Testing a Developmental Cascade Model from Prenatal Maternal Emotion Dysregulation to Toddler Behavior Dysregulation Through Postnatal Parenting Stress and Infant Physiology.

OBJECTIVE: Early behavioral dysregulation places children at elevated risk for later psychopathology. Maternal emotion dysregulation during pregnancy is a transdiagnostic vulnerability that may shape child regulatory development through both prenatal biological influences and postnatal caregiving. However, less is known about the specific postnatal mechanisms through which prenatal emotion dysregulation confers risk for toddler behavioral dysregulation. This study examined whether prenatal maternal emotion dysregulation was associated with toddler behavioral dysregulation indirectly through infant parasympathetic regulation (baseline respiratory sinus arrhythmia; RSA) and postnatal parenting stress. METHODS: Participants were 385 mothers and their infants recruited during the third trimester. At the third trimester, maternal emotion dysregulation was assessed using the Difficulties in Emotion Regulation Scale. At 7 months postpartum, parenting stress was measured using the Parenting Stress Index, and infant parasympathetic regulation was assessed using baseline RSA during a neutral resting period. At 18 months, toddler behavioral dysregulation was evaluated using the Infant-Toddler Social Emotional Assessment. We tested direct and indirect pathways among prenatal maternal emotion dysregulation, postnatal parenting stress, infant baseline RSA, and toddler behavioral dysregulation with structural equation models. RESULTS: Higher prenatal maternal emotion dysregulation was associated with greater postnatal parenting stress and lower infant baseline RSA. Postnatal parenting stress was concurrently associated with higher infant baseline RSA and higher toddler behavioral dysregulation. Infant RSA was not directly associated with toddler behavioral dysregulation. Parenting stress partially accounted for associations between prenatal maternal emotion dysregulation and toddler behavioral outcomes. CONCLUSION: This study provides evidence for prospective indirect pathways in which maternal emotion dysregulation during pregnancy contributes to elevated parenting stress in infancy, which is linked to both infant parasympathetic regulation and toddler behavioral dysregulation. Although prenatal maternal emotion dysregulation was associated with infant baseline RSA, infant RSA was not associated with toddler dysregulation, suggesting partly distinct pathways of physiological and behavioral regulation development. These findings highlight pregnancy and infancy as important periods in early child development.

Duke Scholars

Author Elisabeth D Conradt Psychiatry, Child & Family Mental Health & Community Psychia ...