Intersubjective disruptions and caregiver–infant interaction in early Autistic Disorder

The objective of this study was to describe intersubjective attitudes in infants who are later diagnosed with autism and to provide information about caregiver's behaviors during early spontaneous interactions. Interactive sequences from 42 home-movies (HM) from the first 18 months of life of three groups of children – non-regressive Autistic Disorder (AD; n. 15), Mental Retardation (MR; n. 12), or Typical Development (TD; n. 15) – were organized in three semester of age (T1; T2; T3) and analyzed through the Infant and Caregiver Behavior Scale (ICBS) using the Observer 4.0^®. Rate and duration of ICBS items were explored at each time by Anova with group as between factor. Discriminant analysis was also used. TD, compared to both AD and MR, had higher score at T1 on the duration of ‘Syntony’, and at T2 on ‘Accepting invitation’ and ‘Maintaining social engagement’. At T2 ‘Orienting to name’ d9/27/2010ifferentiates TD from AD. At T3 some items differentiate TD from AD while on other items AD shows significant lower scores compared to MR. ‘Regulation down’ is able to correctly identify between AD and MR both at T1 and at T3. In AD there is a progressive disruption of the temporal structure of moments of interpersonal exchange. Difficulties in intersubjective behaviors are sensitive at an early age and become specific after the first birthday. The less amount of caregiver's ‘regulation down’ is discussed in relation of the infant's lack of spontaneous intersubjective acts.     

Hair cortisol in mother–child dyads: examining the roles of maternal parenting and stress in the context of early childhood adversity

European Child & Adolescent Psychiatry - Physiological stress is thought to be one way that early adversity may impact children's health. How this occurs may be related to parental factors...     

A role for the microbiome in mother–infant interaction and perinatal depression

Abstract

Perinatal depression is a significant public health problem, due to its negative impact on maternal well-being and long-term adverse effects for children. Mother–infant interaction and maternal responsiveness and sensitivity are a hypothesized mechanism by which perinatal depression effects child development, and increasing research in the microbiota–gut–brain axis may provide a new avenue of investigation. There is limited efficacy for treatment of perinatal depression for improving the mother–infant relationship and child outcomes. The maternal microbiota may be the basis of child outcomes through foetal programming and sharing of microbes between mother and infant. There is evidence that less diversity of the intestinal microbial community is associated with neuropsychiatric disorders, including depression and anxiety in mothers and offspring. Assessing the maternal and child’s microbial communities may be an important missing component in mother–infant attachment-based therapies during treatment of perinatal depression. Probiotics and prebiotics require further research as additions to mother–infant interventions. Further research may enable identification of bacterial genes that indicate specific pathways that could be targeted to improve outcomes for mother and child.     

Antenatal mental representations about the child and mother–infant interaction at three months post partum

OBJECTIVE: To study the predictive value of antenatal maternal mental representations about the child for mother-infant interaction at three months after birth. PROBANDS: A total of 73 pregnant women attending a routine ultrasound examination during the third trimester, who agreed to return with their baby for the interaction study. METHODS: Antenatally a questionnaire for assessing maternal representations about the child was given to the mothers. Also, depression and pregnancy risk were assessed. At three months, mother and infant were video-taped during a 4-phase interaction. Interaction analysis was performed using the Munich Communication Diagnostic Scale. RESULTS: Overall maternal regulatory ability was predicted by a compound factor comprising the antenatal representations. Maternal interactive behavior was not predicted by antenatal representations about the child. Infant overall eye contact was predicted by maternal representations as was interaction readiness during the still-face period. Significant covariates were maternal age, education, parity and the Pregnancy Optimality Score as well as neurologic optimality of the infant. CONCLUSION: Antenatal maternal representations about the child predicted parental regulatory ability and infant interaction behavior especially during the still-face period.     

Mother to infant or infant to mother? Reciprocal regulation of responsiveness to stress in rodents and the implications for humans

Optimal early development in most species is dependent upon a stable relationship between the mother and her infant. The research described here focuses on the reciprocal nature of this dyad in rodents and humans, with respect to the regulation of responsiveness to stress in both mother and offspring. Dietary influences are critical not only to regulate infant growth but also to modulate the response of the neuroendocrine system to stress and, possibly, to influence some aspects of brain development. In particular, we discuss the role of leptin, a protein produced in the adipose tissue and present in maternal milk, that reduces responses to stress in the infant. We suggest that leptin acts on both central (hypothalamus and hippocampus) and peripheral (pituitary, adrenal gland) targets in the infant to reduce exposure to glucocorticoids and enhance hippocampal development during a sensitive period of brain development. There is also evidence to support the reverse regulatory influence, in which maternal state is profoundly affected by stimulation from the young. During the period of lactation, mothers exhibit lower neuroendocrine and behavioural responses to several types of stressors, except possibly those representing a threat to the infant. This ability to "filter" relevant from irrelevant stimuli while caring for their young might be viewed as adaptive for the mother-infant dyad, and the inability to filter adequately stressful stimuli could at least in part be associated with the development of postpartum depression.     

Perinatal depression,PTSD, and trauma: Impact on mother–infant attachment and interventions to mitigate the transmission of risk

Abstract

Early interactions between infants and their caregivers are fundamental to child development, and the parent–infant relationship is believed to provide the foundation for healthy and secure attachment relationships and for infant mental health. Over time, these secure attachment relationships become the backbone for positive child outcomes across development. Abundant research to date confirms that parental mental illness, including depression and PTSD following trauma exposure, may have a detrimental impact on parenting quality and subsequent early child relationship formations. This review paper summarizes the literature on the role of sensitive parenting and a healthy mother–infant relationship in establishing a secure mother–infant attachment bond, which in turn is critical for the child’s healthy socioemotional and cognitive development. The review also highlights the roles of maternal perinatal depression, PTSD, and/or exposure to interpersonal violence or childhood maltreatment onto parenting, bonding, and child attachment style towards the caregiver. The final section discusses existing therapeutic interventions and approaches that bolster early parenting practices and early maternal–child relationships. Specific emphasis is placed on relational interventions that address bonding and attachment disturbances in the context of maternal perinatal mental health risk and trauma.     

Ethnic differences in prevalence and determinants of mother–child bed-sharing in early childhood

Background

To date few studies have examined how multiple layers of influences shape the emergence of bed-sharing practices in the first 2 years postpartum. In our report, we examined bed-sharing in a large multiethnic sample, exploring the influences of three broad classes of influence on bed-sharing at single time points and across time: (1) sociodemographic and (2) contextual factors such as breastfeeding, maternal mental health and stress, and (3) child temperament and sleep habits.

Methods

Frequencies of bed-sharing were assessed at two time points, 2 and 24 months, in a population-based multiethnic (Dutch, Turkish or Moroccan, and Caribbean) sample of 6309 children born in the Netherlands.

Results

In Dutch mothers, the majority of mothers did not share their beds with their child, and bed-sharing rates decreased from 2 to 24 months. Other ethnic groups showed higher bed-sharing rates, typified by both increases in bed-sharing (the Turkish and Moroccan group) and persistence of bed-sharing over time (the Caribbean group). There were few family and child characteristics associated with bed-sharing in the non-Dutch ethnic groups. In contrast, bed-sharing in Dutch mothers was associated with child temperament and sleeping problems, maternal depression, and sociodemographic variables like crowding and maternal education.

Conclusions

Our results suggest that mothers with a Turkish and Moroccan or Caribbean background were more influenced by cultural values, whereas bed-sharing practices were more reactive in the Dutch group.     

Different,difficult or distinct? Mothers' and fathers' perceptions of temperament in children with and without intellectual disabilities

Background Can ratings of temperament be a way of identifying young children with intellectual disabilities (ID) who are at risk for being experienced as difficult? We aimed to explore parents' reports of temperament in their young children with or without ID, as well as positive and negative impact of the child on parents. Method Mothers and fathers of 55 children recently diagnosed with ID and 183 age‐matched typically developing (TD) children completed the EASI Temperamental Survey and two scales of the Family Impact Questionnaire measuring positive and negative impact of the child on parents. Results Parents rated children with mixed ID/DD (developmental delay) as shyer and more impulsive, and less active and sociable when compared with TD children. Children with mixed ID/DD were also reported to have more negative and less positive impact on the family compared with the TD group. In subgroup analyses, children with Down syndrome and cerebral palsy/motor impairment were described as having less negative impact on parents and were described as low in negative emotionality. Children with autism spectrum disorder (ASD), ID/DD nos and other less common diagnoses had a similar pattern of temperament with high emotionality, shyness and impulsivity, and low activity and sociability. Parents of children with ASD and ID/DD reported the highest level of negative impact. Conclusions Temperamental characteristics such as high negative emotionality and impulsivity, which can be identified earlier than behavioural problems, could be indicators of negative impact on parents of young children with ID. Despite great variability in temperament among children with mixed ID/DD, results indicated common temperamental characteristics among children with ASD, ID/DD and other diagnosis.     

Identity–expression interaction in face perception: Sex,visual field,and psychophysical factors

We investigated the psychophysical factors underlying the identity–emotion interaction in face perception. Visual field and sex were also taken into account. Participants had to judge whether a probe face, presented in either the left or the right visual field, and a central target face belonging to same person while emotional expression varied (Experiment 1) or to judge whether probe and target faces expressed the same emotion while identity was manipulated (Experiment 2). For accuracy we replicated the mutual facilitation effect between identity and emotion; no sex or hemispheric differences were found. Processing speed measurements, however, showed a lesser degree of interference in women than in men, especially for matching identity when faces expressed different emotions after a left visual presentation probe face. Psychophysical indices can be used to determine whether these effects are perceptual (A’) or instead arise at a post-perceptual decision-making stage (B”). The influence of identity on the processing of facial emotion seems to be due to perceptual factors, whereas the influence of emotion changes on identity processing seems to be related to decisional factors. In addition, men seem to be more “conservative” after a LVF/RH probe-face presentation when processing identity. Women seem to benefit from better abilities to extract facial invariant aspects relative to identity.     

Assessment of early mother–child relation in infants with oesophageal atresia

Fifteen one-year old infants with oesophageal atresia and their parents were used to demonstrate how the Parent–Child Early Relational Assessment (PCERA) can be used to explore the mother–child interaction in a clinical sample of children. The infants and their mothers were videotaped for 5-min episodes during feeding and free play, and the quality of the mother–infant interactions was assessed by PCERA. The results showed areas of strength regarding most of the maternal, infant and dyadic components. There was concern about maternal positive physical contact, maternal quality of verbalizations to or about the child, maternal social initiative, infant's communicative competence and infant's visual contact with mother. This concern of social proximity between infants and their mothers was most prominent in the feeding situation. The present study indicates that oesophageal atresia in infants may constitute stressors impinging on the parent–infant relationship. PCERA was found to be an adequate assessment tool with acceptable reliability to evaluate the mother–infant interaction.     

Maternal parenting styles and mother–child relationship among adolescents with and without persistent attention-deficit/hyperactivity disorder

We investigated mothering and mother–child interactions in adolescents with and without persistent attention-deficit/hyperactivity disorder (ADHD) in a sample of 190 adolescents with persistent DSM-IV ADHD, 147 without persistent ADHD, and 223 without ADHD. Both participants and their mothers received psychiatric interviews for diagnosis of ADHD and other mental disorders; and reported on the Parental Bonding Instrument about mother's parenting style, the Social Adjustment Inventory for Children and Adolescents for interactions with mothers and home behavioral problems. The mothers also reported on their ADHD and neurotic/depressive symptoms. Our results based on both informants showed that both ADHD groups obtained less affection/care and more overprotection and control from the mothers, and perceived less family support than those without ADHD. Child's inattention and comorbidity, and maternal depression were significantly correlated with decreased maternal affection/care and increased maternal controls; child's hyperactivity–impulsivity and maternal neurotic trait were significantly correlated with maternal overprotection; and child's inattention and comorbidity, and maternal neurotic/depressive symptoms were significantly correlated with impaired mother–child interactions and less family support. Our findings suggested that, regardless of persistence, childhood ADHD diagnosis, particularly inattention symptoms and comorbidity, combining with maternal neurotic/depressive symptoms was associated with impaired maternal process.     

Construct validity of the Parent–Child Sleep Interactions Scale (PSIS): associations with parenting,family stress,and maternal and child psychopathology

Study objectivesUsing a multi-method design, this study examined the construct validity of the Parent–Child Sleep Interactions Scale (PSIS; Alfano et al., 2013), which measures sleep-related parenting behaviors and interactions that contribute to preschoolers’ sleep problems.MethodsParticipants included a community sample of 155 preschoolers (ages 3–5 years; 51.6% female). Primary caregivers completed the PSIS. Parenting styles and behaviors were assessed with laboratory observations and parent reports. Parent and child psychopathology and family life stress were assessed with clinical interviews and parent reports.ResultsBivariate correlations revealed significant associations between the PSIS and a number of variables, including lower observed parental support and quality of instruction; higher observed parental intrusiveness; authoritative, authoritarian, and permissive parenting styles; current maternal depressive and/or anxiety disorders and depressive symptomatology; increased stressful life events; lower marital satisfaction; and higher child depressive, anxiety, attention-deficit/hyperactivity disorder (ADHD), and oppositional defiant disorder (ODD) symptoms. The patterns of association varied based on the specific PSIS scale.ConclusionsThe PSIS demonstrates meaningful associations with parenting, maternal psychopathology, family stress, and child psychopathology and functioning. Findings suggest that the PSIS is a valid measure for assessing sleep-related parent/child behaviors and interactions among preschoolers, suited to real-world settings.     

When is an assessment an intervention? Parent perception of infant intentionality and language

OBJECTIVE: To determine whether the process of having parents rate their infant's intentionality and language using parent-report questionnaires influences parents' tendency to view infants as intentional or linguistic. METHOD: The Infant Intentionality Questionnaire (IIQ) and the MacArthur Communicative Development Inventories (CDI) were administered to three groups of mothers. Forty mothers completed the interviews longitudinally when their infants were 8, 10 and 12 months old. A group of 20 mothers completed the interviews longitudinally when their infants were 10 and 12 months old. A third group of 20 mothers completed the interviews at 12 months only. RESULTS: IIQ scores increased across age but also were higher if parents had more experience with the questionnaire. CDI scores increased with age, but there was no effect of repeated testing. CONCLUSIONS: Previous experience with the IIQ seems to have enhanced the tendency to perceive intentionality. In contrast, repeated testing with the CDI did not alter parent perception of child language. These results suggest that some parent-report instruments (e.g., the IIQ) can alter the test-taker's awareness and thus could serve as an intervention. Parent-report instruments that tap something that is salient, familiar, and easily observable (e.g., the child's language) are less likely to alter the parent's perception.     

Associations between obsessive–compulsive symptoms,revenge, and the perception of interpersonal transgressions

Anger and aggression have only recently gained center stage in research on obsessive–compulsive disorder (OCD). An investigation of obsessive–compulsive (OC) symptoms focusing on the outcome of unresolved anger (i.e., revenge), however, is absent from the literature. The objective of the present research was therefore to provide a first step towards filling this gap and, hence, to systematically examine the associations between OC symptoms and different aspects of revenge (i.e., attitudes, dispositions, motivations). In three independent studies with nonclinical participants (N=504), we tested the hypothesis that OC symptoms relate to greater revenge. Individuals high in OC symptoms reported more positive attitudes toward revenge (Study 1), scored higher on a measure of trait revenge (Study 2), and reported increased revenge motivation regarding a real-life transgressor (Study 3). Furthermore, Study 4 (N=175) demonstrated that individuals high in OC symptoms perceived interpersonal transgressions more frequently in their daily lives. OC symptoms were positively related to the number of transgressions that respondents disclosed. Our results suggest that revenge and interpersonal hurt play a significant role in OCD.     

Relational psychophysiology: Lessons from mother–infant physiology research on dyadically expanded states of consciousness

Abstract

The authors illustrate how their work on mother–infant “relational psychophysiology” might inform psychotherapy research. They examined psychophysiology in 18 mother–infant dyads (infants' age: 5 months) during normal interaction and a still-face perturbation. They measured respiratory sinus arrhythmia (RSA) as an index of emotion regulation and explored whether skin conductance (SC) concordance, previously linked to therapist empathy, occurs in mothers and infants. During the still-face episode, SC concordance correlated to infant negative engagement. Upon reengagement, when mothers often soothe their infants, concordance instead correlated to behavioral synchrony, an index of maternal sensitivity. Furthermore, maternal RSA became correlated to infant negative engagement. These findings suggest that a mother trying to calm her infant calms herself physiologically and her sensitivity on a behavioral level becomes coherent physiologically. Implications for psychotherapy research are discussed.     

Predictors of diagnosis of child psychiatric disorder in adult–infant social-communicative interaction at 12 months

To establish which social interactive behaviours predict later psychiatric diagnosis, we examined 180 videos of a parent–infant interaction when children were aged one year, from within the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort. Sixty of the videos involved infants who were later diagnosed with a psychiatric disorder at seven years, and 120 were a randomly selected sex-matched control group. Interactive behaviours for both the caregiver and the one year old infant were coded from the videos according to eight holistic categories of interpersonal engagement: Well-being, Contingent Responsiveness, Cooperativeness, Involvement, Activity, Playfulness, Fussiness, and Speech. Lower levels of adult activity and speech in interaction at one year significantly predicted overall diagnosis of child psychiatric disorder.     

Maternal personality traits,antenatal depressive symptoms and the postpartum mother–infant relationship: a prospective observational study

Social Psychiatry and Psychiatric Epidemiology - Maternal depression has been associated with bonding difficulties and lower maternal sensitivity in observed mother–infant interactions....