Dyadic processes between mothers and preterm infants: Development at ages 2 to 5 years

In order to identify antecedents to cognitive, language, and social competence from 2 to 5 years of age in preterm children at biological and social risk, this study used multiple procedures, administered in the laboratory, at 13 and 20 months, to measure components of the social interactions between 51 mothers and their preterm infants. Two variables, maternal responsiveness to infant vocalization and infant irritability, were found to be significant predictors of later competence. Whereas greater maternal responsiveness, as expected, led to increased language and social skills, greater infant irritability during stressful situations also foretold later increased competence in expressive and receptive language and social cognition. Children born at higher birthweights and with longer gestations were more likely to be more irritable than those born at very low birthweights. The findings suggest different implications for negative affect in preterms who have experienced respiratory distress as contrasted to full-term children, but indicate similar positive consequences for maternal verbal responsiveness.     

Infant food refusal and parental social support

The purpose of this study was to examine the relations between various aspects of social support and maternal and infant outcome variables in a group of families having infants showing food refusal compared to a control group. In the case of early food refusal, the results indicated that access to emotional support and satisfaction with support were related to maternal psychosomatic health. The relationships were interpreted as showing that social support has moderating effects on negative outcomes of food refusal.     

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.     

Evaluating associations between maternal social support and cognitive development for infants in poverty

Infant cognitive development may be associated with maternal social support, although these relations have not been well-examined for infants living in poverty. We explore whether maternal social support is associated with cognitive development for 113 infants living in poverty. Infant cognition was measured at age 9–12 months using the Bayley Scales of Infant and Toddler Development 3rd edition. Mothers provided information regarding perceived social support received from fathers, family, friends, and community members. Controls included maternal race and infant sex. Linear regression revealed no significant relationships between maternal social support and infant cognition in this sample.     

Infant–mother social referencing interactions: Description and antecedents in maternal sensitivity and infant irritability

The purpose of the study was to describe naturally occurring infant and maternal behaviours in terms of social referencing in a stranger wariness situation, and to explore antecedents to such behaviouts in early maternal sensitivity and infant irritability. One hundred and ten 10-months-old infants and their mothers were videotaped. Infant social referencing behaviour was defined as puzzled looks directed at mother's face after the infant had discovered the stranger. Almost half of the infants looked with a puzzled expression at their mothers immediately after discovering the stranger, and a majority of the mothers sent a positive message back to the infants. Twenty per cent of the infants never looked at their mothers and 20% of the mothers did not respond when their infants turned to them. Infants whose mothers had responded positively to the referencing look showed positive responses to the stranger to a higher degree than infants who did not reference or those who were not responded to. Antecedents to infant and mother interactive behaviours were sought in maternal sensitivity (general sensitivity, physical contact, responsiveness, intrusiveness, response to distress, and effectiveness in comforting) and in infant irritability as observed when the infants were 4 months old. It was found that infants who did not reference their mothers for information at 10 months had experienced less sensitive mothering 6 months earlier and had also shown more irritability.     

Infant irritability: The impact of fetal alcohol exposure,maternal depressive symptoms,and low emotional support from the husband

Objectives: The aim of this study was to investigate the impact of fetal alcohol exposure, maternal depressive symptoms, and low emotional support from the husband on infant irritability in the first one and a half years of life. Four models describing the interplay of these factors were assessed: A direct effect model, an interaction or threshold model, a mediational model and a transactional model. Method: A sample of initially 458 women was assessed in a prospective 3‐wave study across the first 17 months after childbirth. Fetal alcohol exposure was questioned retrospectively six weeks after birth. Infant irritability was reported by the mothers and fathers. Results: Support for the direct effect model and the interaction model could be found: Fetal alcohol exposure and low emotional support from the husband were associated with increased infant irritability at 5 months. The impact of fetal alcohol exposure was moderated by postnatal depressive symptoms. More irritability was reported if both risk factors, prenatal alcohol exposure and maternal depressive symptoms, were present. Infant irritability and maternal depressive symptoms were associated cross‐sectionally. At the age of 17 months only a main effect of prenatal alcohol exposure on irritability could be found. Conclusion: Direct effects of fetal alcohol exposure, maternal depressive symptoms, and low emotional support from the husband on infant irritability as well as an interaction between fetal alcohol exposure and maternal depressive symptoms were revealed. The interaction can be understood in terms of a diathesis‐stress model. However, no longitudinal associations between maternal depressive symptoms and infant irritability could be found.     

Similarities and differences in mothers' and observers' ratings of infant security on the Attachment Q-Sort

This study examined the similarities and differences in maternal and observer Attachment Behavior Q-Sort ratings (AQS; Waters, 1995) and their relations to dimensions of the developmental ecology - maternal sensitivity, infant irritability, parental stress and psychosocial risk. Data was gathered from low risk (adult mothers; N=44) and high risk mother-infant dyads (adolescent mothers; N=83) when infants were aged 6, 10 and 15 months old, attachment being assessed at 15 months by both mothers and independent observers. A common factor was extracted from both sorts and served to operationalize the similarities between mother and observer ratings. Regressions were conducted to extract maternal and observer AQS scores that were unrelated to each other to represent the difference between the two sorts. Correlation analyses indicated that the common AQS factor was moderately linked to maternal sensitivity and parental stress, and showed a weak association to psychosocial risk and infant irritability. Residual maternal scores showed greater correlations with infant irritability and parental stress than did observer residual scores. Observer scores showed a greater correlation with psychosocial risk than maternal scores. Results suggest that common AQS variance presents a pattern of associations with ecological variables that is coherent with attachment research. Variance related to irritability, stress and risk appear to drive the differences between maternal and observer observations.     

Life Satisfaction and Coping in Hindu Adolescents in India

This exploratory study examined the relations between approach and avoidance coping behaviors and general life satisfaction in a sample of 248 Hindu adolescents from an urban area in India. The major findings were threefold. First, gender differences were observed, with females reporting more frequent use of the strategies of seeking social support, direct problem solving, and internalizing behaviors. Second, using multiple regression analyses, the coping behaviors of problem solving and externalizing behaviors accounted for significant, unique variance in life satisfaction scores. Third, gender did not moderate the relations between any of the coping behaviors and life satisfaction. Possible implications for health promotion are discussed.     

The role of maternal responsiveness in predicting infant affect during the still face paradigm with infants born very low birth weight

There is limited empirical literature addressing infants' response to a standardized stressor with infants born very low birth weight (VLBW). The purpose of this study was to assess the relative strength of maternal responsiveness in predicting infant affect in response to the Still Face (SF) paradigm in a cross‐sectional cohort of ethnically diverse infants born VLBW and their mothers (N = 50; infants 6–8 months old). Infant affect and maternal responsiveness were coded in 1‐s intervals while dyads participated in the SF. In addition, perinatal medical status, developmental status, and infant temperament were assessed. Findings revealed that positive infant affect during and after the SF stressor were strongly associated with baseline infant positive affect and maternal responsiveness at the reunion episode, respectively. In contrast, when predicting negative infant affect during and after the SF stressor, prior infant negative affect was strongly and uniquely significant. Infant positive affect, negative affect, and maternal responsiveness were not significantly associated with gender, infant perinatal medical history, developmental status, or temperament. Future research is warranted to determine how these findings relate to infants' stress reactions in naturalistic settings and if relationship‐focused interventions may reverse infant negative emotionality, enhance positive emotionality, and thereby improve self‐regulation and longer term social and cognitive developmental outcomes in medically at‐risk infants.     

Mexican‐Origin Parents’ Stress and Satisfaction: The Role of Emotional Support

Guided by a process model of parenting and the integrative model, this study examined sources of emotional support (i.e., partner, maternal, paternal) as related to stress and satisfaction resulting from the parenting role in a sample of Mexican‐origin young adult parents who participated in the National Longitudinal Study of Adolescent to Adult Health (Add Health) during Wave IV. Participants were male and female parents (26–35 years of age; 59% female; N = 737) who had children and a partner. Results from structural equation modeling revealed support from mothers as salient; high levels of maternal support were associated with high levels of parenting satisfaction. Tests of indirect effects suggested that parenting satisfaction played an intervening role in the link between maternal support and parenting stress. The pattern of results held across levels of linguistic acculturation but varied by gender. Understanding the mechanisms that predict parenting stress and satisfaction within the Mexican‐origin population may help in the identification of culturally sensitive intervention strategies.     

Oxytocin trajectories and social engagement in extremely premature infants during NICU hospitalization

Extremely premature infants, born 28 weeks gestation or less, are at high risk for impaired socioemotional development, due in part to exposure to early stressful social experiences that alter brain development. Understanding mediators that link experience with outcomes is necessary to assess premature infant responses to social experiences that are critical to brain development. The hormone oxytocin (OT), released during supportive interactions, has potential as a biomarker of the premature infant's responses to social experiences. The purpose of this study was to examine associations among infant plasma OT trajectories and maternal-infant social engagement behaviors during initial hospitalization. This study also examined demographic correlates of engagement behaviors in mothers and infants. Plasma from 28 extremely premature infants, born gestational ages 25–28 6/7 weeks, was collected at 14 days of life, then weekly until 34 weeks. Social engagement behaviors were measured by the Parent-Child Early Relational Assessment during a videotaped feeding when the infant was receiving one-quarter full oral feeds. Maternal-infant demographics were extracted from the medical record. Higher infant plasma OT was associated with lower infant social engagement, but no associations were found with maternal social engagement. Infant social engagement was positively related to maternal social engagement. Maternal parity was related to maternal social engagement, and infant demographics did not predict infant social engagement. The significant, yet negative, association between infant OT and engagement provides support for the measurement of OT as a neurobiological antecedent to infant social behaviors. Finally, this research suggests that during the earliest period of infant socio-behavioral development, premature infants are behaviorally reactive to the social engagement behaviors of their mothers.     

Infant distractibility from social events mediates the relation between maternal responsiveness and infant language outcomes

Research demonstrates that contingent and appropriate maternal responsiveness to infant requests and bids for attention leads to better language outcomes. Research also indicates that infants who are less distracted by irrelevant competing stimulation and attend efficiently to audiovisual social events (e.g., faces and voices) show better language outcomes. However, few studies have assessed relations between maternal responsiveness, infant attention to faces and voices, and distractibility, and how together these factors lead to early language outcomes. A newly developed audiovisual protocol, the Multisensory Attention Assessment Protocol (MAAP; Bahrick et al., 2018), allows researchers to examine individual differences in attention to faces and voices and distractibility, and to assess relations with other variables. At 12 months, infants (n = 79) in an ongoing longitudinal study participated in the MAAP to assess intersensory matching of synchronous faces and voices and attention to an irrelevant competing visual distractor event. They also were observed in a brief play interaction to assess infant bids for attention and maternal responsiveness (accept, redirect, or ignore). At 18 months, receptive and expressive language were assessed using the Mullen Scales of Early Learning. Several noteworthy findings emerged: 1) mothers were generally responsive, accepting 74% and redirecting 14% of infant bids, 2) infants who had a greater number of their bids redirected by mothers, and who had better intersensory matching of synchronous faces and voices, showed less attention to the distractor, and 3) infants who showed less attention to the distractor had better receptive language. Findings demonstrate that maternal redirecting of infant attention by mothers who are generally responsive may promote better infant attentional control (lower distractibility) which in turn predicts better receptive language in toddlers.     

Religious support and psychological well-being: gender differences among religious Jewish Israelis

The moderating effect of gender on the relation between religious support and well-being was examined using 334 religious Jewish men and women in Israel. Specifically, social support, religious support (Religious Leader Support (RLS), Religious Community Support (RCS), and G-d Support (GS)), anxiety, and life satisfaction were assessed. All support measures were significantly associated with less anxiety and more life satisfaction. Hierarchical multiple regression analyses indicated that all three types of religious support were uniquely related to life satisfaction. For GS and RCS, this unique effect was also found regarding anxiety. As hypothesised, gender moderated the relations between religious support and well-being regarding both RLS and RCS. The relation with life satisfaction was stronger for women in comparison to men, and the reverse was true regarding anxiety. Surprisingly, no moderation by gender was found regarding GS. Findings are discussed regarding the importance of assessing gender in future religious support research.     

Infant–mother and infant–father synchrony: The coregulation of positive arousal

To examine the coregulation of positive affect during mother–infant and father–infant interactions, 100 couples and their first‐born child were videotaped in face‐to‐face interactions. Parents' and infant's affective states were coded in one‐second frames, and synchrony was measured with time‐series analysis. The orientation, intensity, and temporal pattern of infant positive arousal were assessed. Synchrony between same‐gender parent–infant dyads was more optimal in terms of stronger lagged associations between parent and infant affect, more frequent mutual synchrony, and shorter lags to responsiveness. Infants' arousal during mother–infant interaction cycled between medium and low levels, and high positive affect appeared gradually and was embedded within a social episode. During father–child play, positive arousal was high, sudden, and organized in multiple peaks that appeared more frequently as play progressed. Mother–infant synchrony was linked to the partners' social orientation and was inversely related to maternal depression and infant negative emotionality. Father–child synchrony was related to the intensity of positive arousal and to father attachment security. Results contribute to research on the regulation of positive emotions and describe the unique modes of affective sharing that infants coconstruct with mother and father. ©2003 Michigan Association for Infant Mental Health.     

Perceived partner support in pregnancy predicts lower maternal and infant distress

Maternal postpartum emotional distress is quite common and can pose significant risk to mothers and infants. The current study investigated mothers' relationships with their partners during pregnancy and tested the hypotheses that perception of prenatal partner support is a significant predictor of changes in maternal emotional distress from midpregnancy to postpartum, and contributes to maternal ratings of infant distress to novelty. Using a prospective longitudinal design, 272 adult pregnant women were interviewed regarding their partner support, relationship satisfaction, and interpersonal security (attachment style and willingness to seek out support), and they completed standardized measures of prenatal symptoms of depression and anxiety (distress). At 6 to 8 weeks' postpartum, mothers reported these symptoms again and completed measures of their infants' temperament. Structural equation modeling (SEM) was used to test direct and indirect contributions of partner support, relationship satisfaction, and interpersonal security to maternal and infant postpartum distress. Mothers who perceived stronger social support from their partners midpregnancy had lower emotional distress postpartum after controlling for their distress in early pregnancy, and their infants were reported to be less distressed in response to novelty. Partner support mediated the effects of mothers' interpersonal security and relationship satisfaction on maternal and infant outcomes. A high-quality, supportive partner relationship during pregnancy may contribute to improved maternal and infant well-being postpartum, indicating a potential role for partner relationships in mental health interventions, with possible benefits for infants as well.     

Infant emotion regulation: Relations to bedtime emotional availability,attachment security,and temperament

The present study examines the influences of mothers’ emotional availability toward their infants during bedtime, infant attachment security, and interactions between bedtime parenting and attachment with infant temperamental negative affectivity, on infants’ emotion regulation strategy use at 12 and 18 months. Infants’ emotion regulation strategies were assessed during a frustration task that required infants to regulate their emotions in the absence of parental support. Whereas emotional availability was not directly related to infants’ emotion regulation strategies, infant attachment security had direct relations with infants’ orienting toward the environment and tension reduction behaviors. Both maternal emotional availability and security of the mother–infant attachment relationship interacted with infant temperamental negative affectivity to predict two strategies that were less adaptive in regulating frustration.     

Convergence of multiple sources of information on infant individuality: neonatal behavior,infant behavior,and temperament reports

To shed light on the notion of enduring individual infant characteristics, convergence of three presumably interrelated measures of infant individuality was examined. Data collected included standardized behavioral assessments of the newborn (NBAS), maternal reports of infant temperament (at 3 and 9 months), and naturalistic observations of infant behavior at 1, 3, and 9 months. Infant temperament reports were significantly stable from 3 to 9 months; observed infant fussiness was significantly stable from 1 to 3 and 3 to 9 months; observed altertness/social responsiveness was not stable over time. Analyses of convergence of neonatal and infant behavior revealed that 9-month infant alertness/social responsiveness was significantly correlated with neonatal habituation. Similar analyses of neonatal behavior and reported temperament revealed that 3-month reported dullness was significantly correlated with neonatal habituation and range of state. At 9 months, temperament ratings of infant fussiness and unpredictability were significantly correlated with autonomic stability; fussiness was also significantly correlated with regulation of state. Finally, no significant relationships were observed between reported temperament and observed infant behavior. These results fail to support a simple notion of enduring individuality in infants over their first year of life.     

The influence of high-risk pregnancies and social support systems on maternal perceptions of the infant

This study examines the effects of high-risk pregnancies on the maternal perception of the full-term healthy infant, as well as the influence of social support systems on these effects. Thirty mothers after high-risk pregnancy and 30 mothers after low-risk pregnancy were interviewed when their infants were 3 months old. Their perceptions of own and average baby were evaluated as well as the amount and availability of and their satisfaction with social support. The obtained results confirm the hypothesis that mothers after high-risk pregnancies tend to perceive their infant as significantly more difficult than mothers after low-risk pregnancies. A main finding of this study is that high-risk pregnancy mothers perceive an average baby in a much more positive way. Social support was not found to affect significantly the maternal negative perception of the infant after a high-risk pregnancy. These findings are discussed in the context of the continuity of the process of maternal affiliation to the infant before and after delivery.     

The influence of infant irritability on maternal sensitivity in a sample of very premature infants

The relationship between maternal sensitivity and infant irritability was investigated in a short‐term longitudinal study of 29 very preterm infants. Infant irritability was assessed at term with the Brazelton NBAS, the Mother and Baby Scales (MABS) and the Crying Pattern Questionnaire (CPQ). Maternal sensitivity was assessed by nurses' ratings in the neonatal care unit and at three months during mother–infant interaction observation. Cross‐lagged panel analysis indicated that neonatal irritability did not influence sensitivity at 3 months nor did maternal sensitivity in the newborn period lead to reduced irritability at 3 months. Both irritability and maternal sensitivity showed moderate stability over time (r = 0.55 and r = 0.60, respectively). It is concluded that in early infancy maternal sensitivity shows little influence on infant irritability in very preterm infants. Copyright © 2003 John Wiley & Sons, Ltd.     

Responsive parenting: establishing early foundations for social, communication, and independent problem-solving skills

Mothers whose infants varied in early biological characteristics (born at term, n = 120; born at very low birth weight [VLBW], n = 144) were randomized to a target group (n = 133) or developmental feedback comparison group (n = 131) to determine whether learning responsive behaviors would facilitate infant development. The target condition included videotaped examples, problem-solving activities, and mothers' critique of their own behaviors through video procedures across 10 home visits. All target versus comparison mothers showed greater increases across multiple responsiveness behaviors observed in 4 assessments conducted across 6-13 months of age; changes in emotionally supportive behaviors were strongest for target mothers of infants born at VLBW. Increased maternal responsiveness facilitated greater growth in target infants' social, emotional, communication, and cognitive competence, supporting a causal role for responsiveness on infant development. Although benefits were generally comparable across risk groups, aspects of social and emotional skills showed greater change for those born at VLBW. Evidence for responsiveness as a multidimensional construct was provided as well as the importance of different aspects of responsiveness mediating the effect of the intervention on different infant skill domains.