Emotion processing in mothers with bonding disorder during the first year postpartum: Results of an adapted fMRI emotional GoNoGo Task
Maternal bonding refers to the unique emotional connection between a mother and her baby that gradually develops during the pre- and postpartum period. However, 3-24% of women report bonding disorders (BD), often accompanied by constraints for the mother-infant relationship with consequences for child development. The underlying neural patterns are not clarified yet. Our present study investigates the neural and behavioral patterns that underlie the processing of emotional infant stimuli over the 1 year postpartum. Mothers with and without BD (N = 45) completed an adapted (newly developed) Emotional Infant GoNoGo Task while fMRI scanning at 3, 6 and 12 months postpartum. Our results show that response inhibition towards emotional infant faces elicits stronger results than towards adult faces in all mothers. While behavioral performance in BD is impaired, the neural responses to emotional infant faces as compared to neutral faces are increased at 3 months postpartum in limbic structures such as the anterior cingulate and insula, as well as nucleus caudatus. At 6 and 12 months behavioral reactions assimilate in BD to those of healthy controls, while differences in neural reactions between BD and healthy controls increase at 6 months and decrease again at 12 months. These effects are independent of depressive symptoms. Our findings point to an experience-based adaptive process of emotion processing and responses to infants affect during the first year postpartum as a specific characteristic of clinical bonding disorder and thus might point to potential or future therapeutic interventions targeting emotion processing and regulation in mothers with BD.

Key Findings We present an adapted version of an Emotional GoNoGo Task for fMRI with infant stimuli: Behavioral inhibition towards emotional infant faces leads to increased activity in emotion regulation networks compared to adult faces in women during the 1st year postpartum.
Women with postpartum bonding disorder (BD) show increased neural reactions (ACC, NCl Caudate, Insula) towards emotional baby faces (not adult faces, irrespectively of instructed inhibition and of valence) compared to a healthy control group (CG) at 3 months postpartum.
On a behavioural level, women with BD show increased reaction times to positive emotional adult faces and higher error rates during the inhibition of reaction towards emotional baby faces at 3 months.
Differences in neural reactions to emotional baby faces between BD and CG increase at 6 months and decrease again at 12 months, while behavioral reactions in BD assimilate to those of CG