Maternal Psychopathology Research Articles

The relationship between maternal psychopathology and offspring incontinence and constipation at school age: A prospective cohort study

BackgroundThere is evidence for an association between maternal psychopathology and offspring incontinence and constipation, but it is unclear if there is a critical/sensitive period of exposure to maternal depression and/or anxiety in the antenatal or postnatal period. MethodsMothers from the Avon Longitudinal Study of Parents and Children provided data on their depression and anxiety (antenatal and postnatal) and their child's urinary and faecal incontinence and constipation at age 7 (6489 participants). We used multivariable logistic regression to examine evidence for independent effects of maternal depression/anxiety on offspring incontinence/constipation and to investigate if there was a critical/sensitive period of exposure. We examined evidence for causal intra-uterine effects using a negative control design. ResultsPostnatal maternal psychopathology was associated with an increased risk of offspring incontinence and constipation (e.g. postnatal anxiety and daytime wetting OR: 1.53; 95 % CI: 1.21–1.94). Data were consistent with a postnatal critical period model and there was evidence for an independent effect of maternal anxiety. Antenatal maternal psychopathology was associated with offspring constipation (e.g. antenatal anxiety OR: 1.57; 95 % CI: 1.25–1.98), but there was no evidence for a causal intra-uterine effect. LimitationsAttrition and maternal reports without use of diagnostic criteria for incontinence/constipation are potential limitations. ConclusionsChildren exposed to maternal postnatal psychopathology had a greater risk of incontinence/constipation, and maternal anxiety had stronger associations than depression. Health professionals should be vigilant to effects of maternal psychopathology on child development. Identification of mechanisms linking maternal psychopathology to child incontinence/constipation is required to inform evidence-based support.

Transcultural skills for early childhood professionals.

Transcultural skills are especially useful for those involved in the perinatal period, when parents and babies must adapt to one another in a setting of migration a long a focus of transcultural clinical practice. The aim of this article is to provide useful transcultural skills for any health care worker (e.g., psychologists, child psychiatrists, midwives, family doctors, pediatricians, specialized child-care attendants, and social workers) who provide care or support to families during the perinatal period. It highlights the cultural aspects requiring attention in relation to representations of pregnancy, children's needs, obstetric complications, and postnatal problems. Taking into account the impact of culture on clinical evaluation and treatment can enable professionals to distinguish what involves cultural representations of pregnancy, babies, and sometimes of disease from what is associated with interaction disorders or maternal psychopathology. After explaining the relevance of transcultural clinical practices to provide migrant mothers with better support, we describe 9 themes useful to explore from a transcultural perspective. This choice is based on the transcultural clinical practice in our specialized department. The description of these 9 themes is intended to aid in their pragmatic application and is illustrated with short clinical vignettes for specific concepts. We describe situations that are extreme but often encountered in liaison transcultural clinical practice for maternity wards: perinatal mourning with cultural coding, mediation in refusal of care, cultural misunderstandings, situations of complex trauma and of multiple contextual vulnerabilities, and difficulties associated with acculturation. The transcultural levers described here make it possible to limit cultural misunderstandings and to promote the therapeutic alliance. It presupposes the professionals will concomitantly analyze their cultural countertransference and acquire both the knowledge and know-how needed to understand the elements of cultural, political, and social issues needed to develop clinical finesse. This combined theoretical-clinical article is intended to be pedagogical. It provides guidelines for conducting transcultural child psychiatry/psychological interviews in the perinatal period aimed at both assessment and therapy.

Preschool Behavioral Problems: Links with Maternal Oxytocin and Caregiving Sensitivity in the Postnatal Period, and Concurrent Maternal Psychopathology and Attachment State-of-Mind

This study investigated maternal oxytocin, caregiving sensitivity and mother-to-infant bonding at 3-months postpartum as predictors of child behavior and psychological outcomes in the preschool years, when controlling for concurrent maternal negative emotional symptoms and adult attachment state-of-mind. Forty-five mother–child dyads were assessed at 3-months and 3.5 years postpartum using mix of questionnaires, observational, interview and biological methods. Results showed that lower levels of maternal baseline oxytocin at 3-months postpartum significantly predicted emotional reactivity in the child at 3.5 years. When maternal adult attachment state-of-mind and negative emotional symptoms were included, lower levels of maternal baseline oxytocin at 3-months postpartum significantly predicted withdrawn child behavior. In addition, unresolved adult attachment and maternal negative emotional symptoms were significantly associated child behavioral disturbance in a range of areas. Findings highlight maternal postnatal oxytocin as a potential indicator of children who may be more likely to show emotional reactivity and withdrawn behavior in the preschool years.

Intergenerational effects of maternal depression and co-occurring antisocial behaviors: The mediating role of parenting-related processes.

Co-occurring maternal depression and antisocial personality disorder (ASPD) are associated with the development of psychopathology in children, yet little is known about risk mechanisms. In a sample of 122 racially diverse and economically disadvantaged families, we prospectively investigated (a) to what extent child socioemotional problems were related to maternal depression-only, ASPD-only, or the co-occurrence of both and (b) specificity in parenting-related mechanisms linking single-type or comorbid maternal psychopathology to child outcomes at age 3. Compared to mothers without either ASPD or depression, exposure to maternal depression-only and comorbid depression/ASPD predicted child problems as a function of greater parenting stress and lower maternal sensitivity. Mothers with comorbid depression/ASPD uniquely exhibited more negative parenting and had children with more socioemotional problems than mothers with depression-only. Compared to mothers with neither ASPD nor depression, mothers with depression-only uniquely impacted child difficulties via lower maternal efficacy. Study findings suggest areas of parenting intervention. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Pathways link environmental and genetic factors with structural brain networks and psychopathology in youth.

Adolescence is a period of significant brain development and maturation, and it is a time when many mental health problems first emerge. This study aimed to explore a comprehensive map that describes possible pathways from genetic and environmental risks to structural brain organization and psychopathology in adolescents. We included 32 environmental items on developmental adversity, maternal substance use, parental psychopathology, socioeconomic status (SES), school and family environment; 10 child psychopathological scales; polygenic risk scores (PRS) for 10 psychiatric disorders, total problems, and cognitive ability; and structural brain networks in the Adolescent Brain Cognitive Development study (ABCD, n = 9168). Structural equation modeling found two pathways linking SES, brain, and psychopathology. Lower SES was found to be associated with lower structural connectivity in the posterior default mode network and greater salience structural connectivity, and with more severe psychosis and internalizing in youth (p < 0.001). Prematurity and birth weight were associated with early-developed sensorimotor and subcortical networks (p < 0.001). Increased parental psychopathology, decreased SES and school engagement was related to elevated family conflict, psychosis, and externalizing behaviors in youth (p < 0.001). Increased maternal substance use predicted increased developmental adversity, internalizing, and psychosis (p < 0.001). But, polygenic risks for psychiatric disorders had moderate effects on brain structural connectivity and psychopathology in youth. These findings suggest that a range of genetic and environmental factors can influence brain structural organization and psychopathology during adolescence, and that addressing these risk factors may be important for promoting positive mental health outcomes in young people.

Association of Maternal Smoking during Pregnancy with Neurophysiological and ADHD-Related Outcomes in School-Aged Children.

Data of a longitudinal cohort study were analyzed to investigate the association between prenatal tobacco exposure and electroencephalographical (EEG) power spectrum in healthy, school-aged children as well as its relationship with attention deficit hyperactivity disorder (ADHD)-related symptoms. Group comparisons (exposed, non-exposed) were performed to test whether prenatal tobacco exposure was associated with brain activity and ADHD symptoms, with adjustments made for covariates including child's sex, child's age, maternal age, maternal smoking habit before pregnancy, alcohol consumption during pregnancy, gestation age, and maternal psychopathology. Tobacco-exposed children showed higher brain activity in the delta and theta frequency bands. This effect was independent of the considered covariates. However, the effects on hyperactivity were found to significantly depend on maternal age and alcohol consumption during pregnancy, but not on the amount of exposure. In summary, smoking during pregnancy significantly affected the resting-state brain activity in children, independent of socio-demographic factors, indicating potential long-lasting effects on brain development. Its impact on ADHD-related behavior was shown to be influenced by socio-demographic confounding factors, such as maternal alcohol consumption and the age of the mother.

Threat versus deprivation in mother's childhood: Differential relations to hair cortisol and psychopathology in pregnancy

BackgroundThe negative effects of childhood maltreatment can be intergenerational, and the prenatal period may play an important role in this intergenerational transmission. Maternal hypothalamic-pituitary-adrenal (HPA) axis dysfunction and maternal psychopathology represent two mechanisms through which the effects of childhood maltreatment are hypothesized to be transmitted across generations. ObjectiveThis study first sought to extend prior research on pathways of intergenerational transmission by examining whether mothers' childhood experiences of abuse versus neglect differentially relate to maternal HPA activity and to maternal psychopathology during the prenatal period. Second, exploratory analyses examined the links between maternal variables and their State Protective Service involvement as a parent, as an indicator of maladaptive caregiving. MethodsDuring the third trimester of pregnancy, 51 women reported on experiences of childhood maltreatment, on State Protective Service involvement as an adult parent, and on current depressive and post-traumatic stress symptoms, and provided a hair sample for cortisol assay. ResultsRegression analyses indicated that greater severity of abuse, but not neglect, in childhood was associated with higher maternal depressive symptoms (β = 0.488, p = .020). In contrast, greater severity of neglect, but not abuse, in mothers' childhood was associated with lower maternal hair cortisol concentration (β = −0.437, p = .031). Lower maternal hair cortisol concentration, but not maternal psychopathology or severity of childhood abuse or neglect, in turn, was associated with State Protective Service involvement (β = −0.785, p < .001). ConclusionsFindings extend prior work by suggesting that childhood abuse and neglect may have different sequelae for mothers during pregnancy and that these sequelae may have different relations to parenting.

Children with learning disorders discourse with their mothers: The role of maternal affectivity and psychopathology symptoms

Children with learning disorders discourse with their mothers: The role of maternal affectivity and psychopathology symptoms

Excessive Crying, Behavior Problems, and Amygdala Volume: A Study From Infancy to Adolescence

Excessive crying in infancy has been associated with increased risk of later behavioral problems. To identify individuals at risk for behavioral problems and to understand the mechanisms underlying excessive crying and irritability in infancy, research into the neurobiology of excessive crying is needed. We examined whether excessive crying and irritability in infancy are associated with behavioral problems and amygdala volume among children and adolescents. This study included 4,751 singleton children from the prospective population-based Generation R Study cohort, born in the Netherlands in 2002 to 2006. Excessive crying (>3 hours on at least 1 day/wk) and irritability (Mother and Baby Scales questionnaire) were parent-rated at 3 months. Amygdala volume was measured at 10 years using magnetic resonance imaging, and internalizing and externalizing were parent-rated at 1.5, 3, 6, 10, and 14 years and self-rated at 14 years. Covariates included child age, sex, national origin, gestational age, and maternal age, psychopathology score, parity, education, relationship status, and family income. Children who cried excessively in infancy had higher parent-rated internalizing (effect estimate= 0.20 SD-units, 95% CI= 0.14, 0.27) and externalizing (0.17 SD-units, 95% CI= 0.10, 0.24) throughout childhood (linear mixed models), and smaller amygdala volume at 10 years (-0.19 SD-units, 95% CI=-0.32,-0.06) (linear regression model). The pattern of associations for both behavioral problems and amygdala volume was similar for irritability. Excessive crying and irritability in infancy may reflect an early vulnerability to behavioral problems and may be linked with neurobiological differences in the development of the amygdala.

Maternal anxiety, exposure to the COVID-19 pandemic and socioemotional development of offspring

The COVID-19 pandemic context may predispose mothers to increased maternal psychopathology, which may be associated with offspring socioemotional development. The aim of this study is to analyze the relationships between prenatal anxiety and depression and exposure to the COVID-19 pandemic with offspring socioemotional development, controlling for postnatal anxiety and depression. A total of 105 mother-child dyads were assessed in pre- and postnatal periods. Questionnaires were used to assess the impact of the pandemic, indicators of psychopathology, and the socioemotional development of the offspring. Results suggest that negative pandemic experiences are indirectly associated with offspring socioemotional development via prenatal maternal anxiety symptomatology and after controlling for postnatal anxiety and depression. These indicators predispose to emotional deficits and increase the risks of psychopathological and neurodevelopmental disorders. It is important to adopt health policies that provide timely assessment of development in early childhood to reduce the risks associated with these deficits.

Investigation of adolescents and their mothers in terms of nomophobia.

Nomophobia (NoMP) is the fear of being unable to interact with others via mobile phones and is a current topic in adolescents` mental health. The purpose of this study was to investigate the association between NoMP in adolescents and their mothers` level of NoMP. The levels of depression, anxiety, attention deficit/hyperactivity-impulsivity symptoms, NoMP, and perceived parental emotional availability were examined. One hundred fifty-five adolescents (60% girls) were included in the study with their mothers. Ninetythree (60%) adolescents (67.7% girls) and 64 (41.3%) mothers were classified as nomophobic. There was a positive correlation between the NoMP levels of adolescents and their mothers. Nomophobic girls perceived less paternal support. All psychopathologic symptoms were higher in the nomophobic mothers. There was no difference between nomophobic and non-nomophobic adolescents in terms of maternal psychopathologies. We suggest that parental effects should be investigated during the assessment of NoMP, especially in adolescent girls. The phone usage habits of mothers and their relationship with their adolescent children were closely associated with adolescent NoMP.

On the complex and dimensional relationship of maternal posttraumatic stress disorder during early childhood and child outcomes at school-age.

Several studies have shown associations between maternal interpersonal violence-related posttraumatic stress disorder (PTSD), child mental health problems, and impaired socioemotional development. However, the existing literature lacks evidence linking constellations of risk factors such as maternal interpersonal-violence-related PTSD, psychopathology, and interactive behavior with toddlers and outcome measures at school-age. This study involved a prospective, longitudinal investigation of 62 mothers and examined the relationship between maternal variables measured when children were in early childhood (mean age 27months), and child outcomes when children were school-age (age mean=83.2months) while retaining a focus on the context of maternal PTSD. To identify and weigh associated dimensions comparatively, we employed sparse canonical correlation analysis (sCCA) aimed at associating dimensions of a dataset of 20 maternal variables in early childhood with that of more than 20 child outcome variables (i.e., child psychopathology, life-events, and socioemotional skills) at school-age. Phase 1 variables with the highest weights were those of maternal psychopathology: PTSD, depressive and dissociative symptoms, and self-report of parental stress. The highest weighted Phase 2 child outcome measures were those of child psychopathology: PTSD, anxiety, and depressive symptoms as well as peer bullying and victimization. sCCA revealed that trauma-related concepts in mothers were significantly and reliably associated with child psychopathology and other indicators of risk for intergenerational transmission of violence and victimization. The results highlight the dimensional and multifaceted nature-both for mothers as well as children-of the intergenerational transmission of violence and associated psychopathology.

Transmission of maternal psychopathology to child neurodevelopment – the potential role of human milk composition

Transmission of maternal psychopathology to child neurodevelopment – the potential role of human milk composition

A Prospective Cohort Study on the Intergenerational Transmission of Childhood Adversity and Subsequent Risk of Psychotic Experiences in Adolescence.

Previous studies have shown a robust relationship between childhood adversity and subsequent psychotic symptoms. However, the role of familial risk factors underlying this relationship remains largely unclear. Here, we tested whether offspring childhood adversity and postnatal maternal psychopathology mediated the relationship between maternal childhood adversity and offspring psychotic experiences. N = 3068 mother-offspring dyads were included. Maternal history of childhood adversity was retrospectively assessed using the Childhood Trauma Questionnaire during pregnancy. Maternal psychopathology was assessed during and after pregnancy. Twenty-four offspring childhood adversities were assessed by maternal interview when the child was 10 years old. Offspring psychotic experiences were examined using self-report at 14 years. Structural equation mediation models were conducted to explore whether maternal postnatal psychopathology and offspring childhood adversities sequentially mediated the relationship between maternal childhood adversity and offspring psychotic experiences. Analyses were adjusted for sociodemographic confounders. Maternal history of childhood adversity was associated with offspring childhood adversities (β = 0.12, 95% CI: 0.09 to 0.16). Offspring childhood adversity mediated the association of maternal childhood adversity with offspring hallucinations (βindirect effect = 0.008, 95% CI: 0.002 to 0.014, proportion mediated = 16.3%) and delusions (βindirect effect = 0.006, 95% CI: 0.000 to 0.012, proportion mediated = 13.1%). Intergenerational transmission of childhood adversity can be considered of relevance in the etiology of psychosis vulnerability and can potentially serve as a modifiable risk factor.

Links between mothers' ACEs, their psychopathology and parenting, and their children's behavior problems-A mediation model.

Children of mothers with a history of adverse childhoods are at greater risk of behavior problems. However, the mechanisms through which a mother's early adverse experiences (ACEs) are transmitted to her children need further study. Our goal was to examine a conceptual mediational model linking mothers' ACEs, maternal psychopathology symptoms, and parenting behaviors with children's internalizing and externalizing behaviors sequentially. A sample of 153 Israeli mothers of children ages 3-12 (52% girls) participated in the study, and most of the mothers (94.7%) were cohabiting with a spouse. Mothers completed online questionnaires about their early adverse experiences, psychopathology symptoms, parenting behavior, and their children's internalizing and externalizing behavior. Results showed that mothers with higher ACE scores reported more maternal psychopathology symptoms and more internalizing behavior in their children. The mother's psychopathology in and of itself mediated the link between her ACEs and her child's internalizing and externalizing behavior. Moreover, an indirect sequential path emerged linking ACEs with the mother's psychopathology symptoms, which, in return, were linked with hostile parenting. Hostile parenting, in turn, was linked with children's internalizing and externalizing behavior. These findings highlight the complicated and intertwined ways in which adverse experiences early in the mother's life might put her child's wellbeing at risk. The findings suggest that ACEs are linked to maternal affect dysregulation, which interferes with parenting, increasing the risk of behavior problems in children. The findings underscore the need to assess mothers' adverse history, psychological distress, and parenting behavior, and provide treatments that can reduce the intergenerational transmission of early adverse experiences.

Examining Interpersonal Traumas Across Low Income Latinx Mother-Youth Dyads: Associations Between Maternal Child Abuse Exposure and Racial Discrimination with Mother and Youth Psychopathology

Child abuse has intergenerational consequences for psychopathology, however, there remains a paucity of research regarding how these experiences affect Latinx families, particularly those at risk for additional negative life events, such as racial discrimination. This study aims to contribute to this gap in the literature by examining the impact maternal child abuse exposure has on youth and maternal psychopathology, as well as whether these associations are moderated by racial discrimination, in a sample of 224 Latinx mother-youth dyads. Hierarchical regressions revealed small but significant maternal child abuse exposure x racial discrimination interactions for youth depression and anxiety, but not maternal depression or anxiety, which were solely positively associated with maternal child abuse exposure. Findings highlight the multifarious, and at times convergent, nature of trauma and oppression among Latinx families, as well as the impact across generations. Future work is needed to further elucidate developmental pathways of intergenerational trauma in understudied populations.

Relationship Between Sleep Habits and Maternal Psychopathology in Children with and without Autism Spectrum Disorder

Objective: The aim of this study was to examine the relationship between sleep habits and maternal psychopathology in children with autism spectrum disorder, and to compare them with children with developmental delay and typically developing children. Materials and Methods: In this cross-sectional study, 131 children aged 18-42 months who applied to the neurodevelopmental delay clinic were evaluated. The Childhood Autism Rating Scale was administered by a clinician. Child Sleep Habits Questionnaire and Symptom Checklist 90 were filled in by mothers. Results: Children with Autism Spectrum Disorder were found to have more sleep onset delay and sleep anxiety than children with developmental delay and typical development. A relationship was found between sleep problems in children and psychiatric problems of mothers. Conclusion: A comprehensive evaluation including sleep problems and parental mental health evaluation while performing neurodevelopmental evaluation provides important data both in the diagnosis and the rehabilitation processes.

Effect of maternal eating disorders on mother-infant quality of interaction, bonding and child temperament: Alongitudinal study.

This study aims to investigate the effect of maternal eating disorders (ED) on mother-infant quality of interaction at 8weeks and bonding and child temperament at 1 and 2years postnatally. We also aimed to explore the relationship between maternal ED psychopathology, comorbid psychiatric difficulties, and both mother-infant quality of interaction and bonding in women with ED. Women were recruited to a prospective longitudinal study. By the time of giving birth, the sample consisted of 101 women of the initial 137 (73.7%). Overall, 62 women (ED=36; HC=26) participated in the 8-week assessment, 42 (ED=20; HC=22) at 1year, and 78 (ED=34; HC=44) at 2years. Mann-Whitney U Test was used to explore association between maternal ED and mother-infant quality of interaction and between maternal ED and bonding. Spearman correlations were used to explore associations between maternal ED psychopathology, comorbid psychiatric difficulties, and both mother-infant quality of interaction and bonding. We found no differences between early mother-infant interaction and bonding in mothers with ED in comparison to HC. High levels of maternal ED psychopathology were correlated with high anxiety levels, higher negative affectivity, and lower extraversion in children of ED mothers both at 1 and 2years. Furthermore, high levels of ED psychopathology were also associated with lower effortful control at 1year. Findings imply that maternal ED have an impact on child temperament. Future research should focus on resilience and on which protective factors might lead to positive outcomes. These factors can be then used as therapeutic and preventative targets.

Linking maternal psychopathology to children's excessive crying and sleeping problems in a large representative German sample-The mediating role of social isolation and bonding difficulties.

Attaining self-regulation is a major developmental task in infancy, in which many children show transient difficulties. Persistent, clinically relevant difficulties in self-regulation include excessive crying or sleeping disorders. Many families with affected childrenare burdened with multiple psychosocial risk. This suggests that regulatory problems are best conceptualized as the maladaptive interplay of overly burdened parents and a dysfunctional parent-child interaction. The current study examines whether social isolation and bonding difficulties function as mediating mechanisms linking maternal psychopathology to (1) children's excessive crying and (2) sleeping problems. The sample comprised N=6598 mothers (M=31.51years) of children between zero to three years of age (M=14.08months, 50.1% girls). In addition to socio demographic data, the written questionnaire included information on maternal depression/anxiety, isolation, bonding, and children's regulatory problems. Hypotheses were tested with a mediation model controlling for psychosocial risk and child characteristics. As expected, maternal symptoms of depression/anxiety were linked to infants' excessive crying and sleeping problems. Social isolation and bonding difficulties mediated this association for excessive crying as well as for sleeping problems, but social isolation was a single mediator for sleeping problems only. The findings provide important insights in the mediating pathways linking maternal psychopathology to children's regulatory problems.

Effects of maternal trauma and associated psychopathology on atypical maternal behavior and infant social withdrawal six months postpartum

ABSTRACT Maternal psychopathology given a history of maltreatment and domestic violence exposure increases the risk for child psychopathology. Infant social withdrawal is one warning sign of adverse developmental outcomes including child anxiety and depression. It remains unclear how maternal trauma-related psychopathology might affect infant social withdrawal six-months postpartum. Methods: One-hundred ninety-five women and their six-month-old infants were studied in an at-risk community sample. Maternal trauma history, posttraumatic stress (PTSD) and major depressive (MDD) disorders were assessed. Maternal and infant behaviors were coded from videotaped interactions. Results: Maternal trauma was correlated with atypical maternal behavior (AMB) and infant social withdrawal (p ≤ .001). PTSD and MDD, and comorbid PTSD/MDD predicted increased AMB (p ≤ .001) but only maternal MDD was predictive of infant social withdrawal (p ≤ .001). Effects of maternal MDD on infant withdrawal were mediated by AMB. Conclusions: At six-months postpartum, maternal MDD was associated with infant withdrawal. AMB is an important target for early intervention.