Disruption of Maternal Parenting Circuitry by Addictive Process: Rewiring of Reward and Stress Systems

Yale Child Study Center, Yale University New Haven, CT, USA.
Frontiers in Psychiatry 07/2011; 2:37. DOI: 10.3389/fpsyt.2011.00037
Source: PubMed


Addiction represents a complex interaction between the reward and stress neural circuits, with increasing drug use reflecting a shift from positive reinforcement to negative reinforcement mechanisms in sustaining drug dependence. Preclinical studies have indicated the involvement of regions within the extended amygdala as subserving this transition, especially under stressful conditions. In the addictive situation, the reward system serves to maintain habitual behaviors that are associated with the relief of negative affect, at the cost of attenuating the salience of other rewards. Therefore, addiction reflects the dysregulation between core reward systems, including the prefrontal cortex (PFC), ventral tegmental area (VTA), and nucleus accumbens (NAc), as well as the hypothalamic-pituitary-adrenal axis and extended amygdala of the stress system. Here, we consider the consequences of changes in neural function during or following addiction on parenting, an inherently rewarding process that may be disrupted by addiction. Specifically, we outline the preclinical and human studies that support the dysregulation of reward and stress systems by addiction and the contribution of these systems to parenting. Increasing evidence suggests an important role for the hypothalamus, PFC, VTA, and NAc in parenting, with these same regions being those dysregulated in addiction. Moreover, in addicted adults, we propose that parenting cues trigger stress reactivity rather than reward salience, and this may heighten negative affect states, eliciting both addictive behaviors and the potential for child neglect and abuse.

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    • "Unlike many mothers who find engaging with their own children to be a uniquely rewarding experience, mothers with addictions may be less able to respond appropriately to their children's cues, finding them less intrinsically rewarding or salient and more stress-provoking (Rutherford et al., 2011). Current research is focusing on the ways in which drug addiction involves altered brain responses that underlie maternal behavior (Strathearn and Mayes, 2010), having previously demonstrated that infants' cues activate dopaminergically innervated brain reward circuits similar to those associated with drugs of abuse (Strathearn et al., 2008). "
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    • "The neurological bases of the altered maternal response are receiving increasing attention with a view to better understanding maternal insensitivity to infant cues. However, most studies to date have been done using fMRI (e.g., [4], [5], [6], [7], [8]) while very few have been done with event-related potentials (ERPs) (e.g., [9], [10]). The study by Rodrigo et al. [4] compared the neural response to infant faces in neglectful and control mothers in an attempt to find some neurological bases of maternal insensitivity. "
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    • "Because the postpartum period is a transitional one when new behaviors are established and old behaviors abandoned, it is a critical time to intervene (Fleming et al. 2008). Understanding this time as one of unique vulnerability may also be critical to improving maternal abstinence, particularly among women with alcohol or drug use problems (Rutherford et al. 2011). Understanding the extent and specific patterns of substance use as well as its relationship with PPD could inform risk factor research and designs of targeted interventions to prevent or reduce substance use related problems and consequences. "
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