Anna Fuchs

Impact of a maternal history of childhood abuse on the development of mother-infant interaction during the first year of life

The aim of this study was to examine the impact of a maternal history of abuse on mother-infant interaction (emotional availability; EA) in infancy and early toddlerhood. Over an 18-month period, women giving birth to a child in the local obstetric units were screened using the Childhood Trauma Questionnaire. Women who reported moderate or severe sexual and/or physical abuse were included in the maltreatment group (n=58; MG) and compared with a non-maltreated comparison group (n=61; CG). EA was investigated under experimental conditions when the children were 5 and 12 months of age using the Emotional Availability Scales. While mother-child dyads in the MG showed only very discrete interactional alterations at an infant age of 5 months, their EA differed significantly from the CG at 12 months due to the lack of an increase in EA observed in the MG. Exploratory analyses showed an additional effect of emotional abuse on EA at 12 months. These data indicate that the period when child locomotion develops might represent a critical time window for mothers with a history of abuse. Our results constitute an advance in research on child abuse as they identify a possible time window of non-normative alteration in mother-child interaction. This period could be targeted by strategies to prevent intergenerational transmission of abusive experiences.

Emotional availability in mother-child interaction: the effects of maternal depression in remission and additional history of childhood abuse

The association between maternal depression and adverse outcomes in children is well established. Similar links have been found for maternal childhood abuse. One proposed pathway of risk transmission is reduced maternal emotional availability. Our aim was to investigate whether sensitive parenting is impaired in mothers with depression in remission, and whether among these mothers childhood abuse has an additional impact.

The Early Mother-to-Child Bond and Its Unique Prospective Contribution to Child Behavior Evaluated by Mothers and Teachers

Maternal bonding has been described as the quality of the affective tie from a mother to her infant. This early bonds mental components and its longitudinal impact on child outcome have been markedly understudied. Although most researchers assume impaired maternal bonding to have a negative impact on child development, there is a lack of prospective studies evaluating this hypothesis. Since maternal mental health problems may negatively affect both bonding quality and child development, it is still to be determined whether there is a unique contribution of bonding quality to child behavior problems over and above maternal psychopathology. We examined a community sample of 101 mother-child dyads at the childs age of 2 weeks (t1) and 6 weeks (t2), 4 months (t3), 14 months (t4), and 5.5 years (t5). Maternal bonding and psychopathology were assessed at time points t1-t4 using the Postpartum Bonding Questionnaire (PBQ-16) and the Symptom Checklist Revised (SCL 90-R). Child behavior problems were rated in a multi-informant design by mothers and teachers at t5 using the Strengths and Difficulties Questionnaire (SDQ). In the case of maternal judgment of child behavior problems, bonding at 14 months (t4) proved to be a significant predictor (β = 0.30; p = 0.011). Teacher-rated child behavior problems were significantly predicted by maternal bonding at 2 weeks (t1; β = 0.48; p = 0.025). Our results indicate a prospective influence of the early mother-infant bond on child development and underline the unique contribution of bonding quality to child behavior problems over and above the impact of maternal psychopathology in a community sample.

The effect of a maternal history of childhood abuse on adrenocortical attunement in mothers and their toddlers

We investigated circadian mother-child adrenocortical attunement in the context of a maternal history of childhood abuse (HoA). Mothers were screened after birth using the Childhood Trauma Questionnaire. Women reporting moderate or severe abuse formed the HoA group (n = 37; HoAG) and were compared with a non-maltreated comparison group (n = 45; CG). Three years later, cortisol awakening response (CAR) and diurnal slope (DSL) were assessed. Mother-child interaction was coded using the Emotional Availability Scales at 12 months of age. For the CAR, we found adrenocortical attunement only in the HoAG (2-way interaction: p = .004), particularly if mothers scored low on structuring (3-way interaction: p = .042) and children scored low on responsiveness (3-way interaction: p = .044). DSL-attunement was dependent on maternal sensitivity (3-way interaction: p = .012) and child involvement (3-way interaction: p = .012). In the context of a maternal HoA, it seems possible for mother-child-dyads to show less optimal interactional quality but be stronger attuned to each other biologically.

The maternal brain in women with a history of early-life maltreatment: an imagination-based fMRI study of conflictual versus pleasant interactions with children

BACKGROUND Early-life maltreatment has severe consequences for the affected individual, and it has an impact on the next generation. To improve understanding of the intergenerational effects of abuse, we investigated the consequences of early-life maltreatment on maternal sensitivity and associated brain mechanisms during mother-child interactions. METHODS In total, 47 mothers (22 with a history of physical and/or sexual childhood abuse and 25 without, all without current mental disorders) took part in a standardized real-life interaction with their 7- to 11-year-old child (not abused) and a subsequent functional imaging script-driven imagery task. RESULTS Mothers with early-life maltreatment were less sensitive in real-life mother-child interactions, but while imagining conflictual interactions with their child, they showed increased activation in regions of the salience and emotion-processing network, such as the amygdala, insula and hippocampus. This activation pattern was in contrast to that of mothers without early-life maltreatment, who showed higher activations in those regions in response to pleasant mother-child interactions. Mothers with early-life maltreatment also showed reduced functional connectivity between regions of the salience and the mentalizing networks. LIMITATIONS Region-of-interest analyses, which were performed in addition to whole-brain analyses, were exploratory in nature, because they were not further controlled for multiple comparisons. CONCLUSIONS Results suggest that for mothers with early-life maltreatment, conflictual interactions with their child may be more salient and behaviourally relevant than pleasant interactions, and that their salience network is poorly modulated by the brain regions involved in mentalizing processes. This activation pattern offers new insights into the mechanisms behind the intergenerational effects of maltreatment and into options for reducing these effects.

Link between children’s hair cortisol and psychopathology or quality of life moderated by childhood adversity risk

The hypothalamus-pituitary-adrenal axis (HPAA) and its end product, the glucocorticoid cortisol, has been shown to be associated with psychopathology. Determining cortisol concentrations in hair (HCC) allows the investigation of long-term HPAA-activity. There is a significant scarcity of studies investigating the link between HCC and psychopathology and quality of life in child and adolescent samples. In addition, as the HPAA constitutes a feedback system enabling adaption to environmental demands, it is important to consider the socio-environmental context that the children grow up in. We therefore investigated the associations between child HCC and psychopathology/quality of life and compared these links in two groups of five to 12-year-olds: children living with mothers who report experiences of early life maltreatment (ELM) (high-risk group) and children whose mothers did not report any ELM (low-risk group). We expected that, under conditions of a high-risk environment, elevated HPAA-functioning would be associated with low levels of psychopathology and high levels of quality of life in children. Under low-risk conditions, elevated HPAA-functioning would be associated with high levels of psychopathology and low levels of quality of life in children. For the complete sample of N = 130 children, three-months HCC did not significantly predict child psychopathology or quality of life. However, there was a significant moderating effect of group membership: In the high-risk group, high levels of HCC were significantly associated with high levels of self-reported quality of life. In the low-risk group, there was no association between HCC and self-reported quality of life. For child psychopathology, in the low-risk group, high levels of HCC were significantly associated with high levels of teacher reported behavior problems, whereas in the high-risk group, the association did not reach significance. Our results underline the importance of accounting for the social environment children grow up in when investigating the link between HCC and child psychopathology and quality of life.

Neural processing of the own child’s facial emotions in mothers with a history of early life maltreatment

Early life maltreatment (ELM) has long-lasting effects on social interaction. When interacting with their own child, women with ELM often report difficulties in parenting and show reduced maternal sensitivity. Sensitive maternal behavior requires the recognition of the child’s emotional state depicted in its facial emotions. Based on previous studies, it can be expected that ELM affects the neural processing of facial emotions by altering activation patterns in parts of the brain’s empathy and mentalizing networks. However, so far studies have focused on the processing of standardized, adult facial emotions. Therefore, the current study investigated the impact of ELM on the processing of one’s own child’s facial emotions using functional magnetic resonance imaging. To achieve this, 27 mothers with and 26 mothers without a history of ELM (all without current mental disorders and psychopharmacological treatment) took part in an emotional face recognition paradigm with happy, sad, and neutral faces of their own and an unknown primary school-aged child of the same age and sex. We found elevated activations in regions of the mentalizing (superior temporal sulcus, precuneus) and mirror neuron (inferior parietal lobule) networks as well as in the visual face processing network (cuneus, middle temporal gyrus) in mothers with ELM compared to the non-maltreated mothers in response to happy faces of their own child. This suggests a more effortful processing and cognitive empathic mentalizing of the own child’s facial happiness in mothers with ELM. Future research should address whether this might indicate a compensatory recruitment of mentalizing capacities to maintain maternal sensitivity.