Emotion regulation has been identified as a key factor in depression, but its role in perinatal depressive symptoms remains less understood, particularly at the neural level. The present study aimed to investigate behavioural and neural correlates of emotion regulation in the early postpartum period, and to examine how these relate to depressive symptom severity. 34 peripartum participants completed self-report measures of depressive symptoms (EPDS), emotion regulation difficulties (DERS-16), and regulation strategies (ERQ), of whom 12 also completed a task-based fMRI cognitive reappraisal paradigm. Whole-brain and region-of-interest analyses were conducted to examine neural activation during emotion regulation, and associations with behavioural measures were assessed. Behaviourally, participants with elevated depressive symptoms reported significantly greater overall regulation difficulties (DERS-16), and depressive symptoms correlated positively with DERS-16 scores across the full sample; no significant group differences emerged on the ERQ. Whole-brain fMRI analyses did not reveal significant regulation-specific effects, but region-of-interest analyses showed a consistent pattern of reduced engagement of cortical regulatory regions and altered amygdala responses in the elevated-symptom group, with a large effect size in the amygdala (Cohen's d = -1.01). Analyses indicated that higher depressive symptoms predicted lower posterior cingulate cortex and supplementary motor area engagement, while greater self-reported reappraisal use predicted greater supplementary motor area activation. Although results should be interpreted cautiously given the small fMRI sample, the convergence across behavioural and neural measures supports a frontolimbic dysregulation account of perinatal depressive symptoms and extends an emerging antenatal neural risk-marker literature into the postpartum period. Future studies using larger and longitudinal samples will be important for clarifying these relationships.
Granskare: Olga Kochukhova