Differentiating Maternal Sensitivity to Infant Distress and Non-Distress

Drawing from a domain specificity perspective, we assert that maternal sensitivity to infant distress cues is distinct from maternal sensitivity to non-distress cues. We review evidence from prior research demonstrating that the two constructs have more unshared than shared variance and that sensitivity to infant distress is a unique predictor of infants' early emotional well-being when both types of sensitivity are examined as simultaneous predictors. In addition, we present new evidence to test the hypothesis that maternal sensitivity to infant distress and non-distress have different origins. We draw on data from a subset of mothers and infants who participated in Phase I of the NICHD Study of Early Child Care (Study 1) and from 101 mother-infant dyads who participated in a longitudinal study of the origins of maternal sensitivity (Study 2). In both studies, maternal sensitivity to distress and non-distress were rated when infants were 6 months old. In both studies, socio-demographic risk (i.e., young, unmarried, low income mothers) was a stronger predictor of sensitivity to non-distress than of sensitivity to distress. In Study 2, mothers' emotional and cognitive responses to videotapes of crying infants during the prenatal period predicted maternal sensitivity during tasks designed to elicit infant fear and frustration but were unrelated to maternal sensitivity in a non-arousing free play context. Maternal sensitivity during infancy can be further divided into specific sub-types that have unique origins and unique effects on subsequent child well-being. Methodological, theoretical, and applied implications of such an approach are discussed.     

Behavioral and physiological responsivity, sleep, and patterns of daily cortisol production in infants with and without colic

To describe the behavioral and physiological responses associated with colic, the responses of 20 two-month-old infants with and 20 without colic were studied during a physical examination. Parents kept a diary of infant behaviors (including crying and fussing) for 3 days following the visit. Using Wessel, Cobb, Jackson, Harris, & Detwiler criteria, colic was defined as fussing/crying for 3 hr or more on each of the 3 days. Behavioral data coded by "blind" observers showed that during the physical exam, colic infants cried twice as much, cried more intensely, and were more inconsolable than were control infants. Despite these behavioral differences, heart rate, vagal tone, and cortisol measures indicated no appreciable difference in physiological responsivity for the two groups. At home, parents collected saliva cortisol samples at wakeup, midmorning, midafternoon, and evening for 2 days. In a finding similar to that shown by the laboratory data, the colic and control infants did not have different levels of daily average cortisol. These laboratory and home data provide no evidence of greater responsivity in the physiological substrate of difficult temperament for colic infants and are consistent with evidence of similarity in temperament once colic is resolved. At home, compared with control infants, colic infants did display a blunted rhythm in cortisol production. By diary, they also slept about 2 hr less per day than did control infants. Nighttime sleep was still significantly different when fussing/crying was statistically controlled. These data suggest that colic might be associated with a disruption or delay in the establishment of the circadian rhythm in activity of the hypothalamic-pituitary-adrenocortical axis and associated sleep-wake activity.     

Infant Crying and Adults'' Anticipated Caregiving Responses: Acoustic and Contextual Influences

These studies assessed adults' latencies to signal that they would respond to infant crying as functions of (1) the degree of infant distress they perceived in the cry, and (2) contextual information relevant to caregiving. In the first study (N = 34), listeners waited longer to respond to cries that they had earlier rated as sounding less distressed than when they heard cries of higher distress. Further, those who had been told that the infant needed sleep waited longer to respond than those without this information. This effect of context information, however, was limited to the latencies; in another study (N = 50), listeners' ratings of distress were not affected. Several acoustic features of the cries correlated with distress ratings and with latencies to signal a caregiving response. Taken together, the results suggest that adults' responses to crying are influenced both by acoustic gradations in the cry itself and by the caregiving context. Ratings of degree of distress manifest in the cry, in other words, may be highly predictive of caregiving behavior but not wholly so. Finally, although certain acoustic variations related to greater perceived distress and speed of response, differences were apparent between infants in the magnitude of these variations. The implication that the general process of cry perception may be calibrated, or fine tuned, to the range of acoustic variation provided by individual infants is discussed.     

Coping and Psychological Distress in Mothers of Very Low Birth Weight Young Children

Objective. This study sought to increase understanding of relations among coping strategies, sociodemographic variables, and psychological distress in mothers of high-risk (HR) and low-risk (LR) very low birth weight (VLBW; < 1,500g) infants. Design. The sample (N = 199) consisted of 77 mothers of HR VLBW infants, 43 mothers of LR VLBW infants, and a control group of 79 mothers of healthy, term infants. Data were collected with self-report questionnaires at birth and at 24 months postpartum. Relations among infant medical risk, multiple birth, maternal race, social class, and maternal coping were investigated. Hierarchical regression analyses were used to identify predictors of maternal psychological distress and to determine whether coping differentially moderated maternal psychological distress across groups. Results. Infant medical risk, social support, and maternal coping independently predicted maternal psychological distress. Mothers of HR VLBW infants reported significantly greater psychological distress than mothers of LR VLBW or term infants. Greater use of avoidant and express emotions coping predicted higher psychological distress for all mothers. Greater use of humor coping had a buffering effect, reducing distress only for mothers of HR VLBW infants. Maternal coping scores were related to maternal race and social class, rather than to severity of infant medical risk. Conclusions. Sociocultural sources of resiliency, as well as biological risk factors, should be considered when developing strategies to enhance coping and parenting in HR populations.     

Acoustic Characteristics of Naturally Occurring Cries of Infants with "Colic"

Although infantile colic has long been defined by a perceived excessive amount of crying, acoustic attributes of the cry sound may also contribute to perceptions that this early social behavior is excessive or problematic. From an original sample of 76 infants (38 infants referred to physicians for problematic crying, or "colic," and 38 pair-matched comparison infants), 48 infants who produced naturally occurring cry bouts both before and after an evening feeding were studied: 11 infants with Wessel's colic, 15 infants with non-Wessel's colic, and 22 comparison infants. Standard and vociferous cry segments were selected from up to 2 min of tape-recorded crying for spectrum analysis. Vociferous cry segments had a longer duration, a higher fundamental frequency, and a greater percentage of dysphonation than did standard segments. No differences between infant groups were found in cries before feeding. After feeding, infants who were problematic criers, independent of Wessel's criteria, showed a greater percentage of dysphonation in the vociferous cry segment than did comparison infants. This finding resulted from a decrease in dysphonation in the cries of comparison infants after feeding and an increase in those of infants with non-Wessel's colic. The dominant frequency also increased after feeding in the vociferous cries of infants with Wessel's colic, resulting in these infants having higher-pitched cries after feeding than infants in the other 2 groups. Results indicate that infants who are perceived to have problematic crying have objectively different acoustic features in their cry sounds that are particularly aversive, and that complaints about excessive crying cannot be accounted for simply on the basis of reporting bias in overly concerned or emotionally labile parents.     

Enhancing the Development of Low-Birthweight, Premature Infants: Changes in Cognition and Behavior over the First Three Years

The Infant Health and Development Program is a randomized clinical trial to test the efficacy of educational and family support services and pediatric follow-up offered in the first 3 years of life on reducing the incidence of developmental delay in low-birthweight (LBW), preterm infants in 8 clinical sites ( N = 985). Effects of the intervention on cognitive and behavior problem scores over the 3 years are examined. Significant intervention effects were seen on cognitive scores at 24 and 36 but not 12 months of age; effect sizes were similar at both ages. These effects persist when controlling for earlier cognitive scores. At 24 and 36 months, behavior problem scores for the intervention group were significantly lower than for the follow-up group; the intervention was more efficacious for children with higher initial behavior problem scores. Results are discussed in terms of timing and targeting of services for LBW and disadvantaged children.     

The temporal relationship between infant heart rate acceleration and crying in an aversive situation.

The temporal relationship between heart rate (HR) acceleration and crying was examined in 16 8-16-month-old infants. Consistently, the HR acceleration began well before the onset of crying, suggesting that such acceleration is not merely a by-product of crying. The accelerations observed were above and beyond a return to baseline following orienting. The crying itself validates the association between these instances of HR acceleration and negative effect.     

Antecedents of Maternal Sensitivity During Distressing Tasks: Integrating Attachment,Social Information Processing,and Psychobiological Perspectives

Predictors of maternal sensitivity to infant distress were examined among 259 primiparous mothers. The Adult Attachment Interview, self‐reports of personality and emotional functioning, and measures of physiological, emotional, and cognitive responses to videotapes of crying infants were administered prenatally. Maternal sensitivity was observed during three distress‐eliciting tasks when infants were 6 months old. Coherence of mind was directly associated with higher maternal sensitivity to distress. Mothers' heightened emotional risk was indirectly associated with lower sensitivity via mothers' self‐focused and negative processing of infant cry cues. Likewise, high physiological arousal accompanied by poor physiological regulation in response to infant crying was indirectly associated with lower maternal sensitivity to distress through mothers' self‐focused and negative processing of infant cry cues.     

Minimizing adverse effects of low birthweight: four-year results of an early intervention program

The outcome of an early intervention program for low-birthweight (LBW) infants was examined in this study. The intervention consisted of 11 sessions, beginning during the final week of hospitalization and extending into the home over a 3-month period. The program aimed to facilitate maternal adjustment to the care of a LBW infant, and, indirectly, to enhance the child's development. Neonates weighing less than 2,200 grams and under 37 weeks gestational age were randomly assigned to experimental or control conditions. A full-term, normal birthweight (NBW) group served as a second control. 6-month analyses of dyads who completed all assessments over a 4-year period (N's = 25 LBW experimental, 29 LBW control, and 28 NBW infant-mother dyads) showed that the experimental group mothers reported significantly greater self-confidence and satisfaction with mothering, as well as more favorable perception of infant temperament than LBW control group mothers. A progressive divergence between the LBW experimental and LBW control children on cognitive scores culminated in significant group differences on the McCarthy GCI at ages 36 and 48 months, when the LBW experimental group caught up to the NBW group. Possible explanations for the observed delay in the emergence of intervention effects on cognitive development and the mediating role of favorable mother-infant transactional patterns are discussed in light of recent evidence from the literature.     

Adult Perception of Emotion Intensity in Human Infant Cries: Effects of Infant Age and Cry Acoustics

The relation between adult perception of emotion intensity in the cries of 1- and 6-month-old infants and the acoustic characteristics of the cries was examined. In the first study, adults who were inexperienced in child care rated 40 cries on 3 emotion intensity scales: anger, fear, and distress. The cries of 6-month-olds were rated as being significantly more intense. Different acoustic variables accounted for emotion intensity ratings for the 2 infant ages. Peak amplitude and noisiness of the cry predicted adult judgments of intensity ratings of 1-month-olds' cries; a measure of amplitude ratio (in 2 frequency bands) was the best predictor of intensity ratings of 6-month-olds' cries. In the second study, parents of infants rated the same cries on the same scales. They also rated the older infants' cries as being more intense. The 2 adult groups did not differ on their ratings, and a regression equation derived from one adult group predicted the other adult group's rating of the same infant age better than it predicted its own ratings for the other infant age. Infant age, and its associated acoustic features, seems to be a more important determinant of adults' perception of emotion intensity than are such adult characteristics as gender or infant-care experience.     

The Relations among Infant Temperament, Security of Attachment, and Behavioral Inhibition at Twenty-Four Months

The purpose of this study was to examine the relations among infant temperament, attachment, and behavioral inhibition. 52 infants were seen at 2 days, 5, 14, and 24 months of age. Assessments were made of temperament at 2 days and 5 months of age, and attachment and behavioral inhibition were assessed at 14 and 24 months, respectively. EKG was recorded at each assessment, and measures of heart period and vagal tone were computed. Distress to pacifier withdrawal at 2 days of age was related to insecure attachment at 14 months. 2 types of distress reactivity at 5 months, reactivity to frustration and reactivity to novelty, were identified and related to high vagal tone. Attachment classification at 14 months was directly related to inhibited behavior at 24 months. Infants classified as insecure/resistant were more inhibited than those classified as insecure/avoidant. In addition, an interaction of infant reactivity to frustration and attachment classification was found to predict inhibition at 24 months. Infants classified as insecure/resistant and who had not cried to the arm restraint procedure at 5 months were the most inhibited at 24 months. These findings are discussed in terms of hypotheses regarding multiple modes of distress reactivity and regulation in early infancy and their different social and behavioral outcomes.     

Infant temperament and subject loss due to crying during operant conditioning

Infants who failed to complete a 2-day operant-conditioning task were compared with a stratified random sample of those who did on measures of infant temperament and several demographic characteristics. A discriminant-function analysis revealed that female infants who cried differed from female infants who did not cry on measures of duration of orienting and latency to approach sudden or novel stimuli. Reliable prediction of crying and noncrying could not, however, be made for males. No sex differences emerged in the incidence of crying or in the number of sessions completed. Partially successful females (i.e., those completing 1 of the 2 sessions) could reliably be discriminated from those who cried during the first session on measures of age at testing and maternal ratings of smiling behavior. The results of this study suggest that, as with habituation studies, subject loss in operant-conditioning studies is influenced by individual differences among the infants which may or may not adversely affect external validity.     

The Role of an Early Intervention on Enhancing the Quality of Mother-Infant Interaction

The study examines an intervention designed to influence mothers' sensitive responsiveness toward their infant by presenting information about the newborn's competence to interact and promoting affectionate handling and interaction with the infant. Thirty-six primiparous mothers and their newborn infants participated in the study. On day 2/3 after delivery, mother-infant dyads were assigned to either: (1) an experimental group that received an intervention program designed to enhance mother-infant interaction; or (2) a control group that was presented with an intervention that emphasized basic caregiving skills. One month later an observation was undertaken in the home to assess mother-infant synchronous and asynchronous co-occurrences during free-play and infant bathing. The enhancement group showed a reliably greater frequency of co-occurrences involving vocal exchanges, looking to the partner, and physical contact. There also were differences in mothers' responsiveness to infant crying and involuntary responses. The findings show that even a modest videotaped early intervention can enhance mothers' sensitive responsiveness to the infant.     

Dampening of Adrenocortical Responses during Infancy: Normative Changes and Individual Differences

Changes in cortisol and behavioral responses were examined longitudinally in 83 infants (39 girls, 44 boys) tested at their well-baby exams with inoculations at 2, 4, 6, and 15 months (72 infants completed all testing). Another sample of 2-, 4-, and 6-month-olds ( n = 18 per age) received mock exams without inoculations to determine early developmental changes to the exam procedures. Behavioral distress was coded every 30 sec during the exam, a 5-min inoculation period, and a 20-min recovery period. Salivary cortisol was obtained upon arrival at the clinic and 25 min after the beginning of the inoculation period. To the exam-inoculation procedures, cortisol responses were high at 2 months, decreased significantly between 2 and 4 months, remained comparable between 4 and 6 months, and then declined again between 6 and 15 months. Between 6 and 15 months there was also a decrease in pretest cortisol. By 15 months, significant increases in cortisol from pre- to posttest were no longer observed for most infants. To the exam-only procedures, cortisol responses decreased between 2 and 4 months, and by 4 months most infants failed to show pre- to posttest increases in cortisol. Behavioral distress decreased between 2 and 6 months, but increased again at 15 months. While crying and cortisol were modestly correlated during the 2- to 6-month exam-inoculation procedures, at 15 months no significant correlations were obtained. Behavioral and hormonal reactions thus followed different ontogenetic paths and may provide different information about infant functioning. There was some evidence that the emergence of the circadian rhythm in cortisol might be related to the early decrease in cortisol response.     

Web-based parenting skills to reduce behavior problems following abusive head trauma: A pilot study

Pediatric abusive head trauma causes significant cognitive and behavioral morbidity, yet very few post-acute interventions exist to facilitate long-term recovery. To meet the needs of this vulnerable population, we piloted a web-based intervention with live coaching designed to improve positive parenting and child behavior. The efficacy of this parenting skills intervention was compared with access to Internet resources on brain injury. Participants included seven families (four randomized to the parenting intervention and three randomized to receive Internet resources). Parenting skills were observed and child behavior was rated at baseline and intervention completion. At completion, parents who received the parenting skills intervention showed significantly more positive parenting behaviors and fewer undesirable behaviors during play than parents who received access to Internet resources. Additionally, during play, children in the parenting skills intervention group were more compliant following parent commands than children in the Internet resources group. Lastly, parents who received the parenting intervention reported less intense oppositional and conduct behavior problems in their children post-intervention than did parents in the Internet resources group. These findings provide preliminary evidence for the use of this web-based positive parenting skills intervention to improve parenting skills and child behavior following abusive head trauma.     

Parents’ behavior in response to infant crying: Abusive head trauma education

Abusive head trauma (AHT) is still too common, and probably underestimated. It is the leading cause of death from child abuse. Crying is thought to contribute to the act of shaking. Objectives of this study were to (a) assess parents’ knowledge about infant crying, their ability to manage crying, and their knowledge about AHT; and (b) assess the feasibility and the impact of a simple educational intervention about crying and AHT with parents shortly after their child's birth. A short questionnaire was completed orally by the parents of 190 consecutive newborns in a maternity hospital at day 2 of life. Then, during the routine examination of the child, the pediatrician gave parents a short talk about infant crying and AHT, and a pamphlet. Finally, parents were contacted by phone at 6 weeks for the post-intervention questionnaire assessing their knowledge about crying and AHT. Among 202 consecutive births, parents of 190 children were included (266 parents; 70% mothers) over a 1-month period and answered the pre-intervention questionnaire. The intervention was feasible and easy to provide. Twenty-seven percent of mothers and 36% of fathers had never heard of AHT. At 6 weeks, 183 parents (68% of the sample; 80% mothers) answered the post-intervention questionnaire. Parents’ knowledge improved significantly post-intervention. Parents found the intervention acceptable and useful. Health care professionals such as pediatricians or nurses could easily provide this brief talk to all parents during systematic newborn examination.     

The Relations of Children's Emotion Regulation to Their Vicarious Emotional Responses and Comforting Behaviors

The purpose of the present study was to examine the relations of children's emotional and behavioral regulation (as indexed by heart rate variability and coping styles) to their emotional and prosocial responses to a crying infant. Kindergarten and second-grade children's vicarious emotional responses (e.g., facial reactions and heart rate slope) and comforting behaviors were recorded while children heard a crying infant. The mothers of these children completed a measure designed to assess their children's coping responses when exposed to others in distress. It was found that children who were able to regulate their arousal (as assessed with heart rate variance) and typically responded instrumentally when exposed to others' needy states and conditions were relatively unlikely to become distressed and relatively likely to talk to and comfort the crying infant. Compared to boys, girls were found to be more responsive to the crying infant and were reported to engage in more direct, active coping responses when exposed to others in distress. The results are discussed in relation to research on emotion regulation and coping in interpersonal contexts.     

The family check-up with high-risk indigent families: preventing problem behavior by increasing parents' positive behavior support in early childhood

Seven hundred thirty-one income-eligible families in 3 geographical regions who were enrolled in a national food supplement program were screened and randomized to a brief family intervention. At child ages 2 and 3, the intervention group caregivers were offered the Family Check-Up and linked parenting support services. Latent growth models on caregiver reports at child ages 2, 3, and 4 revealed decreased behavior problems when compared with the control group. Intervention effects occurred predominantly among families reporting high levels of problem behavior at child age 2. Families in the intervention condition improved on direct observation measures of caregivers' positive behavior support at child ages 2 and 3; improvements in positive behavior support mediated improvements in children's early problem behavior.     

The effect of crying on long-term memory in infancy

The influence of crying on infants' long-term memory for a learned response was investigated in 3 experiments. In each, infants were trained to move a crib mobile containing 10 identical objects by means of kicking and were then exposed to a reinforcer containing only 2 of these components. This shift in component numerosity produced crying in 53% of the infants. Infants who cried in response to the reward shift evidenced no retention of the contingency 1 week later (Experiment 1) but did have excellent retention at 1 day (Experiment 2). In Experiment 3, a brief reactivation treatment alleviated forgetting at 3 weeks regardless of the presence of crying in response to the change in mobiles. An unexpected recency effect characterized the efficacy of the reactivation treatment. The results indicate that crying in response to the violation of a reward-expectation habit functions as an amnesic agent to produce accelerated forgetting.     

状态和特质焦虑对情绪刺激时长估计的影响

影响时间知觉的情绪因素可以概括为情绪刺激因素和被试因素两个方面。以55名大学生为被试,估计哭、笑和中性表情面孔刺激呈现时长,并采用状态—特质焦虑量表测查其状态和特质焦虑,研究个体焦虑情绪对于时长估计的影响。结果发现,相对于中性表情刺激条件,在哭、笑表情刺激条件下,参加实验时的状态焦虑分数低于特质焦虑分数者(低常组),体现出高估时长的特点,达到或接近统计学显著水平;而参加实验时的状态焦虑分数高于平时测定的特质焦虑分数者(高常组),表现出未达到统计学显著水平的低估时长的趋势。结果提示我们:低常组高估时距可能是源于生理唤醒效应,而高常组低估时距可能是源于认知注意唤醒效应。