Anger in the context of postnatal depression: An integrative review

Ou, Christine; Hall, Wendy A.

doi:10.1111/birt.12356

Cited by 23 publications

(14 citation statements)

References 49 publications

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“…Although we initially hypothesized that prolactin might induce maternal aggression, our data have revealed a role for this hormone in restraining aggressive behavior. It is becoming increasingly apparent that in addition to the requirement for factors to induce aggressive behavior, unchecked or abnormally high levels of maternal aggression are also detrimental for both mother and offspring ( 1 , 2 ). The presence of a hormonal cue to restrain the investment of energy and time into excessive defensive or aggressive behaviors may be adaptive to ensure sufficient maternal investment into offspring-directed behaviors.…”

Section: Discussionmentioning

confidence: 99%

“…While important, these defense activities must also be balanced with the need for the mother to prioritize offspring-directed behavior to nurture the offspring. Abnormal levels of maternal aggression have been linked to expression of postpartum anxiety and the display of hypervigilant parenting ( 1 , 2 ). Specifically in rodents, high levels of intruder-directed aggression are accompanied by high anxiety–related behavior in lactating mothers ( 1 ).…”

mentioning

confidence: 99%

“…Specifically in rodents, high levels of intruder-directed aggression are accompanied by high anxiety–related behavior in lactating mothers ( 1 ). In humans, increased feelings of anger, including that directed toward other family members or health care providers, is higher in mothers with postpartum depression ( 2 ). This highlights the importance for fine-tuned regulation of maternal aggression during lactation, in order to support healthy and appropriate interactions of the mother with both the infant and with other individuals.…”

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confidence: 99%

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Prolactin-mediated restraint of maternal aggression in lactation

Georgescu

Aung

Grattan

et al. 2022

Proc. Natl. Acad. Sci. U.S.A.

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Aggressive behavior is rarely observed in virgin female mice but is specifically triggered in lactation where it facilitates protection of offspring. Recent studies demonstrated that the hypothalamic ventromedial nucleus (VMN) plays an important role in facilitating aggressive behavior in both sexes. Here, we demonstrate a role for the pituitary hormone, prolactin, acting through the prolactin receptor in the VMN to control the intensity of aggressive behavior exclusively during lactation. Prolactin receptor deletion from glutamatergic neurons or specifically from the VMN resulted in hyperaggressive lactating females, with a marked shift from intruder-directed investigative behavior to very high levels of aggressive behavior. Prolactin-sensitive neurons in the VMN project to a wide range of other hypothalamic and extrahypothalamic regions, including the medial preoptic area, paraventricular nucleus, and bed nucleus of the stria terminalis, all regions known to be part of a complex neuronal network controlling maternal behavior. Within this network, prolactin acts in the VMN to specifically restrain male-directed aggressive behavior in lactating females. This action in the VMN may complement the role of prolactin in other brain regions, by shifting the balance of maternal behaviors from defense-related activities to more pup-directed behaviors necessary for nurturing offspring.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Prolactin-mediated restraint of maternal aggression in lactation

Georgescu

Aung

Grattan

et al. 2022

Proc. Natl. Acad. Sci. U.S.A.

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“…In humans, maternal aggression is an important component of postpartum mood, and disturbances in the regulation of this adaptation can lead to heightened anger toward self, the child or other family members ( 128 ). The likelihood of displaying abnormal levels of anger is also associated with postpartum depression and lower emotional availability for their children ( 128 ). Similarly, elevated postpartum anxiety is linked with abnormally high levels of intruder-directed maternal aggression ( 129 ), an indicator of hypervigilant parenting.…”

Section: Offspring-directed Behaviorsmentioning

confidence: 99%

The Prolactin Family of Hormones as Regulators of Maternal Mood and Behavior

Georgescu

Swart

Grattan

et al. 2021

Front. Glob. Womens Health

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Transition into motherhood involves profound physiological and behavioral adaptations that ensure the healthy development of offspring while maintaining maternal health. Dynamic fluctuations in key hormones during pregnancy and lactation induce these maternal adaptations by acting on neural circuits in the brain. Amongst these hormonal changes, lactogenic hormones (e.g., prolactin and its pregnancy-specific homolog, placental lactogen) are important regulators of these processes, and their receptors are located in key brain regions controlling emotional behaviors and maternal responses. With pregnancy and lactation also being associated with a marked elevation in the risk of developing mood disorders, it is important to understand how hormones are normally regulating mood and behavior during this time. It seems likely that pathological changes in mood could result from aberrant expression of these hormone-induced behavioral responses. Maternal mental health problems during pregnancy and the postpartum period represent a major barrier in developing healthy mother-infant interactions which are crucial for the child's development. In this review, we will examine the role lactogenic hormones play in driving a range of specific maternal behaviors, including motivation, protectiveness, and mother-pup interactions. Understanding how these hormones collectively act in a mother's brain to promote nurturing behaviors toward offspring will ultimately assist in treatment development and contribute to safeguarding a successful pregnancy.

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“…The transition to parenthood can be stressful because women have to navigate physical changes and meet around-the-clock infant-care demands, while experiencing decrements to their sleep, personal autonomy, and time for self and others [ 4 , 5 ]. For mothers, lack of sleep, fatigue, and carrying the majority of infant care responsibilities, mixed with the reduced capacity to meet their needs, can contribute to their experiences of anger [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Correlates of Canadian mothers’ anger during the postpartum period: a cross-sectional survey

Hall

Rodney

et al. 2022

BMC Pregnancy Childbirth

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Background Although some women experience anger as a mood problem after childbirth, postpartum anger has been neglected by researchers. Mothers’ and infants’ poor sleep quality during the postpartum period has been associated with mothers’ depressive symptoms; however, links between mothers’ sleep quality and postpartum anger are unclear. This study aimed to determine proportions of women with intense anger, depressive symptoms, and comorbid intense anger and depressive symptoms, and to examine mothers’ and infants’ sleep quality as correlates of postpartum anger. Methods This cross-sectional survey study was advertised as an examination of mothers’ and babies’ sleep. Women, with healthy infants between 6 and 12 months of age, were recruited using community venues. The survey contained validated measures of sleep quality for mothers and infants, and fatigue, social support, anger, depressive symptoms, and cognitions about infant sleep. Results 278 women participated in the study. Thirty-one percent of women (n = 85) reported intense anger (≥ 90th percentile on State Anger Scale) while 26% (n = 73) of mothers indicated probable depression (>12 on Edinburgh Postnatal Depression Scale). Over half of the participants rated their sleep as poor (n = 144, 51.8%). Using robust regression analysis, income (β = -0.11, p < 0.05), parity (β = 0.2, p < 0.01), depressive symptoms (β = 0.22, p < 0.01), and mothers’ sleep quality (β = 0.10, p < 0.05), and anger about infant sleep (β = 0.25, p < 0.01) were significant predictors of mothers’ anger. Conclusions Mothers’ sleep quality and anger about infant sleep are associated with their state anger. Clinicians can educate families about sleep pattern changes during the perinatal time frame and assess women’s mood and perceptions of their and their infants’ sleep quality in the first postpartum year. They can also offer evidence-based strategies for improving parent-infant sleep. Such health promotion initiatives could reduce mothers’ anger and support healthy sleep.

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Anger in the context of postnatal depression: An integrative review

Cited by 23 publications

References 49 publications

Prolactin-mediated restraint of maternal aggression in lactation

Prolactin-mediated restraint of maternal aggression in lactation

The Prolactin Family of Hormones as Regulators of Maternal Mood and Behavior

Correlates of Canadian mothers’ anger during the postpartum period: a cross-sectional survey

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