Six-week postpartum maternal depressive symptoms and 4-month mother-infant self- and interactive contingency

Infant Ment Health J. 2008 Sep;29(5):442-471. doi: 10.1002/imhj.20191.

Abstract

Associations of 6-week maternal depressive symptoms [Center for Epidemiological Studies Depression Scale (CES-D)] with 4-month mother-infant self- and interactive contingency patterns during face-to-face play were investigated in 132 dyads. Self- and interactive contingency (auto- and lagged cross-correlation, respectively) were assessed by multilevel time-series analysis. Infant and mother gaze, facial and vocal affect, touch, and spatial orientation behaviors were coded second-by-second from split-screen videotape, and a multimodal measure of facial-visual "engagement" was constructed, generating nine modality pairings. With higher CES-D, the self-contingency of both partners was lowered in most modalities. With higher CES-D, interactive contingency values were both heightened (in some modalities) and lowered (in others), varying by partner. These results are consistent with an optimal midrange model. With higher CES-D, interactive contingency showed the following patterns: (a) Mothers and their infants had a reciprocal orientational sensitivity; (b) mothers and infants manifested a reciprocal intermodal discordance in attention versus affect coordination, lowering gaze coordination, but heightening affective coordination; (c) infants heightened, but mothers lowered, touch coordination with partner touch-an "infant approach-mother withdraw" touch pattern. Nonlinear analyses indicated that altered self- and interactive contingency were similar at both the low ("denial") as well as the high ("endorsement") poles of depressive symptoms, in half the findings. These complex, multimodal findings define different aspects of communication disturbance, with relevance for therapeutic intervention.