Coparenting interactions observed by the prenatal lausanne trilogue play: An Italian replication study

The infant–parent interaction is the focus of interest on early interactive relational models in the triadic perspective. This approach considers the mother–father–child interaction as the matrix of early competences, which start to develop well before delivery. This theoretical approach has generated an observation paradigm, the Lausanne Trilogue Play (LTP; E. Fivaz‐Depeursinge & A. Corboz‐Warnery, 1999). The aim of the study was to investigate (a) the psychometric characteristics of coding of the prenatal LTP procedure and their comparison with the Lausanne validation studies and (b) the characteristics of triadic interactions during pregnancy. Ninety‐eight nonreferred, primiparous families were recruited at childbirth courses. In addition to validated questionnaires, observational data were collected at the seventh month of pregnancy in the prenatal LTP. The collected data show good reliability of the LTP coding and a consistent factorial structure in line with the Lausanne validation studies (C. Carneiro, A. Corboz‐Warnery, & E. Fivaz‐Depeursinge, 2006; N. Favez et al., 2006). The Structure of the Play and the Intuitive Parenting Behaviors Scales seem the most representative dimensions in the prenatal period. Coparental abilities during pregnancy represent an interactive matrix for the construction of early family relations and may be considered as protective factors in the child's development of early triadic interactive abilities.     

Prenatal Representations of Family in Parents and Coparental Interactions as Predictors of Triadic Interactions During Infancy

In this study, we explored the predictive role of family interactions and family representations in mothers and fathers during pregnancy for postnatal mother–father–infant interactions during the first 2 years after birth. Families (N = 42) were seen at the fifth month of pregnancy and at 3 and 18 months after birth. During pregnancy, parents were asked to play with their baby at the first meeting by using a doll in accordance with the procedure of the prenatal Lausanne Trilogue Play (LTP; A. Corboz‐Warnery & E. Fivaz‐Depeursinge, 2001; E. Fivaz‐Depeursinge, F. Frascarolo‐Moutinot, & A. Corboz‐Warnery, 2010). Family representations were assessed by administering the Family System Test (T. Gehring, 1998). Marital satisfaction and the history of the couple were assessed through self‐reported questionnaires. At 3 and 18 months, family interactions were assessed in the postnatal LTP. Infant temperament was assessed through parent reports. Results show that (a) prenatal interactions and child temperament are the most important predictors of family interactions and (b) paternal representations are predictive of family interactions at 3 months. These results show that observational assessment of “nascent” family interactions is possible during pregnancy, which would allow early screening of family maladjustment. The findings also highlight the necessity of taking into account paternal representations as a significant variable in the development of family interactions.     

Young infants' triangular communication with their parents in the context of maternal postpartum psychosis: Four case studies

With increasing data on the dynamics of normative couples as they transition to parenthood and become a triad, the need for greater understanding of the impact of parental psychopathology on this transition has become clear. The goal of the current article is to begin exploring this area that has received little attention to date, by describing case examples from a study of clinical families as they transitioned to parenthood. Four representative cases were selected from a pool of 13 mother–father–baby triads, for whom the mother had been hospitalized conjointly with her infant due to a psychotic episode during the postpartum period. The families were observed as part of a clinical consultation that included a semistructured play paradigm known as the Lausanne Trilogue Play (LTP; E. Fivaz‐Depeursinge, & A. Corboz‐Warnery, 1999). Interactions were scored using standardized measures as well as clinical impressions. All families from the clinical sample were noted to struggle and frequently failed to achieve the goals of play. The impact on the infants in terms of their developing sense of self as well as their defensive strategies in this context are discussed, with clinical implications explored.     

The development of the family alliance from pregnancy to toddlerhood and children outcomes at 18 months

This paper presents a longitudinal study of the development of family interactions from pregnancy to toddlerhood. Family interactions are increasingly acknowledged as a predictive factor for children's psychopathological outcomes. We used an observational setting, the Lausanne Trilogue Play, to evaluate the ‘family alliance’, namely, the quality of interactive coordination between family members. Families participated at the 5th month of pregnancy, and at 3‐ and 18‐months after birth. The sample (N=39) consisted of non‐referred primiparous families. Results show that (i) family alliance is stable during the first two years for most families: the quality of prenatal interactions between parents and a baby doll is thus predictive of the subsequent interactions with the actual child; (ii) there are links, but only a few, between family interactions and children outcomes reported by parents. Methodological issues (observation versus self‐reported questionnaires) are discussed. Copyright © 2006 John Wiley & Sons, Ltd.     

The Lausanne Trilogue Play paradigm: Breaking Discoveries in Family Process and Therapy

This article provides a brief history of key developments in the growth of the Lausanne Trilogue Play (LTP) paradigm that paved a foundation for new scholarship featured in the papers that follow. We outline core, foundational elements of the LTP work, highlighting the close interplay between clinical and research applications, the systems orientation in both regards, the dual attention to both top down (metamodel) and bottom up (microanalysis, in particular) frames, and the relevance of transitions from dyad to triad. Next, later developments in methodological refinement and expansion within the LTP’s country-of-origin are described, with closing commentary provided on the path-breaking contributions of several investigations that employed the LTP in five different countries, each illuminating previously under-studied family phenomena. The historical considerations spotlighted in this article, and the lessons learned from new empirical investigations the early work has inspired, are important to consider in tandem as the field begins expanding beyond the LTP’s original foundations and makes increasing use of the paradigm as a research instrument beyond clinical settings.     

The Prenatal Lausanne Trilogue Play: A New Observational Assessment Tool of the Prenatal Co‐Parenting Alliance

The goal of this study is to present a new observational assessment tool, the prenatal Lausanne Trilogue Play situation (LTP). Expectant parents were asked to role play their first meeting with their baby using a doll, and the videotaped interaction was subsequently coded. Scores were correlated with measures of the couples' marital satisfaction as well as the postnatal family alliance 3 months after the baby's birth. Results showed that the prenatal co‐parenting alliance was positively linked to both fathers' marital satisfaction as well as to the postnatal family alliance at 3 months. Thus, the prenatal LTP allows for assessment of the prenatal co‐parenting alliance at the interactional level. It predicts the place the parents will afford their baby after birth and can contribute to methods of clinical assessment and prevention.     

Mother's marital satisfaction associated with the quality of mother‐father‐child triadic interaction

Low marital satisfaction has been shown to be a risk factor for early parenthood and parent‐child relationship problems (Erel & Burman, 1995 ; McHale, 1995 ). The aim of this study was to assess how parental reports of marital satisfaction related to family alliance and coordination in the observed triadic interaction. The study group included 120 families. Marital satisfaction was evaluated during pregnancy, at 4 months, and at 18 months using the Revised Dyadic Adjustment Scale (RDAS; Busby, Christensen, Crane & Larsson, 1995 ) for both parents. Mother‐father‐child interaction was analyzed in the Lausanne Triadic Play setting and coded using the Family Alliance Assessment Scale (Favez, Lavanchy Scaiola, Tissot, Darwiche & Frascarolo, 2011 ) when the child reached 18 months of age. The mother's higher marital satisfaction at every measuring point was associated with a cooperative family alliance and/or higher family coordination at 18 months. The father's experience of marital satisfaction was not related to family interaction at any assessment point. Our study suggests that a mother's experience of lower marital satisfaction during pregnancy may be an early sign of later problems in family relationships.     

Language switching in the bilingual brain: What’s next?

Recent work using functional neuroimaging with early bilinguals has found little evidence for separate neural systems for each language during picture naming (Hernandez, A. E., Dapretto, M., Mazziotta, J., & Bookheimer, S. (2001). Language switching and language representation in Spanish–English bilinguals: An fMRI study. Neuroimage, 14, 510–520). However, switching between languages in early bilinguals during picture naming shows increased activity in the Dorsolateral Prefrontal Cortex (DLPFC) suggesting the importance of maintaining goal related information in order to bias subsequent response selection (Braver, T. S., Barch, D. M., Kelley, W. M., Buckner, R. L., Cohen, N. J., Miezin, F. M., et al. (2001). Direct comparison of prefrontal cortex regions engaged by working and long-term memory tasks. Neuroimage, 14, 48–59; Cohen, J. D., Braver, T. S., & O’Reilly, R. C. (1996). A computational approach to prefrontal cortex, cognitive control and schizophrenia: Recent developments and current challenges. Philosophical Transactions of the Royal Society of London Series B-Biological Sciences, 351, 1515–1527; O’Reilly, R. C., Braver, T. S., & Cohen, J. D. (1999). A biologically based computational model of working memory. In E. Akira Miyake, E. Priti Shah & et al. (Eds.), Models of working memory: Mechanisms of active maintenance and executive control. (pp. 375–411): New York, NY, USA). The current study set out to test early bilinguals using a picture naming paradigm. Results revealed increased activity in the DLPFC and the superior parietal lobule during language switching compared to naming of pictures in a single language. Increased activity was also observed between early learned first and second languages. The results from single language conditions revealed differences in areas devoted to language processing such as the Superior Temporal Gyrus. However, increased activity in brain areas devoted to memory, somatosensory processing and emotion were also observed. Taken together these results replicate previous studies on language switching. They also extend studies on the neural bases of bilingualism by suggesting that early bilinguals’ representation of the two languages may be mediated by neural systems not typically associated with language. The article ends by considering future directions in understanding the brain bases of language switching and single language processing in bilinguals.     

Coparenting in the Context of Mother–Father–Infant versus Mother–Grandmother–Infant Triangular Interactions in Turkey

In this report, coparenting behaviors during triangular interactions among families raising a 3-month-old infant in Turkey are examined. Given the significant role played by extended family members in Turkish culture, coparenting dynamics were examined as mothers and babies played together with grandmothers, as well as together with fathers. Forty-five families took part, and 42 father–mother–baby and 33 grandmother–mother–baby triangular interactions of approximately 10?min in length were filmed during the Lausanne Trilogue Play. From videotapes of the interactions, individual and mutual coparenting behaviors were evaluated using the Coparenting and Family Rating System: 3 Month Adaptation (CFRS3M). Results indicated that while mothers’ own parenting behavior when in the LTP role of Active Parent (AP) was comparable whether with fathers or grandmothers, their behavior when in the LTP role of third party parent (TPP) was comparatively more engaged while with fathers than while with grandmothers. Fathers were comparatively less engaged when occupying the TPP role than were mothers in the TPP role, while grandmothers showed more flirting and distracting behavior in the TPP role than did either fathers or mothers. These findings are significant in documenting meaningful distinctions in Turkish grandmothers’ as well as in Turkish fathers’ and mothers’ coparenting propensities when engaging in triangular interactions with babies during the LTP.     

Is it typical? The ecological validity of the observation of mother-father-infant interactions in the Lausanne Trilogue Play

The Lausanne Trilogue Play (LTP) is a widely used laboratory situation designed for the systematic observation of mother-father-infant interactions for clinical and research purposes. Nevertheless, its ecological validity has never been tested. In this exploratory study, 49 primiparous parents with their 3-month-old infants were assessed by questionnaires to determine the extent to which their behaviour in the LTP was typical, that is, representative of everyday interactions. Results show that (a) most of the parents assessed their behaviour as typical and (b) the quality of triadic interactions was linked with parents’ assessment of the typicality of the infant’s behaviour.     

Coparenting and Toddler's Interactive Styles in Family Coalitions

The current study examined the coparenting and toddler's interactive styles in family coalitions. According to structural family theory, boundaries between generations are clear in alliances, but disturbed in coalitions: the parents look to the child to regulate their conflictual relationship and the child attempts to meet this need. In a normative sample studied longitudinally during the Lausanne Trilogue Play situation (LTP, N=38), 15 coalition cases were detected. Styles of coparenting and of child's interactions were determined and compared in coalition and alliance cases at 18 months. Findings confirm the structural family model by showing the specific ways in which the coparenting and the toddler's interactive styles are associated in 3 different patterns of coalitions: binding, detouring, and triangulation. They illustrate how the child's triangular capacity, or her ability to simultaneously communicate with both parents, is used to regulate the parents' relationship. They suggest that the LTP observational paradigm is a promising assessment method of early family interactions. They point to the importance of assessing early the child's contribution to family coalitions.     

Posttraumatic play in young children exposed to terrorism: An empirical study

The phenomenon of “posttraumatic play” (PTP) has received much clinical recognition and little empirical support. The objective of this study was to examine various aspects of PTP in young children exposed to terror events and their relation to posttraumatic stress disorder (PTSD). Individual play sessions, conducted with 29 young Israeli children directly exposed to terrorism (M age = 5.47, SD = 1.34) and 25 matched unexposed children (M age = 5.62, SD = 0.87), were coded using the Children's Play Therapy Instrument–Adaptation for Terror Research (CPTI‐ATR; S.E. Chazan & E. Cohen, 2003). Analyses using these ratings showed (a) significant differences between the two groups, (b) significant associations with the caregiver's reports on child's exposure, and (c) significant associations with the caregiver's reports on the child's PTSD symptoms. Play activity ratings of predominant negative affects, frequent acting‐out/morbid themes, lowered developmental level, and reduced awareness of the child of him‐ or herself as a player significantly predicted more PTSD symptoms. PTP which included more coping strategies classified as “overwhelmed reexperiencing” and less “reenactment with soothing” was associated with a higher level of PTSD. Play analysis with the CPTI‐ATR may be helpful in identifying PTSD in children and also guide the selection of therapeutic techniques.     

Play with me at my speed: describing differences in the tempo of parent-infant interactions in the Lausanne Triadic Play paradigm in two cultures

The goal of the present study was to examine the tempo of triadic play in Swedish and American families through a comparison of 20 families from each culture. When infants were approximately 3 months old, families in both cultures participated in the Lausanne Triadic Play (LTP), a paradigm that facilitates the examination of the triad as a whole and an organization of its parts. All family play sessions were coded separately in Sweden and America using coding systems that had been developed in each country. Dynamics within the triadic play were compared across cultures, and also across coding systems. Results indicated that both coding systems described a distinct difference in the tempo of play between American and Swedish Families. Overall, although there were many similarities between countries, American families were found to have a faster pace in triadic play than Swedish families. This difference in tempo is explored in the data analyses and the discussion of this article.     

Abstracts

Z ygmond , M. J. and B oorhem , H. (1989) Ethical decision making in Family Therapy. Family Process
A rmsworth , M. W. (1989) Therapy of incest survivors: Abuse or support. Child Abuse and Neglect
W amboldt , F. S. and R eiss , D. (1989) Defining a family heritage and a new relationship identity: Two central tasks in the making of a marriage. Family Process
W ood , W., R hodes , N. and W helan , M. (1989) Sex differences in positive well-being: A consideration of emotional style and marital status. Psychological Bulletin
L ange , A. (1989) The 'help' paradigm in the treatment of severely distressed couples: A combination of paradoxical and problem-solving elements. American Journal of Family Therapy     

Abstracts

Veevers, J. E. (1990) Traumas versus strens: a paradigm of positive versus negative divorce outcomes. Journal of Divorce and Remarriage Kiser, L.J., Pugh, R.J., McColgan, E. B., Pruitt, D. B. and Edwards, N. B. (1991) Treatment strategies for victims of extra-familial child sexual abuse. Journal of Family Psychotherapy Bloch, S., Sharpe, M. and Allman, P. (1991) Systemic family therapy in adult psychiatry. British Journal of Psychiatry Crisp, A. H., Norton, K., Gowers, S., Halek, C., Bowyer, C., Yeldham, D., Levett, G. and Bhat, A. (1991) A controlled study of the effect of the therapies aimed at adolescent and family psycho-pathology in anorexia nervosa. British Journal of Psychiatry Dunn, J. and Plomin, R. (1991) Why are siblings so different? The significance of differences in sibling experiences within the family. Family Process     

Traumatic stress, perceived global stress, and life events: prospectively predicting quality of life in breast cancer patients.

The authors investigated the relationship between stress at initial cancer diagnosis and treatment and subsequent quality of life (QoL). Women (n = 112) randomized to the assessment-only arm of a clinical trial were initially assessed after breast cancer diagnosis and surgery and then reassessed at 4 months (during adjuvant treatment) and 12 months (postadjuvant treatment). There were 3 types of stress measured: number of stressful life events (K. A. Matthews et al., 1997), cancer-related traumatic stress symptoms (M. J. Horowitz, N. Wilner, & W. Alvarez, 1979), and perceived global stress (S. Cohen, T. Kamarck, & R. Mermelstein, 1983). Using hierarchical multiple regressions, the authors found that stress predicted both psychological and physical QoL (J. E. Ware, K. K. Snow, & M. Kosinski, 2000) at the follow-ups (all ps < .03). These findings substantiate the relationship between initial stress and later QoL and underscore the need for timely psychological intervention.     

Book Reviews

Books reviewed:
Inga-Britt Krause, Culture And System In Family Therapy
James, P. McHale and Wendy, S. Grolnick, Retrospect and Prospect in the Psychological Study of Families
E. Mavis Hetherington and John Kelly, For Better or For Worse, Divorce Reconsidered
Elena L. Grigorenka and Robert J. Sternberg, Family Environment and Intellectual Functioning: A Life-Span Perspective
Charles E. Schafer and Steven E. Reid, Game Play: Therapeutic Use of Childhood Games
David Campbell and Barry Mason, Perspectives on Supervision
Carmel Flaskas, Family Therapy Beyond Postmodernism     

Abstracts

K orner , S. and B rown , G. (1990) Exclusion of children from family psychotherapy: Family therapists' beliefs and practices. Journal of Family Psychology
S charff , J.S. (1989) Play with young children in family therapy: An extension of the therapist's holding capacity. Journal of Psychotherapy and the Family
H alperin , S. M. (1989) A neglected triangle: Grandmother, mother, and daughter. Contemporary Family Therapy: An International Journal
W ojcik , J.V. and I verson , E.R. (1989) Therapeutic letters: The power of the printed word. Journal of Strategic and Systemic Therapies
C assano , D.R. (1989) Multi-family group therapy in social work practice. Social Work with Groups
R oberts , M., C aesar , L., P erryclear , B. and P hillips , D. (1989) Reflecting team consultations. Journal of Strategic and Systemic Therapies
W arner , M.S. (1989) Empathy and strategy in the family system. Person Centered Review
D e B ord , J.B. (1989) Paradoxical interventions: A review of the recent literature. Journal of Counseling and Development
C ole , D.A. and J ordan , A.E. (1989) Assessment of cohesion and adaptability in component family dyads: A question of convergent and discrimimant validity, Journal of Counseling Psychology
M usante , L., T reiber , F.A., S trong , W.B. and L ecy , M. (1990) Individual and cross-spouse correlations of perceptions of family functioning, blood pressure and dimensions of anger. Journal of Psychosomatic Research     

The Development of Family Alliance From Pregnancy to Toddlerhood and Child Outcomes at 5 Years

This article presents a longitudinal study of the development of “family alliance” from pregnancy to toddlerhood in a community sample, as well as its links with the emotional and cognitive development of the child at age 5 years. Family alliance is defined as the quality of the interactive coordination between family members. We consider that the alliance constitutes a context for the child to learn emotion regulation and to develop an understanding of inner states. Family interactions (N = 38) were observed at the 5th month of pregnancy and at 3, 9, and 18 months after birth in a standardized situation of observation (Lausanne Trilogue Play). Marital satisfaction and child temperament were assessed through self‐reported questionnaires. Several outcomes of the child at age 5 years were measured: theory of mind performances, predominant emotional themes in pretend play, internalized and externalized symptoms. Results show that (a) three patterns of evolution of family alliance occur: “high stable” (n = 19), “high to low” (n = 10), and “low stable” (n = 9); (b) a high stable alliance is predictive of better outcomes in children at age 5 years, especially regarding theory of mind; (c) the temperament of the child is predictive of child outcomes; and (d) an interaction effect occurs between family alliance and temperament. These results highlight the importance of both family‐level and individual‐level variables for understanding individual differences in the social and cognitive development of children.     

Re: Views

Book reviewed in this article: Asking Questions: A Practical Guide to Questionnaire Design Seymour Sudman and Norman M. Bradburn The Substance Abuse Problems Sidney Cohen, M.D. Career Development in the 1980s: Theory and Practice David H. Montrose and Christopher J. Shinkman Family Therapy in Pastoral Ministry J.C. Wynn