Maternal cognitions and mother–infant interaction in postnatal depression and generalized anxiety disorder.

Abstract

Postnatal depression and anxiety have been shown to increase the risk of disturbances in mother–child interaction and child development. Research into mechanisms has focused on genetics and maternal behavior; maternal cognitions have received little attention. Our aim was to experimentally determine if worry and rumination in mothers with generalized anxiety disorder (GAD) and major depressive disorder (MDD), diagnosed in the postnatal 6 months, interfered with maternal responsiveness to their 10-month old infants. Mothers (N = 253: GAD n = 90; MDD n = 57; control n = 106) and their infants were randomized to either a worry/rumination prime (WRP) or a neutral prime (NP); mother–infant interactions were assessed before and after priming. Type of priming was a significant predictor of maternal cognitions, with WRP resulting in more negative thoughts, higher thought recurrence and more self-focus relative to NP across the entire sample. Interaction effects between group and priming were significant for two parenting variables: Compared with controls, WRP had a more negative impact on maternal responsiveness to infant vocalization for GAD, and to a lesser extent for MDD; WRP led to decreased maternal vocalization for GAD. Also, mothers with GAD used stronger control after the NP than WRP, as well as compared with other groups, and overall post-priming, their children exhibited lower emotional tone and more withdrawal. Across the entire sample, WRP was associated with increased child vocalization relative to NP. This study demonstrated that disturbances in maternal cognitions, in the context of postnatal anxiety and to a lesser degree depression, play a significant role in mother–child interaction.

Repetitive Negative Thinking and Its Role in Perinatal Mental Health

“…This is surprising given the hypothesised key role for RNT (in the form of rumination) in mediating the impact of maternal psychopathology on parenting [22]. Stein et al [23, 24] proposed maternal “preoccupation” (including rumination, worry) as a key mechanism that may account for the transmission of psychopathology from a mother to her offspring – highlighting the potential significance of RNT in the postnatal context. There is clearly a need for more research to advance the understanding of how rumination contributes to poor maternal mental health, compromised parenting quality, and impoverished child outcomes [21].…”

“…For example, O’Mahen et al [34] found that high dysphoric postnatal mothers who received a rumination induction demonstrated less effective problem-solving (as well as less confidence in their problem-solving capacity) on a series of parenting-related scenarios relative to those who received a distraction induction, and also to low dysphoric postnatal mothers in both experimental conditions. In another experiment, Stein et al [24] reported that women with post-partum GAD and major depression who received a worry/rumination prime (i.e., instructed to think about a worry or negative thought) were subsequently less responsive to their infant’s vocalisations than those who received a neutral prime (i.e., instructed to think about their journey to the lab). Interestingly, the effect was stronger in mothers with GAD than in those with depression, consistent with our argument about the importance of RNT in the context of anxiety in this population.…”

Perinatal Generalized Anxiety Disorder: Assessment and Treatment

“…[13][14][15][16] Stein and colleagues 17 found that recurrent negative thinking in mothers with GAD resulted in their being less responsive and engaged in interactions with their infants. In addition, these infants appeared to be withdrawn and were more likely to display lowered emotional tone.…”

The Associations Between Pre- and Postnatal Maternal Symptoms of Distress and Preschooler’s Symptoms of ADHD, Oppositional Defiant Disorder, Conduct Disorder, and Anxiety

“…However, prenatal maternal depression (PND) (O'Donnell, Glover, Barker, & O'Connor, 2014;Van Batenburg-Eddes et al, 2013) and maternal post-partum depression (PPD) (Carter, Garrity-Rokous, Chazan-Cohen, Little, & Briggs-Gowan, 2001;Kim-Cohen, Moffitt, Taylor, Pawlby, & Caspi, 2005;Sciberras, Ukoumunne, & Efron, 2011) have also been found related to ADHD and behaviour problems in preschool children. Impaired maternal sensitivity, insecure infant attachment, and less optimal mother-child interactions have been found associated with post-partum depressions (PPD), which may negatively impact on children's further cognitive and behavioural development (Stein et al, 2012a;Carter et al, 2001;Shaw & Vondra, 1995). The increased risk for child symptom development has also been shown equally related to pre-and postnatal exposure to maternal symptoms of anxiety or depression (Giallo, Woolhouse, Gartland, Hiscock, & Brown, 2015;O'Donnell et al, 2014;Carter et al, 2001).…”