Influences on responsiveness: Interactions between mothers and their premature infants

The responsiveness of mothers to their infants has been found to make an important contribution to children's development. Mothers' cognitive ability, emotional state, and life stresses may influence their responsiveness, as may the medical condition of their infants. The patterns of influence may vary between groups of children with different biological risk conditions and should be examined carefully to determine intervention points for different groups. Forty mothers and their 3-month-old (corrected age) infants with intraventricular hemorrhage (IVH) were observed in free play. Mothers' depressive symptoms, cognitive skills, and the degree of infants' IVH were assessed and expected to be influences on mothers' responsiveness. Results indicated that mothers' depressive symptoms and cognitive skills were associated with their responsiveness, but that depressive symptoms were the stronger predictor. Post hoc analyses suggested that socioeconomic status and depressive symptoms may have related effects on mothers' behavior.     

Affective interactions of depressed and nondepressed mothers and their children

The expressed affect of clinically depressed and nondepressed mothers as measured by the Schedule for Affective Disorders and Schizophrenia: Lifetime Version (SADSL) and their children (1 1/2 to 3 1/2 years) was observed in seminatural situations. The objectives were to investigate how maternal depression enters into affective interactions between mother and child and how the affect patterns of mother and child are related. Fortynine unipolar and 24 bipolar depressed mothers and 45 nondepressed mothers were observed on 2 days, 2 weeks apart, for a total of 5 h. Each minute was coded for the predominant affect of mother and child. Affects relevant to depression (anxioussad, irritableangry, downcast, pleasant, tenderaffectionate) were coded. Depressed mothers expressed significantly more negative affect than did control mothers. Mothers' expressed affect and their selfreports of affect on days of observation were unrelated. Mother's and child's affects, measured on different days, were significantly correlated. Unipolar mothers and mothers severely depressed spent significantly more time in prolonged bouts of negative affect. There was significant synchrony between their bouts and the negative bouts of their daughters. Gender of child was related to mother's and child's affect, and to relations between mother's and child's affect.     

Object perception in 5-month-old infants of clinically depressed and nondepressed mothers

Five-month-old infants of clinically depressed and nondepressed mothers were familiarized to a wholly novel object and afterward tested for their discrimination of the same object presented in the familiar and in a novel perspective. Infants in both groups were adequately familiarized, but infants of clinically depressed mothers failed to discriminate between novel and familiar views of the object, whereas infants of nondepressed mothers successfully discriminated. The difference in discrimination between infants of depressed and nondepressed mothers is discussed in light of infants' differential object processing and maternal sociodemographics, mind-mindedness, depression, stress, and interaction styles that may moderate opportunities for infants to learn about their world or influence the development of their perceptuocognitive capacities.     

Discrimination of facial expression by 5-month-old infants of nondepressed and clinically depressed mothers

Five-month-old infants of nondepressed and clinically depressed mothers were habituated to either a face with a neutral expression or the same face with a smile. Infants of nondepressed mothers subsequently discriminated between neutral and smiling facial expressions, whereas infants of clinically depressed mothers failed to make the same discrimination.     

Interactions between mothers and infants showing food refusal

This study examined the interactional patterns of mothers and their infants who showed food refusal (N = 24) and of mothers and infants in a control group (N = 24) during feeding and play. The observations revealed significant group differences in both infant and maternal behavior. Infants in the case group rejected food more often and showed less clear communication signals than control infants, and mothers of case infants were less sensitive, less cooperative, and had more verbal teaching/control behavior than the control group. These differences pertained to both feeding and play situations. The findings have implications for the development of appropriate and efficient intervention strategies for infants showing food refusal.     

Social skill in self-assertive strategies of toddlers with depressed and nondepressed mothers

The authors examined the effects of maternal depression on the skillfulness of toddlers' self-assertive strategies in interactions with their mother and with a female examiner. The participants were 110 mothers and their 26-month-old toddlers. Of these mothers, 57 had experienced an episode of clinical depression sometime since their child's birth, and 53 had had no history of depression. Toddlers exposed to maternal depression demonstrated significantly less social skill in their self-assertive strategies and more defiance when interacting with their mothers than did toddlers who were never exposed to maternal depression. The chronicity and severity of toddlers' exposure to maternal depression did not account for more pronounced differences in toddlers' skill in self-assertion toward mothers; however, toddlers exposed to more chronic courses of depression demonstrated less skill in their self-assertion toward the examiner. Toddlers who were exposed to maternal depression with a comorbid anxiety disorder did not exhibit less skill in their self-assertion toward mothers than did toddlers in either the depression-only or nondepressed groups. These findings suggest that exposure to maternal depression may interfere with toddlers' development of socially competent self-assertion strategies and may pose risks for future problems in the mother-toddler relationship.     

Interactions between anxious mothers and their infants: An integration of theory and research findings

Children of highly anxious mothers are at risk for developmental difficulties including anxiety disorders, and “anxious maternal behavior” and disturbed mother–infant interactions have been implicated in the transmission of risk. In this article, we describe interactions between mothers who are highly anxious and their young infant, based on the few directly relevant observation studies that are available. For more detail, we draw on a broader literature including studies of depressed mothers and developmental theory. Our goal is to describe how the interactions between anxious mothers and infants look to an outside observer and how they may feel to mothers and infants. We also discuss possible bases for their disturbed interactive behavior, the impact that the disturbances can have on both mothers and infants, buffers and risk factors, and routes to short‐term intervention. Finally, we suggest directions for future research on maternal anxiety and anxious maternal behavior and the significance of such research for clinicians and researchers.     

A model‐based intervention for depressed mothers and their infants

Many studies have reported on the adverse effects of maternal depression on offspring. Infants of depressed mothers are found to be more likely at risk to develop mental and socioemotional problems. In this study, an early intervention program is presented that aims to improve the interaction between depressed mothers and their infants to prevent developmental problems in the children. The program has recently been introduced in the Dutch Community Mental Health Centers as part of a national multicomponent program to reduce the risk of psychiatric and social problems in the offspring of parents with a mental disorder. The intervention for depressed mothers with babies is based on a transactional model in which the mother–child interaction plays a key role in explaining the development of socioemotional problems in the children. The model as discussed in the first part of this article addresses a range of evidenced‐based parental, child, and contextual risk factors that effect the quality of the interactions between depressed mothers and their infants and that contribute to both vulnerability and resilience of the children during later childhood and adolescence. ©2005 Michigan Association for Infant Mental Health.     

Interactions between mothers and infants: impact of maternal anxiety

The aim of the study was to examine the impact of anxiety in the postnatal year on maternal contribution to mother-infant interaction. Participants were 32 mothers with high anxiety and 32 mothers with low anxiety, when their infants were aged 10-14 months. Mother-infant interaction was videotaped during a standardized play situation and coded blind to group status. High trait anxiety mothers showed less sensitive responsivity (p<.05) and reduced emotional tone (p<.05) during interaction. When participants scoring high in depressive symptomatology were removed for a subgroup analysis, the same pattern of results was obtained, suggesting that the observed differences in mother-infant interaction were due to group differences in anxiety.     

Situational-specificity of motivational differences between depressed and nondepressed subjects

Performance on an easy or a difficult coding task for 4 90-sec. repetitions by 15 college women who showed depressive symptoms on the Beck Depression Inventory and the MMPI-Depression Scale and 15 who did not indicated no support for a psychological or motivational deficit in depression. Replication with clinically depressed persons is recommended.     

Evaluating the continuity of symptomatology between depressed and nondepressed individuals

Debate is contentious concerning whether depression should be viewed as a distinct category or as a continuum including overlapping normal and clinical phenomena. A nonparametric item response model was used to evaluate whether the probability of expressing individual symptoms differed between nondepressed and clinically depressed adults experiencing similar levels of overall severity. Even though depressed and nondepressed individuals were equated in terms of overall severity, differences on specific symptoms emerged. Depressed mood, anhedonia, and suicidality were more likely to be expressed in depressed than in nondepressed individuals, whereas hypochondriasis and middle insomnia were more likely to be expressed in nondepressed individuals at similar levels of severity. Such differences are inconsistent with the view of depression as a simple continuum.     

Interactive coordination of currently depressed inpatient mothers and their infants during the postpartum period

In healthy mother–infant dyads, interactions are characterized by a pattern of matching and mismatching interactive states with quick reparation of mismatches into matches. In contrast, dyads in which mothers have postpartum depression show impaired mother–infant interaction patterns over the first few months of the infant's life. The majority of studies that have examined such interaction patterns have drawn on community samples rather than on depressed inpatient samples of mothers who were in a state of current depression at the time of assessment. To date, no study has investigated specific microanalytic patterns of interactive coordination between depressed German mothers and their infants using the Face‐to‐Face Still‐Face paradigm (FFSF). The primary goal of this study was to evaluate specific patterns of dyadic coordination and the capacity for repairing states of miscoordination in an inpatient sample of postpartum currently depressed mothers and their infants as compared with a healthy control group. A sample of 28 depressed inpatient German mothers and their infants (age range = 1–8 months, M age = 4.06 months) and 34 healthy dyads (range = 1–8 months, M age = 3.89 months) were videotaped while engaging in the FFSF. A focus was placed on the play and reunion episodes. Compared with healthy dyads, dyads with depressed mothers showed less coordination of positive matched states and longer latencies when repairing interactive mismatching states into positive matched states. Clinical implications are discussed.     

Intrainformant agreement and family functioning in depressed and nondepressed parents and their children

Abstract

This investigation examined perceptions of family functioning, marital satisfaction, and parent-child bonding in 65 families (child, mother, father) with one or more depressed parents and 26 families with no depressed parent. Intrainformant agreement between offspring and their parents across family functioning measures was examined for the two proband groups. Results revealed more dysfunction in family adaptability, cohesiveness, and parent-child bonding and lower levels of marital satisfaction in the depressed as compared to the nondepressed proband group. Analyses of intrainformant data revealed no significant differences in levels of agreement between informants from the two proband groups for any of the raters. There was, however, significant agreement between informants in both proband groups. Thus, differential reports of family functioning are attributable to variations in perception of functioning, rather than to different levels of internal consistency in reporting across raters in depressed and nondepressed proband groups.     

Attributional style and self-control behavior in depressed and nondepressed children and their parents

Do the reformulated model of learned helplessness and the self-control model apply to clinically depressed children? Are the related cognitive patterns specific to depression? Are the cognitive deficits associated with depression learned from one's parents? To address these questions this investigation examined three groups of children (ages 8–12) and their parents: nonclinic (n =25),nondepressed clinic (n=22),and depressed clinic (n=15).Children were diagnosed depressed on the basis of Kiddie-SADS interview data. Depressed clinic children self-reported more depression, had a more depressive attributional style, and had more self-control problems. There were more depressed mothers in the clinic than in the nonclinic sample. Depressed clinic children had more depressed mothers than did nondepressed clinic children. There were no differences among the three groups of parents in their cognitive patterns. No relationship was found between the attributional style and self-control behavior of children and their parents.     

Differences in automatic social information processing between nondepressed and subclinically depressed individuals

The present research examined individual differences in automatic social information processing. We hypothesized that because nondepressed and subclinically depressed persons have different interpersonal experiences, they may process social information in different ways. In this experiment, participants were asked to make judgments about social relationships after being reminded of a target person. They had to make these judgments under either a light or a heavy memory load. Results showed that when nondepressed participants were reminded of people with whom they had frequent pleasant interactions, they made a greater number of positive judgments about their social relationships than did subclinically depressed participants. When subclinically depressed participants were reminded of people with whom they had had frequent unpleasant interactions, they made a greater number of negative judgments about their social relationships than did their nondepressed counterparts. Moreover, performance in these experimental conditions was unaffected by memory load, suggesting that automatic thoughts about their social relationships had been evoked.     

Stress,coping, executive function,and brain activation in adolescent offspring of depressed and nondepressed mothers

This study examined the associations among chronic stress, activation in the prefrontal cortex (PFC), executive function, and coping with stress in at-risk and a comparison sample of adolescents. Adolescents (N = 16; age 12–15) of mothers with (n = 8) and without (n = 8) a history of depression completed questionnaires, neurocognitive testing, and functional neuroimaging in response to a working memory task (N-back). Children of depressed mothers demonstrated less activation in the anterior PFC (APFC) and both greater and less activation than controls in distinct areas within the dorsal anterior cingulate cortex (dACC) in response to the N-back task. Across both groups, activation of the dorsolateral PFC (DLPFC; Brodmann area [BA9]) and APFC (BA10) was positively correlated with greater exposure to stress and negatively correlated with secondary control coping. Similarly, activation of the dACC (BA32) was negatively correlated with secondary control coping. Regression analyses revealed that DLPFC, dACC, and APFC activation were significant predictors of adolescents’ reports of their use of secondary control coping and accounted for the effects of stress exposure on adolescents’ coping. This study provides evidence that chronic stress may impact coping through its effects on the brain regions responsible for executive functions foundational to adaptive coping skills.     

Prenatal depression predicts postpartum maternal attachment in low-income Latina mothers with infants

Although maternal attachment is an important predictor of infant attachment security and other developmental outcomes, little is known about the formation of maternal attachment in the first few months of the infant's life, particularly among ethnic minority mothers. The current study examined the predictors of postpartum maternal attachment in a sample of 217 Latina women enrolled in a perinatal depression prevention trial. Mothers’ attachment to their infants was measured at 6-8 weeks postpartum using the Maternal Postnatal Attachment Scale. A variety of predictors of early attachment were explored including: depressive symptoms during pregnancy, pregnancy intention, feelings about the pregnancy, and the quality of the partner relationship. The strongest predictor of lower maternal attachment was depressive symptoms late in pregnancy; pregnancy intention was marginally predictive of attachment, with lower scores being associated with unwanted pregnancies. The study fills a critical gap in our understanding of the role of depressive symptoms during pregnancy in shaping mothers’ early attachment to their infants.     

Affective facial expression in sub-clinically depressed and non-depressed mothers during contingent and non-contingent face-to-face interactions with their infants

BackgroundDepression in the postpartum period involves feelings of sadness, anxiety and irritability, and attenuated feelings of pleasure and comfort with the infant. Even mild- to- moderate symptoms of depression seem to have an impact on caregivers affective availability and contingent responsiveness. The aim of the present study was to investigate non-depressed and sub-clinically depressed mothers interest and affective expression during contingent and non-contingent face-to-face interaction with their infant.MethodsThe study utilized a double video (DV) set-up. The mother and the infant were presented with live real-time video sequences, which allowed for mutually responsive interaction between the mother and the infant (Live contingent sequences), or replay sequences where the interaction was set out of phase (Replay non-contingent sequences). The DV set-up consisted of five sequences: Live1-Replay1-Live2-Replay2-Live3. Based on their scores on the Edinburgh Postnatal Depression Scale (EPDS), the mothers were divided into a non-depressed and a sub-clinically depressed group (EPDS score ≥ 6).ResultsA three-way split-plot ANOVA showed that the sub-clinically depressed mothers displayed the same amount of positive and negative facial affect independent of the quality of the interaction with the infants. The non-depressed mothers displayed more positive facial affect during the non-contingent than the contingent interaction sequences, while there was no such effect for negative facial affect.ConclusionsThe results indicate that sub-clinically level depressive symptoms influence the mothers’ affective facial expression during early face-to-face interaction with their infants. One of the clinical implications is to consider even sub-clinical depressive symptoms as a risk factor for mother-infant relationship disturbances.