No abstract

Depression is a common and debilitating mood disorder that increases in prevalence during pregnancy. Worldwide, 7 to 12% of pregnant women experience depression, in which the associated risk factors include socio-demographic, psychological, and socioeconomic variables. Maternal depression could have psychological, anatomical, and physiological consequences in the newborn. Depression has been related to a downregulation in serotonin levels in the brain. Accordingly, the most commonly prescribed pharmacotherapy is based on selective serotonin reuptake inhibitors (SSRIs), which increase local serotonin concentration. Even though the use of SSRIs has few adverse effects compared with other antidepressants, altering serotonin levels has been associated with the advent of anatomical and physiological changes in utero, leading to defects in craniofacial development, including craniosynostosis, cleft palate, and dental defects. Migration and proliferation of neural crest cells, which contribute to the formation of bone, cartilage, palate, teeth, and salivary glands in the craniofacial region, are regulated by serotonin. Specifically, craniofacial progenitor cells are affected by serotonin levels, producing a misbalance between their proliferation and differentiation. Thus, it is possible to hypothesize that craniofacial development will be affected by the changes in serotonin levels, happening during maternal depression or after the use of SSRIs, which cross the placental barrier, increasing the risk of craniofacial defects. In this review, we provide a synthesis of the current research on depression and the use of SSRI during pregnancy, and how this could be related to craniofacial defects using an interdisciplinary perspective integrating psychological, clinical, and developmental biology perspectives. We discuss the mechanisms by which serotonin could influence craniofacial development and stem/progenitor cells, proposing some transcription factors as mediators of serotonin signaling, and craniofacial stem/progenitor cell biology. We finally highlight the importance of non-pharmacological therapies for depression on fertile and pregnant women, and provide an individual analysis of the risk–benefit balance for the use of antidepressants during pregnancy

Nonverbal cues have been fundamental to the survival of our species, and they remain a critical aspect of communication. Starting at the moment of birth, children's facial expressions and body gestures reflecting pleasure and discomfort elicit different responses from caregivers, which can shape the trajectory of child development. Although early expressions of emotion are universal, socialization of the intensity of expressions begins in infancy and may be influenced by the place the child is born, family characteristics, and other factors. The aim of this study is to describe the differences in the intensity of emotional expression between Chilean and U.S. infants at approximately 1 year of age. Infants' emotional expressions of pleasure and discomfort are described in terms of total intensity and specific facial and corporal intensities. The expressions were assessed by videotaping and coding the children's behaviours during a sequence of pleasurable and displeasing activities. The analyses revealed that the U.S. children expressed pleasure and discomfort with greater intensity compared with the Chilean children, specifically through corporal expressions. Highlights This study explores differences in the intensity of emotional expression of Chilean and U.S. infants around 1 year of age. Assessment involved a sequence of videotaped tasks and showed U.S. infants expressed pleasure and discomfort with higher intensity than Chilean infants. Differences between both samples at 1 year reveal the possibility that cultural emotion socialization shapes emotional expressions very early in development.

The present single case study explored and described the intervention process and therapeutic change expression through the Generic Change Indicators model (GCI) aiming to answer the question of “What changes when you change?”. We reasoned that psychotherapy process research in child and dyadic psychotherapy is scarce, as well as needed because it accounts for the content and mechanisms related to the therapeutic change and its association with interventions’ effectiveness.  To explore this possibility, we conducted a single case qualitative study to explore and describe the intervention process through the GCI within a brief intervention mentalization-informed with video-feedback, with a depressive mother and her baby. Specifically, Patient’s ongoing change was determined through the identification of Episodes of Change (EC) and the Moment of Change (MC) that occurs within it. Each MC was then labeled with one of the 19 GCIs. Results of the single case study showed that the GCI model is a feasible model to observe and comprehend dyadic interventions. GCI were observed from the beginning of the intervention, increasing the hierarchical level of the GCI throughout the intervention, and associated with the video-feedback situation. To investigate processes of intervention using the methodology here proposed, allows us to understand the intervention not only from a perspective of effectivity and outcomes but considering the ongoing therapeutic change. In this sense, research like this contributes to the growing body of evidence supporting the training and supervision of psychotherapists.