Nonmaternal care hours and temperament predict infants’ proximity-seeking behavior and attachment subgroups

Using the NICHD Early Childcare dataset (N = 1281), this study examined whether infant temperament and the amount of time infants spend in nonmaternal care independently predict (1) the likelihood that they seek comfort from their mother when needed and (2) placement in a particular subgroup of infant-mother attachment patterns. Mothers reported the number of hours their infant spent in nonmaternal care each month and their infant's difficulty adapting to novel stimuli at 6 months. The degree to which 15-month-old infants seek comfort from their mother during reunion episodes in the Strange Situation was observed using two behavioral scales (“proximity seeking” and “contact maintaining”). Their average score forms the outcome variable of “proximity-seeking behavior.” The other outcome variables were the subgroups of infant-mother attachment patterns: two subgroups for insecure babies (resistant and avoidant) and four subgroups for secure babies (B1, B2, B3, and B4). Easy adaptability to novel stimuli and long hours of nonmaternal care independently predicted a low level of proximity-seeking behavior. These predictors also increased the likelihood of an insecure infant being classified as avoidant (vs. resistant). A secure infant with these same predictors was most likely to be classified as B1, followed by B2, and then B3, with B4 being the least likely classification. Although previous studies using the NICHD dataset found that hours of nonmaternal care had no main effect on infants’ attachment security (vs. insecurity), this study demonstrates that hours of nonmaternal care predict the subcategories of infant-mother attachment.     

Predicting infant attachment classification from multiple, contemporaneous measures of maternal care

This investigation was designed to test whether stylistic differences in maternal caregiving were associated with both secure and insecure mother-infant attachment classifications in a low-income sample. Multiple measures of maternal interactive behavior and care were collected from a sample of 95 urban, low-income mothers and their 12-month-old infants. Contemporaneous relations to attachment were found only at the broad level of composite scores of caregiving. Scores derived from different measures were aggregated to create composites reflecting three caregiver styles—sensitive, controlling, and unresponsive. Mothers of infants with secure attachment classifications showed greater sensitivity and less controlling behavior than mothers of infants with resistant and avoidant attachments, respectively. Mothers of infants with resistant attachments appeared less responsive to their infants' signals than those of infants with avoidant attachments. Group differences were significant, but modest. These results contribute to the growing body of studies relating parental care with infant attachment patterns and indirectly support the more recent conceptual work on intergenerational transmission of attachment. They also raise methodological issues that need to be considered in future work on caregiving and infant-mother attachment.     

Transferences in parent–infant psychoanalytic treatments

In parent–infant treatments, babies sometimes exhibit symptoms such as screaming, clinging, and fearful gaze avoidance of the analyst. The paper investigates if such phenomena may be regarded as transference manifestations, and if so, if they appear both in younger and older infants. Based on three case presentations, it is concluded that some babies are capable of forming both brief and enduring transferences. The term “indirect infant transference” refers to when a baby reacts emotionally to the analyst as long as the parent's transference remains unresolved. “Direct transference” refers to when a baby reacts in a non‐mediated way to the analyst. The necessary tool of investigation for discovering these phenomena is a psychoanalytic method with an explicit, though not exclusive, focus on the baby. Discerning them in the clinical encounter may help us understand the baby's predicament and when and how to address the baby or the parent. These treatments constitute an empirical field awaiting more extensive clinical and theoretical investigation. Already now, they suggest that transference may be rooted in, and may appear during, very early developmental stages. The paper's positions are compared with those put forward by other parent‐infant clinicians.     

Parent–infant co‐sleeping: fathers' roles and perspectives

Dyadic co‐sleeping (mother–baby) is a common strategy for night‐time infant care in the majority of world cultures. Triadic co‐sleeping (mother–father–baby) is less common, although still widely practised cross‐culturally. This paper examines triadic co‐sleeping in an opportunistic sample of parents from the North Tees region of England, and explores fathers' expectations and experiences of sleeping with their babies. Using a prospective study design, 36 sets of parents, pre‐ and post‐natally, were interviewed about infant care strategies, particularly at night. Although they did not anticipate sleeping with their infants at the pre‐natal interview, the majority of fathers (81%) had done so by the time of the second interview. First‐time fathers were afraid that they would squash or suffocate the baby in their sleep, and some were concerned that the infant's presence would adversely affect their own sleep. Fathers used a variety of strategies to help overcome their initial fears of co‐sleeping. Among those for whom triadic co‐sleeping became a regular night‐time infant care strategy, the pleasures of prolonged intimate contact with their infant were clearly apparent. It is suggested that the experience of sleeping with their infant ameliorates some of the distancing effects felt by fathers outside the breast‐feeding relationship, and helps encourage paternal involvement in night‐time infant care‐giving. Copyright © 2000 John Wiley & Sons, Ltd.     

Brief mother–infant treatment: Psychoanalytically informed video feedback

Specific patterns of interactive regulation documented by microanalytic methods of infant research can be applied to clinical interventions with mothers and infants. A brief treatment model is described that includes face‐to‐face split‐screen videotaping (one camera on each partner) and therapeutic observation of the videotape with the parent. The intervention uses “video feedback” informed by a psychoanalytic approach, including positive reinforcement, modeling, and information giving, as well as interpretation, while watching the videotape. Specific interactions in the areas of attention, arousal, affect, and timing regulation are evaluated. The psychoanalytic intervention links the “story” of the presenting complaints, the “story” seen in the videotape, and the “story” of the parent's own upbringing. An attempt is made to identify specific representations of the baby that may interfere with the parents's ability to observe and process the nonverbal interaction. The mother's powerful experience of watching herself and her baby interact, and our joint attempts to translate the action‐sequences into words, facilitates the mother's ability to “see” and to “remember,” stimulating a rapid integration of the mother's procedural and declarative modes of information‐processing. One treatment case, involving six contacts, is presented to illustrate the approach. By applying the specificity of interactive regulation identified by microanalysis of videotape into the psychodynamic treatment of mother–infant pairs, basic research can be translated into clinical practice. ©2003 Michigan Association for Infant Mental Health.     

Attachment patterns and emotion regulation strategies in the second year

With the aim of studying the relationship between methods of emotion regulation and quality of attachment we examined 39 infants with different patterns of attachment, of whom 20 were classified as secure (B), 12 as avoidant (A) and 7 as resistant (C), assessing the regulatory strategies adopted by them during the Strange Situation at 13 months. Secure infants used strategies of positive social engagement more than insecure avoidant infants, while resistant infants displayed greater negative social engagement and less object orientation than the other two groups. Avoidant infants adopted positive and negative hetero-regulatory strategies less than the other groups, also differing from resistant infants in their greater use of object regulatory strategies. There were no significant differences as regards self-comforting regulation. Thus, the findings showed how the most significant differences to emerge between the groups concerned hetero-regulatory strategies, developed by the infant in interaction with attachment figures, and regulatory strategies oriented towards objects. Further analysis showed how the use by part of each attachment group of the emotion regulation strategies varies, differentiating the episodes of the SSP according to their level of stress.     

Read your baby: A follow-up intervention program for parents with NICU infants

An intervention model designed to provide education and support to parents of sick or preterm infants throughout their first year of life is described. The intervention focused on helping parents communicate more skillfully with their infant and encouraging parents to maximize their infant's participation in the family system. Seventeen medium-risk infants received intervention; another seventeen served as controls. Independent evaluations of all families at 12 months adjusted age revealed that intervention babies were significantly advanced on Bayley Scales of Infant Development and Mastery Motivation tasks and that their mothers viewed them as easier to care for and less irritable.     

Predicting adult responses to infant distress: Adult characteristics associated with perceptions,emotional reactions,and timing of intervention

This study examined adult characteristics associated with different responses to infant distress. One hundred eighty‐eight parents viewed four 20‐second segments of videotape in which a 4‐week‐old infant was either (a) fussing mildly, (b) fussing vigorously, (c) crying, or (d) crying vigorously. Participants rated their emotional reactions and perception of cry characteristics following each segment. Participants then viewed a 4‐minute videotape depicting the same infant progressing from calm to vigorous crying, and indicated when they would intervene to pick up the infant. Relatively high levels of empathy and extraversion and low levels of conscientiousness were associated with more sensitive responses to infant distress. Infant‐rearing attitudes had a strong impact on response patterns as well, suggesting that education may be an effective means of increasing parental sensitivity. ©2003 Michigan Association for Infant Mental Health.     

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.     

Attachment security differs by later autism spectrum disorder: A prospective study

Although difficulties with social relationships are key to autism spectrum disorder (ASD), no previous study has examined infant attachment security prior to ASD diagnosis. We prospectively assessed attachment security at 15 months in high‐risk infants with later ASD (high‐risk/ASD, n = 16), high‐risk infants without later ASD (high‐risk/no‐ASD, n = 40), and low‐risk infants without later ASD (low‐risk/no‐ASD, n = 39) using the Strange Situation Procedure. High‐risk/ASD infants were disproportionately more likely to be classified as insecure (versus secure) and more likely to be classified as insecure‐resistant (versus secure or avoidant) than high‐risk/no‐ASD and low‐risk/no‐ASD infants. High‐risk infants with insecure‐resistant attachments were over nine times more likely to receive an ASD diagnosis than high‐risk infants with secure attachments. Insecure‐resistant attachment in high‐risk infants suggests a propensity toward negative affect with the parent in conditions of stress. Insecure‐resistant attachment may prove useful as a potential early index of propensity toward ASD diagnosis in high‐risk siblings, while insecure‐resistant attachment in the context of emergent autism may contribute to difficulties experienced by children with ASD and their families.     

Mothers' responses to the cries of normal and premature infants as a function of the birth status of their own child

Mothers of premature and full-term infants viewed and heard videotapes of premature and full-term infants. The onset of crying by both infants elicited physiological arousal (evident in blood pressure, skin conductance, and heart rate increases) in the adults. The mothers of premature infants responded with especially marked arousal to the infants' cries. These mothers also reported that they were more attentive and alert while the infant was crying. The subjects responded similarly to the cries of full-term and premature infants. Mothers who described their own baby as easy exhibited a lower increase in diastolic blood pressure and heart rate, and reported being more alert, attentive, and willing to interact with the stimulus babies than those whose own baby appeared “difficult.”     

Head start is too late: integrating and applying infant observation studies, and attachment, trauma, and neurobiological research to groups with pregnant and new mothers

In this paper new knowledge generated from theoretical and empirical work in infant observation studies and attachment, trauma, and neurobiology research is integrated and applied to the development of a group for pregnant and new mothers. The purposes of this group were to (1) promote the establishment of a secure base for each baby through optimum self and dyadic affect regulation, the repair of ruptures, and the emergence of positive heightened affective moments; (2) to facilitate secure attachment between mother and infant by helping mothers mentalize the experiences of their babies; (3) to build affiliative bonds between group members and; at the very least, (4) to prevent insecure disorganized attachments. The group interactions also were thought to prevent new psychopathology from developing, as well as to minimize the intergenerational transmission of trauma. A discussion of how this group came out of gestation and birthed itself in a community setting is included.     

How New Knowledge About Parenting Reveals the Neurobiological Implications of Intersubjectivity: A Conceptual Synthesis of Recent Research

Observations of early mother–infant interactions have shown that intersubjectivity is a primary motivation and have underscored the importance of maternal competencies in this development. In our paper we propose a conceptual overview of the different perspectives according to which parental caregiving has been formulated. Psychoanalytical theory has fundamentally promoted the exploration of maternal and paternal intrapsychic constellation, by stressing the role of unconscious processes in parental attitude as well as in infant development. In contrast with psychoanalytical theory, the conceptual framework of attachment has mostly considered real interactions between parents and infant, underlining parental abilities in providing the infant with a secure base. Finally, infant research has explored the complexity of communicative system between parents and infants, which appears already active from the birth of the baby. Recently, these different viewpoints have been broadened by neurobiological research, which has begun to explore maternal brain functioning and structure, by means of new scientific instruments such as fMRI techniques. From these perspectives, we provide an overview of motherhood, underlining both neurobiological and psychological transformations, which begin from pregnancy and run through the first year of the infant, when the mother–infant intersubjective matrix is built. This matrix influences the construction of the infant's Self and support the development of the sense of “we,” a sort of connective net, which ties the baby to parents, letting him feel as a part of the familiar world.     

The Michigan infant mental health home visiting model

Selma Fraiberg's pioneering work with infants, toddlers, and families over 40 years ago led to the development of a field in which professionals from multiple disciplines learned to work with or on behalf of infants, very young children, their parents, and the relationships that bind them together. The intent was to promote social and emotional health through enhancing the security of early developing parent–child relationships in the first years of life (Fraiberg, 2018). Called infant mental health (IMH), practitioners from fields of health, education, social work, psychology, human development, nursing, pediatrics, and psychiatry specialize in supporting the optimal development of infants and the developing relationship between infants and their caregivers. When a baby is born into optimal circumstances, to parents free of undue economic and psychological stressors and who are emotionally ready to provide care and nurturing for an infant's needs, an IMH approach may be offered as promotion or prevention, with the goal of supporting new parent(s) in developing confidence in their capacity to understand and meet the needs of the tiny human they are coming to know and care for. However, when parental history is fraught with abandonment, loss, abuse or neglect, or the current environment is replete with economic insecurity, threats to survival due to interpersonal or community violence, social isolation, mental illness, or substance abuse, the work of the IMH therapist may require intervention or intensive treatment and becomes more psychotherapeutic in nature. The underlying therapeutic goal is to create a context in which the baby develops within the environment of a parent's nurturing care without the psychological impingement that parental history of trauma or loss or current stressors such as isolation, poverty, or the birth of a child with special needs, can incur.     

Moving into tummy time,together: Touch and transitions aid parent confidence and infant development

“Back to sleep” messages can reduce prone practice for infants, with potential for motor delay and cranial deformation. Despite recommendations for “tummy time,” young infants fuss in prone, and parents report uncertainty about how to help infants tolerate prone positioning. We hypothesized that a Child'Space Method lesson, teaching proprioceptive touch and transitions to prone, would facilitate prone tolerance, parent behavioral support, and parent self-efficacy. This randomized study recruited parents (N = 37) of 2- to 5-month-old infants. On two visits, parents answered questions about infant behavior and parent experience, and played with their infant. Lesson group parents had the lesson following the first free play. One week later, lesson parents reported that infants tolerated more prone time and that parents showed more supportive behaviors in bringing infant to prone, as compared to waiting parents. Lesson parents’ efficacy, and infant behavior during play, trended in the hypothesized direction. The study demonstrated how a lesson in preparatory touch, and gradual transitions, promoted infant prone tolerance and also parent support of rolling, side-lying, and prone positioning. The lesson could be incorporated in parent education and early pediatric visits, helping infants and parents negotiate the prone challenge and setting the stage for further parent support of infant development.     

Mothers who are securely attached in pregnancy show more attuned infant mirroring 7 months postpartum

This study contrasted two forms of mother–infant mirroring: the mother's imitation of the infant's facial, gestural, or vocal behavior (i.e., “direct mirroring”) and the mother's ostensive verbalization of the infant's internal state, marked as distinct from the infant's own experience (i.e., “intention mirroring”). Fifty mothers completed the Adult Attachment Interview (Dynamic Maturational Model) during the third trimester of pregnancy. Mothers returned with their infants 7 months postpartum and completed a modified still-face procedure. While direct mirroring did not distinguish between secure and insecure/dismissing mothers, secure mothers were observed to engage in intention mirroring more than twice as frequently as did insecure/dismissing mothers. Infants of the two mother groups also demonstrated differences, with infants of secure mothers directing their attention toward their mothers at a higher frequency than did infants of insecure/dismissing mothers. The findings underscore marked and ostensive verbalization as a distinguishing feature of secure mothers’ well-attuned, affect-mirroring communication with their infants.     

Mother's attachment representations of their premature infant at 6 and 18 months after birth

The effects of premature birth on attachment have generally been examined from the infant's perspective. There is a lack of data concerning parental attachment representations toward a premature child. Because of the psychological stress engendered in parents confronted with a premature birth, we hypothesized that their attachment representations would be altered during the first months after the hospital discharge. Fifty families with a premature infant (25–33 gestation weeks) and a control group of 30 families with a full‐term infant participated to the study. Perinatal risks were evaluated during hospitalization. To assess mothers' representations of their infant, the Working Model of the Child Interview (WMCI, Zeanah & Benoit, 1995 & Benoit, Zeanah, Parker, Nicholson, & Coolbear, 1997) were administered when their children were 6 and 18 months old. The severity of the perinatal risks was found to have an impact on the mothers' attachment representations. At six months, only 20% of the mothers of a prematurely born infant (30% at 18 months) had secure attachment representations, vs. 53% for the control group (57% at 18 months). Furthermore, mothers of low‐risk premature infants more often had disengaged representations, whereas distorted representations were more frequent in the high‐risk group of premature children. These findings suggest that the parental response to a premature birth is linked to the severity of postnatal risks. The fact that secure attachment representations are affected in mothers of low‐risk infants just as much as they are in mothers of high‐risk infants points to the need to conduct further studies aimed at evaluating whether preventive intervention for both low‐risk and high‐risk premature will be helpful.