Emotion dysregulation during pregnancy mediates the association between interpersonal trauma and postpartum bonding difficulties

• In Event: Poster Session 07
  In Poster Session: PS 07 Topic - Family Context & Processes

Abstract

Postpartum bonding difficulties are longitudinally associated with dysfunctional parent-child interactions, difficult child temperament, and impairments in child socioemotional and cognitive development (Mason et al., 2011; de Cock et al., 2016). Maternal experiences of interpersonal trauma, such as childhood maltreatment (CM) and intimate partner violence (IPV), may result in emotion dysregulation, thus posing a risk to healthy mother-infant bonding (Erickson et al., 2019). For example, mothers with emotion regulation difficulties were less competent at recognizing infant’s mental states (Schultheis et al., 2019), and mothers with lower basal respiratory sinus arrhythmia (RSA), a physiological marker of inflexible emotional responding, exhibited less sensitivity toward their 3-month-old infants (Joosen et al., 2013). However, few studies have examined whether maternal emotion dysregulation during the prenatal period serves as a mechanism linking maternal trauma experiences to postpartum bonding outcomes—a direction which could help to identify mothers at risk for bonding difficulties. In the present study, maternal self-report and resting RSA were used to measure emotion dysregulation in the third trimester of pregnancy. We hypothesized that self-reported emotion dysregulation and lower resting RSA would mediate the effects of past (CM) and recent (pregnancy IPV) interpersonal trauma on postpartum bonding difficulties.
Participants were 358 women from an ongoing longitudinal study. The sample was racially and socioeconomically diverse. Participants reported on CM and IPV during pregnancy. Measures of emotion dysregulation including self-report (DERS; Gratz & Roemer, 2004) and resting RSA were collected in the 32-34th week of pregnancy. Bonding was assessed one month postpartum via the Postpartum Bonding Questionnaire (Brockington et al., 2001). A saturated mediational path analysis was specified, and indirect effects were tested using percentile bootstrapping (Falk, 2018). Standardized estimates are presented in Figure 1. CM positively predicted self-reported emotion dysregulation (b = .25, p < .01) as did pregnancy IPV (b = .24, p = .01). There were no significant paths between interpersonal traumas and resting RSA. Self-reported emotion dysregulation in the third trimester predicted greater postpartum bonding difficulties (b = .08, p = .02). The indirect effects of both CM and IPV on bonding through self-reported emotion dysregulation were statistically significant (CM: 95% CI [.002, .040]; IPV: 95% CI [.001, .043]). Indirect effects of CM and IPV on bonding through RSA were non-significant.
Results suggest that expectant mothers with past and recent experiences of interpersonal trauma report more difficulty regulating emotions, which contributed to bonding difficulties in the early postpartum period. Resting RSA, though significantly correlated with self-reported emotion dysregulation in the expected direction, was not a significant mediator of bonding. It may be that RSA reactivity to infant cues, rather than baseline level, is a better predictor of mother-infant bonding (e.g., Leerkes et al., 2015; Ablow et al., 2013). Our results provide further evidence that women exposed to interpersonal trauma are at increased risk for bonding difficulties, and screening for trauma/emotion regulation during prenatal care is warranted. Interventions that improve emotion regulation in the perinatal period have the potential to disrupt the intergenerational transmission of trauma.

Authors

• Kara Cochran, Michigan State University
  Presenting Author

• G. Anne Bogat, Michigan State University
  Non-Presenting Author

• Alytia Akiko Levendosky, Michigan State University
  Non-Presenting Author

• Joseph S. Lonstein, Michigan State University
  Non-Presenting Author

• Amy K. Nuttall, Michigan State University
  Non-Presenting Author

• Maria Muzik, University of Michigan - Ann Arbor
  Non-Presenting Author