Maternal depression and infant attachment security: A meta-analysis

The purpose of this study is to clarify the magnitude of the association between maternal depression and infant attachment nonsecurity, and to identify possible moderators of this relationship. An extensive literature search was conducted using multiple databases of both published and unpublished studies. A meta-analysis was conducted to determine the relationship between maternal depression and infant attachment security and to establish the effect size. The main findings from this meta-analysis, which included 42 studies, indicate that there is a small, yet significant, relationship between maternal depression and infant attachment nonsecurity. The rate of nonsecurity in infants of mothers with depression was approximately 20% higher than expected rates in a nonclinical population, and the association between depressive symptoms and nonsecurity was small, but significant. Infants of mothers with depression were nearly twice as likely to have a nonsecure attachment than were infants of healthy mothers. Depression measure and maternal sample source were identified as significant moderators of the odds ratio effect size. Results of this study demonstrate that there is a significant relationship between maternal depression and infant attachment nonsecurity, and suggest that interventions that focus on both maternal mental health and the attachment relationship are warranted.     

Teenage parenting in different cultures,family constellations,and caregiving environments: Effects on infant development

Teenage parenting was investigated in different ethnic groups (Cuban and American Black), family constellations (single-parent, nuclear, and extended families), and primary caregiving arrangements (mother versus other). One hundred sixty-four infants born to a representative sample of teenage mothers were observed during interactions with their mothers and were given developmental assessments when they were 12, 18, and 24 months of age. Being a Cuban mother, living in a nuclear family, and being a secondary caregiver were each associated independently with stronger social support systems and more positive child-rearing attitudes and mother-infant play interactions. Despite these early advantages, maternal stimulation and infant performance decreased over the second year of life irrespective of ethnic group, family constellation, and caregiving arrangements.     

Maternal adjustment and infant outcome in medically defined high-risk pregnancy.

Biological and psychosocial risk factors in high-risk pregnancy and their relation to infant developmental outcomes were explored in a sample of 153 pregnant Israeli women who had pregestational diabetes mellitus, gestational diabetes mellitus, or were nondiabetic. Questionnaires on coping and resources as well as well-being and distress during the 2nd trimester were administered. Estimates of maternal fuels (HbAlc and fructosamine) were obtained throughout pregnancy. At 1 year, offspring were administered the Bayley Scales of Infant Development and mother-infant interactions were observed. Infants of mothers in the diabetic groups scored lower on the Bayley Scales and revealed fewer positive and more negative behaviors than did infants of mothers in the nondiabetic group. Infant outcomes in the maternal diabetic groups were associated with maternal metabolism. Maternal coping and resources differed in the 3 groups and differentially predicted infant development.     

Maternal touch in caregiving behavior of mothers with and without postpartum depression

The way a mother touches her infant plays a central role in maternal caregiving behavior. Thus, the purpose of the present study was to examine associations between touch and positive and negative caregiving behavior and whether this association differed in mothers with and without postpartum depression, an episode of depressive disorder following childbirth. Positive caregiving behavior was operationalized as sensitive behavior, i.e. the mother’s ability to notice the child’s signals, interpret these signals correctly and respond to them promptly and appropriately. Negative caregiving behavior was operationalized as overriding behavior, i.e. behavior which disturbs the child’s behavior or redirects the child’s attention to follow the parent’s agenda. Seventy mother-infant dyads (44 in the nonclinical group and 26 in the clinical group) participated in a 10 minutes long mother-infant interaction at four months postpartum. The sample is part of an archival dataset of a longitudinal study investigating the parent-child relationship and child development. Three minutes of the interaction were coded a) microanalytically for touch, using a modified version of the Maternal Touch Scale (Beebe et al., 2010), and b) macroanalytically for sensitive and overriding behavior, using the Coding Interactive Behavior measure (Feldman, 1998). Hierarchical regression analyses with bootstrapping showed that caregiving touch, but not affectionate and static touch, was associated with sensitive behavior across the whole sample. Moreover, playful, but not rough-intrusive touch, was associated with overriding behavior across the whole sample. Associations did not differ between mothers with and without postpartum depression.     

Maternal depression and infant temperament characteristics

One hundred-thirty-nine women participated in this longitudinal study from the third trimester of pregnancy through 8-months postpartum. Women completed depression scales at several time points and rated their infant's characteristics and childcare stress at 2- and 6-months postpartum. Mothers' reports of infant temperament were significantly different for depressed and non-depressed mothers, with depressed mothers reporting more difficult infants at both measurement points. These differences remained after controlling for histories of maternal abuse or prenatal anxiety, which occurred more often in the depressed mothers. There were no significant differences in childcare stress or perceived support between the groups. Infant temperament and childcare stress did not change over time. Recommendations for practice include consistent ongoing evaluations of the "goodness of fit" within the dyad and exploring interventions for depressed mothers that provide guidance about interactions with their infants and the appropriateness of the infant behaviors.     

The disturbed caregiving system: Relations among childhood trauma,maternal caregiving,and infant affect and attachment

The interrelations among maternal childhood experiences of physical or sexual abuse, adult trauma-related symptoms, adult caregiving behavior, and infant affect and attachment were investigated among 45 low-income mothers and their 18-month-old infants. A history of physical abuse was associated with increased hostile-intrusive behavior toward the infant, increased infant negative affect, and a decreased tendency to report trauma-related symptoms. A history of sexual abuse was associated with decreased involvement with the infant, more restricted maternal affect, and more active reporting of trauma-related symptoms. Infants of mothers who had experienced childhood violence or abuse were not more likely to display insecure attachment strategies than infants of mothers who had not experienced trauma. However, the form of insecure behavior was significantly different. Insecure infants of violence-exposed mothers displayed predominantly disorganized strategies, whereas insecure infants of mothers with benign childhoods or neglect only displayed predominantly avoidant strategies. Results are discussed in relation to Main and Hesse's (1990) concept of frightened or frightening behavior and to current literature on psychological sequelae of trauma.     

Maternal representation and care of infant sleep

Maternal reports about infant sleep care and ideas about the causes of awakening were obtained from telephone interviews with 104 middle class primiparae when their infants were 1 month and 1 year old. These reports were compared with their expectations about infant sleep before the birth of their child. It was found that most of the mothers were willing to ‘help’ their infants fall asleep, with 19 different kinds of techniques being spontaneously mentioned. Most of the techniques involved physical contact. The changes in technique from before birth to the end of the first year of life mainly concerned a decrease in the use of techniques involving holding the infant in the arms. From 1 month to 1 year, there was a decrease in rocking techniques, while at 1 year the use of a (bottle) feeding technique and taking the child into the parents' bed became apparent. The reasons mothers gave for infant awakenings varied from 1 month to 1 year. At 1 year, the most frequent reason was that the infant has ‘sufficient sleep’. Mothers' representations before the infant birth did not overlap with representations and reports of sleep handling after birth. Mothers were willing to apply and use a great variety of caring techniques that they perceived to be adjusted to the individual needs of their child. © 1998 John Wiley & Sons, Ltd.     

Acoustic features of infant crying related to intended caregiving intervention

The present study investigated the acoustic features of crying associated with intended caregiving intervention. One hundred eighty‐eight parents (138 females, 50 males) viewed a videotape depicting a healthy 4‐week‐old infant progressing from fussing to crying over the course of 4 minutes, and indicated if and when they would pick up the infant in a real‐life situation. There was a distinct peak in responding corresponding to an increase in duration but not fundamental frequency of the infant's cries. This finding is discussed in terms of the existing empirical literature. It is hypothesized that, whereas frequency may convey information about a newborn's neurological integrity and health status at birth, duration and other acoustical variables provide information about slightly older, normal infants' level of distress. Copyright © 2004 John Wiley & Sons, Ltd.     

Maternal sensitivity behavior and infant behavior in early interaction

Maternal sensitivity behavior and infant behavior in early interaction were investigated among 57 Finnish mother–child pairs. Their interaction was video‐recorded at home in free‐play situation when the infants were 3 months and 12 months of age, and evaluated using the Parent–Child Early Relational Assessment Scale (PCERA). Maternal sensitivity behavior was mainly related to infant's positive aspects of mood, social and play behavior, and visual contact, both at 3 months and 12 months of age. Even though maternal sensitivity behavior correlated to infant behavior at 3 months and 12 months, infant behavior at 3 months of age contributed to later maternal sensitivity behavior. ©2001 Michigan Association for Infant Mental Health.     

Internal working models of caregiving and security of attachment at age six

This study describes the relation between internal working models of caregiving, child attachment, and maternal behavior in the home. Thirty-two mothers of 6-year-old children were observed in the home and subsequently interviewed regarding experiential and affective dimensions of parenting. Interviews were examined in order to assess the quality of the mother's thinking regarding two dimensions of caregiving (secure base, competence) which we hypothesized to be related to attachment security. Results indicated a strong correspondence between internal working models of caregiving and child mental representations of attachments as measured from the child's response to a laboratory reunion. The correspondence between mental representations of caregiving and maternal behavior in the home was limited. Representation ratings were most strongly associated with competence-supporting behavior. Implications for infant mental health research and program evaluation are discussed.     

Maternal care and attachment security in ordinary and emergency contexts

One of the foundations of attachment theory is the notion that early care plays a key role in determining the quality of child-caregiver attachment relationships. Studies have consistently shown relations between maternal sensitivity and infant security. Further research is required to resolve issues arising from modest correlations, focus on research in stressful as opposed to ordinary contexts, and questions about the generality of results across cultures and social contexts and about the context specificity of caregiving behavior. This article addressed these issues in 2 studies of child care in home and hospital contexts. Q-sort scores derived from extended naturalistic observations were used. Results are discussed in terms of links between methodology and effect sizes, the generality of links between maternal care and child security, the need for further research on caregiving in ordinary and emergency situations, and the context sensitivity of maternal behavior.     

The role of negative reinforcement in infant caregiving: an experimental simulation

We observed 11 undergraduates in an experiment designed to simulate infant caregiving. In negative reinforcement conditions experienced by all participants, a targeted caregiving response (e.g., rocking a baby doll) produced escape from, and avoidance of, a recorded infant cry. Nine participants' caregiving was shown to be controlled by this negative reinforcement contingency. Nine participants experienced an extinction condition that consisted of an inescapable cry, and the previously reinforced caregiving responses of 2 of these participants were resistant to extinction. For both of these participants, the previously reinforced response was eliminated when an alternative form of caregiving was reinforced. These results highlight the role of negative reinforcement in infant caregiving and suggest the need for additional research on the effects of crying on caregivers as well as the development of effective strategies for minimizing infant crying.     

Maternal concepts and expectations regarding a preterm infant

The objective of the present study was: (a) to identify the concerns, verbally expressed, of 50 mothers regarding their preterm infants (PT) and then compare their verbal expression with those of 25 mothers of full-term infants (FT); and (b) to correlate the mothers' verbal expressions with maternal and infant variables. The following instruments were used to compose and characterize the sample: Structure Clinical Interview for DSM III-R Non-Patient (SCID/NP), State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), and medical charts. Results showed that there was no difference between groups in term of mothers' expectations and conceptualizations; both groups exhibited predominantly positive expectations and concepts. In comparison with FT mothers, PT mothers verbally expressed more feelings and reactions predominantly negative or conflicting in relation to infant birth. Higher levels of maternal anxiety and depression in the PT Group were correlated with more verbal expressions about negative or conflicting emotions. In addition, lower birth weight, higher neonatal risk and longer length of stay in intensive care nursery of the infants were related with more negative or conflicting concepts by the mothers.     

Interweaving social and manipulative development in early infancy: Some direction for infant caregiving

Early infancy has been neglected not having the best opportunities to promote social motor and cognitive development. The maturational concept considering young infants as passive beings provide a misguided view of the developmental process. The human infant is an active being from the very beginning of life. In the social and physical world, they can, by observing and imitating, perform complex actions involving different motor behaviours. In the present review we argue that imitation and manipulative actions are integrated in Expressive Action System (Reed, 1996) where baby-caregiver social interaction is the link between the use and exploration of objects in the world. We present evidence that neonatal imitation and manipulation activities are connected and thus, we propose stimulation practices based in seminal experimental designs where infants should be positioned in favourable postures to observe others acting in the world. This will have an impact on the way that early infants understand the social world and the chain of actions possible in this environment.     

Maternal prenatal stress and infant regulatory capacity in Mexican Americans

The early postpartum period lays important groundwork for later self-regulation as infants’ dispositional traits interact with caregivers’ co-regulatory behaviors to produce the earliest forms of self-regulation. Although emerging literature suggests that fetal exposure to maternal stress may be integral in determining child self-regulatory capacity, the complex pathways that characterize these early developmental processes remain unclear. The current study considers these complex, transactional processes in a low income, Mexican American sample. Data were collected from 295 Mexican American infants and their mothers during prenatal, 6- and 12-week postpartum home interviews. Mother reports of stress were obtained prenatally, and mother reports of infant temperament were obtained at 6 weeks. Observer ratings of maternal sensitivity and infant regulatory behaviors were obtained at the 6- and 12-week time points. Study results indicate that prenatal stress predicts higher levels of infant negativity and surgency, both of which directly or interactively predict later engagement in regulatory behaviors. Unexpectedly, prenatal stress also predicted more engagement in orienting, but not self-comforting behaviors. Advancing understandings about the nature of these developmental pathways may have significant implications for targets of early intervention in this high risk population.     

Maternal styles in infant psychotherapy: Treatment and research implications

Infant psychotherapy, in which the mother is requested to follow the baby's activities without initiating or directing, is described. Mothers demonstrate different styles of involvement with their infants: a protective mode, a prohibitive mode, a competitive mode, and other ways of interfering with their infants' tendency to explore the environment. Attempts to analyze such factors as position, distance and movement are discussed. Research for recording and analyzing the movement of infant and mother dyads is proposed.     

Attachment, caregiving, and altruism: boosting attachment security increases compassion and helping

Recent studies based on J. Bowlby's (1969/1982) attachment theory reveal that both dispositional and experimentally enhanced attachment security facilitate cognitive openness and empathy, strengthen self-transcendent values, and foster tolerance of out-group members. Moreover, dispositional attachment security is associated with volunteering to help others in everyday life and to unselfish motives for volunteering. The present article reports 5 experiments, replicated in 2 countries (Israel and the United States), testing the hypothesis that increases in security (accomplished through both implicit and explicit priming techniques) foster compassion and altruistic behavior. The hypothesized effects were consistently obtained, and various alternative explanations were explored and ruled out. Dispositional attachment-related anxiety and avoidance adversely influenced compassion, personal distress, and altruistic behavior in theoretically predictable ways. As expected, attachment security provides a foundation for care-oriented feelings and caregiving behaviors, whereas various forms of insecurity suppress or interfere with compassionate caregiving.     

Maternal caregiving strategy—a distinction between the ambivalent and the disorganized profile

The present essay proposes a distinction between the characteristics of mothers of anxious/ambivalent infants and mothers of disorganized infants. Based on a recent meta-analysis it is argued that preoccupation and role reversal are not the main characteristics of mothers of ambivalent infants when the four-category partition of attachment patterns is employed. To clarify the distinction between mothers of ambivalent and disorganized infants, the concept of a caregiving strategy is highlighted as distinct from the concept of an attachment strategy. Role reversal is suggested as the major strategy of mothers of disorganized infants (at least those infants who later evince the controlling pattern), while excessively close protection is suggested as the major caregiving strategy of mothers of ambivalent infants. Inconsistency in maternal practices of the latter category is presumed to arise from these mothers' inability to be as vigilant and protective as they desire; as a result they are overwhelmed by the parenting task. © 1998 Michigan Association for Infant Mental Health     

The two cultures

Anhand von zwei Unterbereichen der künstlichen Intelligenz — den Expertensystemen und der wissenschaftlichen Entdeckung — wird aufzuzeigen versucht, daß die Beziehung zwischen der formalen und der intuitiven Kultur aus dem Gleichgewicht geraten ist. Dem Bereich der Intuition sollte größere Aufmerksamkeit gewidmet werden.

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This article is based on a presentation given on a symposium The Art of Science, in Amsterdam, Amolf, 27 May 1987. It was organized to celebrate the 65th birthday of Prof. J. o.