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Maternal ratings of child behavior improve with treatment of maternal depression.

BACKGROUND AND OBJECTIVES: Maternal reports of child behavior are often the sole criterion by which childhood psychiatric disorders are diagnosed and treated, even though maternal distress or psychopathology may influence the accuracy of these reports. This study examines the effect of maternal depression and the impact of its treatment on reported behavior in the depressed women's children. METHODS: A total of 24 women with newly diagnosed major depressive disorder completed a self-rated Beck Depression Inventory (BDI) and a Conners' Parent Rating Scale (CPRS) of child behavior prior to and after 1-2 months of antidepressant treatment. RESULTS: During antidepressant treatment, mean maternal BDI declined by 53%, while mean CPRS score decreased by 20%; these improvements were significantly correlated. Changes in the conduct, learning problem, and impulsive-hyperactive CPRS-subscale scores accounted for 89% of the rated behavioral change. CONCLUSIONS: Reported behavior problems in the children of depressed mothers improved with treatment of the maternal depression, and the degree of reported behavioral improvement was highly correlated with the degree of improvement in depressive symptoms. Maternal depression must therefore be considered in the differential diagnosis of any child being evaluated for behavior or emotional problems.

Antidepressive Agents↗

Surveillance for disparities in maternal health-related behaviors--selected states, Pregnancy Risk Assessment Monitoring System (PRAMS), 2000-2001.

PROBLEM/CONDITION: Disparities in maternal and infant health have been observed among members of different racial and ethnic populations and persons of differing socioeconomic status. For the Healthy People 2010 objectives for maternal and child health to be achieved (US Department of Health and Human Services. Healthy People 2010. 2nd ed. With understanding and improving health and objectives for improving health [2 vols.]. Washington DC: US Department of Health and Human Services, 2000), the nature and extent of disparities in maternal behaviors that affect maternal or infant health should be understood. Identifying these disparities can assist public health authorities in developing policies and programs targeting persons at greatest risk for adverse health outcomes. REPORTING PERIOD COVERED: 2000-2001. DESCRIPTION OF THE SYSTEM: The Pregnancy Risk Assessment Monitoring System (PRAMS) is an ongoing state- and population-based surveillance system designed to monitor selected maternal behaviors and experiences that occur before, during, and after pregnancy among women who deliver live-born infants. PRAMS employs a mixed mode data-collection methodology; up to three self-administered surveys are mailed to a sample of mothers, and nonresponders are followed up with telephone interviews. Self-reported survey data are linked to selected birth certificate data and weighted for sample design, nonresponse, and noncoverage to create annual PRAMS analysis data sets that can be used to produce statewide estimates of different perinatal health behaviors and experiences among women delivering live infants in 31 states and New York City. This report summarizes data for 2000-2001 from eight states (Alabama, Colorado, Florida, Hawaii, Illinois, Maine, Nebraska, and North Carolina) on four behaviors (smoking during pregnancy, alcohol use during pregnancy, breastfeeding initiation, and use of the infant back sleep position) for which substantial health disparities have been identified previously. RESULTS: Although the prevalence of each behavior varied by state, consistent patterns were observed among the eight states by age, race, ethnicity, education, and income level. Overall, the prevalence of smoking during pregnancy ranged from 9.0% to 17.4%. Younger (aged <25 years) women, white women, American Indian women, non-Hispanic women (except in Hawaii), women with a high school education or less, and women with low incomes consistently reported the highest rates of smoking. Overall, the prevalence of alcohol use during pregnancy ranged from 3.4% to 9.9%. In seven states, women aged >35 years, non-Hispanic women, women with more than a high school education, and women with higher incomes reported the highest prevalence of alcohol use during pregnancy. Overall, the prevalence of breastfeeding initiation ranged from 54.8% to 89.6%. Younger women, black women, women with a high school education or less, and women with low incomes reported the lowest rates of breastfeeding initiation. The size of the black-white disparity in breastfeeding varied among states. Overall, use of the back sleep position for infants ranged from 49.7% to 74.8%. Use of the back sleep position was lowest among younger women, black women, women with lower levels of education, and women with low incomes. Ethnic differences in sleep position varied substantially by state. INTERPRETATION: PRAMS data can be used to identify racial, ethnic, and socioeconomic disparities in critical maternal health-related behaviors. Although similar general patterns by age, education, and income were observed in at least seven states, certain racial and ethnic disparities varied by state. Prevalence of the four behaviors among each population often varied by state, indicating the potential impact of state-specific policies and programs. PUBLIC HEALTH ACTION: States can use PRAMS data to identify populations at greatest risk for maternal behaviors that have negative consequences for maternal and infant health and to develop policies and plan programs that target populations at high risk.sk. Although prevalence data cannot be used to identify causes or interventions to improve health outcomes, they do indicate the magnitude of disparities and identify populations that should be targeted for intervention. This report indicates a need for wider targeting than is often done. The results from this report can aid state and national agencies in creating more effective public health policies and programs. The data described in this report should serve as a baseline that states can use to measure the impact of policies and programs on eliminating these health disparities.

Female↗

Hypothalamic paraventricular nucleus modulates maternal aggression in rats: effects of ibotenic acid lesion and oxytocin antisense.

Central oxytocin (OT) appears to be crucial for maternal behavior. OT, through the parvocellular neurons of the hypothalamic paraventricular nucleus (PVN), can exert its physiological and behavioral effects by acting on OT receptors in nonpituitary projections of the PVN. The purpose of the present study was to analyze the role of the PVN and OT on maternal aggressive behavior in two different periods after delivery: on the fifth day (period of high aggressiveness) and on the eighteenth day postpartum (period of low aggressiveness). In the first experiment, ibotenic acid was injected into the PVN in order to lesion the parvocellular neurons. A second experiment was designed to study more specifically the effects of OT using the antisense technique. On the fifth day postpartum, both the PVN lesion by the ibotenic acid and a possible acute reduction of OT synthesis by the antisense administration in that nucleus increased maternal aggressive behavior, while on the eighteenth day postpartum no effect was recorded. We may conclude that central projections of the PVN modulate maternal aggression during a restricted period after delivery, only when lactating females show naturally high levels of aggressive behaviors.

Aggression↗

Disruption of ongoing maternal responsiveness in rats by central administration of morphine sulfate.

The ability of central morphine administration to disrupt established maternal responsiveness in rats was examined. Studies focused on the direct administration of morphine sulfate (M) to the preoptic area (POA), a region known to be involved in the expression of maternal behavior in this species. In the first experiment, crystalline M was administered via bilateral 28 g cannulae to the POA or ventromedial hypothalamus (VMH) of 31 ovariectomized, estrogen-primed, nulliparous, pup-induced, maternal females. All subjects were tested twice for maternal responsiveness; once after M-filled cannulae and once after blank inserts were lowered into place. Behavioral tests lasted for 1 h after foster young were introduced into the test cage, and retrieval, grouping and crouching responses were recorded. Thirteen of 14 females with cannulae placements in the POA showed disruption of maternal responsiveness following morphine treatment. In contrast, only 4 of 17 females with VMH implants showed some deficit in maternal behavior following opiate administration. Results of a second experiment established that M-filled implants placed in the POA of lactating females were capable of disrupting the responsiveness of nursing females toward their own young. Finally, the specificity of morphine's central effects were examined in a third experiment in which lactating females received bilateral POA infusions of morphine (0.5 microgram, n = 7), dextrorphan (an inactive stereoisomer of an active opioid compound; 1.0 microgram, n = 7) or saline alone (n = 6). Whereas maternal behavior was disrupted in all morphine-treated subjects, infusions of dextrorphan or saline had no effect.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Blood pressure responses to feeding in infancy: spin-offs of serendipity.

This article summarizes results from a program of research that has focused on understanding the characteristics of, and factors that shape, acute cardiovascular responses to feeding in infants. The work developed from behavioral observations in rats suggesting a linkage between variations in maternal behavior and adult blood pressure. However, the hypothesis that specific types of interactions, in particular those associated with feeding, might alter cardiovascular function was greatly influenced by a serendipitous observation made by Myron Hofer several years earlier. Myron discovered that nutrient availability is a key regulator of cardiovascular function in newborn rats. Our spin-off studies established that, in newborn rats and human infants, ingestion of nutrient is associated with robust increases in heart rate and blood pressure.

Adult↗

Prenatal exposure to ethinylestradiol elicits behavioral abnormalities in the rat.

Pregnant rats were i.p. injected with a solution of 17alpha-ethinylestradiol (15 microg kg(-1)) every day between day 9 and day 14 of pregnancy and the behavior of the offspring was compared to that of rats born from dams injected with the vehicle only during the same gestational period. The percentage of neonatal death was dramatically high in the prenatally treated group. Growth of the surviving animals was even better than that of controls, but when adult, they exhibited a number of behavioral abnormalities: increased spontaneous motor activity, decreased exploratory behavior, impaired cognitive processing, qualitatively different exploratory drive, and/or persevering behavior, increased anxiety-like behavior and social neophobia. These behavioral alterations, which resemble a number of psychiatric syndromes, suggest that ethinylestradiol altered the ontogenesis of different parts of the central nervous system involved in cognitive and emotional processes. However, it cannot be excluded that the changes in behavior of ethinylestradiol exposed offspring were due to the abnormal maternal behavior of the estradiol treated dams.

Animals↗

Behavioral mechanisms for active maternal potentiation of isolation calling in rat pups.

The ultrasonic vocalization (USV) response of the isolated infant rat is a promising model for studying the neurobiology of an early anxiety state, and potentiation of the USV response after brief maternal encounters is a newly discovered behavioral regulator of this state. Using experimental variations in the contexts and patterns of maternal behavior during pup encounters and manual simulations of maternal behavior, we have identified several specific mother-pup interactions that cause potentiation. When one of these, pup carrying, was manually simulated, potentiation followed only if a characteristic postural transport response had been fully expressed by the pup. These behavioral mechanisms and other data suggest hypotheses for the development and adaptive role of maternal potentiation.

Animals↗

Social, ethical and practical aspects of perinatal substance use.

Substance use in pregnancy has garnered increasing attention over the last decade as a particularly concerning facet of the larger national drug problem. This concern stems from the unique circumstance presented by pregnancy, in which the fetus may suffer harm as a result of maternal behavior. Furthermore, organizing a response to this problem is complicated by the ethically and legally challenging nature of the maternal-fetal relationship. The medical implications of perinatal substance use are profound. A discussion of these associated medical and obstetrical complications lies outside the focus of this paper, and the reader is referred to other reviews (Andres & Jones, 1994; Robins & Mills, 1993). This article is intended to assist obstetricians and others in their approach to the substance using pregnant patient. We first review the scope of this problem in social and financial terms and then review the important ethical and legal issues involved in current policymaking. Lastly, we suggest a clinical intervention focusing on education and improvement in identification and management of this subset of patients.

Adolescent↗

The impact of physical or sexual abuse on chronic depression in adolescent mothers.

This longitudinal investigation explored the impact of a childhood history of physical and sexual abuse on perinatal depressive symptomatology, suicide attempts, and maternal behavior in an ethnically diverse sample of 95 adolescent mothers. Maternal role attainment theory and the cognitive-interpersonal theory of depression provided the conceptual framework for this study. This investigation helps to expand theory on adolescent maternal role attainment by identifying a relationship between history of abuse, depressive symptoms over time, and maternal role behavior problems. Findings do not indicate that a history of childhood maltreatment alone increases a young mother's risk for maternal-child interaction problems.

Adolescent↗

Molecular approaches to aggregation behavior and social attachment.

In many animal species individuals aggregate to live in groups. A range of experimental approaches in different animals, including studies of social feeding in nematodes, maternal behavior in rats and sheep, and pair-bonding in voles, are providing insights into the neural bases for these behaviors. These studies are delineating multiple neural circuits and gene networks in the brain that interact in ways that are as yet poorly understood to coordinate social behavior.

Animals↗

Importance of vaginocervical stimulation for the formation of maternal bonding in primiparous and multiparous parturient ewes.

The importance of vaginocervical stimulation for the formation of the maternal bond between a ewe and its lambs was investigated by studying the ability of artificial mechanical vaginocervical stimulation to induce adoption of an alien lamb after the selective bond with the ewe's own lambs had been formed. Results showed that for both multiparous and primiparous ewes, 5 min of mechanical VCS (using a hand) was effective in inducing complete acceptance of an alien lamb (6-48 h old) between 6.5 and 7.5 h postpartum in the majority of animals (8/10 multiparous, 8/9 primiparous) without interfering with the bond between the ewe and its own lambs. In a second group of multiparous animals, 6 out of 7 animals were also induced to completely accept an alien lamb between 26.5 and 27.5 h postpartum. It was found that the most critical aspect of the VCS was pressure on, and stretching the neck of, the cervix. Results show that VCS is not only important for the stimulation of maternal behavior, but also for the formation of the selective maternal bond. The ability of VCS to trigger the formation of a new maternal bond extends for at least 27.5 h post-partum.

Animals↗

Maternal programming of defensive responses through sustained effects on gene expression.

There are profound maternal effects on individual differences in defensive responses and reproductive strategies in species ranging literally from plants to insects to birds. Maternal effects commonly reflect the quality of the environment and are most likely mediated by the quality of the maternal provision (egg, propagule, etc.), which in turn determines growth rates and adult phenotype. In this paper we review data from the rat that suggest comparable forms of maternal effects on defensive responses stress, which are mediated by the effects of variations in maternal behavior on gene expression. Under conditions of environmental adversity maternal effects enhance the capacity for defensive responses in the offspring. In mammals, these effects appear to 'program' emotional, cognitive and endocrine systems towards increased sensitivity to adversity. In environments with an increased level of adversity, such effects can be considered adaptive, enhancing the probability of offspring survival to sexual maturity; the cost is that of an increased risk for multiple forms of pathology in later life.

Adaptation, Psychological↗

A clinical assessment strategy for maternal acquaintance-attachment behaviors.

The Acquaintance-Attachment Assessment Strategy for Maternal Behaviors (AASMB) is a strategy for assessing maternal attachment in the clinical area. The strategy is based on an eclectic conceptual framework and reflects the progressional nature of the attachment process. A review of the literature summarizes the phases of the attachment process--acquaintance, attachment, and bonding--and the maternal behaviors associated with each phase. The acquaintance and attachment phases are found during the first year of the infant's life and are of interest to the nurse who is assessing the maternal-infant relationship. These phases form the basis for constructing the Opportunity and Proximity-Seeking subscales of the AASMB. The AASMB can be easily utilized by nurses in clinical settings to assess mother-infant dyads for which early maternal-infant separation during the first year is common, such as occurs with premature or ill infants.

Age Factors↗

Mother-child interactions in ADHD and comparison boys: relationships with overt and covert externalizing behavior.

Reciprocal relationships between child characteristics and such familial factors as parental psychopathology and interaction style with the child characterize the development and maintenance of attention-deficit hyperactivity disorder (ADHD) as well as its comorbidity with antisocial behavior. Our goal was to ascertain the ability of negative maternal behavior exhibited during mother-son interactions to predict independently observed overt and covert externalizing behavior in the child, controlling for current maternal symptomatology and the boy's acting out behavior during the interaction. Participants were 49 boys with ADHD and 37 comparison boys, aged 6 to 12 years. Hierarchical multiple-regression analyses revealed that, even with maternal psychopathology and child negativity with the mother partialed, maternal negative behaviors predicted both observed noncompliance exhibited in class and play settings and laboratory stealing. Stealing was predicted from maternal negativity even with child interactional compliance controlled. Differential predictions of noncompliance were revealed in ADHD versus comparison families, yet similar patterns emerged for stealing within each group. Results are discussed in light of the high risk for antisocial behavior in ADHD children.

Acting Out↗

Proximate regulation by mothers: a demonstration of how differing styles affect young children's behavior.

An earlier observational study of mothers and toddlers in the supermarket revealed differential success of 2 styles of maternal behavior. A proactive style of preempting opportunities for misbehavior, in contrast to a reactive style of responding only after misbehavior occurred, was correlated with a lower incidence of undesirable child acts. Here, the 2 styles were studied in the laboratory to explore their function further. In an analog of the supermarket situation, mothers behaved proactively and reactively in trials in which the task was to prevent their 2- or 3-year-old children from playing with desirable toys. Children responded to proactive behavior by engaging in acceptable behaviors longer and by violating fewer rules. The 2-year-old children were less able to comply with the rules. The data illustrate the role parents play in promoting and supporting the development of compliance and self-regulation in children.

Attention↗

Effects of prenatal testosterone on sex and age differences in behavior elicited by stimulus pups in the rat.

From Days 14 to 19, pregnant Wistar rats were treated with either 2 mg of testosterone propionate (TP) or vehicle. Thirty-, 60-, and 90-day-old offspring were tested individually during 15 min daily on 4 days with a stimulus litter, and pup-oriented and non-pup-oriented behaviors were recorded. Sex differences in pup-oriented behaviors observed in oil groups were eliminated by TP treatment, which affected mainly females. Additionally, TP treatment increased the frequency of self-grooming and decreased the time spent near the pups and the frequency of sniffing and pawing only at 90-days of age. Hiding behavior only occurred at 30 days of age, while pawing near the pups and lying-down behavior was observed mainly in adults. Results show that sex differences in behavior are present before subjects become sensitized to show evident maternal behavior, and suggest that prenatal androgens play an important role in the manifestation of these sex differences and that its effects depend on developmental factors.

Animals↗

Studies on how early maternal separation produces behavioral change in young rats.

Previously published studies point to the behavioral interaction between the mother and her litter as the origin of the processes responsible for the behavioral hyperactivity following maternal separation in 2-week-old rats. The following experiments explore (1) the time course over which behavioral hyperactivity develops, (2) environmental and social determinants, (3) the role of sensory stimulation in the regulation of behavior and (4) the olfactory sensory system as a mediator of separation effects. The hypotheses supported best by the data are (1) that tactile and olfactory stimulation repeatedly provided by the mother act to reduce levels of behavioral arousal of the infants and (2) that maternal separation exerts its effect by withdrawal of this regulating influence, allowing a new level of behavioral arousal, more intrinsic to the infant, to be revealed.

Animals↗