Infant touching behaviour during mother–infant face‐to‐face interactions

The study of infant communication during mother–infant interactions has largely focused on infants' distal behaviours, while neglecting their more proximal behaviours, such as touch. Yet, touch is an important modality through which infants and mothers communicate; it is also a vital means through which infants self‐regulate and explore their surroundings. The present study was designed to investigate the touching behaviours of 44, 51/2‐month‐old, healthy, full‐term infants during face‐to‐face mother–infant interactions. A still‐face (SF) procedure was used in order to examine differences in the types and locations of infant touch across normal and perturbed interaction periods, when mothers exhibit changes in their emotional availability. Results revealed that infant touch varied with changes in maternal availability. During the SF period, when mothers were unavailable, infants used more active, soothing, and reactive tactile behaviours (stroke, finger, pat, and pull), and they spent more time touching themselves. In contrast, infants used mostly passive touch (static) during the Normal periods, when their mothers were available. They also spent a significant portion of time touching their mothers. The variations in infant touch across periods suggest that infants communicate their affective states through touch. The findings also support the regulatory and exploratory roles of infant touch, especially during periods of maternal unavailability. Copyright © 2007 John Wiley & Sons, Ltd.     

The co‐construction of joint action between mothers and 2–4‐month‐old infants: the mother's role

The purpose of this longitudinal study was to describe object‐centred interactions between mothers and their 2–4‐month‐old infants, before and during the emergence of reaching and grasping movements. We hypothesized that when reaching movements emerge at around 3 months, mothers alternate between attention stimulation and reaching stimulation, before joint actions between mother and infant develop around objects. Twelve dyads were recorded when infants were 2 months, 3 months and 4 months. The interactive sessions lasted 5 min. Three age‐appropriate toys the infant could handle were available to the mother. A principal component analysis (PCA) was performed on verbal and non‐verbal maternal behaviours, motor infant behaviours and co‐occurrences of those behaviours. The developmental course of prehension in infants when playing with their mother follows similar pathways, as was described when they are observed alone. Mothers appeared to early scaffold prehension skills by verbal and non‐verbal means. Moreover, maternal behaviours change according to the infant's behaviour, and conversely, infant's behaviours influence maternal behaviours: mother plays first an active part in joint action, while later on, the infant achieves joint action when motor skills develop. Copyright © 2000 John Wiley & Sons, Ltd.     

Maternal depression and dyadic interaction: the role of maternal attachment style

Maternal mental health and the contents of her representational world are important determinants of early parent–child relationship. We examined, first, the role of prenatal and postnatal depressive symptoms and maternal attachment style in predicting the quality of mother–child interaction. Second, we analysed whether the secure‐autonomous attachment style can protect the dyadic interaction from the negative effects of maternal depression. The participants were 59 mother–infant pairs examined during pregnancy (T1), 4–5 months postpartum (T2) and when the children were approximately 14 months old (T3). Maternal attachment style was assessed with a modified Adult Attachment Interview ‐procedure, depressive symptoms with Edinburgh Postnatal Depression Scale, and observed mother–child interaction with Care Index. The results show that autonomous mothers were more sensitive and responsive and their children more co‐operative than dyads with dismissing maternal attachment style. As hypothesized, mothers with the combination of both prenatal and postpartum depressive symptoms were highly unresponsive in their dyadic interaction. Further, prenatal depressive symptoms had a stronger impact on maternal unresponsiveness than postnatal symptoms. As hypothesized, mother's autonomous attachment style protected the mother–child interaction from the negative impact of maternal postnatal depressive symptoms, whereas dyads with preoccupied mothers were especially at risk for interaction problems when mothers had postpartum depressive symptoms. Copyright © 2010 John Wiley & Sons, Ltd.     

A randomized controlled trial of mother–infant psychoanalytic treatment: I. Outcomes on self‐report questionnaires and external ratings

Mother–infant relationship disturbances occur in three domains: maternal distress, infant functional problems, and relationship difficulties. They constitute common clinical problems. In Sweden, they are usually handled by nurses as part of public Child Health Centre care. Severe cases are referred to child psychiatry services. This randomized controlled trial compared two groups of mother–infant dyads in a Stockholm sample. One received only Child Health Centre care (the “CHCC” group) while the other received mother–infant psychoanalytic treatment plus CHCC (the “MIP” group). Eighty dyads of mothers and infants under 1½ years of age where the mothers had serious concerns about themselves in their role as mothers, their infants' well‐being, or the mother–baby relationship were randomly selected for either the MIP or the CHCC group. The primary outcomes were mother‐reported depression, mother‐reported infant functional problems, and interviewer‐based relationship assessments, all at 6 months after joining the project. Secondary outcomes were mother‐reported stress and general psychic distress, externally rated video‐recorded interactions, and the consumption of healthcare at the CHC, again all after 6 months. Intent‐to‐treat analyses of Treatment × Time effects significantly favored MIP treatment for maternal depression, mother–infant relationships, and maternal sensitivity. Effects were nearly significant on maternal stress, but nonsignificant on mother‐reported infant functional problems, general psychic distress, maternal interactive structuring and nonintrusiveness, infant responsiveness and involvement, and healthcare consumption. MIP treatment improved mother–infant relationships and maternal sensitivity and depression, all of which are known to influence child development. If effects persist and are reproduced, MIP treatment holds promise for more widespread use.     

Evaluating a home‐based dyadic intervention: Changes in postpartum depression,maternal perceptions,and mother–infant interactions

Psychotherapeutic treatments that focus on improving the relational processes between mothers with postpartum depression (PPD) and their infants, as well as the mother's individual therapeutic needs, have a great potential to positively impact the mother, her infant, and their relationship (K.J. Nylen, T.E. Moran, C.L. Franklin, & M. O'Hara, 2006 ). Utilizing pilot data from an evaluation of a home‐based dyadic therapy for mothers with PPD and their infants, this article reports on a recent academic–community partnership study. The effectiveness of the intervention was examined, specifically regarding changes in mother's mood, parenting experience, and relationship with her infant. In addition, associations were examined among maternal self‐report variables measuring change from pre‐ to posttreatment in PPD, psychological distress, and maternal perceptions of parenting and those variables measuring change in observer ratings of maternal–infant interactions. Results showed improvements in mothers' depression, distress, and perceptions of parenting as well as many ratings of mothers' interactions with their infants. However, only improvements in maternal perceptions of parenting, such as maternal self‐esteem and parenting stress, were associated with better mother–‐infant interactions. Importance of this research for the field of infant mental health as well as clinical implications are discussed.     

Who's controlling whom? Infant contributions to maternal play behavior

Because the way mothers play with their children may have significant impacts on children's social, cognitive, and linguistic development, researchers have become interested in potential predictors of maternal play. In the present study, 40 mother–infant dyads were followed from child age 5–20 months. Five‐month habituation rate and 13 and 20 month temperamental difficulty were found to be predictive of maternal play quality at 20 months. The most parsimonious theoretical model was one in which habituation was mediated by temperamental difficulty in predicting mother play. Consistent with prior speculation in the literature, these data support the possibility that mothers adjust some aspects of their play behaviors to fit their children's cognitive and temperamental capabilities. Copyright © 2003 John Wiley & Sons, Ltd.     

Infant irritability and early mother–infant reciprocity patterns

This study investigated how various forms of neonatal irritability (at 3 days) and irritability at 10 weeks are related to reciprocal interactions between mothers and their infants. Fifty‐six fullterm, first‐born male infants were examined using the Neonatal Behavioral Assessment Scale (NBAS‐K) at 3 days postpartum. Each infant was rated for irritability to aversive stimuli, general irritability, consolability and responsiveness to visual–auditory stimuli. At 10 weeks of age, during a home visit, mother–infant reciprocity was scored for gaze, smile, vocalization and hold behaviors. Based upon maternal reports and behavioral observations, infant irritability was scored at 10 weeks using the NBAS‐K scoring system. Findings revealed that: (1) there were two distinct forms of reciprocity: social and physical; (2) general irritability at 3 days was negatively related to reciprocal hold interaction and positively related to reciprocal social interaction at 10 weeks, and (3) neonatal irritability to aversive stimuli (at 3 days) was positively related to subsequent reciprocal social interaction. Regression analyses showed that neonatal variables were the foremost predictors of reciprocal hold at 10 weeks. Findings are discussed in terms of (1) the need to differentiate between social and physical behavioral patterns, and (2) time‐lag effects with respect to mother–infant interactions. Copyright © 1999 John Wiley & Sons, Ltd.     

Expression of negative affect during face‐to‐face interaction: a double video study of young infants' sensitivity to social contingency

The purpose was to assess infants' sensitivity to social contingency, taking affective state into account, during face‐to‐face interaction with the mother in a double video set‐up. Infants' behaviour during three sequences of live face‐to‐face interaction were compared to two sequences where the interaction between the infant and the mother was set out of phase, by presenting either the infant or the mother with a replay of their partners' behaviour during earlier live interaction. We found a significant negative correlation between the infant's degree of negative affect and the average time of looking at the mother during the live sequences. A median split was calculated to separate the infants into a high‐negative‐affect group and a low‐negative‐affect group on the basis of their emotional responses during the experiment. The low‐negative‐affect infants looked significantly more at their mothers than other foci during the live but not the replay sequences, while the high‐negative‐affect infants did not show this difference. The results suggest that 2–4‐month old infants are able to distinguish between experimental distortion of contingent aspects in live and replay sequences, but that this effect of the replay condition may not be shown by moderate to highly distressed infants. Our findings underline the importance of taking infants' emotional state into account in experiments intended to assess their capacity for intersubjective communication. Copyright © 2006 John Wiley & Sons, Ltd.     

The mediating role of maternal responsiveness in some longer term effects of postnatal depression on infant development

We hypothesized a mediating role for low maternal responsiveness in certain child developmental deficits found previously to be associated with postnatal depression. Forty depressed inpatients and 48 control (non-depressed) mothers and their infants were followed until 42 months postpartum. Mother–infant interactions were impaired at 6 months postpartum in the depressed group. Subsequent cognitive deficits were found in children's Full Scale IQ on the Wechsler Preschool Primary Scale of Intelligence (Revised) at 42 months of age. Statistical modeling of the mediation hypothesis confirmed that these effects were overwhelmingly explained by lowered maternal responsiveness at 6 months. Similarly, increased temperamental difficulties were apparent in children of depressed mothers but were not correlated with maternal responsiveness. Male infants of depressed mothers were disproportionately vulnerable (compared to females) to impaired cognitive abilities associated with maternal depression. The data concur with previous work and provide empirical support for the theoretical prediction that early disturbances of the mother–infant interaction will mediate some developmental deficits in the children of depressed mothers.     

Cultural Differences in Physical Contact Between Hispanic and Anglo Mother–Infant Dyads Living in the United States

This is a study of differences in physical contact and tactile interpersonal behaviours between Hispanic and Anglo mothers and infants living in the United States. Infants were 9 months old and 52 mother–infant dyads, 26 Hispanic and 26 Anglo, were videotaped during free play without toys in a university laboratory playroom. Coders judged the interpersonal distance, physical contact and affectionate touch from the videotapes and mothers responded to a questionnaire about the importance of physical contact and affectionate touch in their relationship with their infant. From questionnaire data we found that Hispanic and Anglo mothers both touch their infants on a daily basis, although Hispanic mothers report touching more frequently, being more affectionate with their infants and having more skin-to-skin contact. From videotaped observations we found that there were no overall differences in mother–infant touch between the two cultures; however, the Hispanic mothers showed more close touch and more close and affectionate touch compared to Anglo mothers, who showed more distal touch. The results are discussed in terms of the role of touch in infant development and cultural differences in the evaluation of close physical contact and touch.     

Attachment and sensitivity in family context: the roles of parent and infant gender

This study examined the role of child gender in fathers' and mothers' sensitivity to and attachment relationships with their infants from a family systems perspective. Eighty‐seven 1‐year‐olds participated in the Strange Situation with each parent. Parental sensitivity was examined during a competing demands task. Results indicated that fathers and mothers were equally sensitive to sons, but fathers were less sensitive than mothers to daughters, and mothers were more sensitive to daughters than to sons. Although mothers and fathers within the same families were similarly sensitive to daughters and sons, daughters' attachment security with fathers and mothers was similar whereas sons' was not. Further analyses revealed that fathers were more sensitive to sons with an insecure relationship with their mothers. Results of this investigation suggest that child gender is relevant for parent–infant, especially father–infant, attachment relationships. Copyright © 2006 John Wiley & Sons, Ltd.     

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.     

Influences of maternal postpartum depression on fathers and on father–infant interaction

Maternal postpartum depression (PPD) has been shown to negatively influence mother–infant interaction; however, little research has explored how fathers and father–infant interaction are affected when a mother is depressed. This study examined the influence of maternal PPD on fathers and identified maternal and paternal factors associated with father–infant interaction in families with depressed as compared with nondepressed mothers. A convenience sample of 128 mother–father–infant triads, approximately half of which included women with significant symptoms of PPD at screening, were recruited from a screening sample of 790 postpartum women. Mothers and fathers completed measures of depression, marital satisfaction, and parenting stress at 2 to 3 months' postpartum and were each videotaped interacting with their infants. Results indicate that maternal PPD is associated with increased paternal depression and higher paternal parenting stress. Partners of depressed women demonstrated less optimal interaction with their infants, indicating that fathers do not compensate for the negative effects of maternal depression on the child. Although mother–infant interaction did not influence father–infant interaction, how the mother felt about her relationship with the infant did, even more so than maternal depression. The links between maternal PPD, fathers, and father–infant interaction indicate a need for further understanding of the reciprocal influences between mothers, fathers, and infants.     

Caregiving representations in war conditions: Associations with maternal trauma,mental health,and mother–infant interaction

Risk features in mothers’ caregiving representations remain understudied in dangerous environments where infants most urgently need protective parenting. This pilot study examines the feasibility of a novel coding system for the Parent Development Interview (PDI) interview (ARR, Assessment of Representational Risk) in assessing 50 war-exposed Palestinian mothers’ caregiving representations. First, we explored the content and structure of risks in the representations. Second, we examined associations between the high-risk representations, mothers’ pre- and postnatal exposure to traumatic war events (TWE), depressive and post-traumatic stress disorder (PTSD) symptoms, and self-rated emotional availability (EA) with their 1-year-old infants. Following three dimensions of high-risk caregiving representations were identified: self/dyadic dysregulation, unavailable, and fearful. Mothers’ prenatal depressive symptoms were associated with dysregulating and fearful representations, and their postnatal PTSD with fearful representations. TWE were not associated with the high-risk representations. Moreover, mothers of boys reported more fearful representations, and mothers with financial difficulties reported more unavailable representations. TWE and high-risk representations were not associated with EA. However, qualitative analysis of the representations indicated risks in the mother–infant relationship. Further, older mothers and mothers with postnatal PTSD reported lower EA. Cultural variance in caregiving representations and the use of self-report measures among traumatized mothers are discussed.     

Interaction between mother and pre-term infant at 34 weeks post-conceptional age

The impact of premature birth and perinatal medical status on early mother–infant interaction was assessed in 75 dyads with pre-term infants divided into three groups. Infants' gestational age at birth and need for neonatal intensive care intervention differentiated the groups: group 1, 23–31 weeks with intensive care; group 2, 32–35 weeks with intensive care; group 3, 32–35 weeks with no intensive care. The methodological approach was based on observations of the dyads performed when the infant reached a post. conceptional age of 34 weeks (4 weeks before estimated due date of delivery). The observations were conducted in the neonatal nursery during cleaning, face-to-face and feeding interactions. Significant group differences were found in infant distress, maternal sensitivity to the infant and dyadic behaviours of positive interaction. Group 1 dyads showed higher scores or more desirable performance than dyads of group 3. Group 2 dyads usually achieved intermediate scores and performed better than dyads of group 3, especially during the feeding situation. We suggest that, in addition to a possible emergence of maternal compensatory mechanisms in the higher-risk groups, the amount of dyadic experience after birth affects the quality of mother–infant interaction at this early stage.     

Social proximity in early mother–infant interactions: implications for gender differences?

In an exploratory study, we investigated degrees of social proximity between mothers and their 9-month-old children. Twenty-four Swedish mother–infant dyads (12 boys and 12 girls) were observed during a brief free play episode. Social proximity was measured through nine items focusing on both communication and social interaction. Overall, we found that mother–daughter dyads displayed significantly higher degrees of social proximity than mother–son dyads. More specifically, mothers with daughters displayed more physical and visual contact, and were also rated as more sensitive than mothers with sons. It was also found that girls were judged as being more compliant than boys. ©1997 John Wiley & Sons, Ltd.     

Observer Influences on Fathers and Mothers: An Experimental Manipulation of the Structure and Function of Parent – Infant Conversation

From studies over the past 20 years four contrasting hypotheses can be made about the nature of parent–infant communication: (1) mothers and fathers display similar skills to their infants and do not exert a differential influence on their development; (2) fathers are less sympathetic to their infants' level of development and therefore inadvertently stretch the child's development more than mothers; (3) both parents differentially socialize their sons' and daughters' early communicative skills; (4) any apparent differences between parents reflect their expectations about being observed. To examine these hypotheses together, this experiment records the communication of 10 mother–infant and 10 father–infant dyads in two conditions: when an observer was present or absent. The analysis revealed two patterns. Firstly, in keeping with most research on parent–child communication, mothers and fathers both simplified their speech to their infants in similar ways. Secondly, both the structure and function of parental communication showed differences between the two conditions and many of these differences were moderated by interactions between condition and sex of parent or child. The data thus provide more support for the first and fourth hypotheses cited above. It is suggested that analyses of parent–infant interaction should move away from simple assumptions about parental ‘influences’ upon children's development to consider the subtleties of different parental styles in different settings.     

A randomized controlled trial of mother–infant psychoanalytic treatment: II. Predictive and moderating influences of qualitative patient factors

A randomized control trial was performed on 75 dyads in Stockholm, Sweden, with infants under 1½ years. It recruited mothers who worried about the babies, themselves as mothers, and/or the mother–baby relationship. Two groups of mother–infant dyads were compared. One received only Child Health Centre care (the “CHCC” group) while the other received mother–infant psychoanalytic treatment plus CHCC (the “MIP” group). Significant treatment effects were found on mother‐reported depression, interviewer‐rated dyadic relationship qualities and externally rated maternal sensitivity, and near‐significant effects on mother‐reported stress, all in favor of MIP. The objective of this study is to investigate the predictive and moderating influences on outcomes by qualitatively assessed maternal and infant characteristics. The qualitative factors covered maternal suitability for psychoanalysis, and “ideal types” of mother and child, respectively. Outcome measures from two interviews with a 6‐month interval were depression (Edinburgh Postnatal Depression Scale (J. Cox, J. Holden, & R. Sagovsky, 1987 ), stress (Swedish Parental Stress Questionnaire (M. Östberg, B. Hagekull, & S. Wettergren, 1997 ), distress (Swedish Symptom Checklist‐90 (SCL‐90; L.R. Derogatis, 1994 ; M. Fridell, Z. Cesarec, M. Johansson, & S. Malling Thorsen, 2002 ) and infant social and emotional functioning (Ages and Stages Questionnaire: Social–Emotional (J. Squires, D. Bricker, K. Heo, & E. Twombly, 2002 ), relationship qualities (Parent–Infant Global Assessment Scale (PIR‐GAS; ZERO TO THREE, 2005), and videotaped interactions (Emotional Availability Scales, Z. Biringen, J.L. Robinson, & R.N. Emde, 1998 ). Suitability for psychoanalysis predicted outcome only on the PIR‐GAS. Two overarching maternal ideal types were created, reflecting their attitude to the psychoanalytic process: “Participators” and “Abandoned.” The Participators benefited more from MIP than they did from CHCC on maternal interactive sensitivity. A contrasting, but nonsignificant, pattern was found among the Abandoned mothers. Two ideal types of babies emerged: those “Affected” and “Unaffected” by the disturbance, respectively. Among Affected babies, dyadic relationships and sensitivity among their mothers improved significantly more from MIP than they did from CHCC. The superior effects of MIP applied especially to Participator mothers and Affected infants. For Abandoned mothers and Unaffected infants, CHCC seemed to be of equal value.     

MATERNAL SELF‐REPORTED DEPRESSIVE SYMPTOMS AND MATERNAL CORTISOL LEVELS INTERACT TO PREDICT INFANT CORTISOL LEVELS

Three basic findings have emerged from research on maternal depressive symptoms and offspring hypothalamic–pituitary–adrenal functioning: (a) Mothers’ depressive symptoms are positively associated with their offsprings’ cortisol stress response, (b) numerous individual and interpersonal maternal characteristics moderate this association, and (c) maternal and infant cortisol levels are highly correlated. In combination, these findings have suggested that maternal cortisol levels may moderate the relation between maternal depressive symptoms and infant cortisol responsivity; the current study assessed this hypothesis. Participants were 297 mother–infant dyads who were recruited from the community. Maternal depressive symptoms were assessed via self‐report. Dyads participated in two differentially stressful infant challenges when infants were 16 and 17 months old. Mother and infant salivary cortisol was collected before and after challenges. Results indicate that maternal cortisol levels moderated associations between maternal depressive symptoms and infant cortisol levels across both challenges. Infants showed higher cortisol levels if their mothers had both higher depressive symptoms and higher cortisol levels, as compared to infants of mothers with higher depressive symptoms and lower cortisol, and to infants of mothers with lower depressive symptoms and either higher or lower cortisol levels. We discuss findings in relation to environmental and biological factors that may contribute to the intergenerational transmission of depressive symptoms.     

Infant Developmental Outcomes: A Family Systems Perspective

The aim of the current study was to examine whether parental mental health, parent–infant relationship, infant characteristics and couple's relationship factors were associated with the infant's development. Forty‐two families took part at three time points. The first, at 3 months postpartum, involved a video recorded observation (CARE‐index) of parent–infant interactions. At 5 months postpartum, in‐depth clinical interviews (the Birmingham Interview of Maternal Mental Health) assessed parental mental health and parental perceptions of their relationship with their infant, their partner and their infant's characteristics. Finally, the Bayley Scales III was carried out 17 months postpartum to assess the infants' cognitive, language and motor development. A higher mother–infant relationship quality was significantly associated with more optimal language development, whilst a higher father–infant relationship quality was associated with more advanced motor development. Additionally, maternal postnatal post‐traumatic stress disorder had a negative impact on the infant's cognitive development, whilst maternal prenatal depression was associated with a less optimal infant's language development. The largest prediction was afforded by parental perceptions of their infant's characteristics. The findings indicate that such perceptions may be crucial for the infant's development and imply that negative internal parental perceptions should be considered when assessing risk factors or designing interventions to prevent negative child outcomes. Copyright © 2013 John Wiley & Sons, Ltd.