Parent-child intervention decreases stress and increases maternal brain activity and connectivity during own baby-cry: An exploratory study

Abstract

Parental responses to their children are crucially influenced by stress. However, brain-based mechanistic understanding of the adverse effects of parenting stress and benefits of therapeutic interventions is lacking. We studied maternal brain responses to salient child signals as a function of Mom Power (MP), an attachment-based parenting intervention established to decrease maternal distress. Twenty-nine mothers underwent two functional magnetic resonance imaging brain scans during a baby-cry task designed to solicit maternal responses to child's or self's distress signals. Between scans, mothers were pseudorandomly assigned to either MP (n = 14) or control (n = 15) with groups balanced for depression. Compared to control, MP decreased parenting stress and increased child-focused responses in social brain areas highlighted by the precuneus and its functional connectivity with subgenual anterior cingulate cortex, which are key components of reflective self-awareness and decision-making neurocircuitry. Furthermore, over 13 weeks, reduction in parenting stress was related to increasing child- versus self-focused baby-cry responses in amygdala-temporal pole functional connectivity, which may mediate maternal ability to take her child's perspective. Although replication in larger samples is needed, the results of this first parental-brain intervention study demonstrate robust stress-related brain circuits for maternal care that can be modulated by psychotherapy.

Figures

Figure 1.

The baby-cry task design. See the Method section for details.

Figure 2.

Mom Power (MP) parenting treatment (vs. control group) decreased parenting stress, especially in mothers with depression. Mothers were grouped according to whether they were depressed or not depressed (filled for depressed, open for nondepressed) and whether they received 12-week MP treatment or control (squares for MP, circles for control). MP intervention goals involve group psychoeducation sessions aimed at increasing stress coping skills and reflective capacity toward sensitive parenting.

Figure 3.

(Color online) (a) Generic baby-cry versus noise, (b) own baby-cry versus generic baby-cry, (c) self baby-cry versus generic baby-cry,(d) own baby-cry > self baby-cry, (e) self baby-cry > own baby-cry.

Figure 3.

(Color online) (a) Generic baby-cry versus noise, (b) own baby-cry versus generic baby-cry, (c) self baby-cry versus generic baby-cry,(d) own baby-cry > self baby-cry, (e) self baby-cry > own baby-cry.

Figure 3.

(Color online) (a) Generic baby-cry versus noise, (b) own baby-cry versus generic baby-cry, (c) self baby-cry versus generic baby-cry,(d) own baby-cry > self baby-cry, (e) self baby-cry > own baby-cry.

Figure 4.

(Color online) (a) Brain image highlighting precuneus region, which showed increased own baby-cry versus generic baby-cry activity with Mom Power (MP) parenting intervention and was also used for further functional connectivity analysis. (b) MP treatment (vs. control group) increased own baby-cry versus generic baby-cry response in the precuneus. Mothers were grouped according to whether they were depressed (filled for depressed, open for nondepressed) and whether they received MP (squares for MP, circles for control).

Figure 5.

(Color online) Time 2–Time 1 change in brain response. (a) Generic baby-cry versus noise directly associated with change in Parenting Stress Index total score (dPSI). (b) Own baby-cry versus generic baby-cry inversely associated with dPSI. (c) Self baby-cry versus generic baby-cry inversely associated with dPSI.

Figure 6.

(Color online) (a) Mom Power (MP) parenting intervention versus control increased differential functional connectivity between the precuneus (as the seed) and subgenual anterior cingulate cortex in the own baby-cry versus self baby-cry contrast (care for own baby vs. preoccupation with self. (b) MP treatment (vs. control group) increased the functional connectivity between the precuneus (seed) and the subgenual anterior cingulate cortex. Mothers were grouped according to whether they were depressed (filled for depressed, open for nondepressed) and whether they received MP (squares for MP, circles for control).

Figure 7.

(Color online) Time 2–Time 1 change in task-dependent functional connectivity (generalized psychological-physiological interaction analysis) with precuneus. (a) Generic baby-cry versus noise directly associated with change in PSI total score (dPSI). (b) Own baby-cry versus generic baby-cry inversely associated with dPSI. (c) Own baby-cry versus self baby-cry inversely associated with dPSI.

Figure 8.

(Color online) Time 2–Time 1 change in task-dependent functional connectivity (generalized psychological-physiological interaction analysis) with left amygdala. (a) Generic baby-cry versus noise directly associated with change in PSI total score (dPSI). (b) Brain image highlighting the Time 2–Time 1 change in own baby-cry versus self baby-cry differential functional connectivity between the left amygdala seed (blue online only) and the temporal pole (red online only) that was associated with the Time 2–Time 1 reduction in parenting stress (dPSI).(c) Parenting stress is decreased with functional coupling between amygdala and temporal pole for own versus self baby-cry that increases over time. Scatterplot of the reduction in PSI (dPSI) on the x-axis and increase in amygdala–temporal pole’s own baby-cry versus self baby-cry differential functional coupling strength (y axis) from Time 1 to Time 2. Mothers were grouped according to whether they were depressed or not depressed (filled for depressed, open for nondepressed) and whether they received MP (squares for MP, circles for control). Of note, all mothers who showed increased own versus self baby-cry functional connectivity had a reduction in parenting stress over time (green shading online only), and none of those who decreased this differential functional connectivity reported reduced parenting stress over time (red shading online only).