Difficult temperament predicts self‐esteem in adolescence

A six‐year longitudinal study investigated the impact of maternal hostile child‐rearing attitudes, role dissatisfaction, and maternal perceptions of adolescent temperamental difficultness on self‐esteem in late adolescence, after controlling for the initial self‐esteem measured in early adolescence. Adolescents (n = 313), derived from the Cardiovascular Risk in Young Finns study, rated their self‐esteem at the study entry at age 12, and six years later at age 18. Maternal reports of child‐rearing attitudes, of role satisfaction, and of the temperament of the adolescent were obtained at the study entry and three years later. Mother's perceptions of adolescent's temperament as difficult at ages 12 and 15 predicted adolescent's self‐reported self‐esteem in late adolescence, whereas earlier self‐esteem did not predict later perceptions of temperament or parenting. We found no evidence that maternal perceptions of parenting indirectly, or after controlling for the initial level, predicted adolescent's self‐reported self‐esteem. Copyright © 2002 John Wiley & Sons, Ltd.     

Clinical Interview for high‐risk Parents of premature infants (CLIP) as a predictor of early disruptions in the mother–infant relationship at the nursery

The relations between mothers' narrative regarding the infant and the premature birth and the quality of mother–infant interaction were examined in mothers of 47 very low birth weight (<1650 g) premature singletons prior to discharge. Maternal representations were assessed with the Clinical Interview for high‐risk Parents of premature babies (CLIP), a semistructured interview that explores mothers' experiences of the pregnancy, delivery, hospitalization period, thoughts and feelings about the infant, and impending discharge. Ten minutes of mother–infant interaction were videotaped, and global and microanalytic codes were used to define three interactive variables: maternal adaptation, maternal touch, and infant withdrawal. Factor analysis of the CLIP items identified two factors with eigen values of 2.00 and above, termed Readiness for Motherhood and Maternal Rejection. Regression analyses were used to predict the three interactive variables by the infant's medical condition, maternal anxiety and depression, and the CLIP factors. Maternal adaptation to the infant's signal and maternal positive touch were each uniquely predicted by the mother's readiness for the maternal role, and were each negatively related to maternal depression. The infant's interactive withdrawal was independently predicted by maternal rejection. The clinical implications of the findings and the potential use of the CLIP for routine detection of early disruptions in the mother–infant relationship are discussed. ©2003 Michigan Association for Infant Mental Health.     

Development of parenting self‐efficacy in mothers of infants with high negative emotionality

Maternal parenting self‐efficacy (PSE) is a potential target for infant mental health interventions because it is associated with a number of positive outcomes for children and mothers. Understanding the development of maternal PSE under conditions of increased parenting stress, such as parenting an infant who is easily distressed and difficult to soothe, will contribute to providing more effective interventions. This study examines the development of maternal PSE in mothers of infants with high negative emotionality (NE). The Neonatal Behavioral Assessment Scale (NBAS; T. Brazelton, 1973 ) was administered twice to 111 infants to select a sample of irritable (n = 24) and nonirritable (n = 29) infants for a prospective study comparing the development of PSE in mothers of infants differing in neonatal NE. Consistent with our hypotheses and previous research, at 8 weeks' postpartum, mothers of irritable infants have significantly lower domain‐specific PSE than do mothers of nonirritable infants. Contrary to our predictions, mothers of irritable infants exhibit a significant increase in domain‐specific and domain‐general PSE from 8 to 16 weeks' postpartum. The implications of these results for infant mental health screening, infant mental health interventions, and research on self‐efficacy theory are discussed.     

Another look inside the gap: ecological contributions to the transmission of attachment in a sample of adolescent mother-infant dyads

Ecological contributions to attachment transmission were studied in a sample of 64 adolescent mother-infant dyads. Maternal sensitivity was assessed when infants were 6 and 10 months old, and infant security was assessed at 15 and 18 months. Maternal attachment state of mind was measured with the Adult Attachment Interview (AAI) after the 1st assessment. Ecological variables considered were maternal education and depression, paternal support, and infant maternal grandmother support. Results indicated that when the contribution of ecological variables was statistically controlled for, sensitivity was a significant mediator and state of mind no longer contributed to infant security. Sensitivity also mediated an association between maternal education and infant attachment, suggesting that attachment transmission is embedded in a more global process of infant attachment development.     

Maternal perinatal mental health: Associations with bonding,mindfulness, and self-criticism at 18 months’ postpartum

The perinatal period is a time of significant transition for women, with changes in maternal mental health from pregnancy to 18 months’ postpartum. This study specifically analyzes maternal self-criticism and mindfulness during pregnancy and at 18 months’ postpartum, and their associations with bonding. A longitudinal study (30 weeks’ gestation–18 months’ postpartum) assessed 32 mother–infant dyads, examining changes in maternal depression, anxiety, self-criticism, and mindfulness. In addition, associations between maternal variables during pregnancy and bonding were investigated. Maternal depression and self-criticism significantly increased from pregnancy to postpartum. Maternal anxiety, self-criticism, and facets of mindfulness during pregnancy were also associated with mother–infant bonding at 18 months. Maternal mental health during pregnancy is subject to change postchildbirth. The lack of control and autonomy accompanying motherhood may result in an increase in self-criticism during this period. Such feelings may elevate a woman's vulnerability to postpartum depression and have consequences for later maternal bonding. Early identification of at-risk mothers is important to increase likelihood of positive outcomes.     

Separation-individuation as a family transactional process in the transition to parenthood

This is a study of the impact of prebirth level of parental and marital individuation on the course of parent-infant and infant development during the first postnatal year. Support was found for the first hypothesis, namely, that a couple's composite individuation profile, taking into account the prebirth separation-individuation of the father and the mother, and their marriage, would be associated with positive infant development and parent-infant transactions related to separation-individuation and mutuality during the first postnatal year. A second hypothesis, that maternal individuation would most strongly predict infant and parent-infant development at 6 months, while paternal individuation would emerge at 1 year as a strong predictor, was not supported. It was found instead that prebirth maternal and paternal individuation were equally strong predictors at six months, while maternal individuation was the primary predictor at 12 months. Other findings on the direct and indirect associations between prebirth parental and marital individuation and postnatal parent-infant transactions suggest that early separation-individuation processes result from a complex configuration of triadic mother-father-infant transactions.     

Infant Developmental Outcomes: A Family Systems Perspective

The aim of the current study was to examine whether parental mental health, parent–infant relationship, infant characteristics and couple's relationship factors were associated with the infant's development. Forty‐two families took part at three time points. The first, at 3 months postpartum, involved a video recorded observation (CARE‐index) of parent–infant interactions. At 5 months postpartum, in‐depth clinical interviews (the Birmingham Interview of Maternal Mental Health) assessed parental mental health and parental perceptions of their relationship with their infant, their partner and their infant's characteristics. Finally, the Bayley Scales III was carried out 17 months postpartum to assess the infants' cognitive, language and motor development. A higher mother–infant relationship quality was significantly associated with more optimal language development, whilst a higher father–infant relationship quality was associated with more advanced motor development. Additionally, maternal postnatal post‐traumatic stress disorder had a negative impact on the infant's cognitive development, whilst maternal prenatal depression was associated with a less optimal infant's language development. The largest prediction was afforded by parental perceptions of their infant's characteristics. The findings indicate that such perceptions may be crucial for the infant's development and imply that negative internal parental perceptions should be considered when assessing risk factors or designing interventions to prevent negative child outcomes. Copyright © 2013 John Wiley & Sons, Ltd.     

Mother–infant behavioral interactions in teenage and adult mothers during the first six months postpartum: Relations with infant development

The purpose of this study was to compare adolescent mothers' (high‐risk group), at‐risk adult mothers' (moderate‐risk group), and no‐risk adult mothers' (low‐risk group) behavioral interactions at one and six months postpartum, and to examine the relationships between maternal behaviors and infant developmental scores on the Bayley scales. Results indicated that high‐risk teenage mothers and moderate‐risk adult mothers vocalized less and had lower contingency rating scores compared to low‐risk adult mothers. Also, infants in the high‐risk and moderate‐risk groups obtained lower mental scores at six months compared to the low‐risk group. Moderate stability across time was found for maternal vocalizations and infant scores on the mental scale. Maternal vocalizations and behavioral contingency rating scores at one month were associated with infants' six‐month performance on the Bayley scales. Specific intervention strategies were discussed with the aim of targeting and improving early maternal behavioral patterns in at‐risk groups. ©2003 Michigan Association for Infant Mental Health.     

Kangaroo mother care and mother‐premature infant dyadic interaction

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

Adolescent individuation in relation to parents and friends: Age and gender differences

The general aim of the study was to examine age and gender differences in various aspects of dependency needs and autonomy strivings of Slovene adolescents in relations to parents and friends. Another research question was whether the components of separation – individuation in relation to parents were related to four aspects of adolescent – friends relationships which resemble some aspects of separation – individuation (i.e., support seeking from friends, friends' idealization, successful separation, fear of losing friends' love). The questionnaires were given to 495 adolescents in Grades 7 to 12. Results showed that early adolescence is a period during which the most prominent changes occur in individuation process. In comparison with other groups, seventh graders showed the highest levels of dependency needs (i.e., high support seeking, high parental idealization). Another group of early adolescents (eighth graders) appeared to be the most ambivalent group as far as individuation towards parents is concerned. A pattern of successful individuation was most evident in the two late adolescent groups. Girls reported greater support seeking and more successful individuation from parents and friends than boys. On the other hand, boys showed more excessive autonomy strivings in their individuation, but they also reported more parental and friends' idealization than girls. We found a support for the thesis about positive associations between the aspects of separation – individuation that are reflected in adolescent – parents and adolescent – friends relations. However, the results also support the thesis that in the case of less satisfactory relations with parents adolescents can compensate for the deprivation of their dependency needs by an increased support seeking in their relations with friends.     

Maternal sensitivity behavior and infant behavior in early interaction

Maternal sensitivity behavior and infant behavior in early interaction were investigated among 57 Finnish mother–child pairs. Their interaction was video‐recorded at home in free‐play situation when the infants were 3 months and 12 months of age, and evaluated using the Parent–Child Early Relational Assessment Scale (PCERA). Maternal sensitivity behavior was mainly related to infant's positive aspects of mood, social and play behavior, and visual contact, both at 3 months and 12 months of age. Even though maternal sensitivity behavior correlated to infant behavior at 3 months and 12 months, infant behavior at 3 months of age contributed to later maternal sensitivity behavior. ©2001 Michigan Association for Infant Mental Health.     

How Do Mothers Feel About Their Very Low Birth Weight Infants? Development of a New Measure

The early relationship between a mother and her very low birth weight (VLBW; <1.5 kg) infant may be difficult to evaluate. Therefore, we aimed to develop a useful and practical method to describe a mother's early relationship with her VLBW infant. Mothers (mean age=27 years, 46% married) of 119 singleton VLBW infants (mean BW=1,056 g, mean GA=28 weeks) admitted to the neonatal ICU at Rainbow Babies and Children's Hospital completed a novel questionnaire regarding their feelings about their infant at 3 weeks' postnatal age, and at 35 weeks', 40 weeks' (term), and 4 months' postmenstrual ages. Factor analysis of initial interview data was used to construct subscales to measure unique domains hypothesized to underpin the beginning maternal–infant relationship. Three subscales were identified: (a) The Worry subscale focuses on the mother's concerns about her infant's current medical condition and future development, (b) the Enjoyment subscale examines the mother's positive feelings about and responsiveness to her infant, and (c) the Separation Anxiety subscale examines the mother's mental anxiety about being physically separated from her infant. Statistical and clinical validation of the subscales produced positive supporting evidence that the subscales are a meaningful measure of the mother–infant relationship. We have developed a unique and practical measure for describing the early mother–VLBW infant relationship.     

PRENATAL AND POSTNATAL MATERNAL REPRESENTATIONS IN NONRISK AND AT‐RISK PARENTING: EXPLORING THE INFLUENCES ON MOTHER–INFANT FEEDING INTERACTIONS

The aim of this study was to investigate the mother–infant relationship in depressive, psychosocial, and cumulative‐risk parenting by assessing prenatal and postnatal maternal representations and mother–infant interactions during feeding at 4 months of age. The sample consisted of 167 mother–infant pairs: 41 nonrisk women, 40 depressive‐risk women, 40 psychosocial‐risk women, and 46 cumulative‐risk women. During pregnancy, the women were interviewed about psychosocial‐risk variables. Maternal representations and depressive symptoms were evaluated during pregnancy and again when the infants were 3 and 4 months old, respectively. All mother–infant pairs were observed in 20‐min video recordings during breast‐feeding. Maternal Integrated/balanced representations were more frequent in the nonrisk group whereas the maternal Nonintegrated/ambivalent category was more represented in the cumulative‐risk group during pregnancy and after the infant's birth. At 4 months, the cumulative‐risk group of mothers and infants showed a lack of reciprocity, conflictual communicative exchanges, and higher food refusal behavior. Moreover, at 4 months, differences between the quality of mother–infant feeding interactions and the quality of prenatal and postnatal maternal representations emerged, showing less adequate maternal scaffolding in the Nonintegrated/ambivalent and Restricted/disengaged women. This study has rich implications for intervention to support the affective and communicative caregiving system and to prevent infant feeding problems and mother–infant relational disturbances in childhood.     

The relation between early mother–infant skin‐to‐skin contact and later maternal sensitivity in South African mothers of low birth weight infants

The relation between early mother–infant skin‐to‐skin contact (SSC) and mothers' subsequent sensitivity to their low birth weight infants was investigated in a study of 12 mother–infant dyads who participated in a South African randomized control study of early SSC. The dyads were visited in the home when infants were under 1 year. Amounts of SSC were taken from hospital records and home interviews. Videotapes of mother–infant interactions in the home were scored for maternal sensitivity on the Maternal Behavior Q‐Sort (D.R. Pederson, G. Moran, & S. Bento, 1999) and the Maternal Behavior subscale of the Nursing Child Assessment Teaching Scale (G. Sumner & A. Spietz, 1994). Amount of SSC in infants' first 24 hr correlated with amount of SSC through the first month. Amount of SSC in infants' first 24 hr independently accounted for maternal sensitivity on both measures, indicating that early mother–infant SSC predicted subsequent maternal sensitivity.     

Adolescents' individuation,romantic involvement,and mothers' wellbeing: A comparison of three family structures

This study compared concurrent as well as longitudinal associations between adolescent development and maternal wellbeing, in nuclear families with both biological parents and in single-mother and stepfather families. It relied on data from the first two waves of a longitudinal study in Germany (N = 436). Maternal wellbeing was assessed from mothers' reports of their sense of family mastery and self-esteem. Adolescent development was assessed from adolescents' reports of three aspects of individuation and of their romantic involvement. For single mothers and mothers in nuclear families, the associations between maternal wellbeing and adolescents' development were inconsistent. Mothers in stepfather families with daughters profited from their daughters' growing detachment. The results suggested that the associations between adolescent development and maternal wellbeing are family structure specific, and observable concurrently and across a one-year time period. The discussion considers the different demands and living situations of the three family structures.     

Evaluating a home‐based dyadic intervention: Changes in postpartum depression,maternal perceptions,and mother–infant interactions

Psychotherapeutic treatments that focus on improving the relational processes between mothers with postpartum depression (PPD) and their infants, as well as the mother's individual therapeutic needs, have a great potential to positively impact the mother, her infant, and their relationship (K.J. Nylen, T.E. Moran, C.L. Franklin, & M. O'Hara, 2006 ). Utilizing pilot data from an evaluation of a home‐based dyadic therapy for mothers with PPD and their infants, this article reports on a recent academic–community partnership study. The effectiveness of the intervention was examined, specifically regarding changes in mother's mood, parenting experience, and relationship with her infant. In addition, associations were examined among maternal self‐report variables measuring change from pre‐ to posttreatment in PPD, psychological distress, and maternal perceptions of parenting and those variables measuring change in observer ratings of maternal–infant interactions. Results showed improvements in mothers' depression, distress, and perceptions of parenting as well as many ratings of mothers' interactions with their infants. However, only improvements in maternal perceptions of parenting, such as maternal self‐esteem and parenting stress, were associated with better mother–‐infant interactions. Importance of this research for the field of infant mental health as well as clinical implications are discussed.     

Timing of Early Maternal Mental Health and Child Cortisol Regulation

Maternal mental health problems can negatively impact children's physiological stress regulation. Yet, little is known of their long‐term effects, especially related to the timing of maternal symptoms. We examined how maternal mental health problems during pregnancy versus in the early postpartum period predict children's cortisol levels and diurnal patterns at 10–12 years. Participants were a selection (N = 102) of an original sample of 805 Finnish families, who were followed from the second trimester of pregnancy (T1) to child's age of 2 months (T2) and 12 months (T3), and again at child's age of 10–12 years (T4). Based on the timing of psychological distress and depressive symptoms (T1–T3), the mothers could be assigned to three distinct mental health trajectory groups: mothers with prenatal mental health problems (n = 15), mothers with early postpartum mental health problems (n = 15) and mothers without mental health problems (n = 72). Children's cortisol (T4) was measured by saliva samples through five within‐1‐day assessments. The results show that maternal prenatal mental health problems predicted a relatively steep increase of child cortisol from awakening to 1 h later, indicating an intensified cortisol awakening response (CAR). Mothers' early postpartum mental health problems instead predicted a reduced CAR. Both maternal prenatal and postnatal mental health problems thus predicted children's later stress regulation, but in unique ways. We discuss the specific roles of direct biochemical effects during pregnancy and postpartum mother–infant interaction quality as modifiers of the hypothalamic–pituitary–adrenal system. Copyright © 2015 John Wiley & Sons, Ltd.     

Evaluation of early relational disturbance in high-risk populations: Borderline personality disorder features,maternal mental state,and observed interaction

Despite the longstanding theoretical association in the attachment literature between maternal trauma history and disturbances in the mother–infant interaction, few studies have investigated mechanisms of transmission of traumatogenic relational patterns in high-risk mother–infant dyads. This study investigated interrelationships among maternal trauma history, distorted maternal representations (DMRs, i.e. disturbed thoughts and feelings about the infant and self-as-parent), maternal mentalisation (i.e. capacity to conceive of self and other's intentions in terms of mental states including thoughts, feelings, and desires), and quality of interaction in a clinical sample of mothers with Borderline Personality Disorder (BPD) features and their infants (N = 61). Measures used included the Childhood Trauma Questionnaire, Parent Development Interview, Mother–Infant Relationship Scale, Borderline Symptom Checklist-23, and the Emotional Availability Scales. The results indicated BPD features mediated the relationship between maternal trauma history and DMRs predicting disturbance in interaction. In addition, analyses showed that maternal mentalisation had a buffering effect between DMRs and maternal non-hostility and yet the severity of BPD features moderated the relationship between mentalisation and DMRs. The findings suggest postpartum borderline pathology may adversely impact the experience of being a parent for women with a relational trauma history including deficits in mentalisation (i.e. hypermentalising) and disturbances in the mother–infant interaction. Implications for research and clinical practice are discussed.     

Perinatal loss and maternal attitudes toward the subsequent child

Twenty-five mothers who had experienced a previous perinatal loss and a comparison group of 30 nonloss mothers completed the Maternal Attitude Questionnaire (MAQ) and the Maternal Separation Anxiety Scale (MSAS) when their children were 16 months old. The purposes of the study were to describe and evaluate the development of a new measure (the MAQ) and to examine the hypothesis that mothers who experienced a perinatal loss would express (a) more concern about the subsequent child's health, (b) more investment in the child, and (c) heightened concern about maternal-child differentiation/separation in comparison to nonloss mothers. The results showed that the MAQ had good internal consistency. None of the three factors of the MSAS differentiated between the two groups of mothers while two subscales of the MAQ did: (1) Maternal Concern with Child's Health and (2) Maternal Concern with Differentiation. Mothers who had experienced a perinatal loss thus expressed more concerns about their children's physical well-being and more concerns about differentiating from their child than mothers who had not had a perinatal loss.