Psychotherapy groups and individual support to enhance mental health and early dyadic interaction among drug‐abusing mothers

The purpose of this controlled study was to examine the outcome of psychodynamic mother–infant group psychotherapy (PGT) outpatient intervention for drug‐abusing perinatal mother–infant dyads. PGT comprised 20 to 24 weekly 3‐hr sessions with 3 to 5 months of follow‐up. A comparison intervention group was formed of mothers participating in individually tailored psychosocial support (PSS) lasting, on average, 12 months and providing mother–infant support and practical counseling. We hypothesized that positive changes would occur in maternal drug abuse, mental health, and mother–infant interaction, especially in the PGT group due to its more intensive therapeutic focus. Participants were 26 drug‐abusing dyads in PGT, 25 in PSS, and 50 dyads in a non‐drug‐abusing comparison group. Assessments were pre‐intervention and at 4 and 12 months' follow‐up, including maternal depressive symptoms and mother–child interaction assessed by the Emotional Availability Scales (EA). As hypothesized, in dyadic interaction maternal hostility decreased significantly in the PGT group, and intrusiveness decreased in both intervention groups, but especially in the PTG group. However, both interventions showed a general improvement in the quality of mother–infant interaction. They also succeeded in sustaining high maternal abstinence, treatment retention, and alleviating depressive symptoms. The findings are discussed in relation to preventing negative transgenerational interaction patterns in the high‐risk dyads.     

Risks and realities: dyadic interaction between 6-month-old infants and their mothers in opioid maintenance treatment

A number of studies point to methadone exposure in utero as a possible risk factor in the developing mother–infant relationship in the first year of life. This study is part of a larger, national follow-up of 38 infants prenatally exposed to methadone or buprenorphine and 36 comparison, low-risk infants. The aim of the present paper is to assess the quality of mother–infant relationship when the infants are 6 months old. Videotaped mother–infant interactions were rated in a global scale (NICHD). Maternal and infant contributions collapsed into the variables “infant style” and “maternal style” showed that the only factor making significant contribution to the outcome measure “dyadic mutuality” was maternal style. The importance of group membership (exposed versus non-exposed), was reduced when controlling for maternal drug use prior to opioid maintenance treatment (OMT), maternal depression and parenting stress as well as infants’ developmental status and sensory-integrative functions. This suggests that prediction of dyadic mutuality should be based on individual characteristics rather than group characteristics. These results support previous research findings that methadone and buprenorphine use per se does not have direct influence on the quality of early mother–infant relationship, but tailored follow-up procedures targeting drug-free pregnancies and parenting support are beneficial for women in OMT and their children.     

Kangaroo mother care and mother‐premature infant dyadic interaction

The aim of this study was to investigate the psychological impact of Kangaroo Mother Care (KMC) on mother‐infant bonding in cases of premature delivery. Examined variables were mother‐infant relationships, maternal anxiety levels, and infant interactive signals. The KMC method requires that babies be undressed and held upright between their mother's breasts for a minimum of 1 hr a day, from birth until they are discharged from hospital. The present study examined 40 premature infants and their mothers, with 21 dyads experiencing KMC and 19 receiving traditional care (TC). Maternal emotional stress was assessed with the Parent Stress Index‐Short Form questionnaire (Abidin, 1990), and mother‐newborn interactive style was assessed with the Nursing Child Assessment Feeding Scale (Barnard, 1975). Results revealed a better mother‐infant interactive style, a significant decrease in maternal emotional stress, and better infant ability to make requests and respond to parental interactive style in the KMC group.     

Dyadic synchrony among young Latina mothers and their toddlers: The role of maternal and child behavior

Synchronous interactions are an important indicator of parent-child relationship quality with positive implications for child development. Latina adolescent mothers face several demographic challenges that place them at risk for less synchronous interactions. To identify factors that may facilitate more optimal parent-child relationships in this population, our study examined maternal sensitivity and children’s behavioral styles as joint predictors of dyadic synchrony among young Latina mothers and their toddlers. Mother-toddler dyads (N = 170) were observed interacting across different tasks, and toddlers’ behavior was observed during the administration of a developmental test. Results of multivariate regressions revealed additive effects of maternal sensitivity and child behavioral styles (i.e., dysregulation and positive attentional control). Maternal sensitivity related to higher dyadic synchrony for the entire sample. Positive attentional control was related to higher dyadic synchrony for mother-daughter dyads only. Although no gender differences in dyadic synchrony or the behavior style variables emerged, the relative contribution of maternal and child factors differed by child gender, suggesting that mothers may have responded differently to similar behavior and affect displayed by boys and girls. The findings provide insights regarding factors that contribute to dyadic synchrony in this understudied population and emphasize the need to consider child gender when studying parent-child interactions in young Latina families.     

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.     

Peer-peer interaction among infants and toddlers with extensive daycare experience

Peer-peer interaction among 10–21- and 24–30-month-olds with extensive daycare experience was studied. Thirteen pairs of familiar agemates were formed, and each dyad was observed in a playpen with toys at their daycare center. Adult preparation and various constraints to peer-peer interaction were minimized. The nine behavioral measures included nonsocial, marginally social, and social play categories. The results revealed equivalent amounts of nonsocial behavior for both age groups, and marginally social behavior was not the dominant play activity at either age. Compared with the younger group, the older children engaged in less marginally social activity, more positive social behavior overall, and more sustained sociable interchanges. Neither age group had high levels of antisocial behavior, but the younger children tended to display more than the older. Support was found for the view that marginally social activity functions as a bridge from nonsocial to social behavior.     

Inhibition of fear acquisition in toddlers following positive modelling by their mothers

The present study used an experimental design to investigate the role of modelling as a protective factor in fear and avoidance learning in a sample of 77 toddlers. Mothers and their 12-20-month-old children were randomly assigned to one of three pre-exposure conditions: (1) a modelling group (n=27) observed their mothers responding positively to a fear-relevant stimulus; (2) a stimulus-only group (n=25) were exposed to a fear-relevant stimulus alone; and (3) a control group (n=25) were exposed to neither modelling nor the stimulus alone. Children in all three groups were then subjected to an observational conditioning trial in which the experimenter reacted with fear and disgust toward the stimulus. When subsequently tested for the acquisition of fear, children in the modelling group showed more positive affective reactions and more approach behaviours than either controls or children exposed to the stimulus alone. The results demonstrate that very young children can rapidly form lasting associations between maternal affective reactions and novel, fear-relevant stimuli. Further, positive maternal reactions to a stimulus can over-ride any fear-evoking effect of negative reactions to that stimulus by a stranger.     

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.     

A model‐based intervention for depressed mothers and their infants

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

Adult-child interaction under dyadic and polyadic conditions

The nature of adult-child interaction was examined under two conditions: dyadic (adult with one child) and polyadic (adult with four children). The subjects were staff and children in day nurseries, who were observed in a specially set-up task situation. In certain respects the interaction assumed different forms depending on group condition. The effects may be seen in stylistic differences in the adults' behaviour: thus in polyads individual children had not only less speech directed to them but also speech that tended to be more directive and prohibitive. While the total number of bids the adults received from children in polyads was considerably greater than in dyads, the increase was a selective one, referring only to requests for help and not to less urgent demands. The main strategy adopted by adults to cope with the increase in demand was by ignoring, the incidence of which was very much greater under polyadic than under dyadic conditions. Joint involvement of adult and child was also much reduced in the former setting. The implications of these findings for children reared under group care conditions are discussed, and attention is drawn to the importance of situational factors in determining caretaker responsiveness.     

Individual and dyadic associations among relational self‐expansion potential,affect, and perceived health

A growing body of literature suggests that specific markers of relationship quality are meaningfully linked to health outcomes. We tested whether relational self‐expansion potential might be one of these markers in cross‐sectional samples of individuals and romantic couples. Study 1 found that greater self‐expansion potential was linked to better perceived physical health via both higher positive affect (PA) and lower negative affect (NA). Study 2 replicated these findings for PA (but not NA) and revealed both actor and partner effects of self‐expansion potential. Results remained robust when statistically accounting for gender, age, body mass index, agreeableness, neuroticism, and perceived partner responsiveness. These findings identify a new relationship‐level “active ingredient” associated with health and have implications for future physical health studies.     

Psychological well‐being and day‐to‐day social interaction among older adults

A sample of 113 healthy older adults used a variant of the Rochester Interaction Record to describe the social interactions they had each day for two weeks. They also completed various measures of psychological well‐being including life satisfaction and loneliness. A series of multilevel random coefficient analyses found that life satisfaction scores were positively related to how enjoyable interactions were, how self‐assured people felt when interacting, how much control they felt they had over interactions, how responsive others were to their needs, and how socially active they were. Analyses that took participants’ marital status into account suggested, however, that interaction outcomes and life satisfaction were related only for married participants, and that these relationships were primarily due to interaction outcomes with spouses.     

Implicit meaning in 18‐month‐old toddlers

A substantial body of evidence demonstrates that infants understand the meaning of spoken words from as early as 6 months. Yet little is known about their ability to do so in the absence of any visual referent, which would offer diagnostic evidence for an adult‐like, symbolic interpretation of words and their use in language mediated thought. We used the head‐turn preference procedure to examine whether infants can generate implicit meanings from word forms alone as early as 18 months of age, and whether they are sensitive to meaningful relationships between words. In one condition, toddlers were presented with lists of words taken from the same taxonomic category (e.g. animals or body parts). In a second condition, words taken from two other categories (e.g. clothes and food items) were interleaved within the same list. Listening times were found to be longer in the related‐category condition than in the mixed‐category condition, suggesting that infants extract the meaning of spoken words and are sensitive to the semantic relatedness between these words. Our results show that infants have begun to construct the rudiments of a semantic system based on taxonomic relations even before they enter a period of accelerated vocabulary growth.     

Spontaneous non‐verbal counting in toddlers

A wealth of studies have investigated numerical abilities in infants and in children aged 3 or above, but research on pre‐counting toddlers is sparse. Here we devised a novel version of an imitation task that was previously used to assess spontaneous focusing on numerosity (i.e. the predisposition to grasp numerical properties of the environment) to assess whether pre‐counters would spontaneously deploy sequential (item‐by‐item) enumeration and whether this ability would rely on the object tracking system (OTS) or on the approximate number system (ANS). Two‐and‐a‐half‐year‐olds watched the experimenter performing one‐by‐one insertion of ‘food tokens’ into an opaque animal puppet and then were asked to imitate the puppet‐feeding behavior. The number of tokens varied between 1 and 6 and each numerosity was presented many times to obtain a distribution of responses during imitation. Many children demonstrated attention to the numerosity of the food tokens despite the lack of any explicit cueing to the number dimension. Most notably, the response distributions centered on the target numerosities and showed the classic variability signature that is attributed to the ANS. These results are consistent with previous studies on sequential enumeration in non‐human primates and suggest that pre‐counting children are capable of sequentially updating the numerosity of non‐visible sets through additive operations and hold it in memory for reproducing the observed behavior.     

Caregiving by low‐income adolescent mothers and the language abilities of their 30‐month‐old children

The primary question of interest in this study was: Are the caregiving practices of low‐income, teenage mothers during the first 2 years of their children's lives predictive of individual differences in the language abilities of their 30‐month‐old children? This question was addressed with a sample of 76 teenage mothers and their children who were participating in a family support program. Various measures of caregiving behavior, assessed when the children were 6, 12, and 24 months old, were significantly related to scores on the Preschool Language Scale—3, the Expressive One Word Picture Vocabulary Test, and Receptive One‐Word Picture Vocabulary Tests of the children.     

Parenting and attachment among toddlers with congenital anomalies: Examining the Strange Situation and attachment Q‐sort

This study assessed parent and child predictors of attachment in a sample of 72 toddlers with neurological (e.g., cerebral palsy) and non‐neurological (e.g., cleft lip and palate) birth defects and their mothers. Parenting quality (e.g., sensitivity) was expected to be more important in predicting the attachment relationship than type and severity of child medical condition. Parenting and indices of severity of child condition were measured via researcher observation. Attachment was measured via the Strange Situation and parent reported Attachment Q‐sort. Parenting quality was better for children with more severe appearance disfigurements. Strange Situation and Q‐sort assessments of attachment were not significantly related. Children with neurological impairments were at greater risk for developing insecure attachments than were children with non‐neurological conditions. Parenting quality also directly predicted Strange Situation assessed attachment security and Q‐sort comfort seeking/exploration but not standard Q‐sort criterion scores. Parenting quality partially mediated the relation between child medical condition and attachment security. Results suggest child medical factors influence parenting, and thereby, child attachment. ©2002 Michigan Association for Infant Mental Health.     

Maternal self‐perceptions and reactions to infant crying among intrusive and withdrawn depressed mothers

This study compared intrusive (N =15) and withdrawn (N = 10) mothers' ratings of their own interaction styles with their infants and the behaviors of videotaped models of intrusive and withdrawn mothers. Withdrawn mothers rated themselves as less withdrawn than the model withdrawn mother. Intrusive mothers viewed themselves as more intrusive than the model intrusive mother. Both groups viewed their own infants as more outgoing than the infants of the model intrusive and withdrawn mothers. The withdrawn mothers reported feeling more distressed when they observed an infant (of an intrusive or withdrawn mother) crying, suggesting that they feel more empathy than the intrusive mothers. © 2001 Michigan Association for Infant Mental Health.