Attention Bias Study for Infants of Mothers with Depression

Overseen By Brandon E Gibb, Ph.D.

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Binghamton University

Disqualifiers: Alcohol, Substance use, Bipolar, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 5

225 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to study how infants of mothers with postpartum depression react to emotional facial expressions and how their level of arousal (alertness or excitement) might influence this response. Researchers will engage infants in simple tasks, such as looking at different faces (Interaction Task and Passive Viewing Task), to determine if a link exists between their responses and their mothers' mental health. Mothers who have experienced major depression since their baby's birth or have no history of depression can participate, and their full-term, healthy infants are eligible. As an unphased trial, this study offers a unique opportunity to contribute to understanding the early emotional development of infants.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this protocol is safe for infants?

Research has shown that both the Interaction Task and the Passive Viewing Task are safe for infants. These tasks are non-invasive, meaning they do not physically enter the body or cause harm.

The Interaction Task examines how mothers and babies interact, particularly when the mother has postpartum depression. Although depression can affect these interactions, the task itself is harmless. It simply observes how infants respond to their mothers and surroundings.

In the Passive Viewing Task, infants view different facial expressions, such as happy or neutral faces. This task uses eye tracking, a safe method that monitors where and how infants look at things. Similar tasks have been safely used in other studies with children and infants sitting on their mothers' laps.

Overall, both tasks are well-tolerated by infants, with no reports of negative effects from similar studies. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores new ways to understand and potentially help infants of mothers with depression. Unlike traditional treatment methods that focus on medication or adult therapy, this trial uses unique interaction and passive viewing tasks to observe how these infants process attention. This could reveal important insights about early development in a high-risk group, potentially leading to innovative, non-invasive interventions that support healthier emotional development from an early age.

What evidence suggests that this trial's treatments could be effective for infants of mothers with depression?

Research shows that babies of mothers with postpartum depression often react differently to emotional faces. One study found that a mother's depression can affect her baby's learning and social growth. Another study observed that babies with depressed mothers had different brain reactions when looking at their mother's face compared to other faces. These differences might arise because the mother's depression affects how she responds to and interacts with her baby. In this trial, all infants will participate in both the Interaction Task and Passive Viewing Task. These tasks could help researchers understand and address these attention differences in babies. ^{3 6 7 8 9}

Are You a Good Fit for This Trial?

This study is for infants born full-term and normal weight, without health problems. Their mothers are divided into two groups: one with no history of depression (low-risk group) and another who had major depressive disorder (MDD) after giving birth (high-risk group). Mothers must not have substance use disorders or a history of bipolar/psychotic disorders.

Inclusion Criteria

I have never been diagnosed with depression or any psychiatric condition.

I have had at least one episode of major depression since my baby was born.

My baby was born full-term, with normal weight, and no health issues.

Exclusion Criteria

Diagnoses of alcohol or substance use disorders currently or at any point during pregnancy

I have never been diagnosed with bipolar or psychotic disorders.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Infants complete a computer-based task viewing facial displays of emotion while an eye tracker records their gaze. Mother and infants complete a standardized interaction task assessing infant gaze and psychophysiology.

1 day

1 visit (in-person)

Follow-up

Participants are monitored for changes in eye gaze, heart rate, and respiratory sinus arrhythmia at 3-, 6-, 9-, and 12-month intervals.

12 months

4 visits (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Interaction Task
• Passive Viewing Task

Trial Overview The trial investigates how babies pay attention to emotional expressions, which might be influenced by their mother's postpartum depression. It involves observing the infants' reactions during tasks that include looking at faces and interacting with others.

How Is the Trial Designed?

Group I: Experimental protocol for all infants Experimental Treatment 2 Interventions

Who Is Running the Clinical Trial?

Binghamton University

Lead Sponsor

Trials

15

Recruited

2,900+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Published Research Related to This Trial

In a study involving 25 inpatient women with major depression and 25 matched controls, no significant differences were found in attention to or memory accuracy for emotional infant faces, suggesting that these biases may not be present in all individuals with depression.

However, in a second study with expecting parents, those with depressive symptoms showed a slower disengagement from sad infant faces, indicating a mood-congruent attentional bias that is linked to rumination, highlighting the importance of emotional context in cognitive processing related to depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Emotional Infant Face Processing in Women With Major Depression and Expecting Parents With Depressive Symptoms. Bohne, A., Nordahl, D., Lindahl, ÅAW., et al.[2021]

Infants of mothers with postpartum depression (PPD) showed fewer instances of high negative facial expressions and more neutral or interested expressions during interactions, indicating a potential impact on their emotional variability.

The study found that PPD diagnosis was linked to less vocal protest from infants, suggesting that these infants may struggle with self-regulation, as their emotional responses were more sustained rather than fleeting.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Maternal postpartum depression is a risk factor for infant emotional variability at 4 months. Vaever, MS., Pedersen, IE., Smith-Nielsen, J., et al.[2021]

In a study of 87 mother-infant pairs, it was found that infants as young as 6 months show an attentional bias towards angry facial expressions, which is influenced by their mothers' perceived stress levels.

Higher maternal stress was linked to a greater initial bias towards angry faces in infants, which decreased over time, suggesting that maternal stress can shape how infants respond to potential threats in their environment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Maternal stress and development of infant attention to threat-related facial expressions. Reilly, EB., Dickerson, KL., Pierce, LJ., et al.[2023]

In a study involving 123 youth aged 9-14, those with major depression showed a stronger negative attention bias towards sad faces compared to those at risk for depression and those with healthy parents, suggesting that this bias may play a role in maintaining depressive symptoms.

The findings indicate that while depressed youth focus more on negative emotional cues, this attention bias was not observed in the behavioral task, highlighting the complexity of emotional processing in youth depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Biased Maintenance of Attention on Sad Faces in Clinically Depressed Youth: An Eye-Tracking Study. Buhl, C., Sfärlea, A., Loechner, J., et al.[2023]

Children of mothers with a history of major depressive disorder (MDD) showed less attention to sad faces compared to children of mothers who have never been depressed, indicating a potential attention bias away from sadness.

This attention bias was not limited to sad faces; it was also observed for other emotional expressions, suggesting that the influence of maternal depression affects children's overall emotional attention, independent of current symptoms of depression or anxiety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Attentional biases in children of depressed mothers: An event-related potential (ERP) study. Gibb, BE., Pollak, SD., Hajcak, G., et al.[2022]

Depressed mothers showed less responsive and emotionally attuned interactions with their infants compared to nondepressed mothers, indicating potential challenges in maternal-infant bonding.

Despite these interaction differences, postnatal depression did not negatively impact infants' performance in cognitive assessments, suggesting that infants can still thrive even when their mothers are experiencing depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of postnatal depression on mother-infant interaction, infant response to the Still-face perturbation, and performance on an Instrumental Learning task. Stanley, C., Murray, L., Stein, A.[2019]

Infants at 8 months old showed heightened attention to fearful faces if their mothers had either decreasing or increasing depressive symptoms, indicating a potential impact of maternal mental health on infant emotional processing.

Overall, the general ability of infants to disengage attention from faces was not linked to maternal depressive symptoms, suggesting that specific emotional biases, like fear, may be more relevant than overall attentional disengagement.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Maternal Depressive Symptoms During the Pre- and Postnatal Periods and Infant Attention to Emotional Faces. Kataja, EL., Karlsson, L., Leppänen, JM., et al.[2021]

Infants of mothers with postpartum depression (PPD) showed less social engagement and more gaze aversion, indicating difficulties in emotional development and interaction, as observed in a study involving 971 women and detailed assessments of mother-infant interactions.

The study found that maternal depression chronicity negatively impacted infant emotional regulation, with lower social synchrony during interactions, suggesting that these subtle behaviors may contribute to the transmission of emotional challenges from mothers to their infants.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Maternal depression and anxiety, social synchrony, and infant regulation of negative and positive emotions. Granat, A., Gadassi, R., Gilboa-Schechtman, E., et al.[2018]

In a study of 39 participants, both citalopram and reboxetine improved how mothers appraised their infants' facial expressions, making them perceive positive emotions more favorably compared to a placebo group.

While the antidepressants positively influenced emotional appraisal, they did not affect attentional vigilance, suggesting that the benefits may specifically enhance mother-infant interactions rather than overall attention to infant emotions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of reboxetine and citalopram on appraisal of infant facial expressions and attentional biases. Stein, A., Murphy, S., Arteche, A., et al.[2021]

The study found that 5-7-year-old daughters of depressed mothers showed a significant attentional bias towards sad faces, indicating early signs of vulnerability to depression.

No similar biases were observed in sons of depressed mothers or children of non-depressed mothers, suggesting that these cognitive biases may be influenced by both maternal depression and the child's sex.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Attentional biases for emotional faces in young children of mothers with chronic or recurrent depression. Kujawa, AJ., Torpey, D., Kim, J., et al.[2021]

Children exposed to antidepressants in utero showed mixed results in motor development; while some aspects of sensorimotor skills improved compared to children of untreated depressed mothers, other measures were poorer, indicating inconsistent effects.

Specifically, higher doses of antidepressants were linked to poorer visuospatial processing outcomes, suggesting a need for further investigation into how antidepressant exposure during pregnancy may affect neonatal adaptation and subsequent motor development.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Antidepressant exposure in pregnancy and child sensorimotor and visuospatial development. Galbally, M., Watson, SJ., Spigset, O., et al.[2021]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4412485/

Interventions for postnatal depression assessing the mother ... The main aim of this paper was to conduct a systematic review and investigate effect sizes of interventions for PND, which assess the quality of the mother– ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC2724169/

Maternal depression and child development - PMC Depressed mothers are less likely to offer contingent stimulation to their infants (14), and this disrupts their performance on nonsocial learning tasks (15).

3. frontiersin.org frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2022.737513/full

Maternal Interaction With Infants Among Women at ... Mothers with severe depressive symptoms had significantly more “negative intrusiveness” and less “positive engagement” with their 6-month-old infants than women ...

4. journals.plos.org journals.plos.org/plosone/article?id=10.1371/journal.pone.0277762

Effects of maternal depression on maternal responsiveness ... Depression and anxiety can negatively impact individual mothers' responsiveness levels and infants' expressive language abilities.

5. sciencedirect.com sciencedirect.com/science/article/pii/S2666915321000524

The impact of postpartum depression and bonding ... A meta-analysis of 46 observation studies reported that maternal depressive symptoms increase the risk of poor parenting behaviors, including impatience, low ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC2819576/

Postpartum Depression Effects on Early Interactions ... In this paper studies are reviewed from the last decade on postpartum depression effects on early interactions, parenting, safety practices and on early ...

7. sciencedirect.com sciencedirect.com/science/article/pii/S0163638324000614

The influence of infant temperamental negative affect and ... Some researchers have found that maternal depression can negatively impact maternal SPE in mother-infant interactions (Mantis et al., 2019, Field, 1995).

8. mdpi.com mdpi.com/2227-9067/12/10/1323

Effects of Maternal Depression and Sensitivity on Infant ... Results: Clinically depressed mothers exhibited lower maternal sensitivity than nondepressed mothers. Infants of depressed mothers used adaptive ER strategies ...

9. withpower.com withpower.com/trial/phase-depression-10-2024-62abf

Attention Bias Study for Infants of Mothers with Depression This N/A medical study run by Binghamton University is evaluating whether Interaction Task and Passive Viewing Task will have tolerable side effects ...