DISORGANIZATION,FEAR AND ATTACHMENT: WORKING TOWARDS CLARIFICATION

In 1990, M. Main and J. Solomon introduced the procedures for coding a new “disorganized” infant attachment classification for the Ainsworth Strange Situation procedure (M.D.S. Ainsworth, M. Blehar, E. Waters, & S. Wall, 1978). This classification has received a high degree of interest, both from researchers and from child welfare and clinical practitioners. Disorganized attachment has primarily been understood through the lens of E. Hesse and M. Main's concept of “fright without solution,” taken to mean that an infant experiences a conflict between a desire to approach and flee from a frightening parent when confronted by the Strange Situation. Yet, looking back, it can be observed that the way Hesse and Main's texts were formulated and read has generated confusion; there have been repeated calls in recent years for renewed theory and clarification about the relationship between disorganization and fear. Responding to these calls, this article revisits the texts that introduced the idea of fright without solution, clarifying their claims through articulating more precisely the different meanings of the term fear. This clarified account will then be applied to consideration of pathways to infant disorganized behaviors.     

IMPLEMENTATION OF AN EVIDENCED‐BASED PARENTING PROGRAM IN A COMMUNITY MENTAL HEALTH SETTING

The process of mental health intervention implementation with vulnerable populations is not well‐described in the literature. The authors worked as a community‐partnered team to adapt and pilot an empirically supported intervention program for mothers of infants and toddlers in an outpatient mental health clinic that primarily serves a low‐income community. We used qualitative ethnographic methods to document the adaption of an evidence‐based intervention, Mothering from the Inside Out, and the pilot implementation in a community mental health clinic. Seventeen mothers and their identified 0‐ to 84‐month‐old children were enrolled in the study. Key lessons from this implementation include (a) the importance of formative work to build community relationships and effectively adapt the intervention to meet the needs of the therapists and their clients, (b) the importance of designing plans for training and reflective supervision that fit within the flow of the clinic and can tolerate disruptions, and (c) that use of an interdisciplinary approach is feasible with the development of a plan for communication and the support of a trained reflective clinical supervisor. These key lessons advance the scientific knowledge available to healthcare managers and researchers who are looking to adapt mental health clinical interventions previously tested in clinical trials to implementation in community settings.     

PREDICTORS OF SELF‐REPORTED GAINS IN A RELATIONSHIP‐BASED HOME‐VISITING PROJECT FOR MOTHERS AFTER CHILDBIRTH

We assessed mothers’ self‐reported gains from a postpartum home‐visiting (HV) project in which home visitors are volunteer mothers from the community. Hypotheses were that gains are positively related to (a) mothers’ felt‐closeness with their home visitor, (b) mothers’ level of sociodemographic risk, and (c) the home visitors’ preproject training in support services for families or children (Professionalism). One hundred sixty‐four clients returned written evaluations of the HV project. Items assessing gains were reduced to two factors: Improved Well‐Being (“Self”) and Improved Infant Care (“Infant”). Repeated measures general linear models, with Gains (Self, Infant) as the repeated measure, and multiple regression analyses evaluated the hypotheses. Across the sample, gains on both factors were moderate, although gain scores were higher regarding Self than for Infant. Results show that (a) Mothers’ felt‐closeness with their volunteer was strongly related to mothers’ gains; (b) high‐risk mothers gained more from the project than did mothers of lower risk, particularly regarding Infant Care; and (c) mothers visited by volunteers who were professionals reported more substantial gains than did mothers visited by volunteers who were not professionals. Findings can help explain variance in mothers’ gains from such projects and could be useful in improving their efficacy.     

FOOD NEGLECT AND INFANT DEVELOPMENT

The impact of food insecurity on child development in the general U.S. population is well‐established, yet little is known about the harm of food neglect relative to other types of maltreatment. Due to the harmful physiological impact of inadequate nutrients and the social impact of food‐related stress, it was hypothesized that food neglect would be more likely to impair infant cognitive and language development than physical abuse, sexual abuse, and other forms of neglect. Families of infants (N = 1,951) investigated by Child Protective Services were studied using the second cohort of the National Survey of Child and Adolescent Well‐Being (NSCAW II; NSCAW Research Group, 2002). Results from multivariable logistic regression models that controlled for likely confounding variables showed that the odds of impairment in cognition and language were significantly greater when food neglect was the most serious form of maltreatment. Considering that both food insecurity and child neglect are associated with poverty and parental mental health problems, it will be important for child welfare and mental health professionals to work collaboratively to better the health of these vulnerable children.     

ROLE OF FIRST‐YEAR MATERNAL EMPLOYMENT AND PATERNAL INVOLVEMENT IN BEHAVIORAL AND COGNITIVE DEVELOPMENT OF YOUNG CHILDREN

Drawing on economic models of child development and attachment relationship perspectives, this study examined the effect of maternal employment in the first year after childbirth on subsequent behavioral and cognitive development in low‐income children. Analyses of data from the Project on Human Development in Chicago Neighborhoods (N = 411) revealed that despite the accompanying family income gains, maternal employment in the first year after childbirth adversely affected caregiver‐reported internalizing and externalizing behavior problems of Hispanic, Black, and White children at ages 3 and 5 years. This study also examined how paternal participation in childcare might affect children's outcomes. Results indicate that greater paternal participation eased the adverse impacts of maternal employment on internalizing behavior problems. There was no evidence that maternal employment was associated with children's memory cognitive functioning or that paternal involvement moderated children's cognitive development. These findings suggest that when early intervention programs are designed to assist low‐income families, enhancing supports (e.g., paternal involvement or parental leave) for working mothers during their child's first year may be valuable for young children's healthy development.     

A THERAPEUTIC PLAYGROUP FOR DEPRESSED MOTHERS AND THEIR INFANTS: FEASIBILITY STUDY AND PILOT RANDOMIZED TRIAL OF COMMUNITY HUGS

Symptoms of depression negatively impact on mother?infant relationships and child outcomes. We evaluated a novel, 10‐session mother?infant therapeutic playgroup—Community HUGS (CHUGS)—which combines cognitive and experiential components through psychoeducation, play, music, and movement. Participants were mothers experiencing a range of postnatal mental health difficulties, including depression, with infants ≤12 months of age. However, the aim was not to treat maternal depression but to ameliorate associated problems in the mother?infant interaction. In the feasibility study, all participants received CHUGS. In the pilot randomized controlled trial (RCT), participants were randomized between intervention and a wait‐list. Outcomes were the Parenting Stress Index (PSI; R.R. Abidin, 1995), Parenting Sense of Competency Scale (Self‐Efficacy subscale; J. Gibaud‐Wallston & L.P. Wandersman, 1978), and the Depression, Anxiety, Stress Scales (P.F. Lovibond & S.H. Lovibond, 1995). In the feasibility study (n = 74), PSI scores dropped on all subscales, all ps < .01. Depression, p < .001, anxiety, p = .01, stress, p = .01, and self‐efficacy, p < .001, all showed improvements, as did observer‐rated mother?infant interactions, p < .001. In the RCT, depression, p < .001, anxiety, p = .005, and stress, p < .001, symptoms were significantly reduced for intervention participants (n = 16), as compared to wait‐list participants (n = 15). The CHUGS program had high participant satisfaction and produced improvements in self‐efficacy, depression, anxiety, stress, and mother?infant interactions that supported the program's acceptability and the utility of further rollout.     

TEMPERAMENTAL ADAPTABILITY,PERSISTENCE, AND REGULARITY: PARENTAL RATINGS OF NORWEGIAN INFANTS AGED 6 TO 12 MONTHS,WITH SOME IMPLICATIONS FOR PREVENTIVE PRACTICE

There is a need for standardized measures of infant temperament to strengthen current practices in prevention and early intervention. The present study provides Norwegian data on the Cameron‐Rice Infant Temperament Questionnaire (CRITQ; J.R. Cameron & D.C. Rice, 1986a), which comprises 46 items and is used within a U.S. health maintenance organization. The CRITQ was filled out by mothers and fathers at 6 and again at 12 months as part of a longitudinal study of mental health during the first years of life (the “Little in Norway” study, N = 1,041 families enrolled; V. Moe & L. Smith, 2010). Results showed that internal consistencies were comparable with U.S. data. The temperament dimensions of persistence, adaptability, and regularity had acceptable or close‐to‐acceptable reliabilities in the U.S. study as well as in this study, and also were unifactorial in confirmatory factor analysis. These dimensions are the focus in this article. Findings concerning parents’ differential ratings of their infants on the three dimensions are reported, as is the stability of parents’ ratings of temperament from 6 to 12 months. In addition, results on the relation between temperament and parenting stress are presented. The study suggests that temperamental adaptability, persistence, and regularity may be relevant when assessing infant behavior, and may be applied in systematic prevention trials for families with infants. The inclusion of concepts related to individual differences in response tendencies and regulatory efforts may broaden the understanding of parent—infant transactions, and thus enrich prevention and sensitizing interventions with the aim of assisting infants’ development.     

IMPACT OF REFLECTIVE SUPERVISION ON EARLY CHILDHOOD INTERVENTIONISTS’ PERCEPTIONS OF SELF‐EFFICACY,JOB SATISFACTION,AND JOB STRESS

Despite widespread recognition of the importance of reflective practice in the field of infant mental health, little quantitative research exists regarding the impact of reflective supervision on professionals’ self‐efficacy, job satisfaction, and work‐related stress. Thirty‐three early childhood interventionists received approximately 9 months of reflective supervision and completed pre‐ and post‐assessments of their job‐related stress and self‐efficacy using a modified version of the Reflective Supervision Self‐Efficacy Scales for Supervisees (S. Shea, S. Goldberg, & D.J. Weatherston, 2012). At the post‐assessment, participants also rated their overall experience of reflective supervision. Reported self‐efficacy increased significantly from pre‐ to post‐assessment, and participants reported a positive overall impact of reflective supervision with respect to a variety of indices, such as job satisfaction, professional development, and the ability to cope with job‐related stress. These results provide necessary quantitative data demonstrating a positive impact of reflective supervision on early childhood professionals and suggest the value of reflective supervision for supporting workforce development.     

COGNITIVE AND SOCIOEMOTIONAL FUNCTIONING AT 4½ YEARS IN CHILDREN BORN TO MOTHERS WHO HAVE RECEIVED TREATMENT FOR SUBSTANCE‐ABUSE PROBLEMS WHILE PREGNANT

Cognitive and socioemotional functioning at 4½ years of age were examined in children born to mothers with substance‐abuse problems (n = 22) recruited from residential treatment institutions while pregnant, and then compared to children born to mothers with mental health problems (n = 18) and children from a low‐risk group (n = 26). No significant group differences in cognitive functioning were found, but the children born to mothers with substance‐abuse problems showed more caregiver‐reported socioemotional problems than did the low‐risk children, like the children born to mothers with mental health problems. Birth weight had an effect on internalizing problems at 4½ years and mediated the relation between group and socioemotional problems, although not when controlling for caregiver education, single parenthood, and anxiety and depression. At 4½ years, 7 children born to mothers with substance‐abuse problems were placed in foster care. These children had lower birth weight and higher caregiver‐rated internalizing problems. In addition to emphasizing the importance of the quality of the prenatal environment, this study suggests that families with previous substance abuse are in need of long‐term follow‐up to address socioemotional problems and enhance further positive child cognitive development. The foster‐placed children may be in particular need of long‐term follow‐up.     

Distraction,amnesia, and the next-in-line effect

Two studies use a free recall task to track, moment by moment, cognitive repercussions of an upcoming performance. As in earlier research, subjects display impaired recall for events which immediately precede an anticipated public performance. This “next-in-line effect” occurs even if the “performance” consists of reading a word to oneself. However, subjects show no memory deficit if their performance is not anticipated, and they have generally poor recall if they know they will be performing—but not when. Distraction and amnesia accounts of these recall deficits are discussed. Ancillary findings illuminate the organization of memory in social settings.