Interactions between depressed and nondepressed Latina mothers and their premature infants

The impact of depression upon mother–infant interaction was studied longitudinally in a sample of very low income, immigrant Latina mothers with premature, very low birth weight infants. Both maternal characteristics and infant characteristics were examined using a rating scale which measured feeding interactions. Results indicate that mothers who were depressed at one month did not interact differently with their premature infants than nondepressed mothers. In addition, infants of mothers who were depressed at one month did not interact differently with their mothers than infants of nondepressed mothers. There were no differences between groups of mothers who remained depressed across the one-year period and groups whose scores reflected no depression or changes in depression levels. These findings challenge previous assumptions about interactions between depressed mother–infant dyads. Results indicate the need to broaden study attention to include socioeconomic, cultural, and life circumstances of families that may have greater impact on child outcomes than single assessments of maternal depression. Such studies may lead to changes in the way services are delivered and the types of interventions provided to non-mainstream families. © 1997 Michigan Association for Infant Mental Health     

Speaking for the baby: A therapeutic intervention with adolescent mothers and their infants

Adolescent mothers frequently experience problems in mother-infant interaction. However, intervention can be very difficult, particularly when complicated by unresolved conflicts involving relationships in the young woman's past. This article describes a therapeutic intervention, based on the work of Fraiberg, which allows the young mother to learn to interpret her infant's cues while also encouraging her to express her own emotions in the context of the mother-infant relationship. Two case studies are discussed to illustrate the use of the technique as part of a program of mother-infant intervention.     

Effects of early hospital-based intervention on mothers and their preterm infants

Mothers of eight Israeli preterm infants were exposed to a standardized but individualized intervention during their stay in the hospital and before their infants were discharged. Mothers and infants in the intervention group were compared to eight control subjects using various outcome measures. While the intervention did not affect maternal personal attitudes and feelings, it positively affected the mother-infant interactions and mothers' perceptions of their infants. The importance of individualized interventions with parents of preterm infants is discussed.     

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.     

Attachment‐based intervention for substance‐using mothers: A preliminary test of the proposed mechanisms of change

Although randomized controlled trials examining the efficacy of attachment‐based interventions have been increasing in recent years, adequate measurement of treatment integrity, integrity–outcome associations, and mechanisms of change has been rare. The aim of this investigation was to conduct a rigorous test of proposed mechanisms of change in the Mothers and Toddlers Program (MTP) treatment model, a 12‐session, attachment‐based individual therapy for substance‐using mothers of children birth to 3 years of age. The MTP aims to improve maternal reflective functioning (RF) and representation quality (RQ) to bring about second‐order change in maternal caregiving behavior. Following guidelines from M.K. Nock ( 2007 ), it was hypothesized that (a) therapist adherence to unique MTP treatment components would uniquely predict improvement in RF and RQ and that (b) improvement in RF and RQ would function as unique mechanisms of change (when compared with other potential mechanisms—reduction in depression and increase in abstinence from drug use) in the improvement of caregiving behavior. Findings supported each hypothesis, confirming the proposed mechanisms of the treatment model. However, improvement in maternal depression also uniquely predicted improvement in caregiving behavior. Results underscore the potential value of attachment‐based parenting interventions for improving mother–child relations and the importance of providing these interventions in clinic settings where mothers have access to comprehensive care (e.g., psychiatric services).     

Home‐based intervention after discharge for Latino families of low‐birth‐weight infants

A home‐based intervention designed for impoverished Latino families of low‐birth‐weight infants was implemented, and the efficacy assessed for infants and mothers. Specially trained public health nurses visited the participants' homes for 4 months for the “short” and 12 months for the “extended” intervention groups. Mothers received support and training in infant care. A third group did not receive the intervention. Assessments were at 4‐ to 6‐month intervals from 1 to 24 months. Although the extended visitation group showed no benefits from the intervention, the short visitation group had higher scores on maternal confidence at one month, and on the Bayley Mental Scores at four months than the group receiving no intervention and extended intervention. The nonvisitation group scored significantly higher than both intervention groups on the HOME scores and on the Mother–Infant Interaction and Feeding scores at three different assessment periods. These data suggest that for poor Latino families home intervention is not beneficial across the board. Instead, efforts should be made to identify families that could benefit from intervention and to tailor the program to the specific needs of Latino families. © 2000 Michigan Association for Infant Mental Health.     

Maternal representations and emotional availability among drug‐abusing and nonusing mothers and their infants

Both negative and idealized maternal prenatal representations may constitute a risk for mother–infant interaction. This study analyzed the role of maternal prenatal representations and pre‐ to postnatal representational change in predicting mother–infant emotional availability (EA) among 51 drug‐abusing mothers and their infants who participated in either psychodynamic group therapy (PGT) or received psychosocial support (PSS) and among 50 nonusing comparison dyads. Maternal representations of her child, the child's father, her own mother, self‐as‐mother, and self‐as‐woman were measured during pregnancy and at 4 and 12 months' postpartum with the Interview of Maternal Representations (M. Ammaniti et al., 1992 ; M. Ammaniti, R. Tambelli, & P. Perucchini, 1998). EA was measured with the Emotional Availability Scales, fourth edition (Z. Biringen, 2008 ) at 4 and 12 months. The results showed that drug‐abusing mothers had more negative prenatal representations of the self‐as‐woman and of the child's father. Postnatally, PSS mothers tended to first idealize their child, but later to experience disillusionment of idealization. Both negative and idealized prenatal representations of the self‐as‐mother predicted mother–infant EA problems, but only among the PGT mothers. For all mothers, negative representational change was detrimental for the mother–infant EA whereas for drug‐abusing mothers, also increasing idealization from the prenatal period to the postnatal period was harmful. Clinicians working with drug‐abusing mothers should aim at supporting the development of a realistically positive view of motherhood.     

A model‐based approach to limb apraxia in Alzheimer's disease

Limb apraxia is a neurological deficit characterized by an inability to pantomime and/or imitate gestures, which can result from neurodegenerative disorders such as Alzheimer's disease (AD). The major goal of the study was to describe comprehensively the apraxia deficits observed in AD patients and to relate those deficits to general cognitive status, measures of daily activity, and other neuropsychological measures. Limb apraxia was assessed on a variety of conceptual and gesture production tasks in 30 AD patients. As a group, AD patients were impaired across gesture production tasks: of note was the greater impairment in imitation, as opposed to pantomime, which was especially pronounced when patients were imitating with a delay. Imitation performance was best predicted by measures of visuospatial processing, while imitation with delay was best predicted by measures of working memory. In addition, pantomime in response to pictures of tools was less accurate than Pantomime to Verbal Command and holding the tool during performance did not decrease the participants' impairment, while introducing a verbal cue during imitation increased the severity of deficits. Furthermore, investigation into patterns of deficits clearly demonstrated that the nature of limb apraxia deficits observed in AD can be quite heterogeneous and that dissociations between the conceptual and the production system exist. Finally, we also report on significant correlations between general cognitive status and limb apraxia.     

Preventive group psychotherapy for at-risk infants and their mothers

There is increased evidence that infants who receive poor quality social stimulation from their primary caregiver are at risk for later developmental difficulties. This paper describes a preventive intervention for mother-infant dyads exhibiting impaired patterns of social interaction. An impaired relationship with the primary caregiver has been found to be associated with social and emotional deficits in early childhood as well as with significant psychopathology in adulthood. The intervention consisted of group treatment of mothers and their infants. Each group session has 4 subsections which, together, were directed towards improving the mothers' ability to relate in a stimulating and nurturant manner to their children. Types of intervention included didactic instruction, modeling, and interpretation of the infant's behavior. Qualitative data suggested that the group intervention has positive effects on the mother-infant dyads.     

The functional concern of mothers for their infants

The Functional Maternal Concern of mothers for their infants was assessed (with an Index derived from Caldwell's Home Observation for the Measurement of the Environment.) when 36 children, heterogeneous with respect to social status, were 6- and 18-months-old. Scores on this Index were related to the mother's IQ and education, as well as to certain temperamental characteristics of the children: cooperativeness and happiness. The Index proved stable over the time period of 6 to 18 months and yielded better predictability of Stanford Binet scores at 48 months than the Bayley Infant test scores. Moreover, there appears to be a minimal level of maternal concern needed to facilitate the child's development which seems to be especially important for the second year of life.     

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.     

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.     

Relationship‐based intervention with at‐risk mothers: Factors affecting variations in outcome

A previous group comparison had shown that in families experiencing the UCLA Family Development Project intervention as opposed to a group that did not, mothers became more responsive to the needs of their infants, and the infants were more secure in their attachment to their mothers. The present study asks whether variations in these outcomes following participation in a relationally based intervention are anticipated by maternal involvement in the intervention, partner support, personality dimensions, and mother–infant interactions that were assessed early in the intervention process. The sample consists of 46 mothers at risk for inadequate parenting who also were poor and generally lacked support. It was found that variations at 12 months of age in the child's secure response to separation, his or her expectation of being cared for (felt security), and the mother's responsiveness to need are anticipated by variations in the mother's 6‐ to 12‐month involvement in the home‐visiting intervention, the quality of her partner's support as measured at six months, and her own trust, ability to form stable relationships, and lack of self doubt. Parents who, at one month, were responsive to the needs of their more soothable babies were more likely to have secure children at 12 months, but these associations were not as robust as those summarized above. © 2000 Michigan Association for Infant Mental Health.     

Facial expressions and vagal tone of infants of depressed and non-depressed mothers

Mothers classified as ‘depressed’, ‘non-depressed’ or ‘low scoring’ on the Beck Depression Inventory and their 3-month-old infants were videotaped during 3-minute face-to-face play interactions. Infants' facial expressions were coded using the AFFEX facial expression coding system and their EKG was recorded during the interactions to assess the relationship between cardiac measures and facial expressivity. Infants of both ‘depressed’ and ‘low scoring’ mothers showed significantly more sad and anger expressions and fewer interest expressions than infants of nondepressed mothers. Cardiac vagal tone, (quantified from the amplitude of respiratory sinus arrhythmia) was correlated with infants' joy and interest expressions and with self-comfort behaviours in the non-depressed and low scoring groups, but not in the depressed group. The results suggest that matermal depression affects infants' affective state and appearance as well as their biobehavioural emotional regulation systems.     

Emotional availability and psychosocial correlates among mothers in substance‐abuse treatment and their young infants

Emotional availability (EA) was investigated among low‐income mothers enrolled in substance‐abuse treatment and their young infants (n = 21) compared with a demographically matched group of mother–infant pairs who, by self‐report, were not at risk for substance abuse (n = 27). The mother–infant dyads in the treatment group generally demonstrated poorer EA functioning than those in the comparison group, but few differences between the groups on individual dimensions of EA were significant. This finding was notable considering that mothers in treatment reported significantly higher levels of depressive symptoms and psychological stress. Treatment effects may have buffered the negative impact of depression and psychological stress on mothers' EA scores. The clinical implications of the findings are discussed as they relate to substance‐abuse‐treatment services for pregnant and parenting women.     

Gaussian model‐based partitioning using iterated local search

The emergence of Gaussian model‐based partitioning as a viable alternative to K‐means clustering fosters a need for discrete optimization methods that can be efficiently implemented using model‐based criteria. A variety of alternative partitioning criteria have been proposed for more general data conditions that permit elliptical clusters, different spatial orientations for the clusters, and unequal cluster sizes. Unfortunately, many of these partitioning criteria are computationally demanding, which makes the multiple‐restart (multistart) approach commonly used for K‐means partitioning less effective as a heuristic solution strategy. As an alternative, we propose an approach based on iterated local search (ILS), which has proved effective in previous combinatorial data analysis contexts. We compared multistart, ILS and hybrid multistart–ILS procedures for minimizing a very general model‐based criterion that assumes no restrictions on cluster size or within‐group covariance structure. This comparison, which used 23 data sets from the classification literature, revealed that the ILS and hybrid heuristics generally provided better criterion function values than the multistart approach when all three methods were constrained to the same 10‐min time limit. In many instances, these differences in criterion function values reflected profound differences in the partitions obtained.     

Right frontal EEG asymmetry and behavioral inhibition in infants of depressed mothers

Recent studies have shown associations between maternal psychopathology and inhibited behaviors in infants. Moreover, physiological factors have been identified as affecting the continuity of behavioral inhibition across childhood. The purpose of the present study was to examine electroencephalogram (EEG) activity and inhibited behavior in 12-month-old infants of depressed versus non-depressed and mothers. Repeated measures MANOVAs indicated that the infants of mothers with stable psychopathology had greater relative right frontal EEG asymmetry, a pattern that typically accompanies greater negative affect and greater withdrawal behaviors. Infants of affectively ill mothers also showed more proximal behaviors toward a stranger and a novel toy than infants of well mothers, but fewer non-proximal behaviors toward their mothers. These results are discussed within a framework of behavioral inhibition for infants exposed to early psychopathologies in their mothers.     

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.     

Happy faces are habituated more slowly by infants of depressed mothers

Three-month-old infants of depressed (n=16) and non-depressed mothers (n=16) were habituated to video clips of a female model reciting phrases while posing happy or sad facial/vocal expressions and dishabituated to the alternate expressions. Overall, infants of depressed mothers took longer to habituate the video clips compared to infants of non-depressed mothers, and those assigned to habituate the sad video clips displayed a novelty response or dishabituated to the happy expressions. These findings suggest that 3-month-old infants of depressed mothers discriminate sad from happy expressions, however, they do not appear to perceive sad expressions as novel.