Approach-avoidance responses to infant facial expressions in nulliparous women: Associations with early experience and mood induction

Infant Behavior and Development 49 (2017) 104–113

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Full Length Article

Approach-avoidance responses to infant facial expressions in nulliparous women: Associations with early experience and mood induction

MARK

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Pietro De Carlia,b, M.E. Riem Madelonc,d,e, , Laura Parolinb a

Department of Developmental and Social Psychology, University of Padua, Padua, Italy Department of Psychology, University of Milano-Bicocca, Milan, Italy c Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands d Centre for Child and Family Studies, Leiden University, Leiden, The Netherlands e Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, The Netherlands b

AR TI CLE I NF O

AB S T R A CT

Keywords: Approach avoidance Infant emotions Negative caregiving experiences Mood manipulation

Infant expressions are important signals for eliciting caregiving behaviors in parents. The present study sought to test if infant expressions affect adults’ behavioral response, taking into account the role of a mood induction and childhood caregiving experiences. A modified version of the Approach Avoidance Task (AAT) was employed to study nulliparous female university students’ implicit responses to infant faces with different expressions. Study 1 showed that sad, neutral and sleepy expressions elicit a tendency for avoidance, while no tendency for approach or avoidance was found for happy faces. Notably, differences between approach and avoidance response latencies for sad faces and participants’ negative caregiving experiences were positively correlated (r = 0.30, p = 0.04, Bonferroni corrected), indicating that individuals who experienced insensitive parental care show more bias toward sad infant faces. In Study 2, we manipulated participants' current mood (inducing sad and happy mood by asking to recall a happy or sad event of their recent life) before the AAT. Results showed that sad mood enhanced the bias toward sad faces that is buffered by positive mood induction. In conclusion, these findings indicate that implicit approach avoidance behaviors in females depend on the emotional expression of infant faces and are associated with childhood caregiving experiences and current mood.

1. Introduction Infant signals are essential in communicating needs and eliciting caregiving reactions in adults (Ainsworth, Bell, & Stayton, 1974; Bowlby, 1969; Soltis, 2004). Infants are fully dependent on their parents and it is therefore likely that specific neurophysiological mechanisms have developed to subserve the perception of infant signals (Esposito, Valenzi, Islam, Mash, & Bornstein, 2015; Kringelbach et al., 2008; Piallini, De Palo, & Simonelli, 2015; Swain et al., 2014; Young et al., 2015). Specifically, facial expressions as well as crying and laughter represent the most powerful ways infants possess in order to communicate their status and to interact with adults. Parents’ ability to properly recognize and respond to these signals is crucial for healthy infant development (Ainsworth, Blehar, Waters, & Wall, 1978; Bowlby, 1969; Klein Velderman, Bakermans-Kranenburg, Juffer, & van IJzendoorn, 2006; Van Zeijl et al., 2006), especially in the domain of emotion regulation (Fonagy, Gergely, Jurist, & Target, 2002; Rutherford, Wallace,

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Corresponding author at: Department of Medical and Clinical Psychology, Tilburg University, The Netherlands. E-mail address: [email protected] (M.E. Riem Madelon).

http://dx.doi.org/10.1016/j.infbeh.2017.08.005 Received 1 June 2017; Received in revised form 15 August 2017; Accepted 18 August 2017 0163-6383/ © 2017 Elsevier Inc. All rights reserved.

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Laurent, & Mayes, 2015). In this study we examined the perception of infants’ emotional expressions in nulliparous women and their effect on approach/avoidance behaviors. The aim of the study was to understand how infant expressions affect adults’ reaction and behavioral response, taking into account two important factors that influence responding to infant emotions: current mood and childhood caregiving experiences. Infant signals elicit not only caregiving responses, but also evoke physiological arousal in adults, as well as negative emotions. A series of studies showed that infant crying elicits aversion (Frodi, Lamb, Leavitt, & Donovan, 1978; Groh & Roisman, 2009; Groh et al., 2015; Out, Pieper, Bakermans-Kranenburg, & Van IJzendoorn, 2010) and, in extreme cases, crying can trigger abuse or neglect (Barr, Trent, & Cross, 2006; Compier-de Block et al., 2014; Soltis, 2004). To our knowledge, no study specifically focused on the role of infant facial emotional expressions in shaping behavioral approach/avoidance responses, but evidence from neurophysiological studies can help in formulating hypotheses. Brain activation during the perception of different expressions on baby faces has been studied both in parents and in individuals without children. Strathearn and colleagues (Strathearn, Li, Fonagy, & Montague, 2008) found that only own-babies’ emotional expressions, in particular happy expressions, were associated with the activation of dopaminergic neural reward circuits. This means that own infant’s smiling is considered a reinforcement for mothers. In nulliparous females Montoya and colleagues (Montoya et al., 2012) found that happy infant faces resulted in more activation in neural reward areas (the ventral striatum, caudate, ventromedial prefrontal and orbitofrontal cortices) than sad infant faces. In contrast, a comparison of sad versus happy infant faces elicited more activation in neural empathy regions (the precuneus, cuneus and posterior cingulate cortex). This suggests that happy faces because of their more rewarding features may elicit a tendency to approach the infant. In contrast, sad faces may elicit a tendency to avoid the negative affect and to provide caregiving behavior to address the cause of negative feelings. Adult facial expressions have been shown to elicit approach or avoidant responses, depending on the valence and salience of the emotional expression. The valence of an emotional expression seems to be automatically evaluated in order to provide a quick and adaptive response (Al-Shawaf, Conroy-Beam, Asao, & Buss, 2016; Bradley, Codispoti, Cuthbert, & Lang, 2001; Lang, Bradley, & Cuthbert, 1998; Tooby & Cosmides, 2008). Emotional expressions elicit different behavioral responses that can be studied by means of a behavioral approach-avoidance task: participants are asked to approach or distance emotional faces presented on the screen through pulling or pushing a lever (Marsh, Ambady, & Kleck, 2005; Roelofs, Elzinga, & Rotteveel, 2005; Seidel, Habel, Kirschner, Gur, & Derntl, 2010). Results consistently show that happiness is associated with approach (Phaf, Mohr, Rotteveel, & Wicherts, 2014). Expressions of fear, sadness and anger elicit conflicting results (Paulus and Wentura, 2016; Phaf et al., 2014), probably because individual differences play a role in the perception of other people’s sadness. For instance, whereas other people’s sadness may elicit empathy and approach behavior aimed at helping the person in distress in some individuals, it may elicit avoidant responses in individuals who feel uncomfortable or even aversion when they are confronted with a sad person. Moreover, results can be explained by the social context of the perceived emotion, both in case of approach or avoidance. For example, a recent study showed that preference for approach or avoidance is influenced by contrast between emotions presented in the task. Paulus and Wentura (2016) showed that negative emotions (anger, fear, sadness) are avoided when paired with happiness, while anger and sadness elicit approach when paired with fear (that elicits avoidance). Thus, contextual and individual difference factors shape approach and avoidant responses to emotional expressions and this may reflect differences in social interaction in real life. Previous research indicates that there is an association between approach avoidance tendencies regarding social stimuli and actual behavior in interaction with these social stimuli, although the mechanism underlying this association is not completely clear (Van Dessel, Gawronski, Smith, & De Houwer, 2017). For instance, highly socially anxious individuals report more avoidance tendencies toward smiling and angry, but not neutral faces, compared to controls (Heuer, Rinck, & Becker, 2007; Staugaard, 2010) and post traumatic symptomatology is associated to a greater bias to avoid happy faces (Clausen et al., 2016). One factor that may influence responses to emotional expressions is childhood caregiving experiences. For example, previous studies have shown that experiences of childhood abuse affect neural responses to sadness (Dannlowski et al., 2013). Adults with histories of maltreatment also have deficits in recognizing emotions (Ardizzi et al., 2015) and childhood abuse has been found to be associated with bias to threat in children (Pine et al., 2005) and in adults (Fani, Bradley-Davino, Ressler, & McClure-Tone, 2011). In addition, it has been shown that parents with a history of abuse respond differently to infant emotions. Parents with a history of parental emotional rejection were less accurate in identifying infant fear and anger and reported more negative attributions when asked to guess the causes of infant behaviors (Leerkes & Siepak, 2006). Since experiences of abuse during own childhood enhance the risk of using harsh caregiving responses (Pears & Capaldi, 2001), it is important to examine influences of childhood experiences on responding to infant emotions. Another factor that may influence the processing of infant emotional expressions is mood. Mothers with a postpartum depression are more likely to identify negative emotions in infant faces while they are more inaccurate at detecting positive emotions (Webb & Ayers, 2015). Mothers with a history of depression may also manifest withdrawal behaviors in response to their infants’ distress. This seems one of the mechanisms implicated in disrupted interaction between depressed mothers and their children (Arteche et al., 2011), especially in terms of interactive emotion regulation (Reck et al., 2004). In a developmental perspective, maternal altered affect recognition could be central to the development of adverse emotional and behavioral outcomes in infants (Kluczniok et al., 2016). Furthermore, research indicates that mild depressive symptoms also affect responding to expressions of infant distress in individuals without children (Riem, Pieper, Out, Bakermans-Kranenburg, & van IJzendoorn, 2011). Although mood and childhood experiences are known to influence parenting behavior, it is yet unclear whether these factors also influence responding to infant emotional expressions before the transition into parenthood. According to the concept of intergenerational transmission (Belsky, Conger, & Capaldi, 2009) also non-parents carry the imprint of parenting style experienced in childhood. It is therefore likely that influences of early parenting experiences on responses to infant emotions become apparent even 105

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before becoming a parent. The current study, therefore, examined the influence of childhood experiences and mood on responding to infant emotional expressions with an approach-avoidance task in individuals without children. We hypothesized that participants would be quicker in approaching infants with positive expressions and avoiding infants with negative expressions, as similar effects were found for adult faces. Moreover, we expected that responses to infants with positive and negative emotional expressions are influenced by childhood experiences and mood induction. In Study 1, we hypothesized that childhood negative caregiving experiences are associated with reduced approach of infant positive expressions and with augmented avoidance of negative expressions. In Study 2, we examined whether induced sad mood after an experimental mood manipulation would stimulate an augmented tendency to avoid sad infant faces and would diminish the tendency to approach happy faces. In contrast, we expected that a positive mood manipulation would have opposite effects, reducing the tendency to avoid sad faces and increasing the tendency to approach happy faces. 1.1. Study 1: approach and avoidant behaviors in response to infant faces The paradigm was adapted from Rinck and colleagues (Heuer et al., 2007; Rinck & Becker, 2007) and is based on the ApproachAvoidance Task (AAT) (Chen and Bargh, 1999; Solarz, 1960), which has been used with emotional faces by Marsh and colleagues (Marsh et al., 2005). Approach was represented by pulling a joystick toward oneself and avoidance by pushing it away. Rinck and Becker (2007) found that this simple association can be biased because participants can assume that they move their hand toward the stimulus when they want to grab it. Thus, they proposed a zoom feature of the task, which means that when the joystick is pulled the face stimulus becomes bigger, simulating it is coming closer to the participant, and becomes smaller when the lever is pushed, simulating that it is moving away. Our paradigm uses four different types of infant expressions: smiling, sad, neutral and sleepy. The sleepy infant was added because it represents a non-positive expression but does not require the intervention of adults, meaning that there is no infant signal of need, contrary to the sad baby. We aimed at designing an implicit task, thus we presented to the participants two different conditions in randomized order: pulling or pushing depending on whether the infant face had a red mark on the forehead or not. Participants were asked to modulate their answers depending on the presence of the red dot, and they did not receive any information or instruction regarding infant expressions. We considered the reaction times of completing the movement of the joystick as an implicit measure of the congruency (or not) of the task for the participants: we expected reaction time (RT) to be quicker when a participant was asked to approach (vs avoid) a happy face or to avoid (vs approach) a sad face. No effect was expected for neutral and sleepy faces. Lastly we hypothesized that since individuals with negative childhood show an attention bias away from faces with negative emotional expressions (Pine, 2003), indicating that maltreatment is related to attention avoidance of negative emotions. Negative caregiving experiences may therefore also lead to an augmented bias in processing sad infants. Therefore we hypothesize shorter reaction times for avoiding (vs. approaching) sad infants in participants with higher scores for childhood negative caregiving experiences. 2. Method 2.1. Participants In a preliminary stage, 220 students (173 females) from Bicocca University of Milan completed the Childhood Trauma Questionnaire Short Form (CTQ-SF, Bernstein et al., 1994, 2003). during lecture time. Sixty-three nulliparous females (Age: M = 20.8, SD = 1.3) with scores ranging from low to high on a questionnaire measuring the negativity of caregiving childhood experiences were randomly selected for participation in exchange for credits. The study was carried out in accordance with the recommendations of the Declaration of Helsinki and was approved by the Ethical Committee of University of Milano – Bicocca. All subjects gave written informed consent before participation. 2.2. Materials and procedure 2.2.1. Stimuli In a preliminary phase the stimuli were validated. A pool of 60 images were collected from the internet representing infant faces in four different categories: smiling, sad, sleepy and neutral. Each face was placed on a neutral grey wallpaper. Luminosity and size (500 × 500 pixels) of the pictures were controlled. The pictures were presented to 30 students (18 females) and they were asked to categorize each of them in one of the four categories previously described. They were asked to evaluate each picture from 1 to 5 answering these questions: “How much do you think this infant needs help?”, “How much do you think this infant is happy?”. Finally, they had to guess whether each infant was a male or a female and his/her age in months. Then we selected pictures that had at least 80% agreement on the emotion expressed among all the participants. Moreover, the infants had to be estimated not older than 24 months by at least 80% of the participants. We selected the five pictures of each category with the highest agreement. Thus, we obtained a pool of 20 pictures to be used in the task. The picture evaluations were different for happiness (F(3, 87) = 100.09, p < 0.001) and for neediness (F(3, 87) = 67.67, p < 0.001) As expected the happy faces were happier (M = 4.43, SD = 0.62) than all the others, and the sad ones (M = 1.36, SD = 0.47) were the least happy, while neutral (M = 2.80, SD = 0.85) and sleepy (M = 2.02, SD = 1.02) were in between. Furthermore, the most needy of help were the sad ones (M = 4.41, SD = 0.56) and the least needy of help were the happy ones (M = 1.92, SD = 0.66), while neutral (M = 2.75, SD = 1.12) and sleepy (M = 3.90, SD = 0.80) were in between. All pictures were duplicated and a red dot was added on infants’ forehead in half of the pictures. 106

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Fig. 1. Schematic explanation of the Approach Avoidance Task modified for the present study.

2.2.2. Approach-avoidance task The task was programmed in Matlab, using the Psychophysics Toolbox extensions (Brainard, 1997; Kleiner et al., 2007; Pelli, 1997). Participants were seated comfortably in front of a computer with a joystick easy to grab with their dominant hand. The distance between participants and the joystick ensured that the joystick motion was directed toward or away from the body. The task was initiated by participants bending the joystick to the left. The task consisted of two blocks in a randomized order. In one block participants were instructed to push the joystick away when they saw a red dot on infants’ forehead and to pull the joystick towards them when they did not see a red dot on infants’ forehead. In contrast, in the other block participants were instructed to pull the joystick towards them when they saw a red dot on infants’ forehead and to push the joystick away when they did not see a red dot on infants’ forehead. Before the start of each block, a training phase ensured that the task was properly understood. In this phase, consisting of 4 trials, participants were presented an adult face and received feedback on their performance. The two blocks were separated by a short break and the participants could decide to start the second block by moving the joystick to the left. Instructions were to try to be as correct and as quick as possible in moving the joystick in one or the other direction. Participants were asked to attend to the center of the screen where the pictures or a small black cross were shown. Each block consisted of 80 trials. Each trial was composed of a starting phase with the presentation of the cross in the center of the screen for 500 ms, then a picture of medium size appeared (see Fig. 1). At this point the participant could push or pull the joystick and consequently the picture changed in size, giving the impression that the picture was pulled toward the participant (i.e. growing bigger) or pushed away (i.e. growing smaller). When the increasing image size reached the screen size or when the decreasing image was 20 × 20 pixels, the picture stopped changing size until the joystick movement (approximately 30°) was completed; then the picture disappeared. The picture disappeared independently of the correctness of the participants’ answers. Then participants brought the joystick back in the upright position while a black cross appeared on the screen. The next image was not presented before the starting position had been reached. Reaction time was measured from the appearance of the picture on the screen to its disappearance. 2.2.3. Negativity of the childhood caregiving experience Participants completed an online Italian version of the Childhood Trauma Questionnaire Short Form (CTQ-SF, Bernstein et al., 1994, 2003). CTQ-SF is a measure of self-reported experiences of childhood abuse. Twenty-eight items were used to assess experiences of physical abuse, emotional abuse, sexual abuse, physical neglect, and emotional neglect. Each item (e.g., “During my childhood I felt hated by family”) was rated on a 5-point Likert scale ranging from never true to very often true. In the current study we focused on the abuse subscales since they were expected to affect reactivity to infant emotional faces (Masten et al., 2008). An abuse scale was created (alpha = 0.78) by averaging the 15 items tapping into the physical abuse, emotional abuse, and sexual abuse dimensions. Two outlying scores were winsorized (Tabachnick & Fidell, 2001) . The mean score was 1.22 (SD = 0.23) ranging from 1.00 to 1.73. 3. Results and discussion A linear mixed model was used to test for differences in reaction time when the participant was asked to approach versus to avoid the infant faces depending on the task request. The model tested the within-subjects fixed effects of the type of infant expression and the condition (i.e. the request to approach or avoid through the joystick). The random term consisted of the intercept and the condition effects, because not enough within-subject (cluster) variability was estimated for each emotion. Results showed significant main effects for type of infant expression (F(3, 6501.2) = 4.20, p < 0.01) and condition (approach or avoidance) (F(1, 56.5) = 46.26, p < 0.001). The interaction effect was significant, too (F(3, 6395.4) = 3.14, p < 0.05): Participants were slower in approaching (M = 0.81, SD = 0.21) than avoiding (M = 0.77, SD = 0.21) infant faces, regardless of type of emotion. Responses to sleepy faces (M = 0.81, SD = 0.26) were slower than to the other faces (Neutral: M = 0.79, SD = 0.20; Happy: M = 0.78; SD = 0.18; Sad: M = 0.79; SD = 0.18). In order to explore the interaction effect of condition and emotion we examined which of 107

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Fig. 2. Reaction times for approach and avoidance behaviors in response to infant emotions. Error-bars represent standard error of the means. ** = p < 0.01; *** = p < 0.001.

infant emotions showed a significant difference between the approach and avoidance conditions. Significance levels of the comparisons are Bonferroni corrected. No effect was found for the happy face (b = −0.02, SE = 0.01, t(58.22) = −1.90, p = 0.06, 95% CI [-0.04, 0.003]), but significant differences were found for the neutral face (b = −0.05, SE = 0.01, t(1339) = −5.59, p < 0.001, 95% CI [−0.07, −0.03]), the sleepy face (b = −0.03, SE = 0.01, t(972.6) = −2.97, p < 0.01, 95% CI [−0.05, −0.01]). and the sad face (b = −0.05, SE = 0.01, t(59.38) = −5.77, p < 0.001, 95% CI [−0.06, −0.03]): participants were slower when they were asked to approach neutral, sleepy and sad pictures than when they were asked to avoid these faces. Results are illustrated in Fig. 2. The bias in response to sad pictures is consistent with our hypotheses, while the ones toward sleepy and neutral pictures are unexpected. To test the association between childhood negative caregiving experiences and bias to avoid sad infants in adulthood, we tested the correlations between the CTQ abuse scale and reaction times (RT) differences (mean approach minus mean avoidance) for each infant expression (happy face: M = 0.02, SD = 0.08; neutral face: M = 0.05, SD = 0.08; sleepy face: M = 0.04, SD = 0.10; sad face: M = 0.05, SD = 0.07). As expected, we found a significant correlation between the negativity of caregiving experience during childhood and the differences in RTs in the sad infant condition (approach-avoidance) r = 0.30, p = 0.04 (Bonferroni corrected). The more negative the caregiving experienced, the greater the bias to avoid the sad infants. The correlations between childhood experience and differences in latency for the other expressions were not significant (sleepy face, r = 0.01, p = 0.99, happy, r = −0.02, p = 0.99, neutral, r = −0.20, p = 0.64, Bonferroni corrected). 3.1. Study 2: emotional context and behavioral response to infant faces Previous research points to a link between sad mood and insensitive caregiving responses to infant signals. For example, postpartum depression has negative effects on maternal sensitivity and parenting behaviors (Field, 2010; Forman et al., 2007; Paulson, Dauber, & Leiferman, 2006; Santona et al., 2015). Depressed mothers in fact, show blunted brain (Moses-Kolko et al., 2010) and behavioral (Field, Diego, & Hernandez-Reif, 2009) responses to infant signals. Moreover, previous research indicates that there is an association between current negative mood and more negative ratings of sad infant faces, irrespectively of parental status (Parsons, Young, Jegindoe Elmholdt, Stein, & Kringelbach, 2017). The current study aimed at exploring the effects of experimentally induced happy or sad mood on approach and avoidant responses to positive and negative infant emotions. To our knowledge, this is the first study examining the effects of mood manipulation on approach and avoidance behavior in response to infant facial stimuli. One study used adult emotional faces; Vrijsen and colleagues (Vrijsen, van Oostrom, Speckens, Becker, & Rinck, 2013) used video fragments to induce the mood manipulation and found no effects on the Approach Avoidance Task in the total sample. However, in a subsample with the highest depressive symptomatology scores the authors found mood-congruent (i.e. happy faces approached more easily after happy manipulation) and mood-incongruent (i.e. angry faces approached less easily after sad manipulation) behavioral tendencies. Since mood is relevant in responding to infant emotional expressions (Riem et al., 2011), we expect a subtle mood manipulation to be effective in shaping approach avoidance responses. In fact, it is known that a simple negative mood induction in mothers is able to produce less optimal interactions with their children (Jouriles, Murphy, & O’Leary, 1989), while after a positive mood manipulation they are more likely to evaluate their children behavior as more favorable (Jouriles & Thompson, 1993). We hypothesize that a change in approach avoidance tendencies toward infant stimuli could work as a mechanism of this mood induction effect, also in 108

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childless participants. In fact, in non-parent individuals transient mood is associated with the quality of the interaction with an infant simulator (Voorthuis et al., 2013). We conducted a within-subject study with two laboratory visits with an intervening period of exactly one week. Participants were asked to think of one of the most sad or happy, respectively, events in their lives (depending on the randomized order of the sessions) and to write it down. Subsequently a simpler version of the AAT described in study 1 was performed. We expected that participants in the negative mood condition would be even quicker in avoiding the sad infant. Furthermore, we expected that participants in the positive mood condition would be less slow in approaching the sad infant and even quicker in approaching the happy one. Finally, we expected that childhood negative experiences would be associated with a more pronounced negative effect of the negative mood induction. 4. Method 4.1. Participants Forty-seven nulliparous females (Age: M = 21.4, SD = 1.7) with scores ranging from low to high on the CTQ-SF abuse scale were randomly selected for participation in exchange for course credits. The sample was recruited from the same population of in Study 1, but none of Study 2 participants had participated in Study 1. The study was carried out in accordance with the recommendations of the Declaration of Helsinki and was approved by the Ethical Committee of University of Milano − Bicocca. All subjects gave written informed consent before participation. 4.2. Materials and procedure Participants were contacted and two appointments were arranged in two consecutive weeks on the same weekday, approximately at the same time of the day. The order of the mood manipulation was randomized. They filled out the PANAS (Watson, Clark, & Tellegen, 1988) and then received verbal and written instructions on the procedure of the mood manipulation. The instructions were: “Dear Student, this research aims at studying the ability to remember past events. We ask you to try to remember an episode of your recent life when you felt particularly HAPPY (SAD). It does not have to be an ‘important’ event and it does not have to be a long episode. The only important thing is that you felt HAPPY (SAD). In the blank space below we ask you to briefly describe the situation, what happened and how you felt.” Participants were told they could take all the time they needed and to tell the experimenter when they thought they finished. After that a shortened version of the AAT was performed. In this task only happy and sad infant faces were presented with a total of 40 trials in each of the two blocks. After the AAT the participants were asked to fill out the PANAS again. 5. Results and discussion We first tested the effectiveness of the mood manipulations using the PANAS evaluations. We performed two 2 × 2 repeated measures ANOVAs, one for the positive subscale and one for the negative subscale of the PANAS. In both cases, predictors were time (pre vs post manipulation) and type of manipulation (positive vs negative). For the negative subscale, results showed a significant interaction time x manipulation (F(1146) = 8.76, p < 0.01). As expected, there was no difference between the ratings pre-manipulation (pre-positive manipulation: M = 18.00, SD = 3.61; pre-negative manipulation: M = 17.70, SD = 4.39, pre-manipulation positive vs negative difference: t(46) = 0.54, p = 0.59) while the post-positive manipulation rating was lower (M = 17.17, SD = 4.06) and the post-negative manipulation rating was higher (M = 19.28, SD = 5.97, post-manipulation positive vs negative difference: t(46) = −2.81, p = 0.007). This indicates that the negative mood manipulation resulted in a more negative mood, whereas the positive mood manipulation resulted in a less negative mood. For the positive subscale, results showed a significant interaction time x manipulation as well, (F(1146) = 13.27, p < 0.001). As hypothesized, there was no difference between the ratings pre-manipulation (pre-positive manipulation: M = 27.08, SD = 5.84; pre-negative manipulation: M = 27.51, SD = 5.07, pre-manipulation positive vs negative difference: t(46) = −2.81, p = 0.007) while the post-positive manipulation rating was higher (M = 29.85, SD = 6.17) and the post-negative manipulation rating was lower (M = 25.63, SD = 6.13, post-manipulation positive vs negative difference: t(46) = −0.40, p = 0.69). We computed a difference score of the PANAS evaluations pre and post manipulations in order to test the correlations between participants’ quality of childhood caregiving experience and the effectiveness of the manipulation. No correlation was significant (all ps > 0.18). To test the effect of the mood manipulation on the behavioral response to emotional infant expressions we calculated the mean latency of approach and avoidance for each condition. Then we subtracted the avoidance latency from the approach latency and we used this score as dependent variable in our model, in order to decrease the number of factors in the model and offer an easier interpretation of the effects. A score above 0 means that the avoidance latency was lower than the approach latency, and a score below 0 means a quicker approach compared to avoidance. We used a linear mixed model with random intercept and mood manipulation and infant emotion expression as fixed factors. Results (presented in Fig. 3) did not show significant main effects of emotion expression (F(1, 129.30) = 1.18, p = 0.28) or manipulation (F(1, 133.65) = 0.05, p = 0.83). However, there was a significant interaction effect, F(1, 129.30) = 5.88, p = 0.02, meaning that the effect of mood manipulation was different across the facial expressions of emotions. The preference for avoidance behavior in response to the sad face was enhanced by the negative mood 109

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Fig. 3. Differences in average reaction times (Approach Latency minus Avoidance Latency) for the Happy and Sad Faces. Left panel shows the effects of happy mood manipulation, while the right panel represents the sad mood manipulation. Error-bars represent standard errors of the mean. * = p < 0.05.

manipulation compared to the positive mood manipulation, b = 0.06, SE = 0.02, t(42.64) = 3.28, p < 0.01, 95% CI [0.03; 0.09]. No other comparison showed significant differences after Bonferroni correction. We tested also each difference in reaction times (i.e. approach-avoidance RTs for the happy face after positive manipulation) for a statistical difference from zero, which is the cut-off to discriminate between the preference for the avoidance or the approach behavior. After Bonferroni correction, only the sad face was more difficult to approach after the negative mood manipulation (M = 0.06, SD = 0.10, t(46) = 4.02, p < 0.001). The other differences in RTs showed no significant difference from 0 (all ps > 0.16). No significant correlations were found between RT differences and the quality of caregiving experienced during childhood, after Bonferroni correction for multiple testing (all ps > 0.18) In sum, these results show that the bias is susceptible to manipulation of the emotional context, but does not depend on the quality of childhood experience. The positive mood manipulation buffers the bias toward the sad face that seems confirmed by the negative mood manipulation.

6. General discussion In this study we examined approach and avoidance behavior in response to different infant emotional expressions in nulliparous women. The aim of the study was to test how infant emotional expressions affect adults’ behavioral responses in terms of predisposition to action. In Study 1, we found that individuals were faster in avoiding vs approaching sad, neutral and sleepy infant faces, indicating a bias to avoid sad, neutral and sleepy infant faces. Notably, the bias to avoid sad faces was heightened in adults who experienced more negative childhood experiences, which is consistent with studies showing that parents with history of maltreatment perceive infant signals in a more negative way (Leerkes & Siepak, 2006). This could be relevant for the intergenerational transmission of parenting: Our study indicates that even before the transition into parenthood, a history of harsh caregiving results in avoidant responses to infant distress. In previous work, the augmented approach/avoidance bias toward social stimuli has been found consistent with actual behavior in interaction with these stimuli, as in the case of angry faces that are associated to augmented avoidance in individuals with social anxiety (Heuer et al., 2007; Staugaard, 2010) or augmented approach in individuals high in trait anger (Veenstra, Schneider, Bushman, & Koole, 2017). Therefore, it is possible that the avoidant response shown by participants with a history of harsh caregiving is predictive of a less than optimal behavioral response to infant distress, even if more research is needed to explore the association between the experimental condition and the actual behavior. In Study 2, we manipulated the emotional context of the task: the negative mood anipulation was consistent with the bias to avoid sad faces, while the positive manipulation buffered the sad faces bias. This extends previous research showing that sad mood affects parenting behavior and indicates that mood influences on responding to infant distress is not specific for parents, but are also present in childless individuals. Unexpectedly we did not find an increased avoidance bias for sad infant faces in individuals with harsh caregiving experiences after induced sad mood. Probably, since maltreated participants have an increased bias toward sad faces, experimentally induced sad mood may not be able to further increase this bias. Several limitations of this study must be acknowledged. First, we only selected nulliparous women, while parents show a different response to infant signals compared to individuals without children (Seifritz et al., 2003). We examined responses of adults without children in order to control for influences of experiences with own children. It is consistent with the concept of intergenerational transmission that also ‘non-parents’ carry the imprint of parenting style experienced in childhood. Our results indicate that mood and childhood caregiving experiences, two factors that play a role in parenting behaviors, influence responses to infant emotional 110

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expressions even before the transition into parenthood. This is consistent with previous research showing that nonparents who are at risk for childhood abuse show physiological hyperreactivity to expressions of infant distress (Crowe & Zeskind, 1992). Of course, implications for the caregiving processes could be better understood in parents and should be studied in future research. In addition, a gender effect could be hypothesized, because males might be more biased than females in processing sad infant faces, consistently with their lower parental investment. Furthermore, it must be acknowledged that childhood caregiving experiences were measured with a retrospective self-report questionnaire. Even though the CTQ is a validated and widely used instrument, retrospective measures are vulnerable to recall bias (Hardt & Rutter, 2004). Future research should examine how early childhood experiences influence the perception of infant faces using longitudinal designs. Finally, the measure of childhood experience of childhood was used to test correlations with a single latency measure, but not inserted in the models to test moderation effects, mainly because of power issues, but also to facilitate interpretation of the models. Unfortunately, this decreases the level of inference based on the data. In particular we did not test if the childhood experience was a direct moderator of the effects of other factors. In conclusion, in this first study to examine approach and avoidant responses to infant emotional faces, we found that these responses were influenced by the quality of individual caregiving experience and current mood. A positive mood seems to reduce the bias to avoid sad infants, perhaps because happy feelings result in higher tolerability of infant distress. In addition, individuals with negative caregiving experiences during childhood show an increased bias to avoid sad infants. 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