Perinatal mental health research: towards an integrative biopsychosocial approach

Bergunde, Luisa; Garthus-Niegel, Susan; Alexander, Nina; Steudte-Schmiedgen, Susann

doi:10.1080/02646838.2022.2101781

Cited by 8 publications

(4 citation statements)

References 8 publications

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“…Furthermore, data revealed that the predictive effect of lifetime trauma and hair AEA for CB-PTSS may be greater for mothers with negative SBE, highlighting the importance of considering subjective peritraumatic experiences. These findings represent an important step in CB-PTSD research and awareness, providing an initial attempt at understanding the biological aetiology of the disorder and paving the way for personalised prevention [ 3 ]. Future research may examine pre-pregnancy and perinatal HEC, particularly AEA, as biological risk indicators of CB-PTSS assessed over several assessment points in the postpartum period, accompanied by assessments of traumatic childbirth experiences, also in more clinical samples.…”

Section: Discussionmentioning

confidence: 99%

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Childbirth-related posttraumatic stress symptoms – examining associations with hair endocannabinoid concentrations during pregnancy and lifetime trauma

Bergunde,

Karl,

Schälicke

et al. 2023

Transl Psychiatry

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Evidence has linked alterations of the endocannabinoid system with trauma exposure and posttraumatic stress disorder (PTSD). Childbirth-related PTSD symptoms (CB-PTSS) affect about every eighth woman and can negatively influence the entire family. While aetiological models of CB-PTSD include psychological risk factors such as maternal trauma history and negative subjective birth experience (SBE), they lack biological risk indicators. We investigated whether lifetime trauma and CB-PTSS were associated with long-term endocannabinoid concentrations during pregnancy. Further, we tested endocannabinoids as mediators between lifetime trauma and CB-PTSS and whether SBE moderated such mediational paths. Within the prospective cohort study DREAMHAIR, 263 expectant mothers completed trauma assessments and provided hair samples for quantification of long-term endocannabinoid levels (anandamide [AEA], 2-arachidonoylglycerol [1-AG/2-AG], and N-acyl-ethanolamides [NAE]) prior to their anticipated birth date. Two months postpartum, CB-PTSS and SBE were measured. Regression models controlling for relevant confounders showed no association between lifetime trauma and hair endocannabinoids during pregnancy, yet higher number of lifetime trauma events and lower hair AEA were significantly associated with CB-PTSS, with the latter finding not remaining significant when Bonferroni corrections due to multiple testing were applied. While hair AEA did not mediate the association between lifetime trauma and CB-PTSS, the effect of lower hair AEA on CB-PTSS was stronger upon negative SBE. Results suggest greater lifetime trauma and reduced maternal hair AEA during pregnancy may be associated with increased risk for CB-PTSS, particularly upon negative SBE. Findings confirm lifetime trauma as a CB-PTSS risk factor and add important preliminary insights on the role of endocannabinoid ligand alterations and SBE in CB-PTSS pathology.

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Section: Discussionmentioning

confidence: 99%

“…These posttraumatic reactions, including reexperiencing, avoidance, and arousal symptoms, represent an important public health issue [ 2 ]. Hence, a better aetiological understanding through extension of psychological models with biological factors is warranted [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Childbirth-related posttraumatic stress symptoms – examining associations with hair endocannabinoid concentrations during pregnancy and lifetime trauma

Bergunde,

Karl,

Schälicke

et al. 2023

Transl Psychiatry

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“…Methodologically, a biopsychosocial or multi-system approach requires multi-method, whole family, longitudinal studies that recognize the importance of the father/partner and couple's relationship (whether co-habiting or separate) in infant outcomes and development (Bergunde et al, 2022 ). It would also be useful to widen this to include co-habiting family members such as step-parents or grandparents, which was highlighted by a review of risk factors for child maltreatment (Ayers et al, 2019 ).…”

Section: Gaps In the Knowledge And Directions For Future Researchmentioning

confidence: 99%

Editorial: From childbearing to childrearing: Parental mental health and infant development

2023

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Editorial on the Research TopicFrom childbearing to childrearing: Parental mental health and infant development Every day, around 385,000 babies are born worldwide. Childbirth is culturally perceived as positive, yet it may be a challenging experience for mothers and fathers. It is estimated that up to one-third of parents have psychological difficulties during pregnancy and postpartum. These difficulties then often affect the relationships between the mother, co-parent, and infant. As the relationships and interactions with both parents are crucial for infant development, parental mental health difficulties may have adverse effects on the family dynamics and the infant. Furthermore, infant characteristics can also affect the relationships and interactions with their parents, making these interactions complex and important to investigate. This Research Topic "From Childbearing to Childrearing: Parental Mental Health and Infant Development" presents 15 papers -14 original quantitative studies and one narrative review -examining the associations between parental mental health and different parenting and infant outcomes. Of the original studies, two used experimental designs, six studies had longitudinal and six cross-sectional designs. All studies included mothers, and one study included both mothers and fathers. Regarding the geographical distribution of the papers, 10 papers were from Europe, one from North America and four were international collaborations between researchers from Europe, North America, and Asia. These are summarized below.

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“…Furthermore, Pittner et al ( 2020 ) recently examined hair cortisone (HairE) concentrations, finding elevations due to abuse, whereas no previous study in this context has examined the ratio between HairF and HairE. Thus, considering the enzyme 11β-hydroxysteroid-dehydrogenase type 2 (11β-HSD2) converts cortisol to its inactive form cortisone, the additional assessment of HairE concentrations (Stalder et al, 2013 ) and the ratio of HairF/HairE (Scharlau et al, 2018 ) may represent a promising approach to obtain further long-term markers of cortisol metabolism, also in the perinatal period (Bergunde et al, 2022 ; Jaramillo et al, 2023 ; Scharlau et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

The effect of maternal childhood maltreatment on postpartum mother–child bonding and maternal hair glucocorticoids

Bergunde,

Karl,

Borrmeister

et al. 2024

European Journal of Psychotraumatology

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Background: Maternal experiences of childhood maltreatment (CM) constitute a risk factor for impairments in the mother–child relationship. One mechanism underlying this intergenerational transmission may be maternal hypothalamic–pituitary–adrenal axis dysregulation. Yet, few studies have examined different maltreatment subtypes, including emotional neglect, considered concurrent depressive symptoms, and used long-term integrated glucocorticoid measures. Objective: This study aimed to investigate associations between maternal CM history, postpartum glucocorticoids in hair, and mother–child bonding. In exploratory analyses, we tested whether specific subtypes of CM had differential implications for glucocorticoid secretion and bonding. Methods: During pregnancy, N = 269 mothers from the prospective cohort study DREAM HAIR provided retrospective information on CM and current information regarding psychological and hair-related variables. Hair samples were collected 8 weeks after delivery for quantification of maternal long-term hair cortisol and cortisone concentrations in 2-cm scalp-near hair samples. Mother–child bonding was measured 8 weeks and 14 months after birth using the Postpartum Bonding Questionnaire. Results: While bivariate correlations revealed significant associations of CM with bonding and hair cortisol, regression findings showed CM was associated with impaired bonding 8 weeks (overall CM trend-level; emotional neglect p = .038) and 14 months (emotional neglect trend level p = .041) after birth, however not after controlling for depressive symptoms at the time point of the outcome. In regression analyses, CM was not associated with maternal hair glucocorticoids 8 weeks postpartum. Maternal hair glucocorticoid concentrations were not related to mother–child bonding and did not mediate associations between CM and mother–child bonding. Conclusion: Data tentatively suggest that mothers with CM experiences, in particular emotional neglect, may be at risk for suboptimal bonding to their child, however current depressive symptoms seem to be more important. Our data provide no evidence for a crucial role of glucocorticoid secretion, yet aetiological processes of long-term glucocorticoid secretion and bonding are complex and more severely affected samples should be examined.

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Perinatal mental health research: towards an integrative biopsychosocial approach

Cited by 8 publications

References 8 publications

Childbirth-related posttraumatic stress symptoms – examining associations with hair endocannabinoid concentrations during pregnancy and lifetime trauma

Childbirth-related posttraumatic stress symptoms – examining associations with hair endocannabinoid concentrations during pregnancy and lifetime trauma

Editorial: From childbearing to childrearing: Parental mental health and infant development

The effect of maternal childhood maltreatment on postpartum mother–child bonding and maternal hair glucocorticoids

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