Transcript Assessing the Impact of Perinatal PTSD on Infant

Assessing the Impact of Perinatal PTSD on Infant Attentional Focusing
and Low-Intensity Pleasure
Rejina Daniel1, Zaneb Akbar1, Sharmila Amirthalingam1, Jackie Finik,1 Jessica Buthman 1 , Benjamin Reissman 1, and Yoko Nomura,1,2
1Department
of Psychology, Queens College, City University of New York, 65-30 Kissena Blvd Flushing NY 11367.
2 Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029
Abstract
Results
Objective: To examine the impact of Perinatal Post Traumatic Stress Disorder (PTSD)
on aspects of infant temperament, specifically infant reactivity at 24 months of age.
Background: Perinatal PTSD, a postpartum anxiety disorder, is often triggered by
complications at delivery, low social support, and previous trauma or abuse.1 Current
research suggests that infant emotional regulation and reactivity is learned from
caretakers, and maternal psychopathology may impact this learning.3
Method: Presence or absence of Perinatal PTSD was assessed by the Perinatal PTSD
Questionnaire. Participating mothers also completed the Infant Behavior QuestionnaireRevised (IBQ-R) to report their infant’s behavior at 24 months of age.
Results: Attentional Focusing (p=.018) and Low-Intensity Pleasure (p=.002)
temperament scores were significantly different between infants born to mothers with
Perinatal PTSD, as compared to those born to mothers without.
Conclusion: Perinatal PTSD has a significant adverse effect on infant temperament in
areas of Attentional Focusing and Low-Intensity Pleasure.
• Attentional Focusing (p=.018) and Low-Intensity Pleasure (p=.002) temperament
scores were significantly different in infants born to mothers with Perinatal PTSD, as
compared to infants born to mothers without Perinatal PTSD.
Measures
Discussion
Sample Population: 92 pregnant women (n=92) receiving prenatal care at Mt. Sinai
Hospital and New York-Presbyterian Queens in New York City were recruited to
participate in a longitudinal study of pregnancy (SIP Study, P.I. Yoko Nomura).
Measures:
• At 6 months postpartum, participants were given the Perinatal PTSD
questionnaire which determined the presence or absence of Perinatal PTSD.
•At 24 months postpartum, participants were also given the Infant Behavior
Questionnaire-Revised (IBQ-R), which prompted mothers to rate their infant’s
temperament and behavior along 18 scales (Activity Level, Distress to Limitations,
Fear, Duration of Orienting, Smiling and Laughter, High Pleasure, Low Pleasure,
Soothability, Falling Reactivity, Cuddliness, Perceptual Sensitivity, Sadness,
Approach and Vocal Reactivity).
Data Analysis:
• The impact of Perinatal PTSD on infant temperament scores was tested using an
Independent t-Test. A positive score of 6 or more items in the 14 item Perinatal PTSD
questionnaire determined the presence or absence of Perinatal PTSD.
Acknowledgements
-Thank you to the families who participated in this study and to the entire team at the Mt. Sinai
Hospital and New York-Presbyterian Queens OB/GYN Clinic and Labor and Delivery Floor.
-This study is funded by the NIMH (K01MH080062, R01MH102729).
• The present study found a significant association between Perinatal PTSD and lower
mean scores of attentional focusing (ability to shift attention from one stimulus to
another) and low-intensity pleasure (degree of enjoyment derived from a low-intensity
stimulus). These two scales are categorized under the general factor of effortful
control.
• Previous studies have likened effortful control to self control of action inhibition and
activation. Effortful control has been proposed to develop rapidly in children from ages
2 to 7 due to the development of the executive attention system.5
• PTSD is marked by risk factors such as regulation of attention, response inhibition,
and dysfunction in the dorsal prefrontal network.3 An fMRI study examining
hyperactivity in emotional processing networks (observed in PTSD) found
corresponding hypoactivity in a dorsal executive function processing network.5
• Future studies can better relate the clinical profile of mothers with perinatal PTSD to
attentional deficits in children using neuropsychological and neuroimaging methods.
References:
1Andersen LB, Melvaer LB, Videbech P, Lamont RF, Joergensen JS. Risk factors for developing post-traumatic stress disorder following childbirth: a systematic review.
Acta Obstet Gynecol Scand 2012;91: 1261–1272.
2Aupperle, R. L., Melrose, A. J., Stein, M. B., & Paulus, M. P. (2012). Executive function and PTSD: Disengaging from trauma. Neuropharmacology, 62(2), 686-694.
3Bosquet Enlow, Michelle, Robert L. Kitts, Emily Blood, Andrea Bizarro, Michelle Hofmeister, and Rosalind J. Wright. 2011. "Maternal posttraumatic stress symptoms and
infant emotional reactivity and emotion regulation." Infant Behavior & Development 34, no. 4: 487-503. Academic Search Complete, EBSCOhost
4Hayes, J. P., Vanelzakker, M. B., & Shin, L. M. (2012). Emotion and cognition interactions in PTSD: A review of neurocognitive and neuroimaging studies. Frontiers in Integrative
Neuroscience Front. Integr. Neurosci., 6.
5Rothbart, M. K. (2011). Becoming Who We Are: Temperament and Personality in Development. New York, NY: Guilford Press.