Conference Venue: Saluation Hotel, Perth British Psychological Society
From: 25 Nov 2005 To: 26 Nov 2005
Identifying mother/infants at risk of severe attachment problems: Developing a cost-and-time effective measure for practitioners
Harvard Medical School
Introduction: Growing evidence links deviations in early care to later poor socio-emotional outcomes (e.g., depression, self-harm) and/or anti-social behaviours (e.g., other-harm). Hence, one clinical priority is to develop instruments for parents suggestive of early relational problems with infants. Parental attachment strategies coded before the birth of the infant from the Adult Attachment Interview (AAI) predict attachment behaviours of the child by one year of age. Though the AAI is one candidate assessment for predicting future mother/infant problems, using it in a clinical context is limited by its length (one hour) and expense (professional coding). Instead, a simple, effective, and cost-efficient assessment is needed that can provide an initial indication of potential future mother/infant relational problems. Such a measure could aid clinicians in determining the need for more complex assessments and/or therapeutic mother/child interventions.
Method: Seventy-six mothers from low-income families participated in a longitudinal study of family risk factors on child development. Factor analysis (PCA) was used to combine a measure capturing a profoundly-distrustful relational attitude (Holmes & Lyons-Ruth, in press) with a measure of Expressed Emotion (EE), to form a Rigid-Distrust (R-D) factor. The relational attitude in part reads “I think it’s a mistake to trust other people. Everyone’s looking out for themselves, so the sooner you learn not to expect anything from anybody else the better”; the EE part captures a lack of flexibility and tolerance towards close others. The new R-D factor explained 65% of variance in the assessments, both contributing loadings at .81.
Results: After first controlling for demographic risk factors and child’s gender, hierarchical regression showed that mother’s Rigid-Distrust attitude was related to government-documented child-maltreatment recorded before the child’s 9th month (ß =.55, p<.001; R2 at final step .40), to hostile-intrusive maternal behaviours coded from video-recording in the home at 18-months (ß =.44, p<.005; R2 at final step .20), and to mother’s classification as disrupted in communication with the infant in a laboratory procedure (?2=8.60, p<.005), also at 18 months.
Conclusions: Research links early parent-infant interaction problems to later poor socio-emotional outcomes and indicates that early intervention is important for altering negative developmental pathways. However, to intervene effectively, practitioners need tools to help them initially assess which infants may be at most risk. The results presented preliminary evidence for an easily administered self-reported measure that shows associations with clinically significant difficulties in parenting. However, further work is needed to establish the predictive efficacy of this measure.