The Impact of Postnatal Depression and Associated Adversity on Early Mother-Infant Interactions and Later Infant Outcome

The impact of maternal depression and adversity on mother-infant face-to-face interactions at 2 months, and on subsequent infant cognitive development and attachment, was examined in a low-risk sample of primiparous women and their infants. The severe disturbances in mother-infant engagement characteristic of depressed groups in disadvantaged populations were not evident in the context of postpartum mood disorder in the present study. However, compared to well women, depressed mothers were less sensitively attuned to their infants, and were less affirming and more negating of infant experience. Similar difficulties in maternal interactions were also evident in the context of social and personal adversity. Disturbances in early mother-infant interactions were found to be predictive of poorer infant cognitive outcome at 18 months. Infant attachment, by contrast, was not related to the quality of 2-month interactions, but was significantly associated with the occurrence of adversity, as well as postpartum depression.     

Interactions of black inner-city mothers with their newborn infants.

Interactions of 45 black inner-city mothers with their healthy full-term newborn infants were observed during a bottle-feeding on the third day after birth. An exhaustive catalog of some 100 mother and infant behaviors was used to describe objectively the interactions of mothers and infants. In addition to being observed with their mothers, infants were examined with the Rosenblith scale. The infants' birth weights, birth order, and sex and maternal medication were found to affect the infants' behaviors and/or the patterns of mother-infant interactions.     

Infant – Mother Attachment among the Dogon of Mali

This study of mothers and infants from the Dogon ethnic group of Mali, West Africa examined three attachment hypotheses: (1) that infant attachment security is linked to the quality of mother-infant communication, (2) that mothers of secure infants respond more sensitively to their infants than do mothers of insecure infants, and (3) that infant disorganization is linked to maternal frightened or frightening behaviors. Participants were 27 mother-infant pairs from a rural town and 15 mother-infant pairs from two agrarian villages; infants ranged in age from 10 to 12.5 months at the first assessment. The distribution of the Strange Situation classifications was 67% secure, 0% avoidant, 8% resistant, and 25% disorganized. Infant attachment security was significantly related to the quality of mother-infant communication as observed in a well-infant exam. The correlation between infant attachment security ratings and maternal sensitivity (assessed in the home) was modest and approached significance. Mothers of disorganized infants had significantly higher ratings of frightened or frightening behaviors. Maternal sensitivity predicted little of the variance in infant security; however, the addition of the frightened/frightening variable in the regression equation tripled the explained variance. The findings are discussed in light of Dogon childrearing practices and key tenets of attachment theory.     

The relationship between neonatal characteristics and three-month mother-infant interaction in high-risk infants

The behavior of 4 groups of infants--healthy term, healthy preterm, sick preterm, and sick full-term--was assessed in the neonatal period using the Neonatal Behavioral Assessment Scale (NBAS). At 3 months postterm, infants and their mothers were observed and videotaped in a free-play session. Both the NBAS and mother-infant interaction data were analyzed to assess the effects of maturity (term vs. preterm), illness (sick vs. healthy), and their interaction. Results revealed that illness of the infant affected both NBAS performance and maternal behavior during the interaction at 3 moths. Infants who were ill performed poorly on the NBAS orientation dimension; this dimension was found to be significantly associated with maternal and infant behaviors at 3 months. These data demonstrate an association between early infant characteristics and subsequent mother and child interactive behaviors. They also identify postnatal illness as an important influence on the development of the mother-infant dyad.     

Neonatal characteristics and mother-infant interaction in two observational situations.

134 mothers and their newborn infants were studied in order to evaluate the realtionship's between neonatal characteristics and mother-infant interaction. The procedure included a newborn assessment with the Brazelton Neonatal Assessment Scale and 2 mother-infant interaction observations, 1 carried out during feeding and the other during a semistructured situation. The results indicated that there were consistent relationships between infant and maternal behavior; more alert and responsive infants had more responsive and sensitive mothers. These consistencies were found for both infants and mothers across the different situations. Both infant and maternal responsiveness to a variey of social stimuli were noted.     

Maternal attitudinal inflexibility: Longitudinal relations with mother-infant disrupted interaction and childhood hostile-aggressive behavior problems

Objective: The Personal Attitude Scale (PAS; Hooley, 2000) is a method that is under development for identifying individuals high in Expressed Emotion based on personality traits of inflexibility, intolerance, and norm-forming. In the current study, the goal was to measure the association between this maternal attitudinal inflexibility, early hostile or disrupted mother-infant interactions, and hostile-aggressive behavior problems in the child.MethodsIn a prospective longitudinal study of 76 low-income mothers and their infants, it was predicted that maternal PAS scores, assessed at child age 20, would be related to difficulties in early observed mother-infant interaction and to hostile-aggressive behavioral difficulties in the child.ResultsResults indicated that maternal difficulties in interacting with the infant in the laboratory were associated with maternal PAS scores assessed 20 years later. Hostile-aggressive behavior problems in the child at age five were also predictive of PAS scores of mothers. However, contrary to prediction, these behavior problems did not mediate the association between mother-infant interaction difficulties and maternal PAS scores, indicating that the child's hostile-aggressive behavior problems did not produce the link between quality of early interaction and later maternal attitudinal inflexibility.ConclusionsThe current results validate the PAS against observable mother-child interactions and child hostile-aggressive behavior problems and indicate the importance of future work investigating the maternal attitudes that are associated with, and may potentially precede, parent-infant interactive difficulties.Practice implicationsThese findings regarding the inflexible attitudes of mothers whose interactions with their infants are also disrupted have important clinical implications. First, once the stability of the PAS has been established, this measure may offer a valuable screening tool for the prenatal identification of parents at risk for difficult interactions with their children. Second, it suggests routes for more cognitive interventions around helping less flexible parents shift perspectives to better take account of their child's outlooks and needs.     

Linking Employment to Attachment: The Mediating Effects of Maternal Separation Anxiety and Interactive Behavior

This study examined the effects of maternal employment and separation anxiety on maternal interactive behavior and infant attachment. 73 mother-infant pairs participated in a laboratory free-play session when infants were 5 and 10 months of age and in the Strange Situation when the infants were 18 months of age. Maternal feelings about being separated from her infant were assessed by questionnaire at 5 months. Employed mothers returned to work before the infants' fifth month, and nonemployed mothers did not work outside the home through their infants' tenth month. Employed mothers who reported high levels of separation anxiety were more likely to exhibit intrusive behaviors at 10 months. While employment was not directly related to attachment, we found infants of high-anxiety employed mothers to develop anxious-avoidant attachments. The results suggest that maternal separation anxiety and interactive style may be important mediators between employment and later infant outcome.     

Childhood experiences of maltreatment,reflective functioning and attachment in adolescent and young adult mothers: Effects on mother-infant interaction and emotion regulation

BackgroundMaternal childhood experiences of maltreatment affect parenting and have consequences for a child’s social-emotional development. Adolescent mothers have a higher frequency of a history of maltreatment than adult mothers. However few studies have analyzed the interactions between adolescent mothers with a history of childhood maltreatment and their infants.ObjectiveThe aim of the study was to examine the effect of maternal childhood experiences of maltreatment on mother-infant emotion regulation at infant 3 months, considering both infant and mother individual emotion regulation and their mutual regulation.ParticipantsParticipants were 63 adolescent and young adult mother-infant dyads recruited at a hospital.MethodsThe mothers were administered the Adult Attachment Interview to evaluate reflective functioning and attachment and the Childhood Experiences of Care and Abuse was used to evaluate maternal childhood experiences of maltreatment. Mother-infant interactions were coded with a modified version of the Infant Caregiver Engagement Phases.ResultsDyads with mothers with childhood maltreatment (vs dyads with mothers with no maltreatment) spent more time in negative emotional mutual regulation (p = .009) and less time in positive and neutral mutual emotion regulation (p = .019). Cumulative maternal childhood experiences of maltreatment were associated positively with mother and infant negative states at individual and dyadic level and with the AAI scales of Passivity and Unresolved Trauma (p < .05). The effect of cumulative maternal childhood experiences of maltreatment on mother-infant emotion regulation was direct and not mediated by maternal attachment and reflective function.ConclusionsMaternal childhood experiences of maltreatment increase the risk connected to early motherhood, affecting mother-infant emotion regulation.     

Predicting IQ from mother-infant interactions.

Longitudinal observations of maternal and infant characteristics were used to investigate the consequences of early day-care intervention for infants at high risk for intellectual retardation due to sociocultural factors. High-risk infants and their mothers were compared on social and intellectual characteristics with a control group not enrolled in an intervention program and with a random sample of mother-child dyads from the general population. Results from group comparisons indicated that mothers of high-risk infants in a day-care intervention group interacted with their infants in ways quite similar to mother of high-risk infants who were not enrolled in the intervention program. Both high-risk groups differed from the general population of mothers on interaction and attitudinal measures. Changes across time on the measures taken were roughly parallel from all three groups. Multiple regression analyses using maternal variables and mother-infant interactional variables to predict 36-month Stanford-Binet scores for the high-risk samples indicated that children's intelligence was predictable from previous maternal behaviors and attitudes, particularly for the control group, and that early day-care intervention apparently had altered the predictiveness of some maternal factors.     

Maternal social networks and mother-infant interactions in full-term and very low birthweight, preterm infants

The relation between maternal social networks and mother-infant interactions at 6 months of age was examined in 34 mother-preterm and 20 mother-full-term dyads. All preterm infants were of very low birthweight and experienced medical complications. Mothers were interviewed regarding their social networks; ratings of maternal behaviors were derived from videotaped mother-infant interactions. There were few between-group differences in mean levels of network variables; however, the association between network structure and maternal sensitivity differed in the 2 groups. A larger number of ties between the mother's family of origin and the mother's friends related to higher maternal sensitivity in full-terms but to lower maternal sensitivity in preterms. The birth of a full-term infant is typically a positive event around which a tightly knit network can coalesce to support the mother. It is less clear that the birth of a preterm infant is a positive event, leaving network members unsure of their roles and how to respond. Under the latter circumstances, fewer ties among network members may decrease the likelihood of ambiguous or stressful communications.     

Parental sensitivity, infant affect, and affect regulation: predictors of later attachment

This longitudinal study on 94 families examined the extent to which parent sensitivity, infant affect, and affect regulation at 4 months predicted mother-infant and father-infant attachment classifications at 1 year. Parent sensitivity was rated from face-to-face interaction episodes; infant affect and regulatory behaviors were rated from mother-infant and father-infant still-face episodes at 4 months. Infants' attachment to mothers and fathers was rated from the Strange Situation at 12 and 13 months. MANOVAs indicated that 4-month parent and infant factors were associated with infant-mother but not infant-father attachment groups. Discriminant Function Analysis further indicated that two functions, "Affect Regulation" and "Maternal Sensitivity," discriminated infant-mother attachment groups; As and B1-B2s showed more affect regulation toward mothers and fathers than B3-B4s and Cs at 4 months, and mothers of both secure groups were more sensitive than mothers of Cs. Finally, the association between maternal sensitivity and infant-mother attachment was partially mediated by infant affect regulation.     

Infant-mother attachment: factors related to its development and changes over time

As part of a large longitudinal study, assessments of attachment relationships in high-risk mother-infant pairs were conducted at 12 and 18 months. With data collected prenatally and during the infant's first 2 years of life, this study attempted to discriminate among 3 major attachment classifications and to account for qualitative changes in attachment relationships. The data included maternal and infant characteristics, mother-infant interactions, life-stress events, and family living arrangements. Several patterns seemed to emerge. Mothers of securely attached infants were consistently more cooperative and sensitive with their infants as observed in a feeding and play situation than mothers of anxiously attached infants. Anxious/resistant infants tended to lag behind their counterparts developmentally and were less likely to solicit responsive caretaking. Anxious/avoidant infants, although robust, tended to have mothers who had negative feelings about motherhood, were tense and irritable, and treated their infants in a perfunctory manner. Male babies were somewhat more vulnerable to qualitative differences in caretaking, while, for girls, maternal personality showed a stronger relationship to security of attachment. Changes from secure to anxious attachments were characterized by initially adequate caretaking skills but prolonged interaction with an aggressive and suspicious mother. Changes toward secure attachments tend to reflect growth and increasing competence among young mothers.     

Stranger responses: effects of familiarity, stranger's approach, and sex of infant

Most investigators examining contextual influences on infant responses to a stranger have limited their study to the initial responses of the infant. Few have considered infant reactions beyond the first minutes of the encounter or the enduring effects of contextual variables once mothers have left. The present study examines the effects of stranger's style of approach, familiarity with the stranger, and infant sex on infant response before and after maternal separation. Familiarity was operationalized in 2 ways: the length of time mothers stayed before leaving infants with the stranger and meeting the stranger a second time. Findings suggest that all these factors influence infant behavior. Ifants looked and smiled at the stranger significantly more when approached slowly. Contrary to expectations, infants (particularly girls) who met the familiar stranger after 1 week protested significantly more when left with her at that time. Trends indicate the length of time mothers stayed was least influential since most infants became extremely distressed once mothers departed.     

Physiological effects of infant exposure to environmental tobacco smoke: a passive observation study

This study explored infant physiologic responses of exposure to environmental tobacco smoke (ETS) using a longitudinal passive observation study with a control group. Fifteen smoking and 15 non-smoking mothers were initially contacted in hospital maternity units, with home visits made when their infants were 2, 4, and 6 weeks old. Exposure to ETS was measured using infant urinary nicotine and cotinine levels. The physiologic effects of infant ETS exposure were measured by rectal temperature, pulse rate, respiratory rate, blood pressure, and oxygen saturation. The smoking mothers in this sample were poorer, had less education, and were less likely to be married than the mothers who did not smoke. At birth, the infants of smoking mothers had higher diastolic blood pressure than infants of non-smoking mothers (p < .008). Mothers who smoke cigarettes should be educated that maternal smoking behavior can affect an infant's cardiovascular function. Parents should also be counseled about the risks of smoking in close proximity and/or in an enclosed space with an infant, especially in a motor vehicle.     

Maternal Responsiveness to Infants in Three Societies: The United States, France, and Japan

This study examines and compares prominent characteristics of maternal responsiveness to infant activity during home-based naturalistic interactions of mother-infant dyads in New York City, Paris, and Tokyo. Both culture-general and culture-specific patterns of responsiveness emerged. For example, in all 3 locales infants behaved similarly, mothers also behaved similarly with respect to a hierarchy of response types, and mothers and infants manifest both specificity and mutual appropriateness in their interactions: Mothers responded to infants' exploration of the environment with encouragement to the environment, to infants' vocalizing nondistress with imitation, and to infants' vocalizing distress with nurturance. Differences in maternal responsiveness among cultures occurred to infant looking rather than to infant vocalizing and in mothers' emphasizing dyadic versus extradyadic loci of interaction. Universals of maternal responsiveness, potential sources of cultural variation, and implications of similarities and differences in responsiveness for child development in different cultural contexts are discussed.     

Emerging Social Regulatory Capacities as Seen in the Still-Face Situation

Early mother-infant interactions support infants' abilities to deal with stressful situations such as the withdrawal of maternal attention. The "still-face" paradigm provides a framework for studying the range of social regulatory capacities available to infants during stressful times. This study examined the responses of 62 3-4-month-old infants during the still-face situation. Infants' responses were coded in real time along 3 dimensions: gaze, affect, and state. 3 findings are presented: (1) Generally, infants responded to the still-face situation with predominantly neutral affect and looking away from their mothers. (2) Infants who looked longer at their mothers early in the still-face showed longer early positive affect and protested her absence less. (3) Girls more often showed an intensely negative response to the still-face. These findings are discussed in the context of the development of social regulatory capacities in infancy.     

Developmental changes and socioeconomic differences in mother-infant picturebook reading

Picturebook reading is a common form of interaction between parents and young children. This study examined developmental changes and socioeconomic differences in picturebook interactions of motherinfant Argentine dyads. 21 middle and 18 low SES mothers with their 12 to 24 months-old infants interacting with two different books, were observed. It was found that mothers of both SES groups adjusted the level of their demands not only to the task requirements (books) but also to the age of the infant. However, it was also found that the style of the interaction was different depending on the SES of the mother-infant pair. A more demanding and elaborated maternal language along with a linguistically more competent child were found in the middle SES group.     

Parental interactions with Latino infants: variation by country of origin and English proficiency

This study examined variation in mother-infant interactions, father engagement, and infant cognition as a function of country of origin, socioeconomic status, and English language proficiency in a national sample of Latino infants (age 9 months) born in the United States and living with both biological parents (N=1,099). Differences between Mexican-American infants, who had lower mother-infant interaction scores and less father physical play than did the other Latino infants, were associated with differences in acculturation (both parents' English proficiency). Indicators of acculturation and paternal reports of happiness with partner were associated with paternal engagement. Indicators of acculturation were also related to mother-infant interactions. Infant cognitive scores were associated with maternal interaction but not father engagement, and maternal but not paternal mental health.     

The Cultural Organization of Parenting: Change and Stability of Behavior Patterns During Feeding and Social Play Across the First Year of Life

Objective. This study explores the cultural patterning of maternal beliefs and practices across the first year of life among middle-class Anglo and Puerto Rican mother-infant dyads in two daily situations, feeding and social play. Design. Sixty middle-class mothers (32 Anglo from northeastern Connecticut, and 28 Puerto Rican from San Juan, Puerto Rico) were interviewed regarding their long-term socialization goals and videotaped in their homes during feeding and social play when their infants were 4-, 8-, and 12-months of age. Results. Group comparisons revealed that across time and contexts the Anglo mothers were more likely to show patterns of beliefs and behaviors that emphasized the infant's personal choice and mastery of the situation, whereas the Puerto Rican mothers were more likely to show patterns of beliefs and behaviors that emphasized the infant's interdependence on the mother. The groups did not differ in nurturant behaviors toward their infants. Conclusions. The organization of feeding and social play differs by culture. Within this larger cultural frame, mother-infant interactions differ by context and adjust to universal aspects of infant development.     

Infants' interactions with mother, sibling, and peer: contrasts and relations between interaction systems

The role of the mother in structuring interactions with the infant during free play was examined at 6 and 9 months. Maternal scaffolding of turn-taking exchanges was then contrasted to the forms of turn-taking apparent in sibling-infant and peer-infant observations. Infants spent more time in turn-taking exchanges with their mothers than with their siblings or peers. These exchanges most often took the form of mothers creating sequences by responding to infants' social and nonsocial acts and by eliciting social and nonsocial responses from the infants. Infants' exchanges with older siblings were briefer and more typically involved the older children eliciting nonsocial responses from the infants but not responding contingently to the infants' interests and actions. Infant peers spent less time in turn-taking exchanges, and their interactions showed less evidence of scaffolding. At the same time, the proportion of strictly social interactions was greatest with peers. Relations were apparent between infants' turn-taking experiences with their mothers and the infants' subsequent interactions with their siblings and with their peers. Relations were also found between infants' interaction experiences with their older siblings and subsequent peer interaction. Those infants with more extensive turn-taking experience with more skilled social partners were subsequently observed to engage in more extensive turn-taking interactions with a peer. These results are discussed in terms of studies on mother-infant attachment and peer competence, maternal scaffolding, and Vygotsky's zone of proximal development.