Maternal Interaction With Infants Among Women at Elevated Risk for Postpartum Depression

• Type of Material: Article
• Authors: Sherryl Goodman, Emory University; Maria Muzik, University of Michigan; Diana Simeonova, Emory University; Sharon A Kidd, University of California San Francisco; Margaret T Owen, University of Texas Dallas; Bruce Cooper, University of California San Francisco; Christine Y Kim, Emory University; Katherine L Rosenblum, University of Michigan; Sandra J Weiss, University of California San Francisco
• Language: English
• Date: 2022-03-03
• Publisher: FRONTIERS MEDIA SA
• Publication Version: Final Published Version
• Copyright Statement: © 2022 Goodman, Muzik, Simeonova, Kidd, Owen, Cooper, Kim, Rosenblum and Weiss.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3389/fpsyg.2022.737513
• Title of Journal or Parent Work: FRONTIERS IN PSYCHOLOGY
• Volume: 13
• Start Page: 737513
• End Page: 737513
• Grant/Funding Information: This research was funded by NICHD, R01 HD084813 [MPIs: SW (Contact), SG, MM]. Other supports to the research include the following: NIMH (MH080147, PI: MM); the Michigan Institute for Clinical and Health Research (UL1TR000433, PI: MM); NIMH (MH065062, PI: Vazquez); NIMH University of Michigan GCRC (M01 RR00042); NICHD (R01 HD081188, PI: SW); NINR (R01 NR002698, PI: SW); Robert C. and Delphine Wentland Eschbach Endowment (PI: SW); NINR (T32 NR016920, PI: SW), NIMH (1P50MH58922-01A1, PI: Nemeroff); NIMH (1 P50 MH077928-01A1, PI: Stowe), NIMH (K23MH096042, PI: DS); Brain & Behavior Research Foundation (PI: DS).
• Keywords: LOW-INCOME; postpartum; SENSITIVITY; PERINATAL DEPRESSION; ATTACHMENT; depression; SYMPTOMS; HISTORY; Social Sciences; UNITED-STATES; MOTHER-CHILD INTERACTION; Psychology, Multidisciplinary; BIPOLAR DISORDER; interaction; RECURRENCE; Psychology; maternal; infant
• Research Categories: Health Sciences, Mental Health; Psychology, Behavioral; Health Sciences, Obstetrics and Gynecology

Abstract

Ample research links mothers’ postpartum depression (PPD) to adverse interactions with their infants. However, most studies relied on general population samples, whereas a substantial number of women are at elevated depression risk. The purpose of this study was to describe mothers’ interactions with their 6- and 12-month-old infants among women at elevated risk, although with a range of symptom severity. We also identified higher-order factors that best characterized the interactions and tested longitudinal consistency of these factors from 6 to 12 months of infant age. We leveraged data from eight projects across the United States (n = 647), using standardized depression measures and an adaptation of the NICHD Mother-Infant Interaction Scales. Overall, these depression-vulnerable mothers showed high levels of sensitivity and positive regard and low levels of intrusiveness, detachment, and negative regard with their infants. Factor analyses of maternal behaviors identified two overarching factors—“positive engagement” and “negative intrusiveness” that were comparable at 6 and 12 months of infant age. Mothers’ ability to regulate depressed mood was a key behavior that defined “positive engagement” in factor loadings. An exceptionally strong loading of intrusiveness on the second factor suggested its central importance for women at elevated depression risk. Mothers with severe depressive symptoms had significantly more “negative intrusiveness” and less “positive engagement” with their 6-month-old infants than women with moderate or fewer depressive symptoms, suggesting a potential tipping point at which symptoms may interfere with the quality of care. Results provide the foundation for further research into predictors and moderators of women’s interactions with their infant among women at elevated risk for PPD. They also indicate a need for evidence-based interventions that can support more severely depressed women in providing optimal care.