Moderating effects of maternal emotional availability on language and cognitive development in toddlers of mothers exposed to a natural disaster in pregnancy: The QF2011 Queensland Flood Study

BackgroundPrenatal maternal stress exposure has been linked to sub-optimal developmental outcomes in toddlers, while maternal emotional availability is associated with better cognitive and language abilities. It is less clear whether early care-giving relationships can moderate the impact of prenatal stress on child development. The current study investigates the impact of stress during pregnancy resulting from the Queensland Floods in 2011 on toddlers’ cognitive and language development, and examines how maternal emotional availability is associated with these outcomes.MethodsData were available from 131 families. Measures of prenatal stress (objective hardship, cognitive appraisal, and three measures of maternal subjective stress) were collected within one year of the 2011 Queensland floods. Maternal emotional availability was rated from video-taped mother-child play sessions at 16 months: sensitivity (e.g., affective connection, responsiveness to signals) and structuring (e.g., scaffolding, guidance, limit-setting). The toddlers’ cognitive and language development was assessed at 30 months. Interactions were tested to determine whether maternal emotional availability moderated the relationship between prenatal maternal stress and toddler cognitive and language functioning.ResultsPrenatal stress was not correlated with toddlers’ cognitive and language development at 30 months. Overall, the higher the maternal structuring and sensitivity, the better the toddlers’ cognitive outcomes. However, significant interactions showed that the effects of maternal structuring on toddler language abilities depended on the degree of prenatal maternal subjective stress: when maternal subjective stress was above fairly low levels, the greater the maternal structuring, the higher the child vocabulary level.ConclusionThe current study highlights the importance of maternal emotional availability, especially structuring, for cognitive and language development in young children. Findings suggest that toddlers exposed to higher levels of prenatal maternal stress in utero may benefit from high maternal structuring for their language development.     

Preterm birth and maternal sensitivity: Findings from a non-western country

IntroductionAlthough there are several studies on maternal sensitivity of preterm-born children conducted in Western countries, the factors affecting the sensitivity of mothers of preterm infants have not been investigated outside the Western context.ObjectivesThis study aimed to compare maternal sensitivity of preterm children at 18 months of corrected age with their healthy term-born peers and explore the factors associated with maternal sensitivity in a middle-income non-Western country. Moreover, the associations of maternal sensitivity with socio-demographic factors, maternal depression, and social-emotional competency and behavior problems of infants were investigated.MethodsIn total, 70 (40 preterm-born and 30 term-born) mother-child dyads participated in this study. An observation-based measurement tool, Maternal Sensitivity Scale, was used to assess maternal sensitivity. Social-emotional competency and behavior problems of infants were evaluated via The Turkish version of the Brief Infant-Toddler Social Emotional Assessment. Maternal depressive symptoms were assessed via the Beck Depression Inventory. In addition, a demographic information form was filled out by the mothers.ResultsMaternal sensitivity scores of preterm infants were significantly lower compared to term infants. Depressive symptoms scores and employment status of mothers, socio-economic status (SES), gestational age, breastfeeding duration, and behavior problems of children were the factors related to maternal sensitivity scores. In hierarchical regression analysis, SES and gestational age were the strongest predictors of maternal sensitivity. After controlling SES and gestational age, maternal depressive symptoms scores negatively predicted maternal sensitivity scores.ConclusionThis study pointed out the factors associated with the maternal sensitivity of preterm infants outside the Western context. Interventions to improve sensitive parenting behaviors of preterm infants are needed, especially in socio-economically disadvantaged groups.     

Early consequences of pre-Oedipal maternal deprivation

Abstract

The goal of this paper is to emphasize the early consequences of pre-Oedipal maternal deprivation, addressing the theories and techniques of the pioneers of child psychoanalysis. Even when these theories differ in their understanding and conceptualization of child psychopathology, their common denominator is that they believe in the importance of the infant’s early experiences of life and the necessary physical and emotional constancy of the mother–infant dyad. This paper approaches the different theories using three clinical vignettes. Through the synthesis of the psychoanalytic therapeutic process of a four-year-old boy, we can see how the conflicts and symptoms evolved and resolved in the course of five years of treatment, during which the boy’s behavior and productivity changed, allowing the treatment to come to an end. This boy was able to work through his traumatic separation experience in analysis, and to develop more mature defense mechanisms that led him toward a better adjustment to his environment. We can conclude that the early interruption of maternal care led to serious symptoms in this child’s behavior and mental organization. If these difficulties had not been addressed in time, the symptoms would have gone on to become severe.     

Battle of the dinosaurs: The impact of internalized bad paternal and maternal objects in a three-year-old boy

Abstract

This paper begins with a summary of W. Ronald D. Fairbairn's object relations theory, with particular focus on his ideas of how paternal objects are internalized alongside maternal objects. A case is then presented of a three-year-old boy who experienced deprivation and frustration from both his mother and father, thus initiating the internalization of bad paternal and maternal objects. Assessment and implications for treatment are then discussed using Fairbairn's model as an organizing framework for developing goals and interventions, and monitoring treatment progress.     

Cognitive development in children of adolescent mothers: The impact of socioeconomic risk and maternal sensitivity

BackgroundAdolescent motherhood is accompanied by a constellation of risk factors that translate into developmental risk for the off-spring. Socioeconomic risk that is associated with adolescent motherhood as well as maternal interactive behaviors may contribute to the impact of adolescent motherhood on children’s developmental outcome.ObjectiveTherefore, the aim of the current study was to investigate differences in children’s cognitive development between children of adolescent and adult mothers in their first two years of life and to examine whether socioeconomic risk (e.g. such as educational and financial problems) and/or maternal sensitivity mediate developmental differences between children of adolescent and adult mothers.MethodsAdolescent mothers (<21 years; N = 64) and adult mothers (>25 years; N = 34) and their infants were included in the current study. Child cognitive development and maternal sensitivity were assessed at three different time points (T1: mean child age 5.26 months; T2: mean child age 14.69 months; T3: mean child age 21.16 months).ResultsChildren of adult mothers showed better cognitive performance at T3 compared to children of adolescent mothers but not at T1 and T2. A multiple mediation model including socioeconomic risk and maternal sensitivity as serial mediators demonstrated that the effect of adolescent motherhood on cognitive development was mediated in a causal effect chain with socioeconomic risk negatively affecting maternal sensitivity and maternal sensitivity affecting children’s cognitive development.DiscussionThe present findings demonstrate that maternal interactive behaviors are not only a simple predictor of cognitive development but may also act as a mediator of the association between more distal variables such as socioeconomic risk and cognitive development in adolescent mothers. This supports the need to promote prevention and intervention programs for adolescent mothers during the early postpartum period to reduce socioeconomic problems and enhance maternal interactive behaviors.     

Changes in patterns of Early Mother-Child Interaction: A longitudinal study of the first 18 months of life

ObjectiveThe main objective of the present longitudinal study is to describe the progression of early adult-child interactions between the first and second years of life. Changes identified in interactions are described, focusing on both the qualitative aspects of maternal responses, as well as maternal response latency to the child's behavior using a microanalytical methodology that collected data on maternal and child behavior in real-time without losing sight of the temporal dimension.ParticipantsThis study examined 52 mother-child dyads from intact families that presented no psychological, social, or biological risk factors at 6, 12 and 18 months of age.InstrumentCITMI-R (early mother-child interaction coding system, revised edition) was used to assess early mother-infant interactions during free play sessions between mother and child the.ResultsThe results indicate that some components of maternal sensitivity improve as children progress towards the second year of life, detecting an increase in sensitive maternal behavior and a decrease in intrusive behavior in the evolutive observed period; moreover, regarding latency of maternal response, we observed that mothers of older children give more time for their children to explore, which stimulates autonomy. Finally, the implication of these results for intervention directed to optimizing early adult-child interactions are addressed.     

Maternal fatigue and burnout: From self-forgetfulness to environmental expectations

ObjectiveThe main objective of this study is to explore, through a qualitative approach, maternal and family expectations that could be related to maternal fatigue and exhaustion. The secondary objective is to identify aspects that could be specific to a specific age group.MethodA total of fourteen French mothers aged 28 to 42 (mean age 32 ± 4.3 years), with at least one child under 10 years of age, participated in a Focus Group. Mothers were grouped into two groups according to the age of their child(ren): 1) with children between 0 and 1 year of age; 2) with children between 1 and 10 years of age. Several themes were discussed: mothers’ sacrifices and efforts, maternal fatigue and exhaustion, maternal, family and social expectations, and means of prevention. A thematic analysis and a classification analysis were carried out.ResultsThe thematic analysis revealed that exhaustion is partly related to expectations and family and social remarks. The classification analyses showed that mothers’ discourse can be classified into three classes: the first class called “Self-forgetfulness and its consequences” (38.1%); the second class called “The mother as the main manager of the family's daily life” (39.2%) and the third “Social pressure” (22.7%).DiscussionThis exploratory study shows that maternal exhaustion has its origin in the tasks and responsibilities often associated with maternal role as well as in the pressure exerted by family and friends. Although differences exist between mothers in the two groups, several factors appear to be independent of the age of the children. Prevention strategies are discussed in this article.     

The Application of Therapists' Maternal Capacity in Prerepresentational Body-Based Transference and Countertransference

Abstract

The paper explores the maternal capacity of therapists in working with patients for whom developmental deficits render the traditional verbal tools of psychoanalytic treatment ineffective, particularly in the early phases of treatment. Viewed from the perspective of a mother in relation to an infant, the therapist's role is seen as providing a safe holding environment, often in non-verbal ways, for the patient. The capacity of male therapists to access their maternal capabilities is considered. The manifestation of preverbal transference and counter-transference is explored through the presentation of relevant clinical material.     

War trauma and infant motor,cognitive, and socioemotional development: Maternal mental health and dyadic interaction as explanatory processes

BackgroundTaking care of infants in conditions of war is highly demanding and a few studies reveal the negative impact of war trauma on maternal and infant well-being. Yet, little is known regarding the influence of trauma on infant development and the potential explanatory mechanisms. First, the present study examines how mothers’ prenatal exposure to traumatic war events is associated with infant cognitive, motor, and socioemotional development. Second, it analyses the mediating roles of maternal postpartum mental health problems, quality of dyadic mother-infant interaction, and earlier infant development (at six months) in the association between prenatal traumatic war events and infants’ developmental skills at 18 months.MethodThis prospective three-wave study involved 502 Palestinian pregnant females in their first trimester during the 2014 Gaza War and participated at delivery (T1) and when the child was six (T2;N = 392) and eighteen (T3; N = 386) months of age. Mothers reported their exposure to traumatic war events (human and material losses, horrors, and threat to life) at T1 and T2, and researchers photo-documented the extent of destruction at T1. Mothers reported infants’ language, fine- and gross-motor, and socioemotional skills at T2 and researchers tested infants’ motor, cognitive-language and socioemotional skills using the Bayley Scales of Infant development (BSID-II) at T3. Mothers reported their mental health problems (symptoms of post-traumatic stress disorder [PTSD], depression and somatization) at T2 and T3 as well as dyadic interaction quality (the emotional availability self-report, [EA-SR] brief) at T2.ResultsFirst, the structural equation model (SEM) on direct effects indicated, in contrast to our hypotheses, that maternal prenatal exposure to traumatic war events did not associate with infants’ developmental skills at T2 and predicted higher level of developmental skills at T3. Second, as hypothesized, we found two negative underlying mechanisms (paths) between high exposure and low levels of motor, cognitive-language, and socioemotional skills at T3: (1) through increased maternal mental health problems at T2, which then were associated with problems at T3, and (2) through increased maternal mental health problems at T2, which then were associated with a low quality of mother-infant-interaction and low level of infant developmental skills at T2.ConclusionImproving maternal mental health and encouraging close and positive dyadic interaction can be critical for infant sensorimotor, cognitive, and socioemotional development in war conditions.     

A Case Study: A Discussion of Depression,Ambivalence, Attachment,and Culture Portrayed in the Therapeutic Environment

ABSTRACT

This paper uses object relations theory to conceptualize and manage the complexities of a home-based case that was followed for a period of six months. It discusses maternal depression in relation to the caregiver role, self-harm, and self-determination. The client's ambivalence issues are addressed, with particular emphasis on transference and countertransference issues in the relationship and the use of transitional space and objects. Also discussed is the effect of maternal depression and ambivalence on mother-infant attachment, with the introduction of interaction-guidance as a treatment modality. An examination of cultural differences and the concomitant ethical implications that arose in the treatment process is provided. Finally, therapeutic implications and reflexivity are addressed.     

Predictors of age-related and individual variability in autobiographical memory in childhood

ABSTRACT

Development of autobiographical memory is as a gradual process beginning in early childhood and continuing through late adolescence. Substantial attention has been paid to early childhood when first personal memories are formed; less attention has been focused on the flourishing of memories from the late preschool years onward. We addressed this void with a three-year cohort-sequential study of age-related changes in the length, completeness, and coherence of autobiographical narratives by children 4–10 years. We also examined the unique and combined variance in autobiographical narrative explained by children’s own language, maternal narrative style, domain-general cognitive abilities, non-autobiographical story recall, and memory-specific skills. There was substantial growth in autobiographical narrative skill across the 4–10-year period. Non-autobiographical story recall was a strong concurrent and cross-lagged predictor for all autobiographical narrative measures. Memory-specific and domain-general cognitive abilities systematically predicted narrative completeness and coherence but not length. Children’s language and maternal narrative style did not contribute additional variance when these predictors were considered. The findings highlight that age-related changes in autobiographical memory are the results of combined contributions of a variety of domain-general and domain-specific predictors.     

Comparison of fetal and maternal heart rate measures using electrocardiographic and cardiotocographic methods

PurposeTo determine the reliability at term of: (1) two methods of measuring fetal heart rate (HR), electrocardiographic (ECG, the ‘gold standard’) and cardiotocographic (CTG) and (2) two ECG methods of measuring maternal HR variability over relatively brief periods of time (s–min).MethodsDuring 20 min of rest (N = 39) and during 2 min of auditory stimulation (mother's recorded voice, n = 19), fetal HR data were collected using an ECG (Monica AN24) and a Hewlett-Packard Model 1351A CTG. Simultaneously, maternal HR data (n = 37) were collected using the same ECG device (Monica AN24) and a second stand-alone cardiac monitor (Spacelab 514T cardiac monitor with a QRS detector).ResultsDuring 20 min of maternal rest, correlations of individual fetal CTG with ECG measures of HR at each second were moderate to high (r = .57–.97) for 77% of fetuses. Correlations of HR averaged over fetuses and over each of the 20 min were high (r = .93–.97); fetal HR averaged over 20 min varied between devices from 0.0 to 0.8 bpm. During 2 min of maternal voice presentation, correlations of fetal HR over each second were moderate to high (r = .54–.99) for 95% of fetuses and high (all rs = .99) when averaged across fetuses in 30 s or 2 min epochs. Average fetal HR between devices over the 2 min voice varied from 0.0 to 0.6 bpm. Correlations and/or % agreement between the two ECG methods of measuring maternal HR were high. Average maternal HR over 10 min showed 81% of pairs with a difference of ≤1 bpm; correlations for HR variability measures varied from r = .89 to .97.ConclusionsGood reliability was demonstrated between individual spontaneous and auditory induced fetal CTG and ECG with high correlations when HR data were averaged over fetuses or in 30–120 s epochs. High reliability of maternal HR measures was obtained using two ECG devices.     

A new vision of a classical question: How to become a mother?

Abstract

This article offers a reflection on conception, pregnancy, and the first mother–infant relationships of mothers with motoric and sensory disabilities. Based on more than 13 years of experience with women with motoric and sensory disabilities who had a desire for a child, the author analyzes this unusual situation from three different points of view: the medical help to procreate, meeting a partner for the mother, and the link with the initial maternal family, i.e. the mother’s mother. The last part concerns the possibility of the development of a mother–infant relationship when bodily function is lacking.     

Correlation between maternal and infant cortisol varies by breastfeeding status

ObjectiveThe objective of this study was to examine associations of mother and infant salivary cortisol, measured three times over the course of a day, and assess whether these varied by breastfeeding status.MethodsWe conducted a cross-sectional study of 54 mothers and their infants aged 4–11 months. Mothers collected their own saliva and that of their infants upon awakening, 30 min after waking and at bedtime. Breastfeeding status was reported by mothers and cortisol level was measured in saliva in μg/dl using standard techniques. We used generalized linear models to evaluate relationships between maternal and infant cortisol levels, and assessed whether the relationship differed by breastfeeding status: formula only compared to partial and full breastfeeding, adjusting for infant sex, race, age, maternal education, and family income.ResultsThirty-four infants received formula only and 20 were either partially or fully breastfed. Breastfeeding was associated with higher household income, higher maternal education, and white race. Cortisol levels were higher among breastfed infants at all three time points. After adjustment, maternal cortisol levels were related with infant cortisol at bedtime only (regression estimate 0.06; 95% CI: 0.10, 1.1; p = 0.02). The adjusted association between bedtime maternal and infant cortisol was stronger among breastfeeding dyads than among formula-feeding dyads (regression estimate 1.0; 95% CI: 0.1, 2.0; p = 0.04 vs. 0.6; CI: −0.1, 1.3; p = 0.10). In addition, we assessed the influence of maternal education and household income in our adjusted model; income strengthened the observed association, whereas maternal education did not change the estimate.ConclusionsBreastfeeding mothers and infants had significant correlations for cortisol at bedtime, while formula-feeding dyads did not. These data suggest that several factors may contribute to cortisol synchrony observed in mother/infant dyads, including the transfer of cortisol in human milk, physical interaction such as skin-to-skin contact, and shared environment. In addition, our findings support household income as a possible contributor.     

Early attachment quality moderates eating disorder risk among adolescent girls

Objective: There is growing evidence that children’s early relational environment has lasting implications for physical and mental health. In this paper, we test whether attachment insecurity in early childhood is associated with increased responsivity to risk factors for eating disorders (EDs; e.g. pubertal weight gain, maternal negative affect) during adolescence.

Design: Hypotheses were tested with longitudinal data from 447 girls (final mean age?=?15.1?years) over a 12-year period. Tests of direct effects, moderation and moderated mediation were conducted using nested structural equation models and bootstrapped estimates of direct and indirect effects.

Results: Early attachment quality was not directly associated with disordered eating attitudes and behaviours (DEABs), but did moderate relations between adolescent ED risk factors and DEABs. Specifically, among girls with an insecure attachment history, higher BMI at age 15 directly predicted more DEABs, while maternal negative affect and pubertal weight gain indirectly predicted DEABs via greater preoccupation with parental relationships. These same direct and indirect paths did not emerge among adolescent girls with a secure attachment history.

Conclusion: Results delineate one way early attachment quality may contribute to EDs among some adolescent girls, and support recent efforts to incorporate relational components into obesity and ED prevention programmes.     

Development and Evaluation of a Decision Aid About Prenatal Testing for Women of Advanced Maternal Age

Objective: To develop and evaluate a decision aid designed to prepare patients of advanced maternal age for counseling about prenatal diagnostic testing. Setting: A regional genetics center. Design: A before/after study. Interventions: Participants used an audioguided workbook to learn about options and outcomes and to clarify personal risks, values, questions, and predispositions. Subjects: 21 women of advanced maternal age and 17 spouses. Main outcome measures: Knowledge of prenatal testing alternatives, decisional conflict, level of anxiety, and acceptability of the decision aid. Results: After using the decision aid, participants had significantly reduced decisional conflict (uncertainty) and a significant increase in knowledge. There was no effect on state or trait anxiety. More than three-quarters of participants were satisfied with the length, clarity, balance, and acceptability of the decision aid. Conclusions: The decision aid shows promise as a useful aid for preparing couples for counseling.     

Maternal avoidance,anxiety cognitions and interactive behaviour predicts infant development at 12 months in the context of anxiety disorders in the postpartum period

BackgroundFew studies have examined the relation between anxiety disorders in the postpartum period and cognitive as well as language development in infancy.AimsThis longitudinal study investigated whether anxiety disorder in the postpartum period is linked to infant development at twelve months. A closer look was also taken at a possible link between maternal interaction and infant development.Study designSubjects were videotaped during a Face-to-Face-Still-Face interaction with their infant (M = 4.0 months). Specific maternal anxiety symptoms were measured by self-report questionnaires (Anxiety Cognition Questionnaire (ACQ), Body Sensations Questionnaire (BSQ), Mobility Inventory (MI)) to check for a connection with infant development. The Bayley Scales of Infant and Toddler Development-III (Bayley-III) were used to assess infant language and cognitive development at one year of age.Subjectsn = 34 mothers with anxiety disorder (SCID-I; DSM-IV) and n = 47 healthy mothers with their infant.Outcome measuresInfant performance on Bayley-III language and cognitive scales.ResultsInfants of mothers with anxiety disorder yielded significantly lower language scores than infants of controls. No significant group differences were found regarding infant cognitive development. Exploratory analyses revealed the vital role of “maternal avoidance accompanied” in infant language and cognitive development. Maternal neutral engagement, which lacks positive affect and vocalisations, turned out as the strongest negative predictor of cognitive development. Maternal anxiety cognitions and joint activity in mother-infant interaction were the strongest predictors of infant language performance.ConclusionsResults underline the importance to also consider the interaction behaviour of women with anxiety disorders to prevent adverse infant development.     

Postnatal mental health and mothers’ processing of infant emotion: an eye-tracking study

ABSTRACT

Background

Postnatal mental illnesses are associated with less maternal sensitivity. Differences in how mothers with and without mental illness process infant emotions could explain this. People with mental illness in non-perinatal populations show certain processing patterns when viewing emotional faces, but it is not clear whether these patterns are present in mothers.