Tiffany Field

Postpartum depression effects on early interactions, parenting, and safety practices: a review.

In this paper studies are reviewed from the last decade on postpartum depression effects on early interactions, parenting, safety practices and on early interventions. The interaction disturbances of depressed mothers and their infants appear to be universal, across different cultures and socioeconomic status groups and, include less sensitivity of the mothers and responsivity of the infants. Several caregiving activities also appear to be compromised by postpartum depression including feeding practices, most especially breastfeeding, sleep routines and well-child visits, vaccinations and safety practices. These data highlight the need for universal screening of maternal and paternal depression during the postpartum period. Early interventions reviewed here include psychotherapy and interaction coaching for the mothers, and infant massage for their infants.

Early interactions between infants and their postpartum depressed mothers

Early face-to-face play interactions in which mothers have been instructed to “look depressed” result in disorganized, distressed behavior on the part of the infants (Cohn & Tronick, 1983). During this manipulation the infants more frequently looked wary, gaze averted, protested, and attempted to elicit responses from the mother, much like the infant interacting with a still-face mother attempts to reinstate their normal interaction (Fogel, Diamond, Langhorst, & Demos, 1982; Stoller & Field, 1982; Trevarthen, 1977; Tronick, Als, Adamson, Wise, & Brazelton, 1978). The infants’ distressed behavior continued even after the mothers resumed their normal behavior. Although the Cohn and Tronick (1983) study was intended to be a simulation of interactions between depressed mothers and infants, it is possible that infants of naturally depressed mothers may be accustomed to depressed behavior and thus may not act distressed when she is invited to “look depressed.” In the present study we investigated whether infants of mothers who became depressed postpartum.would behave like infants of,nondepressed mothers who were invited to “look depressed.” Twenty-four mothers (12 depressed, 12 nondepressed) and their infants were videotaped during face-to-face interactions when the infants were three months old. The “depressed” mothers had been referred to us by the obstetric unit social worker because they looked depressed during the lying-in period. This group of mothers and a randomly selected group of mothers delivering on the same unit were invited to participate in the study when their infants were three months old. All mothers were given the Beck Depression Inventory (Beck, Ward, Mendelson, Mock, & Erbaugh, 1969) and the State-Trait Anxiety Inventory (Spielberger, Gorsuch, & Lushene, 1970). Only those mothers who received scores of 16 or above on the Beck Depression inventory (BDI) were recruited for the “depressed” mothers’ group. The group of nondepressed mothers (scores 14 on BDI) were then selected from the random sample to

Massage therapy effects.

Massage therapy is older than recorded time, and rubbing was the primary form of medicine until the pharmaceutical revolution of the 1940s. Popularized again as part of the alternative medicine movement, massage therapy has recently received empirical support for facilitating growth, reducing pain, increasing alertness, diminishing depression, and enhancing immune function. In this article studies are reviewed that document these effects, and models are proposed for potential underlying mechanisms.

Mother-stranger face discrimination by the newborn

Newborn infants discriminate their mothers face from the face of a stranger shortly after birth. The neonates (M age=45 hours) showed an initial preference for their mothers face. The mothers face (or face and voice) was then presented to the neonates for repeated trials until the infant reached an habituation criterion. In a subsequent discrimination test the infants looked significantly longer at the strangers face, suggesting that the mothers face was discriminated after very limited experience. Although voice cues were not required for this discrimination, the possibility remains that other cues, such as the mothers odor, may facilitate the discrimination of her face.

Massage Reduces Anxiety in Child and Adolescent Psychiatric Patients

A 30-minute back massage was given daily for a 5-day period to 52 hospitalized depressed and adjustment disorder children and adolescents. Compared with a control group who viewed relaxing videotapes, the massaged subjects were less depressed and anxious and had lower saliva cortisol levels after the massage. In addition, nurses rated the subjects as being less anxious and more cooperative on the last day of the study, and nighttime sleep increased over this period. Finally, urinary cortisol and norepinephrine levels decreased, but only for the depressed subjects.

CORTISOL DECREASES AND SEROTONIN AND DOPAMINE INCREASE FOLLOWING MASSAGE THERAPY

In this article the positive effects of massage therapy on biochemistry are reviewed including decreased levels of cortisol and increased levels of serotonin and dopamine. The research reviewed includes studies on depression (including sex abuse and eating disorder studies), pain syndrome studies, research on auto-immune conditions (including asthma and chronic fatigue), immune studies (including HIV and breast cancer), and studies on the reduction of stress on the job, the stress of aging, and pregnancy stress. In studies in which cortisol was assayed either in saliva or in urine, significant decreases were noted in cortisol levels (averaging decreases 31%). In studies in which the activating neurotransmitters (serotonin and dopamine) were assayed in urine, an average increase of 28% was noted for serotonin and an average increase of 31% was noted for dopamine. These studies combined suggest the stress-alleviating effects (decreased cortisol) and the activating effects (increased serotonin and dopamine) of massage therapy on a variety of medical conditions and stressful experiences.

Prenatal depression effects on early development: A review

This review of recent research on prenatal depression suggests that it is a strong predictor of postpartum depression and is more common than postpartum depression. Prenatal depression has been associated with excessive activity and growth delays in the fetus as well as prematurity, low birthweight, disorganized sleep and less responsiveness to stimulation in the neonate. Infants of depressed mothers have difficult temperament, and later in development attentional, emotional and behavioral problems have been noted during childhood and adolescence, as well as chronic illnesses in adulthood. Several variables have confounded the effects of prenatal depression including comorbid anxiety and anger as well as stressful life events. Potential mediating variables are low prenatal maternal dopamine and serotonin levels and elevated cortisol and norepinephrine. The associated intrauterine artery resistance may limit blood flow, oxygen and nutrients to the fetus. Some studies also suggest the heritability of developmental problems for the children of prenatally depressed mothers, including ADHD and antisocial behavior. Multivariate, longitudinal research is needed to disentangle these confounding and mediating variables.

AROMATHERAPY POSITIVELY AFFECTS MOOD, EEG PATTERNS OF ALERTNESS AND MATH COMPUTATIONS*

EEG activity, alertness, and mood were assessed in 40 adults given 3 minutes of aromatherapy using two aromas, lavender (considered a relaxing odor) or rosemary (considered a stimulating odor). Participants were also given simple math computations before and after the therapy. The lavender group showed increased beta power, suggesting increased drowsiness, they had less depressed mood (POMS) and reported feeling more relaxed and performed the math computations faster and more accurately following aromatherapy. The rosemary group, on the other hand, showed decreased frontal alpha and beta power, suggesting increased alertness. They also had lower state anxiety scores, reported feeling more relaxed and alert and they were only faster, not more accurate, at completing the math computations after the aromatherapy session.

Massage therapy is associated with enhancement of the immune system's cytotoxic capacity.

Twenty-nine gay men (20 HIV+, 9 HIV-) received daily massages for one month. A subset of 11 of the HIV+ subjects served as a within subject control group (one month with and without massages). Major immune findings for the effects of the month of massage included a significant increase in Natural Killer Cell number, Natural Killer Cell Cytotoxicity, soluble CD8, and the cytotoxic subset of CD8 cells. There were no changes in HIV disease progression markers (CD4, CD4/CD8 ratio, Beta-2 microglobulin, neopterin). Major neuroendocrine findings, measured via 24 hour urines included a significant decrease in cortisol, and nonsignificant trends toward decrease of catecholamines. There were also significant decreases in anxiety and increases in relaxation which were significantly correlated with increases in NK cell number. Thus, there appears to be an increase in cytotoxic capacity associated with massage. Implications for HIV+ men as those with other illnesses, particularly cancer, are discussed.

Maternal psychological distress, prenatal cortisol, and fetal weight.

Objective: The objective of this study was to examine the effects of maternal psychological distress on estimated fetal weight during midgestation and explore the maternal hypothalamic–pituitary axis and sympathoadrenal dysregulation as potential risk factors for these effects. Methods: Fetal ultrasound biometry measurements and maternal sociodemographic characteristics, emotional distress symptoms, and first morning urine samples were collected during a clinical ultrasound examination for a cross-sectional sample of 98 women who were between 16 and 29 weeks pregnant. Fetal weight was estimated from ultrasound biometry measurements; maternal emotional distress was assessed using the daily hassles (stress), Center for Epidemiologic Studies–Depression (depression), and State-Trait Anxiety Inventory (anxiety) scales; and urine samples were assayed for cortisol and norepinephrine levels. Results: Correlation analyses revealed that both maternal psychological (daily hassles, depression, and anxiety) and biochemical (cortisol and norepinephrine) variables were negatively related to fetal biometry measurements and estimated fetal weight. A structural equation model further revealed that when the independent variance of maternal sociodemographic, psychological distress, and biochemistry measures were accounted for, prenatal cortisol was the only significant predictor of fetal weight. Conclusions: Women exhibiting psychological distress during pregnancy exhibit elevated cortisol levels during midgestation that are in turn related to lower fetal weight. CRH = corticotropin-releasing hormone; HPA = hypothalamic–pituitary axis; IGFBP1 = insulin-like growth factor binding protein 1; eFW = estimated fetal weight; BPD = biparietal diameter; AC = abdominal circumference; FL = femur length; HC = head circumference; SES = socioeconomic status; SEM = structural equation model; CFI = comparative fit index; RMSEA = root mean square error of approximation.