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Inhibitory control in first-time fathers: Neural correlates and associations with paternal mental health

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Inhibitory control in first-time fathers: Neural correlates and associations with paternal mental health

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Content INHIBITORY CONTROL IN FIRST-TIME FATHERS: NEURAL CORRELATES AND
ASSOCIATIONS WITH PATERNAL MENTAL HEALTH
by
Yael H. Waizman, B.S.
A Thesis Presented to the
FACULTY OF THE USC DORNSIFE COLLEGE OF LETTERS, ART,S AND SCIENCES
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
MASTER OF ARTS
(PSYCHOLOGY)
December 2023

ii
Table of Contents
List of Tables…………………………………………………………………………………......iii
List of Figures………………………………………………………………………………….....iv
Abstract…………………………………………………………………………………................v
Chapter 1: Introduction………………………………..………………………………………..…1
1.1. Current Study...………………………………………………………………………..5
1.2. Aim 1…………………………………………………………………………………..5
1.2.1. Hypothesis 1………………………………………………………………………5
1.3. Aim 2…………………………………………………………………………………..6
1.3.1. Hypothesis 2………………………………………………………………………6
1.3.2. Hypothesis 3………………………………………………………………………6
1.3.3. Hypothesis 4………………………………………………………………………6
1.4. Aim 3…………………………………………………………………………………..6
1.4.1. Hypothesis 5………………………………………………………………………6
Chapter 2: Methods……………………………..………………………………..………………..8
2.1. Participants…………………………………………………………………………….8
2.2. Procedures.………………………………………………………….…………………8
2.2.1. Recruitment…………………………………………………………………….....8
2.2.2. Study Visits…………………………………………………………………….....9
2.2.3 MRI Data Acquisition…………………………………………………….…….....9
2.3. Materials……………………………………………………………………..…….....10
2.3.1. fMRI Go/No-Go Task………..………………………………………...………..10
2.3.2. Beck Depression Inventory-II (BDI-II).…………………………….…………..10
2.3.3. State-Trait Anxiety Inventory (STAI)…………………………………………..11
2.4. Analysis Plan…………………………………………………………………............11
2.4.1. Behavioral Analyses…………………………..….……………………………..11
2.4.2. fMRI Preprocessing………………………………..……………………………12
2.4.3. fMRI Analyses……………………..……………………………………………13
Chapter 3: Results………..………………………………………………………………………14
3.1. Hypothesis 1……………….………………………………………………………....14
3.2. Hypothesis 2……………………………………………………………………….....14
3.3. Hypothesis 3……………….………………………………………………………....14
3.4. Hypothesis 4……………………………………………………………………….....14
3.5. Hypothesis 5a………………...……………………………………………………....15
3.6. Hypothesis 5b………………..…………………………………………………….....15
Chapter 4: Discussion………..…………………………………………………………………..17
References………………………………………………………………………………………..34

iii
List of Tables
Table 1. Group means and standard deviations from demographic and questionnaire data..........22
Table 2. Group-level results of the correct no-go > correct go contrast for pink noise
condition (Hypothesis 3).................................................................................................27
Table 3. Group-level results of the correct no-go > correct go contrast for infant cry
condition (Hypothesis 4) ................................................................................................29
Table 4. Group-level results of the correct no-go > correct go contrast for the silent
condition with mean centered-depression scores added as a regressor (Hypothesis 5)..32

iv
List of Figures
Figure 1. Go/No-Go Task Design is identical across the three conditions, the only
difference between them is the sound stimuli (silent, continuous infant cries, or
continuous pink noise)....................................................................................................24
Figure 2. No significant differences in first-time fathers’ accuracy scores for effectively
inhibiting a response on no-go trials across all three conditions (silent, pink noise,
infant cry; H1) of the Go/No-Go task (n = 32)...............................................................25
Figure 3. Group-level significant cluster results of the no-go > go contrast for pink noise
condition (Hypothesis 3)……….....................................................................................26
Figure 4. Group-level significant cluster results of the no-go > go contrast for infant cry
condition (Hypothesis 4)……….....................................................................................28
Figure 5. Group-level significant cluster results of the no-go > go contrast for silent
condition when mean-centered depression scores were added as a regressor
(Hypothesis 5).................................................................................................................31
Figure 6. Greater levels of 6-months PP predicted increased activation in left aPFC when
effectively inhibiting a response………………………………………………………33

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Abstract
Difficulty with inhibitory control, a form of self-regulation, has been linked to negative
parenting outcomes and mental health challenges in mothers. However, the implications of
inhibitory control for first-time fathers have not been investigated. Given the heightened risk of
postpartum mental health issues in both mothers and fathers, research investigating the
relationship between inhibitory control and adjustment to fatherhood is warranted. This study
explored the neural underpinnings of inhibitory control and its associations with paternal mental
health at six months postpartum using an adapted Go/No-Go fMRI task with infant cry, pink
noise, and silent conditions. Contrary to our expectations, we did not observe any differences in
fathers' inhibitory accuracy when completing a Go/No-Go task with infant cry sounds compared
to silence or pink noise, although we did identify distinct patterns of neural activation across the
three sound conditions. Specifically, fathers exhibited neural activation in a greater number of
brain regions when effectively inhibiting in the presence of infant cries (e.g., right dlPFC, right
insula, right IFGoperc, right aPFC, right PMd/SMA, left SMG, left ANG, VMA, and FEF) as
compared to the other two conditions. Moreover, fathers' postpartum depressive symptoms were
positively associated with their activation in the left aPFC while effectively inhibiting during the
silent condition. In contrast, postpartum anxiety was not associated with fathers’ brain activation
across any task conditions. This study offers insights into the neural underpinnings of inhibitory
control, responses to infant cries, and postpartum mental health in first-time fathers, providing a
foundation for future research.

1
Inhibitory control in first-time fathers: Neural correlates and associations with paternal
mental health
Chapter 1: Introduction
New parents’ ability to self-regulate is vital for their own well-being and for effective
caregiving, particularly when addressing their infant's distress. Although some studies have
begun exploring inhibitory control (a form of self-regulation) in mothers (Alves Gracioli &
Martins Linhares, 2019), further research is needed to understand how first-time fathers engage
in inhibitory control. Difficulties with inhibitory control are also common in various mental
health disorders, affecting a wide range of populations, not just parents (Ansari & Derakshan,
2011; Lynch et al., 2004; Richard-Devantoy et al., 2012; Wood et al., 2001). Moreover, given
the high prevalence of mental health concerns in both mothers and fathers during the postpartum
period, it is crucial to investigate the association between inhibitory control and paternal
postpartum mental health in general, and in the presence of emotionally salient parenting stimuli
(e.g., infant cries). As such, this study explored the neural underpinnings of inhibitory control in
the presence of three different sound conditions (silence, pink noise, and infant cry) and their
associations with postpartum mental health in first-time fathers.
In this study, we defined inhibitory control as the ability to self-regulate automatic
thoughts, behaviors, and/or emotions to adapt to the environment (Diamond, 2013). Inhibitory
control involves suppressing unwanted information or actions that compete for mental resources
due to the limited cognitive capacity humans have (Hasher et al., 1991). This process is
commonly probed in fMRI studies using the well-validated Go/No-Go task (Aron & Poldrack,
2006), which includes a go stimulus and a no-go stimulus, often a letter or image, where
participants are instructed to rapidly respond to go stimuli and suppress a response to no-go

2
stimuli. This task measures response inhibition, which involves suppressing a prepotent response
and engaging in a more context-appropriate action.
Since inhibitory control enables self-regulation to adapt to our environment, it is not
surprising that difficulties with inhibitory control are often observed in mental health disorders,
such as depression and anxiety. (Ansari & Derakshan, 2011; Lynch et al., 2004; RichardDevantoy et al., 2012; Wood et al., 2001). For example, individuals who struggle to inhibit
negative thoughts from entering and remaining in their working memory may contribute to the
occurrence of rumination, a common symptom of depression (Joormann, 2010; Joormann et al.,
2007) and anxiety (Olatunji et al., 2013). Moreover, patients with major depressive disorder were
found to be significantly impaired on all inhibition measures, including a Go/No-Go task
(Snyder, 2013).
Beyond exploring inhibitory control and mental health using behavioral or self-report
measures, reviewing the neural correlates that have been found to be implicated by these
processes can offer valuable insight into their relationship. Since people frequently engage in
inhibitory control while processing information from various sensory modalities, Sun et al.
(2022) examined the brain regions engaged during a multisensory Go/No-Go task that
incorporated both visual and auditory stimuli. Sun et al. (2022) found that the left inferior
parietal lobule (IPL), left precentral gyrus (PreCG), bilateral superior temporal gyrus (STG), and
some areas within the ventral stream were implicated in the multisensory Go/No-Go task.
Furthermore, the neural networks associated with inhibitory control while completing a standard
(silent – without any auditory stimuli) Go/No-Go task include the dorsolateral cortex (dlPFC),
ventrolateral prefrontal cortex (vlPFC), supplementary motor area (SMA), posterior parietal
cortex (PPC), inferior parietal lobule (IPL), insula, superior temporal gyrus (STG), and dorsal

3
anterior cingulate cortex (dACC) (Cipolotti et al., 2016; Hung et al., 2018; Krämer et al., 2013;
Munakata et al., 2011; Sun et al., 2022; van Gaal et al., 2008). Some of these brain regions
associated with inhibitory control are also implicated in depression and anxiety, including the
dlPFC, STG, and ACC (De Bellis et al., 2002; Koenigs et al., 2008; Pagliaccio et al., 2015;
Silton et al., 2011; Takahashi et al., 2010).
Although research has begun to explore the neural basis of inhibitory control and mental
health, research on these processes during the postpartum period remains scarce, particularly
among first-time fathers who are at a heightened risk for mental health disorders (Philpott et al.,
2017). One study on fathers found that an increase in grey matter volume in the striatum and
subgenual ACC over the first four months postpartum was associated with fewer depressive
symptoms (Kim et al., 2014). However, the neural correlates of postpartum mental health in firsttime fathers remain unclear, both when examined independently and in the context of inhibitory
control more specifically.
Beyond its association with mental health, inhibitory control seems to also be important
for effective caregiving. For instance, parents need to remain well-regulated in the face of their
child’s distress to meet their child’s needs and promote their own well-being. (Ainsworth, 1979;
Alves Gracioli & Martins Linhares, 2019; Malmberg et al., 2016; Rutherford et al., 2015; Shaffer
& Obradović, 2017). In other words, parents’ ability to manage their own emotional, cognitive,
and physiological arousal using inhibitory control (a form of self-regulation) may facilitate more
sensitive caregiving. Thus, inhibitory control challenges have been linked to maladaptive
caregiving practices and negative emotional outcomes in mothers (Alves Gracioli & Martins
Linhares, 2019), however, these processes remain unclear in the context of fatherhood.

4
While research on fathers' inhibitory control is limited, some studies have investigated
the neural responses fathers have to infant cues. One study found activation in multiple brain
regions, including the mPFC, bilateral anterior insula, IFG, bilateral striatum, bilateral thalamus,
bilateral auditory cortex, bilateral posterior cingulate, and bilateral midbrain structures (Li et al.,
2018) to be associated with infant cries. In a sample of expectant fathers that overlaps with the
current study, bilateral areas of the temporal lobe implicated in processing speech sounds and
social-emotional stimuli were activated in response to infant cries compared to white noise
(Khoddam et al., 2020). Overall, infant cry sounds may engage socio-cognitive areas such as the
VTA, NAcc, STG, insula, mPFC, dlPFC, auditory cortices, and IFG. This work provides
valuable insights into the brain regions implicated by infant cries that may also be involved when
fathers engage in inhibitory control in the presence of their distressed infant.
Recognizing the significance of regulatory prefrontal regions in responding to infant cries
and their association with mental health disorders, studies have aimed to understand the neural
basis of postpartum mental health as it relates to exposure to infant emotional cues. Broadly, it
has been found that mothers with postpartum depression or anxiety have reduced activation in
brain regions involved in emotional response and regulation (e.g., dmPFC, ACC, PCC, insula,
OFC, STG, SFG, medial and middle frontal gyrus, striatum, thalamus, hippocampus, substantial
nigra, VTA, and PAG) in responses to infant cries (Barrett et al., 2012; Laurent & Ablow, 2012;
Pawluski et al., 2017). Despite the attenuation of regulatory prefrontal regions, no published
work has explored the neural underpinnings of infant cries and postpartum depression in the
context of effective regulation. This limits our understanding of the neural mechanisms that may
drive sensitive caregiving in the presence of postpartum mental health difficulties. Additionally,
research examining the neural activation associated with paternal postpartum mental health and

5
inhibitory control is limited. Since fathers play a vital role in infant caregiving that may shape
child development and are prone to mental health problems during the postpartum period, it is
important to study the neural underpinnings of these processes in associations with inhibitory
control.
1.1. Current Study
This study examined the neural correlates of effective inhibitory control among first-time
fathers who participated in MRI scanning when their infants were approximately six months old.
Given the evidence that responses to infant cries might be linked with postpartum mental health,
fathers completed self-report measures (to assess postpartum depression and anxiety) and a
Go/No-Go task in the presence of three different sound conditions (silence, pink noise, and infant
cry sounds). Pink noise is similar to white noise, but whereas white noise is characterized by
equal power at all frequencies, pink noise contains a random assortment of all the audible
frequencies, with more power in the lower frequencies, and therefore sounds more natural to the
human ear.
1.2. Aim 1: Investigate the impact of different sound conditions (silence, pink noise, and
infant cry) on first-time fathers' ability to effectively inhibit a response during the Go/Nogo task.
1.2.1. Hypothesis 1. Since infant cries are emotionally salient and tend to capture new
parents’ attention automatically, we hypothesized that fathers would exert more cognitive effort
to suppress the task-irrelevant emotional stimuli (e.g., infant cries) and remain engaged in the
cognitive task by regulating effectively. Thus, we expected that first-time fathers' accuracy on
the Go/No-go task will be lowest during the infant cry condition compared to pink noise or

6
silence conditions, reflecting the greater cognitive demand of inhibitory control in the presence
of emotionally salient parenting stimuli.
1.3. Aim 2: Explore the neural underpinnings of inhibitory control in first-time fathers
across different sound conditions of a Go/No-go task (silence, pink noise, and infant cry),
focusing on the activation of brain regions associated with inhibitory control, multisensory
and infant cry processing.
1.3.1. Hypothesis 2. Fathers will exhibit neural activation in regions implicated in
inhibitory control (e.g., dlPFC, vlPFC, SMA, PPC, IPL, insula, STG, dACC) while accurately
regulating a response during the standard (silence) Go/No-Go task condition.
1.3.2. Hypothesis 3. Fathers may exhibit neural activation in both multisensory
processing (IPL, PreCG, STG) and inhibitory control (e.g., dlPFC, vlPFC, SMA, PPC, IPL,
insula, STG, dACC) regions when effectively inhibiting a response during the pink noise
condition.
1.3.4. Hypothesis 4. Fathers will exhibit neural activation in regions implicated in
multisensory processing (IPL, PreCG, STG), inhibitory control (e.g., dlPFC, vlPFC, SMA, PPC,
IPL, insula, STG, dACC), and infant cry sounds (e.g., VTA, NAcc, STG, insula, mPFC, dlPFC,
auditory cortices, and IFG) when effectively inhibiting a response during the infant cry
condition.
1.4. Aim 3: Characterize the association between postpartum mental health in first-time
fathers and their neural activation when effectively exerting inhibitory control across
different Go/No-go task conditions.
1.4.1 Hypothesis 5. Since poor mental health is associated with worse inhibitory control
abilities more broadly, we expected that greater levels of postpartum depression and anxiety

7
symptoms will associate with lower accuracy scores (5a) and require more cognitive effort as
measured by greater neural activation in inhibitory areas (5b) to effectively regulate across all
conditions of the Go/No-Go task (silence, pink noise, infant cry).

8
Chapter 2: Methods
2.1. Participants
The current study used existing data from the large longitudinal Hormones and
Attachment across the Transition to Childrearing (HATCH) study (Saxbe et al., 2018, 2019)
funded by the National Science Foundation (NSF). The HATCH study followed first-time
expectant parents within mixed-sex dyads from pregnancy (6-7 months gestation) across the first
year postpartum. In total, 100 couples participated in this longitudinal study, and 38 fathers
completed the postpartum MRI scan. The current study focuses only on fathers who completed
the MRI visit.
Of the 38 fathers who participated in postpartum MRI scanning, Go/No-Go task
performance was unavailable for six of them due to issues with the button box. An additional six
fathers were excluded from fMRI analyses due to drop-out and scanning artifacts that made their
data unusable. Therefore, our behavioral analyses included all 32 fathers, whereas fMRI analyses
included 26 fathers in total. The 32 fathers whose data is analyzed in this study reported the
following ethnic/racial identities: 34.37% Caucasian, 9.37% African American, 21.88% Asian or
Pacific Islander, and 6.25% other. Additionally, 28.13% of our sample reported being Hispanic
or Latino/a. Demographic information for all study visits is provided in Table 1.
2.2. Procedures
2.2.1. Recruitment. Participants were recruited through flyers, social media advertising,
and word of mouth. Interested participants contacted the laboratory and were screened for study
eligibility that was determined based on the following criteria: 1) opposite-sex couples in a
cohabitating relationship; 2) first pregnancy for both expectant parents; 3) viable singleton fetus
at the time of participation; 4) parents were not taking psychotropic medications. Eligible

9
couples were initially invited to the lab during mid-to-late pregnancy where they provided
informed consent. A subsample of the HATCH fathers were invited to complete the MRI visit.
Exclusion criteria for the MRI visit included any contraindications for MR scanning, severe
learning disability, left-handedness, neurological or movement disorders, or history of brain
injury. The study was approved by the Institutional Review Board (IRB) of the University of
Southern California (USC).
2.2.2. Study Visits. The current study analyzed data collected from the six months
postpartum laboratory and MRI visits. The six months postpartum lab visit occurred at the
NeuroEndocrinology of Social Ties (NEST) lab at USC. At this lab visit, participants completed
the Beck Depression Inventory-II (BDI-II; Beck, Steer, and Brown 1996) and the State-Trait
Anxiety Inventory (STAI; Spielberger et al., 1983). The MRI visit was conducted at the Dana
and David Dornsife Cognitive Neuroimaging Center (DNI) at USC approximately two weeks
following the six months postpartum lab visit – although four fathers completed their scan later
than originally planned due to the COVID-19 pandemic disrupting data collection.
2.2.3. MRI Data Acquisition. Whole-brain fMRI images were collected using a Siemens
3 Tesla MAGNETON Prisma System scanner using a 20-channel matrix head coil. Functional
images were acquired using a gradient-echo, echo-planar image (EPI) sequence (TR = 2000 ms;
flip angle: 90°, 90 volumes, slice thickness 2.5 mm). Visual stimuli were projected on the rear
screen using an LCD projector. Participants reported their responses on the button box using the
right index finger. Participants heard the auditory stimuli through the Siemens V14 sound
headphone system.

10
2.3. Materials
2.3.1. fMRI Go/No-Go Task. This project used the widely used inhibitory control
measure, the Go/No-Go task (Aron & Poldrack, 2006). We adapted the task to examine three
sound conditions: silence, pink noise, and infant cry. Each condition was administered as an
independent run. Structural magnetization prepared rapid gradient-echo (MP-RAGE) or diffusion
tensor imaging (DTI) scans, were administered between each condition to ensure no spillover of
auditory stimuli took place between runs. The pink noise and infant cry conditions used
previously-validated auditory stimuli (Riem et al., 2012) and were played continuously
throughout the task, while the silent condition was performed without any sound (Figure 1). Pink
noise was characterized by a logarithmically decreasing power across the frequency spectrum,
resulting in equal power within each octave. This task had an event-related design and runs were
administered in counterbalanced order. A trial on this task began with a randomized stimulus
presentation where participants were instructed to rapidly press a button for all letters presented,
except for the letter, “X,” which appeared in 20% of trials. Then, participants were presented
with a randomized jitter that ranged from 0.5-seconds to a 1-second display. Each condition/run
had 100 trials (80 Go; 20 No-Go). Thus, in total, participants completed 300 trials across the
three conditions (silence, infant cry, and pink noise).
2.3.2. Beck Depression Inventory-II (BDI-II). This 21-item self-report questionnaire
was revised from the original BDI to assess participants’ depressive symptoms (e.g., sadness,
pessimism, loss of pleasure, etc.) in the past two weeks, including today. Participants rated each
item on a 4-point Likert scale ranging from 0 (“No severity”) to 3 (“High severity”). A greater
sum of scores notes greater severity of depressive symptomatology. There were no missing
responses for any of the BDI items. At the request of the university IRB (ethics review board), a

11
single item related to suicidal thoughts or wishes was omitted from this study. This inventory
demonstrated good psychometric properties (Beck et al., 1996) and also exhibited excellent
reliability in our sample (α = .91).
2.3.3. State-Trait Anxiety Inventory (STAI). State anxiety was assessed using the 20-
item STAI self-report questionnaire. We did not measure trait anxiety, only state anxiety, in this
study. Participants rated their present feelings (e.g., “I feel calm,” “I am tense,” etc.) on a 4-point
Likert scale ranging from 0 (“Not at all”) to 4 (“Very much so”). Items that were positively
worded were reverse-scored and a higher sum of scores indicated heightened feelings of anxiety.
There were no missing responses for any of the STAI items. This instrument is widely used,
well-validated (Spielberger et al., 1983), and had excellent reliability in our sample (α = .91).
2.4. Analysis plan
We conducted data analysis in R (R Core Team, 2020) for the behavioral data, and used
FSL (FMRIB's Software Library, www.FMRIb.ox.ac.uk/fsl; Smith et al., 2004) for the fMRI
data. The scripts used to analyze both behavioral and neural data will be uploaded to the Open
Science Framework (OSF) following the publication of the manuscript.
2.4.1. Behavioral Analyses. We used the behavioral data from the Go/No-Go task to
calculate accuracy for correct no-go trials by subtracting the number of impulsive errors (i.e.,
keypresses during no-go trials) that were made from the total number of no-go trials (i.e., 20 total
no-go trials per condition) and divided that by 20 (i.e., total no-go trials per condition). In this
context, greater impulsive errors signify worse inhibitory control and a lower accuracy score.
Three mean accuracy scores were calculated for each condition (mean accuracy score for silence,
mean accuracy score for pink noise, and mean accuracy score for infant cry).

12
To test our hypothesis that fathers' accuracy on the Go/No-go task (i.e., ability to
effectively inhibit a response on no-go trials) would be lowest during the infant cry condition
compared to pink noise or silence conditions (Hypothesis 1), we performed a one-way analysis
of variance (ANOVA) using the 'aov' function in R to compare the mean accuracy scores across
the three conditions (infant cry, pink noise, and silence). The dependent variable in our analysis
was the accuracy of the Go/No-go task, and the independent variable was the condition (infant
cry, pink noise, or silence).
To test our hypothesis that greater levels of postpartum depression and anxiety symptoms
would be associated with lower accuracy scores and require more cognitive effort across all
conditions of the Go/No-go task (silence, pink noise, infant cry; Hypothesis 5a), we conducted
multiple regression analyses using R's 'lm' function. Separate analyses were conducted for each
condition, with depression or anxiety sum of scores as the predictor variables and the
corresponding accuracy scores as the outcome variables while controlling for prenatal depression
or anxiety scores, and the lag time between the six months postpartum lab and MRI visits. We
also included the child’s age as a covariate to control for the fathers’ parenting experience and
their infant’s developmental stage.
2.4.2. fMRI Preprocessing. We visually inspected images to check for severe motion and
image quality. We preprocessed and analyzed the Go/No-Go data using FSL’s fMRI analysis
tool, FEAT version 6.00 for both first-level (Woolrich et al., 2001) and group-level analyses
(Woolrich et al., 2004). T1-weighted images were registered using FLIRT (Jenkinson et al.,
2002). We then conducted motion correction using MCFLIRT (Jenkinson et al., 2002), non-brain
removal using BET (Smith, 2002), spatial smoothing using 5 mm FWHM Gaussian kernel, and

13
high-pass temporal filtering using Gaussian-weighted least-squares straight-line fitting and the
standard value for sigma as set by FSL.
2.4.3. fMRI Analyses. Using FEAT and a fixed-effects design, we conduct whole-brain
lower-level analyses using the General Linear Model (GLM). To identify the neural correlates of
response inhibition in first-time fathers, we extracted whole-brain parameter estimates by
contrasting correct no-go and go trials (e.g., no-go > go) for each sound condition (Hypotheses 2
– 4). Analyses were run only on correct trials to examine effective self-regulation. We created
regressors by convolving the stimulus presentation timing with the canonical hemodynamic
response function. Motion parameters were also included as regressors. Statistical significance
was set for a z-threshold of 2.3 and p < .05 for cluster significance. We applied the same
threshold for the group-level analyses. These first-level analyses were utilized to calculate the
average activation for correct no-go > correct go contrast in the group-level analyses using
FMRIB’s Local Analysis of Mixed Effects (FLAME 1).
To investigate how postpartum mental health is associated with neural activation during
inhibitory control in first-time fathers (Hypothesis 5b), we included either the mean-centered
depression or anxiety scores as a regressor in the group-level GLM analyses for each condition
type separately. This allowed us to investigate whether paternal postpartum mental health is
associated with neural activation during response inhibition across the three conditions of the
task (silent, infant cry, or pink noise).

14
Chapter 3: Results
3.1. Hypothesis 1 (Inhibition Accuracy Across Sound Conditions): To test our
hypothesis that effective inhibitory control would differ across conditions, we compared
accuracy scores for silence, infant cry, and pink noise using a one-way ANOVA. Contrary to our
hypothesis, we found no significant effect of condition on fathers’ ability to effectively inhibit a
response during the Go/No-go task, F(2, 75) = 1.10, p = .34 (Figure 2). The mean accuracy and
standard deviation values for each condition were as follows: infant cry (M = .93, SD = .08), pink
noise (M = .94, SD = .05), and silence (M = .92, SD = .06).
3.2. Hypothesis 2 (Neural Activation for the Silent Condition): To assess the neural
correlates of effective inhibitory control in the silent condition, we examined the main effects of
correct no-go versus correct go contrast. Contrary to our expectations, no significant clusters of
activation were observed, indicating the absence of brain regions exhibiting increased activation
during correct no-go compared to correct go trials during the silent condition.
3.3. Hypothesis 3 (Neural activation or the Pink Noise Condition): To examine the
neural underpinnings of effective inhibitory control in the pink noise condition, we examined the
main effects of correct no-go versus correct go. As expected, one significant cluster of activation
was observed in areas engaged in bimodal Go/No-Go tasks, including the right angular gyrus
(ANG) and the right supramarginal gyrus (SMG) during correct no-go trials compared to correct
go trials in the pink noise condition. Although no significant activation was found in specific
prefrontal regions in this sound condition. See Figure 3 and Table 2 for the peak coordinates, Z
values, and additional cluster information.
3.4. Hypothesis 4 (Neural activation for the Infant Cry Condition): To investigate the
neural activation of effective inhibitory control in the infant cry condition, we examined the main

15
effects of correct no-go versus correct go trial contrast. As predicted, four significant clusters of
activation were observed in regions responsive to infant cries (right dlPFC; right insula; and right
inferior frontal gyrus opercular part, IFGoperc), inhibitory control (right aPFC; right dlPFC; right
premotor and supplementary motor area, PMd/SMA; and right insula), and multisensory and
spatial processing (left SMG; left ANG; visuomotor area, VMA; and right frontal eye fields,
FEF) during correct no-go trials compared to correct go trials in the infant cry condition. See
Figure 4 and Table 3 for the peak coordinates, Z values, and additional cluster information.
3.5. Hypothesis 5a (Inhibition Accuracy and Postpartum Mental Health): To test our
hypothesis that postpartum depression and anxiety symptoms would be associated with
inhibitory control, we ran multiple regression analyses with depression or anxiety as predictors
and inhibition accuracy scores from each task condition as outcome variables. These regression
analyses controlled for prenatal mental health, the lag time between lab and MRI visits, and the
child’s age.
Contrary to our predictions, greater self-reported depressive symptoms were not
associated with fathers’ accuracy scores on any of the task conditions: infant cry (ß=.001, t=.55,
p=.59, 95% CI = [-.004, .007]), pink noise (ß=-0.0002, t=-.13, p=.90, 95% CI = [-.004, .003]), or
silence (ß=.0002, t=.11, p=.92, 95% CI = [-.004, .004]).
Also not aligning with our predictions, higher self-reported state anxiety was not
associated with fathers’ accuracy across any of the conditions: infant cry (ß=.002, t=.79, p=.44,
95% CI = [-.003, .006]), pink noise (ß= -0.0003, t=-.23, p=.82, 95% CI = [-.003, .002]), or
silence (ß=.003, t=1.94, p=.06, 95% CI = [-.0002, .006]).
3.6. Hypothesis 5b (Neural activation to Inhibitory Control and Postpartum Mental
Health): To investigate the neural activation of effective inhibitory control across conditions and

16
their associations with postpartum mental health, we examined the main effects of correct no-go
versus correct go with the inclusion of mean-centered BDI-II or STAI state total scores as
regressors in the group-level analyses.
As predicted, one significant cluster of activation was observed in a regulatory prefrontal
region (left aPFC) during correct no-go trials compared to correct go trials in the silent condition.
See Table 4 and Figure 5 for peak coordinates and Z-values. As a follow-up exploratory analysis,
we used FSL’s Featquery tool to calculate each subject’s mean signal change in this significant
cluster for correct nogo > rest and correct go > rest to determine whether the results were driven
by the correct nogo or the correct go trials. As expected, we found that the cluster of significant
brain activation in aPFC was driven by the no-go trials and not go trials. This suggests that
greater levels of depressive symptoms predict greater activation in the left aPFC when
effectively inhibiting a response on correct nogo trials (p < .05) and not on correct go (p = .59)
trials (Figure 6).
Contradicting our hypothesis, no significant clusters of activation were observed when
mean-centered postpartum depression scores were added as a regressor to the no-go > go contrast
for the infant cry or pink noise condition. Similarly, when we added mean-centered STAI state
anxiety total scores as a regressor into the no-go>go contrast, no significant activation clusters
were observed for any task conditions.

17
Chapter 4: Discussion
This study examined behavioral and neural correlates of inhibitory control and their
associations with postpartum mental health in a sample of first-time fathers. Contrary to our
predictions, we did not observe differences in fathers’ inhibition accuracy when they completed a
Go/No-Go task in the presence of infant cry sounds compared to silence or pink noise. However,
we did find some distinct patterns of neural activation in the presence of the three sound
conditions. Specifically, fathers showed neural activation in more areas of the brain when
inhibiting in the presence of infant cry, including right dlPFC, right insula, right IFGoperc, right
aPFC, right PMd/SMA, left SMG, left ANG, VMA, and FEF. Moreover, activation in the left
aPFC during the silent condition was associated with fathers’ postpartum depressive symptoms.
Our findings shed light on the neural correlates of paternal postpartum depression and infant
cries while engaging in effective regulation.
Our finding that first-time fathers’ inhibition performance did not differ across the three
sound conditions was surprising given that we expected that the potentially distracting and
distressing sound of infant cry would compromise fathers’ accuracy on the task. Previous studies
have shown that processing bimodal audiovisual stimuli may be more efficient than unimodal
processing (Hershenson, 1962; Talsma et al., 2007; Talsma & Woldorff, 2005). This might
explain why the sound conditions in the Go/No-Go task did not interfere with fathers’ ability to
effectively regulate their responses compared to the silent condition. It is also possible that these
fathers are already proficient in effective inhibitory control in general, or that they have gained
substantial experience in adeptly regulating their responses when attending to their infant's
distress during the postpartum period. These explanations could account for the high accuracy
scores observed in our study across sound conditions.

18
Although our Go/No-Go task may not have been sensitive enough to detect subtle
behavioral differences in inhibitory control performance across the different sound conditions,
we observed distinct brain regions that were active during the pink noise (Figure 3) and infant
cry (Figure 4) conditions. For the infant cry condition, increased activation was observed in areas
such as the right dlPFC, right insula, right IFGoperc, right aPFC, right PMd/SMA, left SMG, left
ANG, VMA, and FEF. The increased activation of these regions is consistent with previous
research on the neural systems that are responsive to infant cries in parents (Feldman 2015) and
inhibitory control more broadly (Cipolotti et al., 2016; Hung et al., 2018; Krämer et al., 2013;
Munakata et al., 2011; Sun et al., 2022; van Gaal et al., 2008). Additionally, the ANG and the
SMG are comprised within the IPL, which is implicated in engaging in bimodal Go/No-Go tasks
(Sun et al., 2022). These findings suggest that first-time fathers engage multiple cognitive
processes, including attention, emotion regulation, and cognitive control, when performing
inhibitory control in the presence of infant cries, and that these processes involve brain regions
associated with socio-cognitive functions related to infant cues and multisensory and spatial
processing.
For the pink noise condition, increased activation was found in the right ANG and the
right SMG, which is in line with prior work's findings on multisensory processing (Sun et al.,
2022). However, despite our predictions, there was no significant activation in specific prefrontal
regions during the pink noise condition. The brain activation during the infant cry and pink noise
conditions suggests that first-time fathers engage in multiple cognitive processes when
performing inhibitory control tasks in the presence of different auditory stimuli, highlighting the
complex interplay of inhibitory control when first-time fathers are exposed to varying auditory
environments, such as infant cries and distracting noises. Moreover, despite the similarities in

19
frequency and volume between infant cry and pink noise, the former was associated with a
greater number of activated brain regions, particularly in the frontal areas. This finding suggests
that there may be something uniquely salient about infant cry sounds to first-time fathers as
compared to distracting noises.
While previous studies have examined the neural correlates of postpartum mental health
in mothers, our study provides novel insights into the neural correlates of postpartum mental
health in first-time fathers. Our behavioral findings suggest that depressive symptoms during the
postpartum period do not hinder fathers' ability to effectively engage in inhibitory control across
task conditions. However, when examining the neural correlates of inhibitory control in relation
to postpartum depression, we found that fathers with higher levels of postpartum depression
symptoms displayed increased activation in the left aPFC during the silent condition (Figure 5),
indicating a greater cognitive effort to effectively regulate a response. Our results suggest that
even in the absence of behavioral deficits, postpartum depression symptoms may still be
associated with altered neural activation in inhibitory control regions during some cognitive tasks
(silent Go/No-Go) but not others (infant cry or pink noise). Prior work has demonstrated that the
aPFC helps individuals modify their emotional control strategies to respond effectively to their
environment (Koch et al., 2018). It has also been shown that bimodal audiovisual stimuli are
easier for individuals to process compared to unimodal stimuli (Hershenson, 1962; Talsma et al.,
2007; Talsma & Woldorff, 2005). Therefore, it could be that fathers experiencing more
postpartum depression symptoms may need to utilize more cognitive effort (e.g., greater
activation in aPFC) to adjust their emotional regulation during the silent condition, which
involves unimodal processing. In contrast, during bimodal Go/No-Go tasks (pink noise or infant

20
cry), the processing demands may be lower, resulting in no observable differences in neural
activation associated with postpartum depression symptoms.
Contrary to prior work linking anxiety symptoms to inhibitory control difficulties, firsttime fathers’ state anxiety did not predict their behavioral accuracy on any of the Go/No-Go task
conditions, nor did it elicit greater brain activation in inhibitory control regions when effectively
regulating. The lack of association between postpartum anxiety and inhibitory control in our
study may be due to the low levels of anxiety reported by our sample (only six fathers exhibited
clinical levels of anxiety; STAI state anxiety total score > 39) or the fact that we measured state
rather than trait anxiety.
The current study's findings should be interpreted while considering the following
limitations. First, psychological functioning was assessed using self-report measures, which can
be subject to bias and social desirability. However, we selected widely used and well-validated
questionnaires (Beck et al., 1996; Berry & Jones, 1995; Cohen et al., 1983; Cox et al., 1987;
Haskett et al., 2006). Second, we obtained a small sample size of 32 fathers for behavioral
analyses and 26 fathers for fMRI analyses; the sample was smaller than originally planned due to
the COVID-19 pandemic, which disrupted data collection, and 12 fathers were dropped due to
data collection issues. However, this sample size does exceed most other fMRI studies
investigating the parenting brain that often have fewer than 20 participants. Third, our focus on
fathers in a heterosexual cohabiting relationship excludes fathers who may be divorced, single, in
a non-heterosexual relationship, or in other kinds of living situations. Finally, four of the fathers
had delayed completion of their postpartum scan due to COVID-19 pandemic lockdowns
whereas the rest of the fathers completed the MRI study before the pandemic.

21
Future studies should aim to explore the neural underpinnings of inhibitory control, infant
cries, and mental health in larger more diverse samples that include a wider variety of depression
and anxiety symptoms, inhibitory control abilities, and fathers from non-heterosexual
cohabitating relationships. Furthermore, it would be valuable to explore the associations that
parenting-related stressors or perceived stress levels have with inhibitory control, especially
since fathers are known to experience heightened levels of stress during the transition to
parenthood (Baldwin et al., 2018). Incorporating longitudinal methods may be crucial in better
understanding the directionality between inhibitory control and mental health and the long-term
implications of these constructs on one another. Future research should also investigate the
neural underpinnings of inhibitory control in the context of family-related factors, particularly
since self-regulation abilities have been shown to influence aspects such as romantic relationship
satisfaction (Bornstein et al., 2017) and child developmental outcomes (Ainsworth, 1979; Alves
Gracioli & Martins Linhares, 2019; Malmberg et al., 2016; Rutherford et al., 2015; Shaffer &
Obradović, 2017).
While acknowledging the above limitations and providing areas of future growth in this
field of research, this study holds notable strengths. This is the first study to investigate the
neural underpinnings of inhibitory control, infant cry sounds, and associations with paternal
mental health in the early postpartum period. This work provides insight as to how fathers
regulate their behaviors more broadly and in the presence of infant distress more specifically. It
also assesses the associations between inhibitory control and paternal postpartum mental health.
Another strength of our approach is our use of an inhibitory control task (i.e., Go/No-Go; Aron
& Poldrack, 2006), which is well-validated and widely used in cognitive neuroscience, and our
use of infant cry sounds which are used in parental brain research. The current study’s findings

22
thus provide a foundational extension to cognitive neuroscience literature and parental brain
research, specifically in shedding light on the brain bases of how new father regulate their
behaviors and emotions, particularly in the presence of a distressed infant.

23
Table 1.
Group means and standard deviations from demographic and questionnaire data.
6-Months PP Lab Visit PP MRI Visit
N Mean (SD) N Mean (SD)
Depression 32 9.41 (7.37) – –
State Anxiety 32 31.5 (8.08) – –
Father Age (years) 32 32.44 (4.23) 38 32.58 (4.27)
Child age (months) 32 6.51 (.62) 38 8.27 (3.69)
N % N %
COVID-19 Onset 3 6.67 4 26.32
Race/Ethnicity
Caucasian or White 11 34.37 11 34.37
Black or African American 3 9.37 3 9.37
Asian or Pacific Islander 7 21.88 7 21.88
Other 2 6.25 2 6.25
Hispanic or Latino/a 9 28.13 9 28.13
Note. PP = postpartum; SD = standard deviation; COVID-19 Onset = counts the number of
participants that completed each visit following the COVID-19 pandemic onset.

25
Figure 2. No significant differences in first-time fathers’ accuracy scores for effectively
inhibiting a response on no-go trials across all three conditions (silent, pink noise, infant cry; H1)
of the Go/No-Go task (n = 32).

26
Figure 3. Group-level significant cluster results of the no-go > go contrast for pink noise
condition (Hypothesis 3). Sagittal, coronal, and axial view of whole-brain activation. Analyses
cluster corrected at z = 2.3 (n = 26).

27
Table 2.
Group-level results of the correct no-go > correct go contrast for pink noise condition
(Hypothesis 3).
MINI coordinates
Area (BA) Voxels x y z Z-max
Right ANG (39) 612 46 -64 46 3.55
Right ANG (39) - 36 -48 40 3.5
Right ANG (39) - 40 -48 34 3.49
Right SMG (40) - 44 -44 40 3.31
Right ANG (39) - 38 -56 40 3.2
Right ANG (39) - 32 -64 44 3.12
ANG, angular gyrus. All peaks survived a whole-brain search thresholded at a voxel-wise
family-wise error rate of 0.05 and a z-threshold of 2.3. x, y, z = Montreal Neurological Institute
(MNI) coordinates in the left-right anterior-posterior, and inferior-superior dimensions,
respectively (n = 26).

28
A
B
C
D
Figure 4. Group-level significant cluster results of the no-go > go contrast for infant cry
condition (Hypothesis 4). Sagittal, coronal, and axial view of whole-brain activation. Analyses
cluster corrected at z = 2.3 (n = 26).

29
Table 3.
Group-level results of the correct no-go > correct go contrast for infant cry condition (Hypothesis
4).
MINI coordinates
Cluster
Index Area (BA) Voxels x y z Z-max
A
Right dlPFC (9) 339 32 56 30 4.01
Right dlPFC (9) - 36 50 32 3.38
Right aPFC (10) - 26 52 22 3.26
Right dlPFC (9) - 24 56 36 3.22
Right aPFC (10) - 40 52 24 3.07
Right aPFC (10) - 36 56 22 3.06
B
Left SMG (40) 1209 -62 -36 44 3.65
Left VisMotor (7) - -14 -68 56 3.56
Left VisMotor (7) - -18 -70 56 3.55
Left VisMotor (7) - -26 -58 48 3.49
Left SMG (40) - -56 -40 50 3.49
Left ANG (39) - -52 -42 40 3.46
C
Right PreMot-SuppMot (6) 1318 44 6 46 3.81
Right Insula (13) - 30 22 -2 3.69
Right dlPFC (9) - 48 36 28 3.59
Right IFGoperc (44) - 52 14 -2 3.54

30
Right FrontEyeFields (8) - 48 10 38 3.51
Right PreMot-SuppMot (6) - 52 6 38 3.42
D
Right SMG (40) 3192 60 -40 36 4.06
Right ANG (39) - 58 -52 32 3.99
Right SMG (40) - 58 -40 28 3.89
Right VisMotor (7) - 44 -50 58 3.88
Right VisMotor (7) - 40 -52 52 3.8
Right SMG (40) - 58 -40 48 3.74
dlPFC, dorsolateral prefrontal cortex; aPFC, anterior prefrontal cortex; SMG, supramarginal
gyrus; VisMotor, visual motor; ANG, angular gyrus; PreMot-SuppMot, premotor cortex and
supplementary motor area; IFGoperc, inferior frontal gyrus, opercular part; FrontEyeFields,
frontal eye fields. All peaks survived a whole-brain search thresholded at a voxel-wise familywise error rate of 0.05 and a z-threshold of 2.3. x, y, z = Montreal Neurological Institute (MNI)
coordinates in the left-right anterior-posterior, and inferior-superior dimensions, respectively (n =
26).

31
Figure 5. Group-level significant cluster results of the no-go > go contrast for silent condition
when mean-centered depression scores were added as a regressor (Hypothesis 5). Sagittal,
coronal, and axial view of whole-brain activation. Analyses cluster corrected at z = 2.3 (n = 26).

32
Table 4.
Group-level results of the correct no-go > correct go contrast for the silent condition with mean
centered-depression scores added as a regressor (Hypothesis 5).
MINI coordinates
Area (BA) Voxels x y z Z-max
Left aPFC (10) 313 -38 52 -8 3.83
Left aPFC (10) - -46 48 -12 3.64
Left aPFC (10) - -40 52 2 3.22
Left aPFC (10) - -34 62 -6 2.79
Left aPFC (10) - -32 54 -4 2.63
aPFC, anterior prefrontal cortex. All peaks survived a whole-brain search thresholded at a voxelwise family-wise error rate of 0.05 and a z-threshold of 2.3. x, y, z = Montreal Neurological
Institute (MNI) coordinates in the left-right anterior-posterior, and inferior-superior dimensions,
respectively (n = 26).

33
Figure 6. PP, postpartum; aPFC, anterior prefrontal cortex. Each subject’s mean signal change in
the significant cluster (Table 4) was calculated using Featquery for nogo > rest and go > rest.
This allowed us to conclude that the significant cluster of activation found when including
postpartum depression scores (H5) as a regressor in higher-level analysis in FSL was driven by
the nogo (p < .05) and not the go (p = .59) trials (n = 26).

34
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Abstract (if available)

Abstract Difficulty with inhibitory control, a form of self-regulation, has been linked to negative parenting outcomes and mental health challenges in mothers. However, the implications of inhibitory control for first-time fathers have not been investigated. Given the heightened risk of postpartum mental health issues in both mothers and fathers, research investigating the relationship between inhibitory control and adjustment to fatherhood is warranted. This study explored the neural underpinnings of inhibitory control and its associations with paternal mental health at six months postpartum using an adapted Go/No-Go fMRI task with infant cry, pink noise, and silent conditions. Contrary to our expectations, we did not observe any differences in fathers' inhibitory accuracy when completing a Go/No-Go task with infant cry sounds compared to silence or pink noise, although we did identify distinct patterns of neural activation across the three sound conditions. Specifically, fathers exhibited neural activation in a greater number of brain regions when effectively inhibiting in the presence of infant cries (e.g., right dlPFC, right insula, right IFGoperc, right aPFC, right PMd/SMA, left SMG, left ANG, VMA, and FEF) as compared to the other two conditions. Moreover, fathers' postpartum depressive symptoms were positively associated with their activation in the left aPFC while effectively inhibiting during the silent condition. In contrast, postpartum anxiety was not associated with fathers’ brain activation across any task conditions. This study offers insights into the neural underpinnings of inhibitory control, responses to infant cries, and postpartum mental health in first-time fathers, providing a foundation for future research.

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Asset Metadata

Creator Waizman, Yael (author)

Core Title Inhibitory control in first-time fathers: Neural correlates and associations with paternal mental health

School College of Letters, Arts and Sciences

Degree Master of Arts

Degree Program Psychology

Degree Conferral Date 2023-12

Publication Date 10/30/2023

Defense Date 04/24/2023

Publisher Los Angeles, California (original), University of Southern California (original), University of Southern California. Libraries (digital)

Tag infant cry,inhibitory control,OAI-PMH Harvest,paternal brain,postpartum anxiety,postpartum depression,transition to parenthood

Format theses (aat)

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Saxbe, Darby (committee chair), Morales, Santiago (committee member), Stange, Jonathan (committee member)

Creator Email waizman@usc.edu,waizmanyael@gmail.com

Permanent Link (DOI) https://doi.org/10.25549/usctheses-oUC113761202

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