Maternal caregiving moderates relations between maternal childhood maltreatment and infant cortisol regulation

Abstract

Background: Children of maltreated mothers are at increased risk for adverse physical and psychological health. Both prenatal and postnatal alterations in offspring biological stress systems have been proposed as mechanisms contributing to such transmission. The aim of the current study was to assess whether maternal postnatal care of the infant moderated any effect of maternal childhood maltreatment on infant cortisol output during a mild stressor at 4 months of age.

Methods: Participants included 181 mother-infant dyads, screened at recruitment to result in 57.4% reporting one or more forms of childhood maltreatment. Mothers were assessed for quality of caregiving, and infants were assessed for infant salivary cortisol output during the Still-Face Paradigm at infant age 4 months. Maternal childhood maltreatment was assessed using the Maltreatment and Abuse Chronology of Exposure (MACE) self-report scales.

Results: Greater severity of maternal childhood neglect interacted with higher levels of maternal disoriented caregiving to predict higher infant cortisol output over the course of the Still-Face Paradigm. In contrast, maternal childhood abuse interacted with higher levels of maternal negative-intrusion to predict lower infant cortisol output. Greater maternal role confusion was linked to greater infant cortisol output regardless of maternal maltreatment history.

Conclusions: Maternal caregiving may moderate the effects of risk factors existing prior to the infant's birth. Disoriented caregiving in the context of maternal childhood neglect and negative-intrusive behavior in the context of maternal childhood abuse were associated with opposite directions of effect on infant stress hormone output. The results suggest that interventions addressing risks from both prenatal and postnatal periods may be most effective in mitigating intergenerational effects of maltreatment.

Keywords: Infancy; abuse; cortisol; intergenerational transmission; mother–infant interaction; neglect.

Figure 1

Distribution of infant cortisol levels (AUCg) as a function of the severity of maternal childhood neglect, (A) without and (B) with the severity of maternal childhood abuse controlled; and distribution of infant cortisol levels (AUCg) as a function of the severity of maternal childhood abuse, (C) without and (D) with the severity of maternal childhood neglect controlled. MCAbuse, maternal childhood abuse; MCNeglect, maternal childhood neglect; Plots show standardized residuals from regression models. AUCg, area under the curve with respect to ground. AUCg metric is nmol/L. Regression data presented with estimation of missing data using FIML. Plotted data reflect N = 181

Figure 2

Graphic illustration and region of significance of the interaction between severity of maternal childhood neglect and maternal disorientation on infant cortisol output (AUCg). Figure (A) plots the association between maternal disorientation and infant cortisol output (AUCg) for two levels of maternal childhood neglect: low (solid line) and high (dashed line). Low neglect is defined as 1 SD below the mean; high neglect is defined as 1 SD above the mean. AUCg, area under the curve with respect to ground (total cortisol output). (B) Region of significance plotted using the Johnson–Neyman method (Johnson & Neyman, 1936). Graph derived using linear regression without FIML (N = 152). MCNeglect, maternal childhood neglect. The range of observed values of maternal disorientation is 1.00, 7.00. When maternal disorientation is outside the interval [−4.04, 3.20], the slope of maternal neglect on infant AUCg is p < .05. Thus, maternal childhood neglect is significantly associated with higher infant AUCg when maternal disorientation is >3.20

Figure 3

Graphic illustration and region of significance of the interaction between severity of maternal childhood abuse and maternal negative intrusion on infant cortisol output (AUCg). Figure (A) plots the association between maternal negative intrusion and infant cortisol output (AUCg) for two levels of maternal childhood abuse: low (solid line), and high (dashed line). Low abuse is defined as 1 SD below the mean; high abuse is defined as 1 SD above the mean. AUCg, area under the curve with respect to ground (total cortisol output). (B) Region of significance plotted using the Johnson–Neyman method (Johnson & Neyman, 1936). Graph derived using linear regression without FIML (N = 152). MCAbuse, maternal childhood abuse. The range of observed values of maternal negative intrusion is 1.00, 7.00. When maternal negative intrusion is outside the interval [−19.67, 4.12], the slope of maternal abuse on infant AUCg is p < .05. Thus, maternal childhood abuse is significantly associated with lower infant AUCg when maternal negative intrusion is >4.12