Selective attention to fearful faces during pregnancy

BACKGROUND There is some evidence that pregnancy may be associated with cognitive affective changes, including increased ability to encode emotional faces signaling threat and increased anxiety. Nevertheless, findings to date are inconsistent, and there are few data on correlations with endocrine and hormonal measures. The aim of this study was to investigate danger sensitivity, as measured by selective attention to fearful and angry faces during pregnancy, and to correlate findings with distress and anxiety levels, glucocorticoid (cortisol) and gonadal hormones (estrogen, progesterone and testosterone). METHODS Selective attention to fearful, angry and happy faces was assessed in pregnant women (n=44) and non-pregnant controls (n=25) using a modified version of an emotional Stroop task. General distress was assessed using the K-10, and state and trait anxiety using the Spielberger State-Trait Inventory. Levels of cortisol, estrogen, progesterone and testosterone were determined at trimester 2 and 3. Analyses of variance, regression and correlational analyses were used to investigate associations between variables. RESULTS Pregnant women showed altered attentional responses to fearful faces, in comparison to controls. When analyzed according to different levels of distress (K-10>20 or K-10≤20), distressed pregnant women had significantly increased selective attention to fearful faces compared to distressed non-pregnant controls. Attention to fear was significantly associated with increased levels of estrogen and progesterone at trimester 2, and decreased levels of cortisol at trimester 3 of pregnancy. CONCLUSION Heightened sensitivity to danger cues during pregnancy is consistent with a perspective that emphasizes the importance of parental precaution and the adaptive significance of responding to potentially hazardous stimuli during this period. Such changes may be particularly apparent in distressed women, and may be mediated by changes in glucocorticoid and gonadal hormone systems during pregnancy.

[1]  Dennis J. L. G. Schutter,et al.  Testosterone Reduces Unconscious Fear but Not Consciously Experienced Anxiety: Implications for the Disorders of Fear and Anxiety , 2005, Biological Psychiatry.

[2]  D. Perrett,et al.  Salience of emotional displays of danger and contagion in faces is enhanced when progesterone levels are raised , 2007, Hormones and Behavior.

[3]  Hervé Abdi,et al.  Processing Faces and Facial Expressions , 2003, Neuropsychology Review.

[4]  A. Schwartzman,et al.  Automatic and effortful emotional information processing regulates different aspects of the stress response , 2006, Psychoneuroendocrinology.

[5]  J. Buitelaar,et al.  Physiological stress reactivity in human pregnancy—a review , 2005, Neuroscience & Biobehavioral Reviews.

[6]  A. Schwartzman,et al.  Stress and selective attention: the interplay of mood, cortisol levels, and emotional information processing. , 2002, Psychophysiology.

[7]  S. Rauch,et al.  Differential prefrontal cortex and amygdala habituation to repeatedly presented emotional stimuli , 2001, Neuroreport.

[8]  M. Haselton,et al.  Parental precaution: Neurobiological means and adaptive ends , 2011 .

[9]  C. Spielberger,et al.  Manual for the State-Trait Anxiety Inventory , 1970 .

[10]  L. Price,et al.  Update on stress and depression: the role of the hypothalamic-pituitary-adrenal (HPA) axis. , 2003, Revista brasileira de psiquiatria.

[11]  Michael B. Lewis,et al.  Fear recognition across the menstrual cycle , 2005, Hormones and Behavior.

[12]  R. Kessler,et al.  Screening for serious mental illness in the general population with the K6 screening scale: results from the WHO World Mental Health (WMH) survey initiative , 2003, Archives of general psychiatry.

[13]  J. Westermann,et al.  Determination of cortisol in saliva and serum by a luminescence-enhanced enzyme immunoassay. , 2004, Clinical laboratory.

[14]  R. Kessler,et al.  Short screening scales to monitor population prevalences and trends in non-specific psychological distress , 2002, Psychological Medicine.

[15]  Steven L. Neuberg,et al.  Author's Personal Copy Neuroscience and Biobehavioral Reviews Human Threat Management Systems: Self-protection and Disease Avoidance , 2022 .

[16]  R. Crawley,et al.  Cognition in pregnancy and the first year post-partum. , 2003, Psychology and psychotherapy.

[17]  C MacLeod,et al.  Biased cognitive operations in anxiety: accessibility of information or assignment of processing priorities? , 1991, Behaviour research and therapy.

[18]  P. Vuilleumier,et al.  Facial expression and selective attention , 2002 .

[19]  J. DiPietro,et al.  Continuity in self-report measures of maternal anxiety, stress, and depressive symptoms from pregnancy through two years postpartum , 2008, Journal of psychosomatic obstetrics and gynaecology.

[20]  Dan J Stein,et al.  Validity of the Kessler 10 (K-10) in detecting DSM-IV defined mood and anxiety disorders among pregnant women , 2009, Archives of Women's Mental Health.

[21]  P. Ekman.  Pictures of Facial Affect , 1976 .

[22]  Victoria N. Luine,et al.  Changes in anxiety and cognition due to reproductive experience: A review of data from rodent and human mothers , 2010, Neuroscience & Biobehavioral Reviews.

[23]  A. Douglas,et al.  Adaptive Responses of the Maternal Hypothalamic‐Pituitary‐Adrenal Axis during Pregnancy and Lactation , 2008, Journal of neuroendocrinology.

[24]  Jack van Honk,et al.  1 hz rTMS over the right prefrontal cortex reduces vigilant attention to unmasked but not to masked fearful faces , 2002, Biological Psychiatry.

[25]  J. Honk,et al.  Conscious and preconscious selective attention to social threat: different neuroendocrine response patterns , 2000, Psychoneuroendocrinology.

[26]  S. Lightman,et al.  Emotional sensitivity for motherhood: Late pregnancy is associated with enhanced accuracy to encode emotional faces , 2009, Hormones and Behavior.

[27]  Frank Z. Stanczyk,et al.  Pregnancy, the postpartum, and steroid hormones: effects on cognition and mood , 1999, Psychoneuroendocrinology.

[28]  Dan J Stein,et al.  Altered prefrontal cortical function during processing of fear-relevant stimuli in pregnancy , 2011, Behavioural Brain Research.

[29]  E. Haan,et al.  Correlations among Salivary Testosterone, Mood, and Selective Attention to Threat in Humans , 1999, Hormones and Behavior.

[30]  J. Henry,et al.  A review of the impact of pregnancy on memory function , 2007, Journal of clinical and experimental neuropsychology.

[31]  C. Kirschbaum,et al.  Salivary cortisol in psychoneuroendocrine research: Recent developments and applications , 1994, Psychoneuroendocrinology.

[32]  K. Roelofs,et al.  The effects of social stress and cortisol responses on the preconscious selective attention to social threat , 2007, Biological Psychology.

[33]  Matthew Garner,et al.  Anxiety and orienting of gaze to angry and fearful faces , 2007, Biological Psychology.

[34]  D. Algom,et al.  Selective attention improves under stress: implications for theories of social cognition. , 2003, Journal of personality and social psychology.

[35]  S. Rauch,et al.  Neurobiology of emotion perception I: the neural basis of normal emotion perception , 2003, Biological Psychiatry.

[36]  J. Adam,et al.  Selective attention deficits during human pregnancy , 2003, Neuroscience Letters.

[37]  P. Putman,et al.  Emotional stroop performance for masked angry faces: it's BAS, not BIS. , 2004, Emotion.

[38]  E. Fox,et al.  Do threatening stimuli draw or hold visual attention in subclinical anxiety? , 2001, Journal of experimental psychology. General.

[39]  J. Olsen,et al.  Stress and salivary cortisol during pregnancy , 2005, Psychoneuroendocrinology.

[40]  Richard L. Morris,et al.  Assessment of State and Trait Anxiety in Subjects with Anxiety and Depressive Disorders , 2004, Psychiatric Quarterly.

[41]  Colin MacLeod,et al.  Contrasting two accounts of anxiety-linked attentional bias: selective attention to varying levels of stimulus threat intensity. , 2003, Journal of abnormal psychology.