Susan C. McDonough

Depressive Symptoms During Pregnancy: Impact on Neuroendocrine and Neonatal Outcomes

OBJECTIVE To explore the interplay of maternal depressive symptoms on the infant limbic-hypothalamic-pituitary axis (LHPA) and neurological development. DESIGN Pregnant women were monitored for depressive symptoms using the Beck Depression Inventory (BDI) at 28, 32, and 37 weeks of gestation and at delivery. A mixture growth curve analysis divided the women into three risk groups: low/stable, intermediate, and high/increasing depression based on BDI scores. The infant neuroendocrine system was examined using cord blood for adrenocorticotrophic hormone (ACTH) and cortisol measurements. Two-week-old infants were examined using Neonatal Intensive Care Unit Neurobehavioral Scale (NNNS). RESULTS Infants born to women of the high/increasing depression group had significant ACTH elevation at birth. On NNNS examination, these infants were more hypotonic and habituated to auditory and visual stimuli. CONCLUSION When compared to non-depressed women, maternal depressive symptoms, even in the absence of major depressive disorder, appeared to facilitate a different developmental pathway for the infant LHPA and early neurological development.

Video Feedback in Parent-Infant Treatments

Video feedback has been integrated into several therapeutic approaches as a way of engaging parents to focus on interactive behavior to reinforce positive interactions and to identify areas of noncontingent behavior. This article reviews the technical and theoretical contributions of the most important video feedback-based interventions that are currently used with families that include young children.

Parenting stress and depressive symptoms in postpartum mothers: Bidirectional or unidirectional effects?

Despite the consistent link between parenting stress and postpartum depressive symptoms, few studies have explored the relationships longitudinally. The purpose of this study was to test bidirectional and unidirectional models of depressive symptoms and parenting stress. Uniquely, three specific domains of parenting stress were examined: parental distress, difficult child stress, and parent-child dysfunctional interaction (PCDI). One hundred and five women completed the Beck Depression Inventory and the Parenting Stress Index - Short Form at 3, 7, and 14 months after giving birth. Structural equation modeling revealed that total parenting stress predicted later depressive symptoms, however, there were different patterns between postpartum depressive symptoms and different types of parenting stress. A unidirectional model of parental distress predicting depressive symptoms best fit the data, with significant stability paths but non-significant cross-lagged paths. A unidirectional model of depressive symptoms predicted significant later difficult child stress. No model fit well with PCDI. Future research should continue to explore the specific nature of the associations of postpartum depression and different types of parenting stress on infant development and the infant-mother relationship.

Emotional resilience in early childhood: developmental antecedents and relations to behavior problems.

Abstract:  To test whether the development of emotional resilience is a function of sensitive caregiving and child negative affect, we tested the joint contributions of 7‐month maternal sensitivity and infant negative affect to the prediction of 33‐month emotional resilience across the first 3 years of life. The aims of this study were to examine whether maternal sensitivity and infant negative affect predict long‐term emotional resilience and whether this was associated with preschool behavior problems. Using a sample of 181 mother–infant dyads, we found that (a) maternal sensitivity at 7 months, but not infant negative affect, longitudinally predicted emotional resilience during preschool and (b) emotional resilience was negatively associated with anxiety/depression in preschool.

Predictors of recovery from prenatal depressive symptoms from pregnancy through postpartum.

BACKGROUND Identifying predictors of the course of depressive symptoms from pregnancy through postpartum is important to inform clinical interventions. METHODS This longitudinal study investigated predictors of recovery from prenatal elevated depressive symptoms in the postpartum period. Forty-one pregnant women completed demographic, interpersonal, and psychosocial self-report assessment measures at 32 weeks of gestation and again 12 weeks postpartum. RESULTS Of those with elevated depressive symptoms, defined as a Beck Depression Inventory-II (BDI-II) score ≥10, at the prenatal baseline, 39% (n=16) recovered to nonelevated symptom levels postpartum, whereas 61% (n=25) experienced sustained elevated symptoms. Women who recovered evidenced significantly lower baseline depression severity and more frequent engagement in physical activity and cohabitated with a romantic partner. In multiparous women (n=25), history of past postpartum depression (PPD) differentiated between those with transient and those with persisting symptoms, although history of lifetime depression did not. None of the additional demographic, interpersonal, or psychosocial variables investigated differentiated between groups. Logistic regression analysis showed prenatal depression severity and exercise frequency as predictors of recovery postpartum. CONCLUSIONS Results suggest most women will not experience spontaneous recovery. Women with prenatal heightened symptom severity and previous experiences with PPD are acutely vulnerable to experience sustained symptoms. In contrast, having a cohabitating partner and engagement in prenatal exercise predicted symptom improvement. Physical exercise may be an important clinical recommendation, as it may improve mood. Given the small sample size, these results are preliminary. Implications and future research recommendations are discussed.

Public-Academic Partnerships: Working Together to Meet the Needs of Army National Guard Soldiers: An Academic-Military Partnership

The conflicts in Afghanistan and Iraq have greatly increased the number of veterans returning home with combat exposure, reintegration issues, and psychiatric symptoms. National Guard soldiers face additional challenges. Unlike active duty soldiers, they do not return to military installations with access to military health services or peers. The authors describe the formation and activities of a partnership among two large state universities in Michigan and the Michigan Army National Guard, established to assess and develop programming to meet the needs of returning soldiers. The process of forming the partnership and the challenges, opportunities, and benefits arising from it are described.

MATERNAL SENSITIVITY AND LATENCY TO POSITIVE EMOTION FOLLOWING CHALLENGE: PATHWAYS THROUGH EFFORTFUL CONTROL

The ability to self-generate positive emotions is an important component of emotion regulation. In this study, we focus on childrens latency to express positive emotions following challenging situations and assess whether this ability operates through early maternal sensitivity and childrens effortful control. Longitudinal relations between maternal sensitivity, infant negative affect, effortful control, and latency to positive emotion following challenge were examined in 156 children who were 33 months of age. Structural equation models supported the hypothesis that maternal sensitivity during infancy predicted better effortful control and, in turn, shorter latencies to positive emotions following challenge at 33 months. Directions for future research are discussed.