Investigating Learning, Decision-Making, and Mental Health in Pregnancy: Insights From a UK Cohort Study

Parental capacity to learn from infant responses is a fundamental component of early dyadic interactions. However, the precise cognitive processes involved in these interactions and how these processes are influenced by mental health difficulties remain unclear.

We investigated the computational basis of learning and decision-making in males and nulliparous females (Study 1) and pregnant participants enrolled in a cohort study (Study 2), using a two-armed bandit task adapted to simulate playful interactions with an infant. Participants chose between two competing bandits (i.e., two toys) with different underlying nominal probabilities for three outcomes (i.e., infant sad, neutral, and happy facial expressions). In Study 1, we manipulated the baseline emotional context of the task (i.e., the infant started either happy or sad) to investigate its effect on the processing of emotional feedback and decision-making. In both studies, we explored whether individual differences in mental health and personalities difficulties associated with variation in parameters.

In Study 1, the emotional context manipulation influenced both learning rates and how neutral outcomes were evaluated. Participants starting with a happy infant exhibited faster learning and a more negative evaluation of neutral outcomes compared to those starting with a sad infant. In Study 2, participants reporting higher levels of personality difficulties and antenatal depressive symptoms showed reduced learning rates. These associations were weaker in Study 1.

Our findings provide novel evidence regarding the role of the emotional context in learning and decision-making processes. For parents with depressive symptoms and personality difficulties, dampened responsivity to emotional feedback and inflexibility in updating beliefs about the values of actions may underlie fewer sensitive behaviours when interacting with their infants.