Postnatal maternal depression is associated with difficulties in maternal responsiveness. As most signals arising from the infant come from facial expressions one possible explanation for these difficulties is that mothers with postnatal depression are differentially affected by particular infant facial expressions.
Participants 15 controls, 15 depressed and 15 anxious mothers were asked to rate a number of infant facial expressions, ranging from very positive to very negative. Each face was shown twice, for a short and for a longer period of time in random order. Results revealed that mothers used more extreme ratings when shown the infant faces i.
Mothers suffering from postnatal depression were more likely to rate negative infant faces shown for a longer period more Facial expression of mothers than controls. The differences were specific to depression rather than an effect of general postnatal psychopathology—as no differences were observed between anxious mothers and controls.
There were no other significant differences in maternal ratings of infant faces showed for short periods or for positive or neutral Facial expression of mothers faces of either length. The findings that mothers with postnatal depression rate negative infant faces more negatively indicate that appraisal bias might underlie some of the difficulties that these mothers have in responding to their own infants signals.
The early post partum period is vital for the development of the early mother—child responsivity and the mother—child relationship. However, to date, the process underlying this difficulty has not been fully elucidated.
Murray, Fiori-Cowley, Hooper, and Cooper also found that depressed mothers responded more to infant expressions of negative affect than control mothers and, moreover, that the nature of their responsiveness differed.
While such naturalistic observational findings are important, the Facial expression of mothers influencing this maternal behaviour and in particular the nature of the mother's processing of infant facial expressions of emotion requires further investigation. A further question concerns the specificity of the effects of depression.
Thus, while the adverse effects of Facial expression of mothers on maternal sensitivity to the infant have been well established, far less is known about the effects of other psychiatric disorders commonly occurring after childbirth such as anxiety, and the findings have been inconsistent.
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Evidence concerning cognitive processing of emotional expressions in adults from experimental studies provides a number of hypotheses that can be applied to infant studies. Generally, depressed people also tend to valence happy faces as neutral, neutral faces as sad Gur et al.
In addition, research on attentional bias has shown that depressed people selectively attend to specific emotional cues in facial expressions i. Importantly, studies have found that both appraisal and attentional biases are not always observed. For instance, appraisal biases seem to be specific to ambiguous cues i. This is important because infant faces have a different configuration from those of adults Lorenz, including a relatively large head, predominance of the brain capsule, large and low lying eyes and bulging cheek region, which is thought to be important for eliciting parental Facial expression of mothers Lorenz, Furthermore, in order to explore whether any biases found are specific to depression, and not to more general postnatal psychiatric disturbance, comparison is made with a group of mothers suffering from anxiety.
Although cognitive biases are also observed in Facial expression of mothers disorders, those are by and large characterised by specific attention biases towards threatening rather than negative information Mogg et al.
In order to examine these questions we used images from a range of different infants, each showing a spectrum of expressions. Our main hypotheses are: H1 Depressed participants will display a negative appraisal bias and will therefore valence neutral and negative faces as more negative than Facial expression of mothers participants. H2 The negative appraisal bias will be specific to depression, and Facial expression of mothers a result of general postpartum disorder; thus, anxious postnatal mothers will not show appraisal bias when compared to controls.
H3 The negative appraisal bias will be more prominent for stimuli shown for longer presentations. Mothers were drawn from a community sample mainly recruited from the postnatal wards of the John Radcliffe Hospital. Women who met inclusion criteria i. Mothers who fulfilled the clinical criteria for depression or Generalised Anxiety Disorder GAD in the diagnostic interview were considered eligible for the study. In addition to scoring below threshold in the screening questionnaires, control mothers were included in the study if they met criteria for no present or past psychiatric Facial expression of mothers.
During the 3 months home visit mothers completed the face rating task after the SCID interview. The first 15 women who received a principal diagnosis for a depressive disorder DEP were recruited into the current study and were matched with 15 controls and 15 mothers with GAD.
Based on the diagnostic interview at 3 months, of the 30 case mothers recruited into this study four were comorbid for depression and anxiety. Of these, three had a principal diagnosis of depression and one had a principal GAD diagnosis. Mothers were matched for infant birth order and educational background. There were no differences across groups on these two variables see Table 1 for sample details and these characteristics are representative of the full study sample.
Approval for the study was obtained from the Oxfordshire Research Ethics Committee reference number Fifty baby faces were used in the study, ten for each of five target emotions positive, muted positive, neutral, muted negative, negative. Images were drawn from a database of digital photographs of 27 infants who were filmed at home see Kringelbach et al. Faces were shown as greyscale images and matched for size and luminosity. Keyboard buttons Facial expression of mothers labelled Facial expression of mothers and only designated response keys were registered by the computer.
Average scores were computed for each facial expression in each length condition. Distributions of average appraisal score in each facial expression and in each length were examined and all met criteria for normality.
In a second step, given our particular interest in the specificity of depression and because an overlap of high anxiety and depression symptoms could undermine the differences between our two index groups, we examined the differences between GAD and DEP without the four comorbids of our sample.
Next, we examined the effect of length of presentation H3 via repeated measures analysis of variance. There were no significant differences between control and GAD groups. Likewise, there was no evidence of group differences in any of the specific long presentation conditions examined. A 2 Duration by 3 Group repeated measures analysis of variance was performed for each Stimulus Facial expression of mothers. However, participants tended to give more extreme ratings when either positive or negative baby faces were presented for a longer time.
The effect sizes were stronger in the former condition i. Parity effects were examined in all conditions.
There were no significant overall parity effects in either short or long presentations, nor significant specific parity effects in any other condition. The aim of this study was to examine whether mothers with postnatal depression showed a systematic bias in their interpretation of infant facial expressions, and whether any biases found were specific Facial expression of mothers postnatal depression or common to both depression and anxiety.
One further issue, which had not previously been studied in baby faces, was whether the length of viewing had any effect on the outcome.
We found that all Groups rated baby faces as more negative or more positive when Facial expression of mothers for a longer period than a shorter period of time. More importantly we found that negative faces seem to be particularly susceptible to the effects of timing, with more negative interpretations being elicited by longer exposures. This suggests that conscious perceptions of the sad emotion seem to be associated with the appraisal bias.
Mothers in the depression group rated infant negative faces as more negative compared to the controls over the longer exposure condition.
This was not evident in the shorter exposure period, and there were no differences for positive faces. These data support previous research concerning negativity bias when rating faces with a negative valence in the context of Facial expression of mothers Bouhuys et al.
It is also consistent with the findings of Weinberg, Olson, Beeghly, and Tronick that differences in interactions between depressed and well mothers emerged only under conditions of interaction stress. Our results support observational evidence that when mothers are exposed to prolonged negative expressions on infant faces, they are more likely to interpret them more negatively, and this was specific to depression.
Conceivably, this bias may affect the nature of their responsiveness to infants. First time mothers were more likely to rate positive faces more positively. While again no similar studies have been conducted, it might be speculated that this might Facial expression of mothers new mothers to engage with their infants.
Notably there was scarce evidence for the effects of maternal GAD on Facial expression of mothers response to infant facial expression. The study had a number of limitations: In conclusion this study found that mothers suffering from postnatal depression were more likely to rate infant faces more negatively than controls and that this was specific to depression rather than a general effect of postnatal psychopathology.
Further research needs to investigate whether such biases in interpretation of infant faces translates into a mother's behavioural responsivity to her infant. This research was supported by the Wellcome Trust no. We are grateful to all the mothers who participated in the study.
We also thank Dr. Morten Kringelbach for helping with the matching of infant images. National Center for Biotechnology InformationU. Author information Article notes Copyright and License information Disclaimer. This article has been cited by other articles in PMC. Abstract Postnatal maternal depression is associated with difficulties in maternal responsiveness.
Postnatal depression, Cognitive bias, Baby face, Mother—child interaction. Introduction The early post Facial expression of mothers period is vital for the development of the early mother—child responsivity and the mother—child relationship.
Table 1 Demographics and screening characteristics Facial expression of mothers group. Control Anxiety Depression Statistics Mother age in years Open in a separate window.
The EPDS consists of 10 questions specifically designed for screening postnatal depression avoiding the confounds between depression symptoms and complaints typical in early motherhood. It includes questions about the nature of worry, the topics of worry, the somatic symptoms of GAD, and the amount of impairment that worry is causing in the respondent's life.
Evidence of reliability and validity has been extensively reported First et al. Overview of data analysis Distributions of average appraisal score in each facial expression and in each length were examined and all met criteria for normality.