to not attend tertiary education (odds ratio = 2.55; 95% confidence interval = [1.10, 5.5.88]) and not to have completed year 10 (odds ratio = 2.13; 95% confidence interval = [1.04, 4.33]). We found no significant associations between maternal depressive symptoms or paternal emotional problems and offspring educational attainment. Maternal anxiety symptoms, but not depression and paternal emotional problems, are associated with poor educational attainment and achievement in adolescent offspring. The findings highlight that efforts to improve the outcomes of offspring of mothers with anxiety could focus on educational attainment.

The impact of maternal mental health on child eating beyond infancy is understudied. This study explores whether maternal feeding practices and concerns mediate the association between maternal depression and anxiety symptoms and eating behaviours at age three years. Data from 409 mother-child dyads in the Growing Up in Singapore Towards healthy Outcomes cohort were analysed. Maternal mental health was assessed using the Beck Depression Inventory-II and State-Trait Anxiety Inventory, feeding practices and concerns with the Preschooler Feeding Questionnaire, and child eating behaviours with the Children's Eating Behaviour Questionnaire. Structural equation modelling was used to test pathways. Depression symptoms in mothers showed direct and indirect links to child eating behaviours. For example, maternal depression symptoms were directly associated with enjoyment of food (B=0.011, p=0.015) and indirectly with food responsiveness (B=0.004, p=0.034) via use of food to calm the child. Anxiety symptoms, however, had only indirect associations with child eating behaviours through maternal feeding concerns, not practices. For example, maternal anxiety symptoms were indirectly linked with food responsiveness through perceived difficulty in feeding (B=-0.001, p=0.011). Depression and anxiety symptoms influence children's eating behaviours differently. Anxiety symptoms were linked with child eating behaviours only through maternal feeding concerns, whereas depression symptoms were linked with child eating behaviours both directly and indirectly via feeding to calm the child. As maternal anxiety symptoms are linked with more child eating concerns, the validity of mother-reported child eating behaviours requires consideration.

The purpose of this study was to investigate the impact of depressive and anxiety symptoms on maternal bonding to the infant 2-3 months postpartum and the influence of the mother's bonding to the infant during pregnancy and to her own caregiver during her childhood on maternal bonding 2-3 months postpartum. This study originated from a community-based cohort study carried out in rural Bangladesh. Trained staff collected data and administrated the questionnaires during the third trimester of pregnancy, at childbirth and 2-3 months postpartum. Maternal depressive and anxiety symptoms were assessed with the Edinburgh Postnatal Depression Scale and the State Anxiety Inventory and the mother's emotional bonding to the infant with the Postpartum Bonding Questionnaire. The results showed that 11% of the women reported depressive symptoms, 35% anxiety symptoms, 3.4% both depressive and anxiety symptoms and 51% neither depressive nor anxiety symptoms. Mothers with depressive symptoms were older, were poorer, fewer were literate, reported more intimate partner violence and showed lower emotional bonding to their infants 2-3 months postpartum compared to mentally well and anxious mothers. Approximately 11% of the mothers reported mild bonding disturbances and nearly one third of them showed depressive symptoms. Depressive symptoms and giving birth to a girl were negatively associated to a mother's emotional bonding to her infant, while maternal anxiety symptoms and high bonding to the foetus during pregnancy were positively associated to the mother's emotional bonding to the infant 2-3 months postpartum.

Risk of conduct and oppositional defiant disorder symptoms in offspring of parents with mental health problems: Findings from the Raine Study

Risk for internalizing symptom development in young children: Roles of child parasympathetic reactivity and maternal depression and anxiety exposure in early life.

Maternal anxiety and depression during pregnancy and early childhood have been associated with child anxiety and attention-deficit/hyperactivity disorder (ADHD). However, previous studies are limited by their short follow-up, few assessments of maternal symptoms, and by not including maternal and child ADHD. The present study aimed to fill these gaps by investigating whether maternal anxiety and depressive symptoms from pregnancy to child age 5 years increase the risk of child anxiety disorders at age 8 years. This study is part of the population-based Norwegian Mother, Father, and Child Cohort Study. Maternal anxiety and depressive symptoms were assessed by the Hopkins Symptom Checklist (SCL) six times from pregnancy through early childhood, and ADHD symptoms by the Adult Self-Report Scale (ASRS). At age 8 years (n = 781), symptoms of anxiety disorders and ADHD were assessed, and disorders classified by the Child Symptom Inventory-4. Logistic regression models estimated the risk of child anxiety depending on maternal symptoms. The mothers of children classified with an anxiety disorder (n = 91) scored significantly higher on the SCL (at all time points) and ASRS compared with the other mothers. In univariable analyses, maternal anxiety and/or depression and ADHD were associated with increased risk of child anxiety (odds ratios = 2.99 and 3.64, respectively), remaining significant in the multivariable analysis adjusted for covariates. Our findings link maternal anxiety, depression, and ADHD during pregnancy and early childhood to child anxiety at age 8 years.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00787-024-02374-1.

Bidirectional effects of toddler temperament and maternal overprotection on maternal and child anxiety symptoms across preschool.

Exposure to maternal anxiety symptoms during infancy has been associated with difficulties in development and greater risk for developing anxiety later in life. Although previous studies have examined associations between prenatal maternal distress, infant brain development, and developmental outcomes, it is still largely unclear if there are associations between postnatal anxiety, infant brain development, and cognitive development in infancy. In this study, we used resting-state functional magnetic resonance imaging to examine the association between maternal anxiety symptoms and resting-state functional connectivity in the first year of life. We also examine the association between frontolimbic functional connectivity and infant cognitive development. The sample consisted of 21 infants (mean age=24.15 months, SD=4.17) that were scanned during their natural sleep using. We test the associations between maternal trait anxiety symptoms and amygdala-anterior cingulate cortex (ACC) functional connectivity, a neural circuit implicated in early life stress exposure. We also test the associations between amygdala-ACC connectivity and cognitive development. We found a significant negative association between maternal trait anxiety symptoms and left amygdala-right ACC functional connectivity (p<.05, false discovery rate corrected). We found a significant negative association between left amygdala-right ACC functional connectivity and infant cognitive development (p<.05). These findings have potential implications for understanding the role of postpartum maternal anxiety symptoms in functional brain and cognitive development in infancy.

Prenatal depression and anxiety can significantly impact a child's neurodevelopment. However, the specific timing and patterns of these maternal psychological symptoms during pregnancy that influence the child's neurodevelopment remain unclear. This study aimed to investigate the associations of maternal depressive and anxiety symptoms across pregnancy trimesters and their trajectories with neurodevelopmental outcomes in children aged 0 to 24 months. A total of 16,229 singletons born between January 2020 and December 2023 were included in this prospective study. Maternal depressive and anxiety symptoms in each trimester of pregnancy were assessed by Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 scale, respectively. The neurodevelopmental status of children aged 0-24 months was assessed by the Ages and Stages Questionnaire-Third Edition. Group-based trajectory model was employed to identify distinct trajectories of prenatal depressive and anxiety symptoms throughout pregnancy. Poisson regression was used to assess the associations of maternal depressive and anxiety symptoms, as well as their trajectories, with the child's neurodevelopment. A total of 1,791 (11.04%) children had neurodevelopmental delay in the communication domain, 1,127 (6.94%) in the gross motor domain, 1,750 (10.78%) in the fine motor domain, 1,137 (7.01%) in the problem-solving domain, and 1,724 (10.62%) in the personal-social domain. Maternal depressive and anxiety symptoms during pregnancy, especially in the second and third trimester, were associated with a higher risk of neurodevelopmental delay in all domains, with the most profound impact observed in the fine motor domain. Four trajectories were identified for prenatal depressive and anxiety symptoms, respectively. Compared with children whose mothers had low level of depressive or anxiety symptoms throughout pregnancy, children whose mothers experienced consistently moderate or high level of these symptoms had a higher risk of neurodevelopmental delay, while children whose mothers experienced moderate level of depressive or anxiety symptoms that decreased to low levels after the first trimester did not show a different risk of neurodevelopmental delay. Maternal depressive and anxiety symptoms during pregnancy have an adverse impact on the neurodevelopment in offspring. This study highlights the importance of improving the mental health of pregnant women in order to support optimal neurodevelopment for their children.