Mind the baby: The role of the nanny in infant observation

The influence of nannies and other significant caregivers on a child's psychological and emotional development may be profound and if unrecognized may contribute to psychopathology in adulthood. However, the significance of the nanny has been relatively neglected within the psychoanalytic literature. In this paper I will discuss the impact of early caregivers other than the biological mother on the psychic development of the child, and the role of the nanny within the family dynamics as a figure attracting powerful unconscious phantasies and unwanted projections. These ideas will be illustrated by a detailed account of a year‐long observation of an infant who had a succession of several different nannies in her first three months before her parents employed a more permanent nanny. It is proposed that the baby's emerging attachments to her two primary caregivers, mother and nanny, developed in parallel and influenced each other, with observable impact on her behaviour and developing personality. The paper concludes with a review of the place of infant observation within psychoanalytic training and how the experience of witnessing the earliest infant‐caregiver relationships in an extra‐analytic setting both refines understanding of developmental theory and builds a foundation for psychoanalytic practice.     

Perceived stress,recurrent pain,and aggregate salivary cortisol measures in mid‐adolescent girls and boys

Measures of perceived stress have been criticized for theoretical inconsistency. However, the validated pressure activation stress scale has been suggested as a theoretically sound alternative. But it is unclear how pressure and activation stress relate to objective and subjective measures including commonly used aggregate cortisol measures and health complaints respectively. Specifically, this study aimed at investigating how pressure and activation stress were related to aggregate salivary cortisol measures and recurrent pain in mid‐adolescent girls and boys. Mid‐adolescents (119 girls and 56 boys) provided self‐reports in questionnaires on activation and pressure stress and recurrent pain (headache, stomach ache, neck/shoulder and back pain). Additionally, adolescents sampled saliva during an ordinary school day: (1) immediately at awakening; (2) 30 minutes after waking up; (3) 60 minutes after waking up, and (4) at 8 p.m. These samples were analyzed for cortisol. Hierarchical regressions showed no statistically significant associations between activation and pressure stress and cortisol, neither for girls nor for boys. However, activation and pressure stress were significantly associated with recurrent pain but only for girls. The findings may relate to subjective and objective measures reflecting distinct aspects of stress‐related functioning. However, the study participants included mid‐adolescents whose bodily systems are flexible and still relatively unaffected by the strain of their daily stress perceptions. To conclude, the non‐significant relationships between activation and pressure stress and commonly used aggregate measures of cortisol adds to the understanding of how perceived stress may relate to physiological functioning in the daily life of adolescents when using such aggregate measures.     

Development of mother–infant interaction in tickling play: The relationship between infants’ ticklishness and social behaviors

This study examined the development of mother–infant tickling interaction and the relationship between infants’ ticklishness and social behaviors including infants’ looking at mothers’ face, mothers’ narrative tickling, and mothers’ laughter. Twenty-two Japanese infants aged 5 months (n = 10, five girls) and 7 months (n = 12, four girls) and their mothers were videotaped. Results revealed that the mothers’ narrative tickling was more frequent at 7 than at 5 months and the infants’ strong ticklishness showed the same tendency. The infants’ strong ticklishness was linked with the occurrence of other social behaviors. In conclusion, infants’ ticklishness was heavily connected with social behaviors. The mode of the tickling interaction at 7 months was different from that at 5 months especially in the increase of mother’s narrative tickling. A possible function of such mother’s narrative tickling to facilitate infant active communication at a higher cognitive level including anticipation, was discussed.     

MATERNAL TRAUMA AFFECTS PRENATAL MENTAL HEALTH AND INFANT STRESS REGULATION AMONG PALESTINIAN DYADS

We examined how diverse and cumulated traumatic experiences predicted maternal prenatal mental health and infant stress regulation in war conditions and whether maternal mental health mediated the association between trauma and infant stress regulation. Participants were 511 Palestinian mothers from the Gaza Strip who reported exposure to current war trauma (WT), past childhood emotional (CEA) and physical abuse, socioeconomic status (SES), prenatal mental health problems (posttraumatic stress disorder and depression symptoms), and perceived stress during their secondtrimester of pregnancy as well as infant stress regulation at 4 months. While all trauma types were associated with high levels of prenatal symptoms, CEA had the most wide‐ranging effects and was uniquely associated with depression symptoms. Concerning infant stress regulation, mothers’ CEA predicted negative affectivity, but only among mothers with low WT. Against hypothesis, the effects of maternal trauma on infant stress regulation were not mediated by mental health symptoms. Mothers’ higher SES was associated with better infant stress regulation whereas infant prematurity and male sex predisposed for difficulties. Our findings suggest that maternal childhood abuse, especially CEA, should be a central treatment target among war‐exposed families. Cumulated psychosocial stressors might increase the risk for transgenerational problems.     

The role of stressful life events on the cortisol reactivity patterns of breast cancer survivors

Objective: Atypical patterns of cortisol secretion following an acute stressor have been commonly reported in breast cancer survivors. Stressful life events have been associated with blunted acute cortisol levels in other populations. The purpose of this study was to explore the role of stressful life events on cortisol secretion patterns of breast cancer survivors following an acute stressor.

Design: The Trier Social Stress (TSST) was used to elicit a moderate stress response in breast cancer survivors (n = 19) and a control group (n = 17). Saliva samples were collected before, during and after the TSST to provide cortisol concentrations. During recovery, we recorded the frequency and subjective impact of stressful life events in the past year using the Life Experience Survey.

Results: Simple regressions analyses were performed; results suggest no group differences between the total number of stressful life events and their subjective impact. However, the total number of stressful life events as well as their subjective impact correlated negatively with the peak cortisol concentration in breast cancer survivors.

Conclusions: The cumulative effect of stressful life events, positive and negative, may impact the endocrine stress system of breast cancer survivors more so than that of women with no history of cancer.     

Consistency in physiological stress responses and electromyographic activity during induced stress exposure in women and men

Physiological responses serve the role as objective indicators of stress as well as a link between psychosocial stress and various health outcomes. The aim of the present exposure session was to compare different physiological stress responses (systolic and diastolic blood pressure, heart rate, urinary epinephrine and norepinephrine, salivary cortisol) as well as trapezius muscle activity, measured by surface electromyography, during mental and physical stress in 11 women and ten men. The results show significantly increased activity in all measures but cortisol and significant associations between sympathetic arousal and EMG activity. The association between sympathetic arousal and muscle activity is of importance for understanding the high prevalence of musculoskeletal disorders in mentally stressful but physically light work tasks. Men had higher blood pressure and a more pronounced increase in epinephrine output than women, whereas women had higher heart rate. It was concluded that sympathetic activity is more sensitive to moderately intense stress exposure than pituitary adrenocortical (cortisol) activity and that men respond to performance stress with more epinephrine output than women. Although the correlations between the different indicators of sympathetic arousal were high, together they could still only explain 30–70% of the inter-individual variance. Thus, several parameters are needed in order to obtain a reliable measure of sympathetic activity.     

Hierarchy of interactive functions in father‐mother‐baby three‐way games

In developmental research, the family has mainly been studied through dyadic interaction. Three‐way interactions have received less attention, partly because of their complexity. This difficulty may be overcome by distinguishing between four hierarchically embedded functions in three‐way interactions: (1) participation (inclusion of all participants), (2) organization (partners keeping to their roles), (3) focalization (sharing a common focus) and (4) affective contact (being in tune). We document this hierarchical model on a sample of 80 families observed in the Lausanne Trilogue Play situation across four different sites. Hierarchy between functions was demonstrated by means of Guttman scalability coefficient. Given the importance of the child's development in a threesome, the pertinence of this model for family assessment is discussed. Copyright © 2004 John Wiley & Sons, Ltd.