Good for mom, good for baby: Treating post-partum depression with group CBT may help infants regulate emotions

When mothers of newborns get cognitive behavioural therapy (CBT) for post-partum depression, their infants show improvements in physiological markers of emotional regulation, results from a trial by researchers at McMaster University suggest. “This is the first time that anyone has shown in a randomized controlled trial—the strongest study design possible in humans—that treating mothers with an inexpensive, scalable talking therapy (CBT) can lead to adaptive changes in infant brain functioning,” said Dr. Ryan Van Lieshout, senior author of the study and associate professor of the department of psychiatry and behavioural neurosciences at McMaster University and Canada Research Chair in Perinatal Mental Health. The study also found that CBT delivered in group sessions by peers (other people who had recovered from post-partum depression) was effective in reducing symptoms of post-partum depression. Indeed, the earlier CBT is delivered the better, as mothers who got treatment immediately had better outcomes, as did their infants, than those who had to wait. Post-partum depression affects one in five new mothers and birthing parents, and research has shown it impacts their offspring’s ability to regulate emotions. Treating the parents’ post-partum depression could reduce the children’s risk of future psychiatric problems, the researchers suggest. “The development of emotion regulation is largely shaped by maternal interactions early in life and infants depend on continuous exchanges with caregivers to regulate any emotional distress,” Dr. Van Lieshout said in a press release. “The constant give-and-take between parents and infants forms the foundation of their future self-regulatory capacity beyond infancy.” “Early problems with emotion regulation are very important because they are involved in the development of almost all kinds of mental health problems later in life,” he said. Read: Ontario to expand list of tests midwives can order; midwives say it's a first step The researchers randomized 73 mother-infant pairs to either receive CBT at enrollment or be put on a waiting list to receive it nine weeks later. Each group had weekly two-hour-long group CBT sessions for nine weeks. The sessions took place between 2018 and 2020 and were led by trained people who had recovered from post-partum depression. To measure the infants’ capacity to regulate emotions, the researchers used ECG to record high-frequency heart rate variability (HF-HRV). Previous studies suggest HF-HRV can be used as a marker for infant emotion regulation capacity. It may reflect how well the parasympathetic nervous system can adapt and provides an indication of how well infants respond physiologically to stressors, Dr. Van Lieshout and colleagues note in their study. The researchers also used EEG to measure frontal alpha asymmetry (FAA), the relative activity between the right and left frontal areas of the brain. Some researchers think this reflects the infant’s motivation to approach or withdraw from a situation. Previous studies found that infants who have parents suffering from post-partum depression tend to have lower HR-HRV and greater right FAA at rest. Both predict poor emotion regulation and increased risk of psychiatric problems as they age. In the recent trial conducted by Dr. Van Lieshout and colleagues, mothers who had CBT immediately had clinically significant decrease in post-partum depression symptoms after the sessions. Infants of those mothers had significantly more adaptive changes in the markers of emotional regulation (HF-HRV and FAA) compared to infants with mothers on the waitlist. There were no differences in infants’ temperament between the two groups. The results support previous work by the same group, which found that infants of mothers with post-partum depression showed improvement in HF-HRV and FAA measures after nine weeks of CBT compared to baseline. While the study results hint that delivering CBT to mothers may lead to reduced risk of future psychiatric problems in their infants, a larger study is still needed, the researchers concluded. The study was published as a peer-reviewed pre-proof in the Journal of Affective Disorders in June. Read: One-day virtual workshop developed to treat postpartum depression

Good for mom, good for baby: Treating post-partum depression with group CBT may help infants regulate emotions

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