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Mind-mindedness and maternal responsiveness in infant–mother interactions in mothers with severe mental illness

Published online by Cambridge University Press:  27 January 2010

S. Pawlby ,
C. Fernyhough ,
E. Meins ,
C. M. Pariante ,
G. Seneviratne  and
R. P. Bentall
S. Pawlby*
Affiliation:
Section of Perinatal Psychiatry and Stress, Psychiatry and Immunology, Institute of Psychiatry, King's College London, London, UK
C. Fernyhough
Affiliation:
Psychology Department, Durham University, Durham, UK
E. Meins
Affiliation:
Psychology Department, Durham University, Durham, UK
C. M. Pariante
Affiliation:
Section of Perinatal Psychiatry and Stress, Psychiatry and Immunology, Institute of Psychiatry, King's College London, London, UK
G. Seneviratne
Affiliation:
Section of Perinatal Psychiatry and Stress, Psychiatry and Immunology, Institute of Psychiatry, King's College London, London, UK
R. P. Bentall
Affiliation:
School of Psychology, University of Bangor, Wales, UK
*
*Address for correspondence: Dr S. Pawlby, PO 71, Section of Perinatal Psychiatry and Stress, Psychiatry and Immunology, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK (Email: susan.pawlby@kcl.ac.uk)
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Abstract

Background

Previous cross-diagnosis studies of interaction between mothers with severe mental illness and their babies have concluded that mothers with schizophrenia have deficits in interaction, but these studies have not included healthy controls.

Method

In-patients on a mother and baby unit, with diagnoses of schizophrenia (n=15), depressive mood disorders with or without psychosis (n=23), or mood disorders where mania was the predominant feature, with or without psychosis (n=12), were observed interacting with their infants on admission and discharge. Mothers' mind-mindedness and other measures of the quality of maternal and infant behaviour were coded. Findings from this sample were compared with those from healthy mothers and their infants (n=49).

Results

Compared with healthy controls, on admission depressed mothers were marginally less likely to comment appropriately on their infants' mental states. Both the depressed and mania groups were more likely to touch their babies and engage in attention-seeking behaviours. Interactional behaviours of mothers in the schizophrenia group were not markedly different from healthy controls. On discharge there were fewer differences between the clinical and healthy groups, although the depressed group continued to engage in more attention-seeking and touching behaviour and the mania group continued to touch their infants more. Only mothers in the schizophrenia group showed changes in interactional behaviours between admission and discharge, talking more to their infants.

Conclusions

The findings challenge previous conclusions that mothers with schizophrenia have deficits in their interactions with their babies, and demonstrate that mothers with severe mental illness are able to respond appropriately to their infants' cues.

Keywords

Infant-mother interactionmind-mindednessschizophreniasevere mental illness
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 11 , November 2010 , pp. 1861 - 1869
Copyright
Copyright © Cambridge University Press 2010

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References

APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV). American Psychiatric Association: Washington, DC.Google Scholar
Abel, KM, Webb, RT, Salmon, MP, Wan, MW, Appleby, L (2005). Prevalence and predictors of parenting outcomes in a cohort of mothers with schizophrenia admitted for joint mother and baby psychiatric care in England. Journal of Clinical Psychiatry 66, 781–789.Google Scholar
Arnott, B, Meins, E (2007). Links between antenatal attachment representations, postnatal mind-mindedness, and infant attachment security: A preliminary study of mothers and fathers. Bulletin of the Menninger Clinic 71, 132–149.Google Scholar
Cannon, M, Caspi, A, Moffitt, TE, Harrington, H-L, Taylor, A, Murray, RM, Poulton, R (2002). Evidence for early childhood, pan-developmental impairment specific to schizophreniform disorder: results from a longitudinal birth cohort. Archives of General Psychiatry 59, 449–457.Google Scholar
Cohen, J (1988). Statistical Power Analysis for the Behavioral Sciences. Lawrence Erlbaum Associates: Hillsdale, NJ.Google Scholar
Cohn, JF, Campbell, SB, Matias, R, Hopkins, J (1990). Face-to-face interactions of postpartum depressed and non-depressed mother–infant pairs. Developmental Psychology 26, 15–23.Google Scholar
Corcoran, R, Mercer, G, Frith, CD (1995). Schizophrenia, symptomatology and social inference: Investigating ‘theory of mind’ in people with schizophrenia. Schizophrenia Research 17, 5–13.Google Scholar
Crittenden, PM (2004). Care-Index; Manual. Family Relations Institute: Miami.Google Scholar
Hay, DF, Pawlby, S, Waters, CS, Sharp, D (2008). Antepartum and postpartum exposure to maternal depression: Different effects on different adolescent outcomes. Journal of Child Psychology and Psychiatry 49, 1079–1088.Google Scholar
Howard, LM, Thornicroft, G, Salmon, M, Appleby, L (2004). Predictors of parenting outcome in women with psychotic disorders discharged from mother and baby units. Acta Psychiatrica Scandinavica 110, 347–355.Google Scholar
Lundy, BL (2003). Father- and mother-infant face to face interactions: Differences in mind-related comments and infant attachment? Infant Behavior and Development 26, 200–212.Google Scholar
McGrath, JJ, Hearle, J, Jenner, L, Plant, K, Drummond, A, Barkla, JM (1999). The fertility and fecundity of patients with psychosis. Acta Psychiatrica Scandinavica 99, 441–446.CrossRefGoogle Scholar
Meins, E (1997). Security of Attachment and the Social Development of Cognition. Psychology Press: Hove.Google Scholar
Meins, E, Fernyhough, C (2006). Mind-mindedness Coding Manual. (http://www.dur.ac.uk/elizabeth.meins/mm%20manual.pdf).Google Scholar
Meins, E, Fernyhough, C, Fradley, E, Tuckey, M (2001). Rethinking maternal sensitivity: Mothers' comments on infants' mental processes predict security of attachment at 12 months. Journal of Child Psychology and Psychiatry 42, 637–648.Google Scholar
Meins, E, Fernyhough, C, Wainwright, R, Clark-Carter, D, Das Gupta, M, Fradley, E, Tuckey, M (2003). Pathways to understanding mind: Construct validity and predictive validity of maternal mind-mindedness. Child Development 74, 1194–1211.Google Scholar
Meins, E, Fernyhough, C, Wainwright, R, Das Gupta, M, Fradley, E, Tuckey, M (2002). Maternal mind-mindedness and attachment security as predictors of theory of mind understanding. Child Development 73, 1715–1726.Google Scholar
Murray, L, Fiori-Cowley, A, Hooper, R, Cooper, P (1996). The impact of postnatal depression and associated adversity on early mother–infant interactions and later infant outcome. Child Development 67, 2512–2526.Google Scholar
Murray, L, Kempton, C, Woolgar, M, Hooper, R (1993). Depressed mothers' speech to their infants and its relation to infant gender and cognitive development. Journal of Child Psychology and Psychiatry 34, 1083–1101.CrossRefGoogle Scholar
Murray, L, Sinclair, D, Cooper, P, Ducournau, P, Turner, P (1999). The socioemotional development of 5-year-old children of postnatally depressed mothers. Journal of Child Psychology and Psychiatry 40, 1259–1271.Google Scholar
O'Connor, TG, Heron, J, Golding, J, Beveridge, M, Glover, V (2002). Maternal antenatal anxiety and children's behavioural/emotional problems at 4 years. Report from the Avon Longitudinal Study of Parents and Children. British Journal of Psychiatry 180, 502–508.Google Scholar
Pawlby, S, Fernyhough, C (2009). Enhancing the relationship between mothers with severe mental illness and their infants. In Keeping the Baby in Mind: Infant-Centred Early Intervention in Practice (ed. Svanberg, P. O. and Barlow, J.), pp. 164–172. Routledge: London.Google Scholar
Pawlby, S, Hay, DF, Sharp, D, Waters, CS, O'Keane, V (2009). Antenatal depression predicts depression in adolescent offspring: prospective longitudinal community based study. Journal of Affective Disorders 113, 236–243.Google Scholar
Pawlby, S, Marks, M, Clarke, R, Best, E, Weir, D, O'Keane, V (2005). Mother-infant interaction in postpartum women with severe mental illness, before and after treatment. Archives of Women's Mental Health 8, 120.Google Scholar
Riordan, D, Appleby, L, Faragher, B (1999). Mother–infant interaction in post-partum women with schizophrenia and affective disorders. Psychological Medicine 29, 991–995.Google Scholar
Sameroff, AJ, Seifer, R, Zax, M (1982). Early development of children at risk for emotional disorder. Monographs of the Society for Research in Child Development 47, 1–82.Google Scholar
Schachter, J, Elmer, E, Ragin, N, Wimberley, F (1977). Assessment of mother-infant interaction: schizophrenic and nonschizophrenic mothers. Merrill-Palmer Quarterly 23, 193–205.Google Scholar
Snellen, M, Mack, K, Trauer, T (1999). Schizophrenia, mental state, and mother-infant interaction: examining the relationship. Australian and New Zealand Journal of Psychiatry 33, 902–911.Google Scholar
Wan, MW, Penketh, V, Salmon, MP, Abel, K (2008 a). Content and style of speech from mothers with schizophrenia towards their infants. Psychiatry Research 159, 109–114.Google Scholar
Wan, MW, Salmon, MP, Riordan, D, Appleby, L, Webb, R, Abel, KM (2007). What predicts mother-infant interaction in schizophrenia? Psychological Medicine 37, 537–546.Google Scholar
Wan, MW, Warren, K, Salmon, MP, Abel, K (2008 b). Patterns of maternal responding in postpartum mothers with schizophrenia. Infant Behaviour and Development, 31, 532–538.Google Scholar