Psychiatry - August 2008 - (Page 30)

briefly held mental states, but miss bigger changes such as sustained emotion; on the other hand, longer blocks may capture more complex brain responses but also average them out, making subtle responses more difficult to detect. Brain activity during these blocks may then be measured and compared between periods of attending to stimuli of interest and control stimuli to generate maps of the brain, indicating differences in brain Parenting is a key foundational component of secure attachments. It is the first attachment for infants, and a key or even defining event in the life of adults that may be described in many ways: a stage in life, a personal choice, a psychological and biological transition, a cultural creation, a necessity for the species, and a state of mind. These varied and important characterizations underscore how the real and Forming enduring emotional bonds is critical to health. Parenting is a key foundational component of secure attachments. It is the first attachment for infants, and a key or even defining event in the life of adults activity that may be important for one set of perceptions and thoughts versus another. So far, a small group of studies have been published in which parents have been the subjects and infant cries and pictures have been stimuli. In such studies, for example, comparisons of brain activity measured during baby cry versus control sound experience may yield significant differences in certain brain regions that may then be said to relate to the parental experience of a baby cry and therefore the associated parenting thoughts and behaviors. Some of these studies had small subject numbers and fixed effects analyses that do not take intersubject variability into account, while other studies use random effects analyses to account for intersubject variability and permit generalization of findings. I will first describe some aspects of the psychology and neurobiology of parenting (much of which comes from animal research) and human parenting studies with brain imaging published to date. I will then present single brain data from our own group, and conclude with a general model of the parenting brain. imagined roles of parents are woven through the tapestry of our developmental psychology. Given the importance of parenting, surprisingly little work has focused on how adults make psychological and biological adjustments to make room in their lives for infants. In 1956, Donald Winnicott, a pediatrician and psychoanalyst, drew attention to “primary maternal preoccupations.” He described this state as “almost an illness” that a mother must experience and recover from in order to create and sustain an environment that can meet the physical and psychological needs of her infant. Winnicott1 further speculated that this special state began toward the end of the pregnancy and continued through the first months of the infant’s life. Although this concept has been incorporated into subsequent clinical formulations of disordered mother-infant interactions,2,3 it has received relatively little scientific attention, especially in consideration of the normative developmental trajectory of parenting.4–6 Rodent studies have pinpointed brain circuits crucial for maternal behaviors and suggest regions of likely importance for human parenting. Indeed, recent human brain imaging studies are showing that analogous circuits are active in human parenting.41 Although the central nervous system events that accompany parenting relationships in humans are largely unknown, substantial conservation across mammalian species is likely.7,8 Classical lesion studies in rodent model systems (rats, mice, and voles) have implicated the medial preoptic area (MPOA) of the hypothalamus, the ventral part of the bed nucleus of the stria terminalis (BNST), and the lateral septum (LS) as regions pivotal for regulation of pupdirected maternal behavior in rodents.9–11 Other animal studies highlight the role of a variety of hormones and neuropeptides in parental care, including estrogen, prolactin, and oxytocin.10,12,13 The central roles of the hypothalamus and oxytocin have also been highlighted with respect to adult social bond formation.14,15 Behavioral studies have shown that maternal behavior in the days following birth serves to “program” the subsequent maternal behavior of the adult offspring as well as establishing the pups’ levels of hypothalamic-pituitary-adrenal responsiveness to stress.16–18 There is growing evidence that early-life programming of the mice pups’ long-term parenting behavior19 may be mediated through modulation of the stress-response system.20 The observation that the effects of early adverse experiences on stress reactivity21 appear to be reversible with environmental enrichment22 may point the way to interventions in humans in which there may be neglect or abuse. BABY CRY AND THE PARENT BRAIN The process of using fMRI to explore the brain basis of these responses in parents began with Lorberbaum and colleagues23,24 using standard baby cries as stimuli. Building on the thalamocingulate theory of maternal behavior in animals developed by MacLean,25 PSYCHOLOGY AND BIOLOGY OF PARENTING Forming enduring emotional bonds is critical to health. 30 Psychiatry 2008 [ A U G U S T ]

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Psychiatry - August 2008 Editor’s Message Editorial Advisory Board Contents Borderline Personality Disorder: Are Proliferative Symptoms Characteristic? Short-acting versus Long-acting Medications for the Treatment of ADHD Baby Stimuli and the Parent Brain: Functional Neuroimaging of the Neural Substrates of Parent-Infant Attachment These Boots Are Made for Stalking: Characteristics of Female Stalkers Managing Attention Deficit Hyperactivity Disorder in the Emergency Department Obstructive Sleep Apnea, Hypoxia, and Metabolic Syndrome in Psychiatric and Nonpsychiatric Settings Improving the Quality of Life in Patients with Alzheimer’s Disease The Process of Getting New Drugs to Market Journal Watch Classified Advertising Information for Authors

Psychiatry - August 2008

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