Attentional biases in women with postpartum depressive symptoms: A comparative eye-tracking study

Postpartum depression (PPD) has been linked to alterations in emotional processing, yet attentional biases toward infant emotional expressions remain poorly understood and findings are inconsistent. This study examined whether mothers with PPD symptoms differ from mothers without symptoms and non-depressed non-mothers in visual attention to emotional infant and adult faces.

26 mothers with PPD symptoms, 30 mothers without symptoms, and 21 non-depressed non-mothers. Participants completed a free-viewing eye-tracking task presenting emotional (happy, angry, sad) and neutral faces of infants and adults. Measures of initial orientation and attentional maintenance were analyzed using linear mixed models.

Mothers with PPD oriented faster to happy infant faces than both control groups, but this early bias was not accompanied by greater sustained attention. Greater PPD symptom severity was marginally associated with slower orientation to infant sadness. At later stages, mothers with PPD showed reduced avoidance of infant sadness and increased sustained attention to angry infant expressions. Higher PPD scores were associated with greater maintenance of attention to negative expressions across infant and adult faces. For adult stimuli, mothers with PPD showed increased sustained attention to negative and reduced processing of positive expressions, whereas mothers without PPD and non-mothers preferentially attended to happy faces.

PPD is associated with a dynamic, context-dependent pattern of attention rather than a uniform bias. While attentional processing of adult faces fits cognitive models of depression, responses to infant faces reflect a more complex pattern combining an early orientation toward positive stimuli but subsequent capture by negative cues.