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BACKGROUND: Posttraumatic stress disorder (PTSD) is linked with dysfunction in neural circuitry supporting threat reactivity (amygdala, insula) and emotion regulation (ventromedial prefrontal cortexvmPFC). These same regions are activated in response to infant cues and associated with sensitive parenting, crucial for positive child outcomes, and potentially disrupted in the context of maternal posttraumatic stress symptoms (PTSS). Intergenerational transmission of PTSD risk has been demonstrated, yet the neural correlates of maternal PTSS to infant distress remain untested. METHODS: Trauma-exposed mothers completed the PTSD Checklist for DSM-5 and a caregiving interaction coded for maternal sensitivity. Functional MRI was conducted during an infant cry task (n=77) at 8-12 weeks postpartum and at 10-12 months (n = 31). Whole-brain and region-of-interest analyses examined associations between PTSS and activation to mothers' own infant cries versus control sounds. RESULTS: Mothers with higher PTSS showed decreased activation to own infant cry in salience (insula, amygdala, hypothalamus), and regulatory (vmPFC, superior medial frontal gyrus) regions. Lower insula activation was related to lower maternal sensitivity. Improvements in PTSS across the first year postpartum correlated with increases in right amygdala activation. CONCLUSIONS: Elevated maternal PTSS was linked with blunted neural responses in regions critical for threat detection, processing infant emotional cues, and supporting sensitive caregiving. Exploratory longitudinal findings demonstrate malleable amygdala reactivity across the postpartum period. These results provide novel evidence for neural mechanisms underlying maternal PTSS and caregiving in postpartum women.
Lipschutz et al. (Wed,) studied this question.