Mothering revisited: A role for cortisol?

This selective review first describes the involvement of the maternal hypothalamic-pituitary-adrenal (HPA) axis during pregnancy and the postpartum period, and the relation between peripartum HPA axis function and maternal behavior, stress reactivity and emotional dysregulation in human mothers. To provide experimental background to this correlational work, where helpful, animal studies are also described. It then explores the association between HPA axis function in mothers and their infants, under ongoing non-stressful conditions and during stressful challenges, the moderating role of mothers' sensitivity and behavior in the mother-child co-regulation and the effects of more traumatic risk factors on these relations. The overarching theme being explored is that the HPA axis - albeit a system designed to function during periods of high stress and challenge - also functions to promote adaptation to more normative processes, shown in the new mother who experiences both high cortisol and enhanced attraction and attention to and recognition of, their infants and their cues. Hence the same HPA system shows positive relations with behavior at some time points and inverse ones at others. However, the literature is not uniform and results vary widely depending on the number, timing, place, and type of samplings and assessments, and, of course, the population being studied and, in the present context, the state, the stage, and the stress levels of mother and infant.

Influence of patient, caregiver, and family factors on unmet healthcare needs in children with drug-resistant epilepsy undergoing epilepsy surgery evaluation.

OBJECTIVE: The aim of this study was to assess whether patient, caregiver, and family factors correlate with unmet healthcare needs in children with drug-resistant epilepsy (DRE) who were evaluated for epilepsy surgery. METHODS: Caregivers of children with DRE completed questions on unmet healthcare needs, including physical and mental needs. Patient (demographic, seizure severity, and comorbidities), caregiver (sociodemographics, depression, and anxiety), and family (family functioning, resources, and demands) factors were evaluated. A series of bivariable regression was conducted to assess the associations with unmet needs (overall, physical, and mental needs), followed by multivariable regression. RESULTS: Of the 86 children with DRE, 32 (37.2%) reported having overall unmet healthcare needs, 21 (24.4%) have unmet physical, and 13 (15.1%) have unmet mental healthcare needs. Multivariable regression showed that the odds of overall unmet needs in children were higher in patients with higher depressive symptoms (odds ratio [OR] = 1.7, p = 0.03), and caregivers who were unemployed (OR = 3.8, p = 0.008). The odds of unmet physical needs in children were higher among patients with higher depressive symptoms (OR = 2.0, p = 0.02), caregivers who were older (OR = 1.1, p = 0.02), and caregivers who were unemployed (OR = 6.5, p = 0.008). There were no significant correlates between patient, caregiver, and family factors with unmet mental needs (all p > 0.05). INTERPRETATION: Children with DRE were at risk for not receiving needed healthcare. Patient factors such as patient depressive symptoms, and caregiver factors such as caregivers' age and employment status were associated with unmet needs. Identifying the predictors of unmet healthcare needs is a necessary step in addressing unmet needs in this population with DRE.

Exploring the morphological and emotional correlates of infant cuteness.

Ethologists have observed that "baby schema" or infant cuteness is an adaptive protective mechanism ensuring the young's survival. Past efforts to quantify cuteness have been restricted to line measurement techniques. We developed a novel data-driven approach to quantify infant cuteness into a single metric. Using the Psychomorph program, we delineated facial elements of 72 infant pictures using 206 facial points and identified the facial components that were significantly related to subjective cuteness perceptions of the faces. 108 nulliparous females rated the pictures on cuteness and emotional dimensions. We found that cuter infants have larger cephalic curvature compared to a smaller chin, a big smile, and round chubby features among others. We also investigated the relationship between cuteness and emotional responses. Our results show that a greater degree of cuteness elicits both increased positive emotional responses and decreased negative emotional responses. Cuter infants also elicited greater feelings of alertness, interest, and the need to respond. In fact, the participants' emotional responses were predictive of both data-driven scores and subjective perceptions of cuteness.

Executive function in teen and adult women: Association with maternal status and early adversity.

The aim of this study was to determine the impact of maternal age on executive function and the moderating effects of women's maternal status and early-life experiences. Four groups of women were assessed as a function of their age (teens vs. adults) and maternal status (mothers vs. nonmothers). Participants completed executive function tests, including Spatial Working Memory (SWM), Intra-Extra-Dimensional-Set-Shift (IED), and Stockings of Cambridge (SOC). Women also completed the Childhood Trauma Questionnaire to assess their experiences of early adversity. Results showed that for the IED-task, there were main effects of age and maternal status and an interaction between the two; adults performed better than teens, mothers performed better than nonmothers, and teen nonmothers performed the least well of all groups. For the SWM-task, adults performed better than teens. Our results indicate that although age is an important factor for proper executive functioning, different tasks are affected differently and other factors such as maternity and adverse childhood experiences moderate this functioning.