Parental Embodied Mentalizing AssessmentTM as a function of parenting stress and emotion regulation difficulties: a comparative study between postpartum depressed and nondepressed mother-infant dyads

Abstract Background In the early preverbal mother-infant communication, the impact of postpartum depression (PPD) on Parental Embodied Mentalizing (PEM) remains unclear. PEM may also depend on maternal parenting stress and emotion regulation difficulties. This study is the first to investigate PEM in mothers with and without PPD using the clinical coding system Parental Embodied Mentalizing Assessment (PEMA TM ). It was hypothesized that PPD-mothers exhibit more PEMA TM risk and fewer protective factors as a function of higher parenting stress and greater difficulties in emotional regulation compared to controls. Methods DSM-IV diagnosed PPD- ( n = 68) and non-diagnosed mothers ( n = 61) with infants aged 3–10 months were assessed during a 5-minute videotaped, free-play interaction. The observational tool PEMA TM categorizes kinesthetic movement patterns into eight risk and four protective factors. Independent t-tests compared group differences. Multiple linear regressions examined the Parenting Stress Index (PSI) and Difficulties in Emotion Regulation Scale (DERS) as predictors of PEMA TM factors, controlling for sociodemographic covariates. Results Significant group differences were identified ( d = 0.40 to 1.30). PEMA TM risk factors were higher in PPD-mothers, but sociodemographic variables emerged as significant confounders. Only Obstructing Self-Regulation was predicted by the parenting stress child domain (ß = 0.36 to 0.37), whereas Developmental Inadequacy was predicted by the parenting stress parent domain (ß = −0.58 to −0.55), and, after controlling for covariates, by difficulties in emotion regulation (ß = 0.48 to 0.52). Protective factors, especially Sustained Presence , were significantly lower in PPD-mothers and predicted by the parenting stress child domain (ß = −0.43 to −0.32). Conclusions All mothers exhibited mainly risk-related PEM; however, PPD-mothers demonstrated more pronounced and frequent risk factors compared to the control group. Protective factors were reduced among PPD-mothers due to elevated child-related parenting stress. The consideration of child-related parenting stress and sociodemographic risk separately, within the context of diagnostic specificity in PPD, is warranted. Further research is needed on developing clinical thresholds and understanding the impact of the PEMA™ factors on child development.