Parentingbrainchanges: Theeffects of parentingstress, depression, andanxietyonparentingbrain

초록

Parenting is rewarding but stressful. Parenting stress co-occurs depression and anxietywhile a caregiver is primarily responsible for caringa children (Fang et al., 2021; Wolf et al., 2002). We investigated whether 1) parenting stress, depression, and anxiety are associatedwith structural changes of the parenting brain, and 2) whether there are any functional changes in the structurally alteredbrain regions. This study included 179 primary caregivers of school children (Female 170, mean [SD] age = 40.84 [3.09] years old). The participants completed the self-report questionnaires of Parenting Stress Index (PSI), Beck Depression/Anxiety Inventory (BDI/BAI) and underwent structural and resting-state functional MRI scanning. MR data were acquired using 3T scanner and preprocessed with FreeSurfer 7 and CONN 21 toolbox. Firstly, partial correlation analyseswere performedbetween scores of the questionnaires and 68 parcellated brain regions and covariates include child’s sex, caregiver’s sex, age, handedness, intracranial volume and number of children in household. Secondly, we explored any causality between the three psychological factors (i.e., parenting stress, depression, and anxiety) and altered brain regions via structural equation analysis. Third, we computed functional connectivity (FC) values between two seed regions (i.e., right fusiform gyrus (R.FFG); left entorhinal cortex (L.ERC))and each voxel of thewhole brain to identify effects of the psychological factors on brain function of caregiver (voxel threshold uncorrectedp<0.001 ; cluster thresholdq<0.01with cluster-size correctedFDR). The study is approved by the Institutional Review Board of Korea Brain Research Institute (KBTI-202206-HR-001). We found significant positive correlations between several subscales of PSI and BDI at q=0.05. Structurally, significant negative correlations were found 1) betweenR.FFGarea and subscales of PSI (r=-0.24 for ‘adaptability’; r=-0.26 for ‘acceptability’; r=-0.26 for ‘child domain’) and 2) betweenL.ERCandBDI score. (r=-0.25). Higher BDI scores led to greater child domain scores of PSI, which subsequently contributes to an area reduction inR. FFG (NFI=0.97, CFI=0.986, RMSEA=0.067). Higher PSI scores led to greater BDI scores, which further contribute to area reduction inL.ERC (NFI=0.975, CFI=0.987, RMSEA=0.074 for child domain based model; NFI=0.961, CFI=0.993, RMSEA=0.033 for parent domainbasedmodel). Functionally, we found negative effects of BAI anxiety (K=142, q<0.005; T=-5.57, q<0.001), BDI depression (K=166, q<0.001; T=-5.77, q<0.001), PSI ‘depression’ (K=194, q<0.001; T=-6, q<0.001), andPSI ‘spouse’ (K=146, q<0.005; T=-4.9, q<0.001) onFCbetweenR.FFGand the ipsilateral inferior frontal gyrus. BAI anxiety showed positive effects on FC between L.ERC and the right inferior occipital cortex (K=157, q<0.001; T=5.22, q<0.001). PSI ‘discipline’ presented positive effect onFCbetweenL.ERCand the ipsilateral paracinguate gyrus (K=142, q<0.001; T=5.03, q<0.001) whereas PSI ‘health’ showed negative effect on FC between L.ERC and the right opercular cortex (K=213, q<0.001; T=-5.44, q<0.001). This study showed that the parenting brain is shaped by structural and functional changeswhere parenting stress, depression, and anxiety play a role. Parenting stress and depressionmutually contribute to structural changes and parenting stress and anxiety alters functional changes inFFGandERC, which areknown for subservingemotional processingandmemory.