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.     

The impact of optimality on maternal sensitivity in mothers with substance abuse and psychiatric problems and their infants at 3 months

The main aim of this study was to investigate the predictive validity of four different optimality indexes, as well as infant perinatal status, in relation to maternal sensitivity in interaction at 3 months. The four optimality indexes comprised items related to substance abuse, psychiatric condition, relational experience and socioeconomic status (SES). Maternal sensitivity in mother-infant interaction was assessed in two different groups of mothers. One group consisted of mothers with substance abuse and psychiatric problems who underwent treatment during pregnancy. The other group of mothers had neither substance abuse nor psychiatric problems. The expectant mothers were interviewed in the third trimester of pregnancy. Medical records and meconium were obtained from the infants at birth. Three months after birth, maternal sensitivity in mother-infant interaction was assessed. Altogether 79 mother-infant dyads participated in the study. The mothers' optimality associated with relational experiences, as well as the infants' perinatal status were found to predict maternal sensitivity in mother-infant interaction at 3 months. The SES index was also significantly related to maternal sensitivity. The relation between group and maternal sensitivity was mediated by the mothers' optimality associated with relational experiences. This study points to the importance of addressing the mothers' own relational experiences and their current representations of motherhood during treatment, in order to support and enhance maternal sensitivity.     

Mother-infant interaction and children's socio-emotional development with high- and low-risk mothers

Charting the dynamic character of mother-infant interaction requires using observational systems of sequential coding in real time. A longitudinal study was designed to approach maternal sensitivity in a more complex way using sequential analysis. The study was conducted with 20 high- and 20 low-risk mothers and their infants (aged: 3, 12 and 15 months) to examine the relation among mothers' risk status for physical abuse and their maternal interactive profiles, using micro-social sequential analyses, and the subsequent quality of attachment developed by their children at 15 months of age. Results showed significantly different timings in maternal responses in high- and low-risk groups, that the high-risk mothers were less sensitive: more intrusive and less discriminate regarding their infant's behavior. Significant differences between groups were also found after infant difficult behavior. High-risk mothers' infants were significantly more likely to develop insecure attachment. Sensitivity is proposed as a constellation of timings in early mother-infant interaction.     

Bed-sharing, breastfeeding and maternal moods in Barbados

Bed-sharing among Barbadian mothers and infants was studied in relationship to maternal and infant characteristics. This prospective study followed 226 healthy, well-nourished mother–infant dyads at birth, 7 weeks, 3 months, and 6 months postpartum. At each age, approximately half of the infants shared the same beds as their mothers. Bed-sharing was associated with demographic characteristics, especially fewer home conveniences, and also maternal characteristics, including less information seeking by the mother and younger maternal age at first pregnancy. Bed-sharing was also associated with lower infant birth weights. Maternal moods were significantly correlated with bed-sharing, such that mothers who reported having more despair and anxiety were also more likely to sleep with their infants. Bed-sharing was also significantly associated with increased breastfeeding at all infant ages, but this relationship was no longer significant once the effects of maternal moods were controlled. This study emphasizes the importance of assessing maternal moods in studies evaluating the risk and benefits of bed-sharing.     

Characteristics that help mothers maintain their infants'' focus of attention

Disadvantaged mothers' use of interactive strategies which maintained their infants' focus of attention were examined at 6, 12, and 24 months to evaluate for patterns in this interactive strategy and determine if patterns could be predicted from early infant and maternal characteristics. Four distinct clusters were identified with mothers in each cluster increasing in their use of maintaining over time but differing in the age at which the increase occurred. While infants' biologic risk was unrelated to cluster membership, more positive scores on mothers' perceptions of child rearing history, child rearing attitudes, self-esteem, and social support when the infants were 6 months old were reported by mothers who displayed a pattern of high levels and steady increase in maintaining. More negative scores on these characteristics were reported by mothers who displayed low levels of maintaining and delays in increasing this interactive strategy. Results are discussed in light of disadvantaged mothers' ability to adapt to their infants' changing needs and early identification of mothers' who may have greater difficulty in the adaptational process.     

Targeting adolescent mothers with depressive symptoms for early intervention

Infants of mothers with depressive symptoms show developmental delays if symptoms persist over the first 6 months of the infant's life, thus highlighting the importance of identifying those mothers for early intervention. In Study 1, mothers with depressive symptoms (n = 160) and mothers without depressive symptoms (n = 100) and their infants were monitored to identify variables from the first 3 months that predict which mothers would still be symptomatic at 6 months. A "dysregulation" profile was noted for the infants of depressed mothers, including lower Brazelton scores, more indeterminate sleep, and elevated norepinephrine, epinephrine, and dopamine levels at the neonatal period, and greater right frontal EEG activation, lower vagal tone, and negative interactions at the 3- and 6-month periods. A group of maternal variables from the neonatal and 3-month assessments accounted for 51% of the variance in the mothers' continuing depressive symptoms. These variables included greater right frontal EEG activation, lower vagal tone, and less positive interactions at 3 months, and elevated norepinephrine, serotonin, and cortisol levels at the neonatal stage. In Study 2, a similar sample of mothers with depressive symptoms (n = 160) and without depressive symptoms (n = 100) was recruited and followed to 3 months. Those symptomatic mothers who had values above (or below) the median (depending on the negative direction) on the predictor variables identified in Study 1 (taken from the first 3 months) were then randomly assigned to an intervention or a control group at 3 months. These groups were then compared with each other, as well as with the group without depressive symptoms, at 6 and 12 months. The intervention, conducted from 3 to 6 months, consisted of free day care for the infants and a rehab program (social, educational, and vocational) plus several mood induction interventions for the mothers, including relaxation therapy, music mood induction, massage therapy, and mother-infant interaction coaching. Although the mothers who received the intervention continued to have more depressive symptoms than did the nondepressed mothers, their interactions significantly improved and their biochemical values and vagal tone normalized. Their infants also showed more positive interations, better growth, fewer pediatric complications, and normalized biochemical values, and by 12 months their mental and motor scores were better than those of the infants in the control group.     

Separation anxiety in mothers of latency-age fearful children

The hypothesis that mothers of children who have symptoms indicative of separation anxiety are themselves separation-anxious was tested by scoring mothers' TAT themes for separation concerns. The stories of 15 mothers of fearful children were compared to the stories of 26 mothers of children manifesting behavior disorders and 21 mothers of children having had no psychiatric contact. Different kinds of separation concerns were found to differentiate the groups of mothers. The stories of mothers of fearful children expressed significantly more concerns about abandonment and rejection and more often expressed a desire to stay near the loved one; the mothers of children with behavior disorders were found to tell significantly more stories with nurturance-succorance themes. The results lend support to the theory of anxious attachment in that mothers of fearful children seem to share the same concerns that have been ascribed to their children. On the other hand, it seems that separation anxiety may not be a unidimensional construct as different components seem to be more relevant to some symptom clusters than to others.     

Attitudinal and demographic predictors of breast-feeding and bottle-feeding behavior by mothers of six-week-old infants

The demographic and attitudinal characteristics of 42 bottle feeding and 41 breast feeding mothers of 6 week old infants were compared. The women were patients of private physicians in Nashville, Tennessee. Data was obtained from self-administered questionnaires distributed through the physicians' offices. The women were primarily middle class whites and one-half of the women were multiparous and one-half were primiparous. On the basis of the information obtained in the questionnaires respondents were given scores on 13 demographic and family history characteristics and on 16 attitudinal scales which measured the mothers' preceptions of family life, child rearing, and breast feeding. Discriminant function analysis was used to assess the differences in the mean scores on each of the 29 variables for the 2 groups of mothers. Major findings were: 1) breast feeding mothers were significantly more educated and had significantly more breast feeding friends than bottle feeding mothers; 2) breast feeding mothers viewed their husbands as significantly more supportive of their feeding method than bottle feeding mothers; 3) bottle feeding mothers perceived more conflict in their marriages than breast feeding mothers; 4) bottle feeding mothers tended to favor accelerating the development of their infants more than the other mothers; and 5) breast feeding mothers had more positive attitudes toward breast beeding than bottle feeding mothers. Most of the women in both groups decided on their method of feeding prior to delivery, and complications during and following delivery did not alter their plans significantly. The 2 groups did not differ significantly in the degree to which they: 1) fostered dependency in their infants; 2) felt possessive toward their infants; 3) rejected the housewife role; and 4) were secluded at home.     

Preventive group psychotherapy for at-risk infants and their mothers

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

Infant feeding and maternal attitudes among mothers of low-income

Demographic variables, maternal attitudes, knowledge, practices, and support systems were examined in a sample of 50 women attending a public health clinic for well baby visits. Black women were nonsystematically selected an approached as they were waiting for their babies. Because the number of white women attending the clinic was small, an effort was made to include all of them. Data were obtained through individual interviews conducted by a trained interviewer. A questionnaire was constructed to obtain demographic information, information regarding prenatal awareness, delivery, mother infant interaction in the hospital, nutrition and infant care during the 1st year of life, and attitudes. 68% of the women were black and 32% were married. Most unmarried mothers lived with parents (50%), other relatives (26.5%), or ex husbands/boyfriends (5.9%). The mean educational level of 11.8 years was higher than anticipated for studies of public health department clinic populations. Teenagers made up 38% of the sample. 74% of the women reported family incomes below $8000. 64% had more than 1 child. Only 2 mothers in the sample had attended childbirth classes. 2/3 of the mothers recalled receiving no prior information about labor and delivery procedures and medications. Practices during the 1st few days after delivery indicate that only 20% of the mothers held their babires in the 1st hour after delivery and none of the mothers had the baby rooming in with them. 54% of the babies spent some time in the high risk nursery. This limited the mothers' opportunities to interact with and feed them. Only 3 of the mothers breastfed their babies for any length of time. 2 of them decided to breastfed because that was the best nutrition for the baby, and 1 did so because her mother had breastfed. The most common reasons given for bottlefeeding were not wanting to nurse (43.5%) and inconvenience (26.1%). Only 13% mentioned the necessity of back to school/work as a reason for not breastfeeding. No differences were observed between teenage mothers and older mothers in regard to the reasons for not breastfeeding. Since the number of breastfeeding mothers in this study was too small to permit statistical analysis, only scores for bottlefeeding mothers were compared. Bottlefeeding mothers of the low income group had statistically significant higher mean scores on 3 attitudinal scales: seclusion of the mother, acceleration of development, and mother's covert attitudes toward breastfeeding. Lower scores alone or with their spouses suggest that, when the childrearing responsibility was shared with extended family, mothers tended to be stricter with their children and minimized physical and emotional dependence of the children on them. Mothers who lived with spouses or alone tended to be more nurturing and less strict with their children.     

Intergenerational association of alexithymic characteristics for college students and their mothers.

The intergenerational association of alexithymic characteristics of mothers and their children were examined in a sample of 232 pairs of college students and their mothers. Scores on the Toronto Alexithymia Scale, Parental Bonding Inventory, and the Family Environmental Scale of college students were significantly correlated with their mothers' memories of when they were also 20 years old. College students' scores were significantly correlated with their mothers' scores on each questionnaire. The student-mother pairs were further divided into two family types, nuclear and extended families. Correlations were higher for scores of the nuclear family than for those of the extended family. Such results suggest there may be intergenerational transmission of alexithymia and related factors from mothers to children.     

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.     

Belief in a just world and subjective well-being: mothers of normal and Down syndrome children

A cross-sectional study examined the relationship between three dimensions of the belief in a just world and the subjective well-being of Pakistani mothers of normal and Down syndrome children (n = 100 each). Personal belief in a just world and two dimensions of general belief in a just world-beliefs in immanent and ultimate justice-were assessed along with four dimensions of subjective well-being: life satisfaction, mood, state anxiety, and depression. It was hypothesized that personal belief in a just world and belief in ultimate justice would be positively associated with subjective well-being for both groups of mothers. Results were obtained through moderated regression analyses. In line with our hypothesis, personal belief in a just world positively predicted life satisfaction and mood level and negatively predicted state anxiety and depression in both groups of mothers. In contrast, beliefs in immanent and ultimate justice were not consistently adaptive. In particular, the more the mothers of a Down syndrome child believed in immanent justice, the more anxiety they experienced the previous week. In addition, the more the mothers of normal children believed in ultimate justice, the more they experienced anxiety. The pattern of results persisted when controlled for mothers' education, the total number of their children and marital status. Overall, the results support the role of personal belief in a just world as a personal resource in adverse as well as normal life circumstances.     

Do postpartum anxiety and breastfeeding self-efficacy and bonding at early postpartum predict postpartum depression and the breastfeeding method?

We investigated whether postpartum anxiety (PPA) and breastfeeding self-efficacy and bonding at the early postpartum period can be used to predict postpartum depression and the breastfeeding method, and we sought to identify factors related to postpartum depression. Of the 510 eligible women, 185 (36%) returned the questionnaire on all three occasions (1 day, 3 days, and 1 month after childbirth). The mothers' progress on the State-Trait Anxiety Inventory (STAI), Breastfeeding Self-Efficacy Scale Short Form (BFSES-SF), and Postnatal Bonding Questionnaire (PBQ) was observed over three periods. A repeated-measures ANOVA revealed that the mothers at high risk of developing postpartum depression (PPD) were those who did not show an increase in BFSES-SF score at early postpartum, and mothers whose bonding disorders have deteriorated rapidly. The results of the logistic regression analysis revealed a significant difference in employment as a factor related to postpartum depression. Compared to Regular, Part-time status was 4.4 times more likely and Unemployed status was 2.3 times more likely to cause postpartum depression. For the early detection of PPD, it is necessary to identify (1) mothers who do not show an increase in the BFSES-SF score, (2) mothers whose bonding disorders have deteriorated rapidly, and (3) part-time or unemployed mothers as characteristic of postpartum depression.     

Knowledge gained by mothers enrolled in a home visitation program

This study examined whether new mothers would gain knowledge of child development after participating in a home visitation program for six months, and whether there would be differences between adolescent mothers and older mothers. Forty-seven mothers were administered the Knowledge Inventory of Development and Behavior: Infancy to School-age (KIDS) after the birth of their babies and six months later. Results indicated an overall increase in total knowledge of child development for mothers (of all ages) participating in a home visitation program. KIDS subscale scores indicated a significant increase in new mothers' knowledge about both infant and school-age development. There was no significant difference between the adolescent and older mothers in knowledge of infant development.     

Illness perception ratings of high-risk newborns by mothers and clinicians: Relationship to illness severity and maternal stress

Objective: Patients' views of illness are often thought to differ from those of medical staff, although this is rarely assessed. This study examined the correspondence between mothers' and clinicians' perceptions of the same high-risk newborns, as well as with an objective measure of illness severity. We also investigated how mothers' perceptions were related to reported stress. Methods: Mothers of 99 high-risk infants admitted to either a neonatal intensive care or neonatal high dependency unit, which offers specialized but not intensive care, completed illness perception ratings of their baby's condition as well as perceived stress 3 to 5 days following admission. At the same time, a standardized measure of neonatal illness severity was calculated and the baby's primary neonatologist completed illness perceptions ratings. Results: Unlike clinician ratings, mothers' illness perceptions were not significantly correlated with illness severity. Mothers generally rated babies in both units as sicker and having a more serious illness than did neonatologists. Whereas clinicians, compared with mothers, rated babies in intensive care as having an illness that would affect their life more and last for a longer time. Mothers rated medical treatment to be significantly more helpful than did clinicians, particularly for babies admitted to the high dependency unit. Mothers' stress was significantly associated with illness perceptions but unrelated to illness severity. Conclusions: Significant differences exist in the perceptions of illness severity, helpfulness of treatment, and the long-term effects of the baby's illness between parents and clinicians and this may lead to misunderstandings and misinterpretations in communication. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Patterns of psychological distress in mothers of preterm infants

Mothers of preterm infants experience significant psychological distress, with elevated levels of inter-correlated depressive, stress, anxiety and post-traumatic stress symptoms. In a sample of racially and ethnically diverse mothers of preterm infants, we identified differing patterns of psychological distress during infant hospitalization and examined the effect of these psychological distress patterns on longitudinal trajectories of each psychological distress measure and on maternal perceptions of the child over the first year of the infant's life. Mothers of preterm infants (N = 232) completed five questionnaires assessing depressive symptoms, anxiety, post-traumatic stress symptoms, stress due to infant appearance, and stress due to parental role alteration during enrollment during the neonatal hospitalization, discharge, and at 2, 6, and 12 months of age adjusted for prematurity. Latent class analysis on the enrollment psychological distress variables allowed us to identify five sub-groups of mothers exhibiting similar patterns of psychological distress, differing primarily in degree and type: low distress, moderate distress, high NICU-related distress, high depressive and anxiety symptoms, and extreme distress. These classes continued to show different longitudinal trajectories for the psychological distress measures through 12 months corrected age. Mothers in the extreme distress class and, to a lesser degree, mothers in the high depressive and anxiety symptom class remained at risk of significant psychological distress one year after discharge and had less positive perceptions of their child (greater worry and higher perceptions of child vulnerability). In conclusion, distinctive sub-groups of mothers during hospitalization had different patterns of psychological distress throughout the 12-month period and may require different interventions in the NICU.     

Maternal anxiety and depression and development of prematurely born infants in the first year of life

The purpose of this study was: (a) to assess and to compare anxiety and depression symptoms in mothers of preterm neonates during hospitalization in the Neonatal Intensive Care Unit, after discharge, and at the end of the infants' first year of life; and (b) to assess the child's development at 12 months of chronological corrected age (CCA). Thirty-six mothers, with no psychiatric antecedents assessed with the SCID-NP, were evaluated by STAI and BDI. The infants were assessed with Bayley-II Scales. There was a significant decrease in clinical symptoms of state-anxiety in mothers (p = .008), comparing the period during hospitalization and after discharge of the infants. Clinical symptoms of anxiety and depression were observed in 20% of the mothers at the end of the infants' first year of age. The majority of the infants exhibited normal development on Bayley-II at 12 months CCA; however, 25% of the infants displayed cognitive problems and 40% motor problems. The mothers' anxiety and depression symptoms decreased at the end of the first year of life of the pre-term infants and the children showed predominately normal development at this phase.     

Interactions between mothers and infants: impact of maternal anxiety

The aim of the study was to examine the impact of anxiety in the postnatal year on maternal contribution to mother-infant interaction. Participants were 32 mothers with high anxiety and 32 mothers with low anxiety, when their infants were aged 10-14 months. Mother-infant interaction was videotaped during a standardized play situation and coded blind to group status. High trait anxiety mothers showed less sensitive responsivity (p<.05) and reduced emotional tone (p<.05) during interaction. When participants scoring high in depressive symptomatology were removed for a subgroup analysis, the same pattern of results was obtained, suggesting that the observed differences in mother-infant interaction were due to group differences in anxiety.     

PATERNAL SEPARATION ANXIETY:

Employed mothers of young children worry about the effects of daily separation on their children Do fathers have similar anxieties? Because fathers are expected to leave the home and go to work, psychologists have not studied fathers' concerns about daily separation from their babies and pre-school children In this study, we investigated fathers' and mothers' separation anxiety and the relationships between separation anxiety and family and child-care characteristics The sample included 589 married couples from a larger study of families and center-based child care Data were collected through in-home and center visits Fathers and mothers had similar levels of Separation Anxiety However, fathers reported slightly higher Concern for the Child, and mothers reported higher Employment Concerns Fathers' perceptions of their wives' anxieties were higher by half a standard deviation compared with mothers' reports Fathers' and mothers self reported separation anxieties were modestly correlated Paternal separation anxiety was most strongly associated with fathers' perceptions of their wives' separation concerns, not with mothers' reported anxieties, which suggested ego defensiveness and projection