Gervais & Fessler (G&F) describe the complex phenomenon of contempt within functional networks of attitudes and emotions. The related inverse concept of parental sensitivity may provide a framework for underlying brain mechanisms. Maternal sensitivity comprises the thoughts and behaviors required for parenting, including recognition and acknowledgment of baby, reflective self-awareness, and emotion regulation toward social attachment (Ainsworth & Bell Reference Ainsworth and Bell1970; Bowlby Reference Bowlby1958; Mayes et al. Reference Mayes, Swain and Leckman2005; Swain et al. Reference Swain, Mayes and Leckman2004). This is also present for fathers (Swain & Lorberbaum Reference Swain, Lorberbaum and Bridges2008; Swain et al. Reference Swain, Dayton, Kim, Tolman and Volling2014a) with brain circuits that are highly adaptable (Kim et al. Reference Kim, Rigo, Mayes, Feldman, Leckman and Swain2014; Reference Kim, Strathearn and Swain2016b) – perhaps a critical realization because they relate to child outcome (Kim et al. Reference Kim, Rigo, Leckman, Mayes, Cole, Feldman and Swain2015b). Indeed, studies of brain activity as a function of listening to baby cry in the early postpartum period have established responses in adaptable social brain circuits, including those concerning emotion response and regulation in addition to dissociable and volitional attention and executive function, reward and motivation, and sensorimotor circuits (Buckner et al. Reference Buckner, Andrews-Hanna and Schacter2008; Seeley et al. Reference Seeley, Menon, Schatzberg, Keller, Glover, Kenna, Reiss and Greicius2007; Sripada et al. Reference Sripada, Angstadt, Kessler, Phan, Liberzon, Evans, Welsh, Kim and Swain2014; Swain Reference Swain2011; Swain et al. Reference Swain, Kim, Spicer, Ho, Dayton, Elmadih and Abel2014b).

Brain affect regulation centers are more sensitive for vaginal versus cesarean deliveries (Swain et al. Reference Swain, Tasgin, Mayes, Feldman, Constable and Leckman2008) and breastfeeding versus formula-feeding mothers (Kim et al. Reference Kim, Feldman, Mayes, Eicher, Thompson, Leckman and Swain2011). In these studies, brain responses to infant stimuli vary according to maternal mood, and predict parental sensitivity (Elmadih et al. Reference Elmadih, Wan, Downey, Elliott, Swain and Abel2016), as well as the related constructs of empathy (Ho et al. Reference Ho, Konrath, Brown and Swain2014) that guide sensitive decision-making (Swain & Ho Reference Swain and Ho2017). Own versus other baby cry stimuli have been studied for associations with maternal mental state talk (Hipwell et al. Reference Hipwell, Guo, Phillips, Swain and Moses-Kolko2015). In this work, mothers were filmed in face-to-face interaction with their 4-month-old infants, and maternal behaviors were blindly and independently coded. Higher functional activity in the right fronto-insular cortex to own versus other baby cry at the group level, in addition to bilateral subcortical regions including the thalamus, amygdala, hippocampus, and putamen, was positively associated with mental-state talk. Rather than being related to global aspects of observed caregiving, relationships were reported between brain activity and perceptual and contextual covariates, such as maternal felt distress, urge to help, depression severity, and recognition of own infant cry. This suggests many nuances of parental brain activity that may fit with the notion of sentiments (G&F), in which, for example, contempt may co-exist with other sentiments important for parenting such as liking, loving, respect and caring (parental nurturance) (Davis & Panksepp Reference Davis and Panksepp2011).

Further brain evidence for the necessary plasticity in parental brain circuits among the same mothers includes affect regulation brain function changes in response to baby cry (Swain Reference Swain2008) and structure changes over the postpartum according to positive perceptions of baby (Kim et al. Reference Kim, Leckman, Mayes, Feldman, Wang and Swain2010a) suggesting adaptability according to parental affect and circumstances. Maternal brains are more sensitive to infant cry according to perception of early-life caregiving (Kim et al. Reference Kim, Leckman, Mayes, Newman, Feldman and Swain2010b), suggesting long-term transgenerational effects of parental sensitivity on affect regulation. Finally, a widespread set of brain responses were reported in a recent study of mothers responding to child visual feedback after a caring decision (Ho et al. Reference Ho, Konrath, Brown and Swain2014). Responses that correlated with dimensions of empathy included the amygdala, ventrolateral prefrontal cortex (PFC), and supplementary motor area that may also fit with broader work on altruism (Brown & Brown Reference Brown and Brown2015; Preston Reference Preston2013; Swain et al. Reference Swain, Konrath, Brown, Finegood, Akce, Dayton and Ho2012) and critically inform progress on consciousness connecting sensory with motor output as aspects. Although most of the work has involved relations of brain activity with caregiving sentiments, there are presumably relations with corollary variables such as contempt. This is included in the literature on the corollary of long-term adverse effects on maternal sensitivity – perhaps akin to contempt – in which postpartum psychopathology and reduced sensitivity have just begun to be studied.

Indeed, postpartum depression is associated with deficits in parenting (Feldman et al. Reference Feldman, Granat, Pariente, Kanety, Kuint and Gilboa-Schechtman2009), which may include exaggerated components of the sentiment of contempt. Ongoing research on brain function beyond the normal range of parental anxiety (Leckman et al. Reference Leckman, Feldman, Swain, Eicher, Thompson and Mayes2004; Kim et al. Reference Kim, Mayes, Feldman, Leckman and Swain2013), such as with postpartum depression, suggests impairments in specific empathy and emotion regulation circuits (Moses-Kolko et al. Reference Moses-Kolko, Horner, Phillips, Hipwell and Swain2014). Highlights of this research on maternal depression and brain function include evidence for reduced reward circuit activity (Laurent & Ablow Reference Laurent and Ablow2012), dampened emotion circuit response (Barrett et al. Reference Barrett, Wonch, Gonzalez, Ali, Steiner, Hall and Fleming2012), and connectivity (Wonch et al. Reference Wonch, de Medeiros, Barrett, Dudin, Cunningham, Hall, Steiner and Fleming2016) using own baby picture stimuli. Furthermore, even less severe adverse circumstances can interfere with parental brain responses such as the stress of poverty (Kim et al. Reference Kim, Ho, Evans, Liberzon and Swain2015a; Reference Kim, Strathearn and Swain2016b) and lack of parent–infant synchrony (Atzil et al. Reference Atzil, Hendler and Feldman2011; Reference Atzil, Hendler, Zagoory-Sharon, Winetraub and Feldman2012; Reference Atzil, Hendler and Feldman2014) – perhaps also related to contempt.

An important next step is to elucidate brain mechanisms that reflect change with a parenting treatment, such as Mom Power (MP) – equipped with cognitive-behavioral therapy techniques, mindfulness, and distress tolerance practices – likely to decrease contempt. It has been shown that mothers undergoing MP exhibit reduced parenting stress, less depression and anxiety, and increased bonding toward their children (Muzik et al. Reference Muzik, Rosenblum, Alfafara, Schuster, Miller, Waddell and Kohler2015). For the first time, (Swain et al. Reference Swain, Ho, Rosenblum, Morelen, Dayton and Muzik2017), mothers were studied before and after parenting intervention. Twenty-nine mothers with a wide range of depression symptoms were pseudo-randomly assigned to either MP (n=14) or control (n=15). Compared with control, MP decreased parenting stress and increased child-focused responses and connectivity in social brain areas. Furthermore, over 13 weeks, reduction in parenting stress was related to increasing child-focused versus self-focused baby-cry responses in amygdala-temporal pole functional connectivity, which may mediate maternal ability to take the perspective of her child. Future studies may explore the brain basis of contempt among parents to understand when it may be compatible with sensitive parenting and when it may be incompatible with parental sensitivity yet perhaps amenable to treatment to the benefit of child outcome.