Quality of attachment,perinatal risk,and mother–infant interaction in a high‐risk premature sample

Thirty‐three families, each with a premature infant born less than 33 gestational weeks, were observed in a longitudinal exploratory study. Infants were recruited in a neonatal intensive care unit, and follow‐up visits took place at 4 months and 12 months of corrected age. The severity of the perinatal problems was evaluated using the Perinatal Risk Inventory (PERI; A.P. Scheiner & M.E. Sexton, 1991 ). At 4 months, mother–infant play interaction was observed and coded according to the CARE‐index (P.M. Crittenden, 2003 ); at 12 months, the Strange Situation Procedure (SSP; M.D.S. Ainsworth, M.C. Blehar, E. Waters, & S. Wall, 1978 ) was administered. Results indicate a strong correlation between the severity of perinatal problems and the quality of attachment at 12 months. Based on the PERI, infants with high medical risks more frequently tended to be insecurely attached. There also was a significant correlation between insecure attachment and dyadic play interaction at 4 months (i.e., maternal controlling behavior and infant compulsive compliance). Moreover, specific dyadic interactive patterns could be identified as protective or as risk factors regarding the quality of attachment. Considering that attachment may have long‐term influence on child development, these results underline the need for particular attention to risk factors regarding attachment among premature infants.     

Consistency in infant sleeping arrangements and mother–infant interaction

This study examined the association between infant sleeping arrangements (i.e., habitual co‐sleeping, inconsistent co‐sleeping, and non‐co‐sleeping) and quality of mother–infant interaction during play in a sample of mothers, each with a typically developing infant (N=70). Mother–infant dyads who experienced consistency in infant sleeping arrangements in a typical week at 6 months (i.e., habitual co‐sleeping or non‐co‐sleeping) were characterized by more positive maternal and infant behavior and dyadic quality of interaction at 9 months compared with dyads who experienced inconsistency in sleeping arrangements. Additionally, a greater amount of co‐sleeping per week was associated with an increased duration of breastfeeding, mothers working fewer hours, less infant temperamental intensity, and less maternal depression. This study underscores the advantages of empirically based studies that consider consistency in infant sleep experience as a factor that is associated with more positive mother–child interaction.     

A collaborative effort to study mother—child interaction in three risk groups: Social risk mother,adolescent mother,preterm infant

This paper describes the collaborative efforts of three intervention projects with similar data sets on high-risk populations of mothers and their children at 13 and 20 months. The three projects collected data on a total of 190 dyads from three risk groups: adolescent mothers and their infants, high social risk mothers and their infants, and high social risk mothers and their preterm infants. The authors define the common set of measures and resulting variables used collaboratively to measure parent-child interaction and compare the three risk groups at both 13 and 20 months.     

Maternal recollected anxiety and mother–infant interaction in preterm infants

This study focused on the relationship between maternal recollected anxiety and the quality of mother–preterm infant interaction. In a observational study, 52 mothers and their preterm infants were videotaped at home in a standardized object–play interaction situation, at the infant's age of 6 months. Observations concentrated on different aspects of maternal behavior, including sensitive responsiveness, involvement, level of activity, and intrusiveness. Mothers were interviewed about their experiences during the period of neonatal intensive care and were, on the basis of their answers, divided into high‐anxiety and low‐anxiety mothers. In general, and independent of the infant's current interactive behavior and medical status, high‐anxiety mothers were more intrusive and more active during interaction with their infants than were mothers who recalled little or no anxiety during the postnatal period. ©1999 Michigan Association for Infant Mental Health.     

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.     

Changing patterns of infant behavior and mother–infant interaction: Intra- and interindividual variability

Mother–infant dyads were observed weekly at their homes for a 15-month period. In this way longitudinal data about the infants’ crying, fretting/fussing, smiling and different types of physical contact with the mother were collected. The subject of this study concerns the variability and stability in macroscopic patterns of associations between these behaviors. Different types of associations were found between the behaviors, and most of them changed considerably as the infant developed. Individual differences in the nature of the associations and in the changes they underwent over time predominated, but in a limited number of cases the infants shared the same developmental trajectories of behavioral associations. The results show how the use of intensive time series designs can be advantageous in clarifying issues of long-term variability and stability in human behavior. They also support the notion of changing patterns of behavior being a normal feature of early development.     

Perceived mother‐infant relationship difficulties in postnatal depression

Postnatal depression has been associated with mother–infant relationship difficulties, but there has been less research in clinical populations. This study aims to identify characteristics of reported mother–infant relationship difficulties in mothers with postnatal depression who had been referred to a tertiary Mother and Baby Service. Forty‐one mothers with postnatal depression completed self‐report and interview measures with regards to their mental state, social adversity, and perceptions on their relationship with their infants. Almost one‐third of mothers (31.7%) reported severe difficulties, including rejection of the infant and maternal pathological anger. A low birth weight and maternal dissatisfaction towards their social role were found to be significantly related to perceived mother–infant interaction difficulties. Self‐reports correlated satisfactorily with interview schedules. A significant proportion of mothers reported difficulties in relating to their infants which can be reliably identified by means of the self‐report measures used. Copyright © 2004 John Wiley & Sons, Ltd.     

Associations between mother–child interaction and children's later self and mother feature knowledge

Associations between mother–child interaction at 12 months and children's feature knowledge of self and mother at 20 months were investigated in 81 dyads. Mother–Child interaction was assessed by scales adapted from the Parent Child Early Relational Assessment (1985). Self‐ and mother knowledge were assessed by Self‐ and Mother Feature Knowledge Scales. Associations were found between mother–child interaction and later self‐ and mother feature knowledge. Maternal behavior characterized by positive affect and sensitive responsiveness and child behavior characterized by positive affect, responsiveness, and balanced attention between mother and environment were related to a more complex knowledge of self and mother. On sensorimotor items children knew more about self than about mother while on representational items children knew more about mother than about self. The findings support the view that more harmonious interactions are related to more complex self‐ and mother feature knowledge.     

Tonal synchrony in mother–infant interaction based on harmonic and pentatonic series

This study reports the occurrence of ‘tonal synchrony’ as a new dimension of early mother–infant interaction synchrony. The findings are based on a tonal and temporal analysis of vocal interactions between 15 mothers and their 3-month-old infants during 5 min of free-play in a laboratory setting. In total, 558 vocal exchanges were identified and analysed, of which 84% reflected harmonic or pentatonic series. Another 10% of the exchanges contained absolute and/or relative pitch and/or interval imitations. The total durations of dyads being in tonal synchrony were normally distributed (M = 3.71, SD = 2.44). Vocalisations based on harmonic series appeared organised around the major triad, containing significantly more simple frequency ratios (octave, fifth and third) than complex ones (non-major triad tones). Tonal synchrony and its characteristics are discussed in relation to infant-directed speech, communicative musicality, pre-reflective communication and its impact on the quality of early mother–infant interaction and child's development.     

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.     

Mothers' affect dysregulation,depressive symptoms,and emotional availability during mother–infant interaction

Maternal affect dysregulation and maternal depressive symptoms were examined as predictors of maternal emotional availability (EA) during mother–infant interaction in a nonclinical sample. In particular, we investigated if affect dysregulation predicts EA and is more important than are depressive symptoms in predicting EA. Questionnaire measures and 30 min of free play were obtained from 46 mothers of 4‐ to 5‐month‐old infants. Mothers' self‐reported affect dysregulation was inversely related to EA, but mothers' depressive symptoms were not related to EA. More specifically, mothers' tendency to use unhealthy externalizing behaviors to reduce tension and distress predicted less EA. These results suggested that even in relatively low‐risk samples, mothers' self‐reported affect dysregulation, particularly the tendency to act out inappropriately in response to tension and distress, may be a more proximal predictor of EA than are depressive symptoms.     

Maternal and infant characteristics connected to shared pleasure in dyadic interaction

The aim of the study was to analyze which maternal factors (depressive symptoms, effect of life events, maternal sensitivity and structuring) and infant characteristics (temperament, social withdrawal symptoms, interactive behavior, genotype, gender) contribute to shared pleasure (SP) in parent–infant interaction. Participants were 113 mother–infant dyads. The mothers filled in the Edinburgh Postnatal Depression Scale, the Infant Behavior Questionnaire, and the Life Events Questionnaire. The dyads were videotaped in a free-play situation, and the videos were analyzed using the Alarm Distress Baby Scale and the Emotional Availability Scales. The infants were genotyped for four genes involved in emotion regulation. The occurrence and duration of SP (SP-MD) in mother–infant interactions were analyzed from the videotapes. Higher maternal sensitivity and depressive symptoms, better infant responsiveness, and the infant having the GG variant of the gene tryptophan hydroxylase isoform 2 (TPH2) -307 were associated with the occurrence of SP. Lower level depressive symptoms, better maternal structuring, and greater infant involvement were associated with the longer duration of SP. Those dyads where the mother and infant were best able to read each other's positive cues and to respond to them were more likely to experience mutual positive affect, as seen in SP.     

Problematic dyadic interaction among toddlers and their polydrug‐cocaine‐using mothers

Dyadic interactions between 84 at‐risk toddlers and their nondrug‐, polydrug‐non‐cocaine‐, or polydrug‐cocaine‐using mothers were examined during unstructured play. Coded videotaped behaviors revealed two maternal constructs (interactive competence, maladaptive engagement) and three toddler constructs (responsiveness, active positive initiation, play). Cocaine‐using mothers displayed more maladaptive engagement than did prenatal nondrug users; however, poorer interactive competence further distinguished them from polydrug‐but‐noncocaine users. Toddlers of cocaine‐using mothers displayed less responsiveness and positive initiation than non‐drug‐group peers; however, these behaviors did not reliably differ from polydrug‐non‐cocaine counterparts. Play interest remained relatively similar across groups. Results suggest that difficulties in social interaction appear to continue among cocaine‐using mothers during dyadic exchanges with their offspring in the second year; however, toddler deficits do not appear to be greater than those experienced by polydrug‐non‐cocaine counterparts.     

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.     

Quantitative evaluation of infant behaviour and mother–infant interaction: An overview of a japanese interdisciplinary programme of research

This paper provides an overview of an interdisciplinary programme of research started more than 20 years ago at the University of Tokyo. A major aim of this programme was (and still is) to develop methods and related forms of quantitative analysis that provide rigorous evaluations of infant behaviour from a particular theoretical perspective. In one part of the programme telethermography is used to measure emotional changes in young infants. Contrary to the accepted view in attachment theory, infants as young as 2–3 months showed evidence of stress following separation from the mother (as indexed by a drop in the skin temperature of the infant's forehead). In another part, we established the presence of interpersonal synchrony between arm movements of the newborn and the speech of the mother and other adults, using computer assisted pattern recognition techniques. On the basis of this finding, we have proposed a simulation model of mother-infant interaction from the perspective of system information theory. In general, our programme of research provides a theoretically driven set of techniques and analytical approaches that may provide deeper insights into early development and parenting.     

Maternal substance use and mother–infant feeding interactions

The purpose of this study was to examine the impact of maternal polydrug cocaine use during pregnancy and associated risk factors such as maternal psychopathology and negative infant temperament on the quality of mother–infant feeding interactions at 2 months of infant age. Participants were 45 mother–infant dyads (19 cocaine‐exposed and 26 nonexposed) who were recruited at birth and assessed again 2 months of infant age. Mother–infant interactions during feeding were videotaped and coded with regard to dyadic reciprocity, maternal noncontingency, and dyadic conflict. Results indicated that maternal cocaine use was associated with higher dyadic conflict. Moreover, cocaine‐using mothers were also more likely to use marijuana and alcohol, and use of such substances was associated with lower dyadic reciprocity and higher maternal noncontingency during interactions. Results also suggested that one pathway to higher dyadic conflict during interactions among cocaine‐using mothers was through the impact of cocaine on infant risk conditions like lower gestational age and negative temperament (e.g., higher distress to novelty). Interventions focusing on promoting the quality of mother–infant interactions in combination with substance abuse treatment may be especially promising for this population. ©2001 Michigan Association for Infant Mental Health.     

Neonatal imitation in a mother–infant setting

Imitation of tongue protrusions and mouth openings was investigated in 18 newborn infants using a procedure differing in three ways from previous laboratory studies: the mother presented the target gestures, she was permitted to adjust to the infant's reactions, and the infant's baseline response rate was assessed during face-to-face interaction. This procedure was assumed to facilitate infant imitation. Compared with baseline responses in face-to-face interaction, both tongue protrusions and mouth openings were imitated in the two conditions. No imitation, however, was found when the responses in the two imitation conditions were compared. These results are less convincing than those found in strictly controlled laboratory experiments. A less restrictive procedure did not, therefore, promote imitation. The mixed results could be explained by too short an exposure to the target gesture. If repeated and insistent gesturing is a crucial condition, neonatal imitation might be understood to be the result of instruction and teaching, rather than a means of mutual communication. © 1998 John Wiley & Sons, Ltd.     

Six‐month follow‐up of two mother–infant psychotherapies: Convergence of therapeutic outcomes

Fifty‐eight mothers and infants participating in two infant–mother psychotherapeutic interventions in a comparative infant–mother clinical intervention study were followed six months after treatment ended. One treatment was an infant‐led psychotherapy, Watch, Wait, and Wonder (WWW). The other was a more traditional mother–infant psychodynamic psychotherapy (PPT). Infants ranged in age from 10 to 30 months at the outset of treatment, which took place in weekly sessions over approximately five months. Results indicated that positive effects observed from the beginning to the end of treatment in both treatment groups in infant symptoms, parenting stress, and mother–infant interaction were maintained or improved further at six‐month follow‐up. Additionally, decreased maternal depression, gains in infant cognitive development and emotion regulation, and improved infant–mother attachment security or organization had been observed posttreatment only in the WWW group. Interestingly, between the posttreatment to follow‐up period the PPT group also showed such gains. Thus, for these variables it would be more accurate to say that the outcomes were similar for the two treatment groups but change emerged at a different pace. Nevertheless, an advantage persisted in the WWW group in relation to mothers' comfort dealing with infant behaviors and their ratings of parenting stress which improved more in this group from the end of treatment to follow‐up. The direct inclusion of the infant as an initiator in WWW was set forth as an explanation of differentially timed treatment effects. ©2002 Michigan Association for Infant Mental Health.