Effects of maternal trauma and associated psychopathology on atypical maternal behavior and infant social withdrawal six months postpartum

ABSTRACT

Maternal psychopathology given a history of maltreatment and domestic violence exposure increases the risk for child psychopathology. Infant social withdrawal is one warning sign of adverse developmental outcomes including child anxiety and depression. It remains unclear how maternal trauma-related psychopathology might affect infant social withdrawal six-months postpartum. Methods: One-hundred ninety-five women and their six-month-old infants were studied in an at-risk community sample. Maternal trauma history, posttraumatic stress (PTSD) and major depressive (MDD) disorders were assessed. Maternal and infant behaviors were coded from videotaped interactions. Results: Maternal trauma was correlated with atypical maternal behavior (AMB) and infant social withdrawal (p ≤ .001). PTSD and MDD, and comorbid PTSD/MDD predicted increased AMB (p ≤ .001) but only maternal MDD was predictive of infant social withdrawal (p ≤ .001). Effects of maternal MDD on infant withdrawal were mediated by AMB. Conclusions: At six-months postpartum, maternal MDD was associated with infant withdrawal. AMB is an important target for early intervention.

KEYWORDS:

• Maternal trauma
• maternal depression
• maternal PTSD
• atypical maternal behavior
• infant behavior

Acknowledgments

We thank Elisa T. Bronfman, PhD, at the Department of Psychiatry, Harvard Medical School, for her substantial assistance in the preparation of the article. We also extend thanks to Peter Catapano, DDS, in the Department of Pediatrics for his support and special thanks to Prof. F. Xavier Castellanos in the Department of Child & Adolescent Psychiatry at the NYU Grossman School of Medicine for his guidance and help in bringing together the co-authors and in inspiring the completion of the resulting paper.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by the Academic Pediatric Association and the Maternal and Child Health Bureau, U.S. Department of Health Resources and Services Administration (Bright Futures Young Investigator Award), the Department of Health, New York State (Empire Clinical Research Investigator Grant), and the National Institutes for Health Postdoctoral training Grant Developmental Neuroscience (T32MH018264) to the first author (N.B.); by Grant UL1 TR000038 from the National Center for the Advancement of Translational Science, National Institutes of Health, and by funding to the senior author (D.S.S.), from the Swiss National Science Foundation NCCR-SYNAPSY grant (n° 51AU40_125759); by the Alicia Koplowitz Foundation (Spain), and by the Timothy and Michele Barakett Foundation via the New York University (NYU) Department of Child & Adolescent Psychiatry.