Disrupted caregiving behavior as a mediator of the relation between disrupted prenatal maternal representations and toddler social-emotional functioning.

The development of maternal representations of the child during pregnancy guides a mother's thoughts, feelings, and behavior toward her child. The association between prenatal representations, particularly those that are disrupted, and toddler social-emotional functioning is not well understood. The present study examined associations between disrupted prenatal representations and toddler social-emotional functioning and to test disrupted maternal behavior as a mediator of this association. Data were drawn from 109 women from a larger prospective longitudinal study (N=120) of women and their young children. Prenatal disrupted maternal representations were assessed using the Working Model of the Child Interview disrupted coding scheme, while disrupted maternal behavior was coded 12-months postpartum from mother-infant interactions. Mother-reported toddler social-emotional functioning was assessed at ages 12 and 24 months. Disrupted prenatal representations significantly predicted poorer toddler social-emotional functioning at 24 months, controlling for functioning at 12 months. Further, disrupted maternal behavior mediated the relation between disrupted prenatal representations and toddler social-emotional problems. Screening for disrupted representations during pregnancy is needed to facilitate referrals to early intervention and decrease the likelihood of toddler social-emotional problems.

Feasibility of training service providers on the AMBIANCE-Brief measure for use in community settings.

The Atypical Maternal Behavior Instrument for Assessment and Classification-Brief (AMBIANCE-Brief) was developed to provide a clinically useful and psychometrically sound assessment of disrupted parenting behavior for community practitioners. With prior evidence of this tool's reliability and validity in laboratory settings, this study aimed to determine whether providers from family service agencies could become reliable in the use of the level of disrupted communication following a brief training. Providers (N = 46) from three agency sites participated in a 2-day AMBIANCE-Brief training and, at the end of the training, coded eight videotaped mother-child interactions. Novice participant coding was compared to expert consensus ratings using intraclass correlations. On average, participants' interrater agreement was good (ICCmean  = .84, SD = 0.10), with 89% meeting the reliability standards of ICC ≥ .70. In response to queries, 100% of participants indicated that they would recommend the AMBIANCE-Brief training to their colleagues, 85% reported that the AMBIANCE-Brief measure would be useful or very useful for their clinical practice, and 56% of participant clinicians believed that parents would find the measure acceptable or very acceptable for integration into intervention or support planning. Altogether, these findings speak to the feasibility of using the AMBIANCE-Brief in community settings. Future studies are needed in diverse clinical and community contexts to evaluate whether use of this assessment tool can inform more targeted interventions tailored to the specific needs of families.

El Instrumento Abreviado para Evaluación y Clasificación de la Conducta Materna Atípica (AMBIANCE-Abreviado; Madigan, Bronfman, Haltigan y Lyons-Ruth, 2018) se desarrolló para ofrecer a quienes practican en la comunidad una evaluación clínicamente útil y sicométricamente acertada de la conducta de crianza trastornada. Con la anterior evidencia de la confiabilidad y validez de esta herramienta en el marco de los laboratorios (Cooke, Eirich, Racine, Lyons-Ruth y Madigan, 2020), este estudio se propuso determinar si se podría confiar en quienes proveen el servicio como parte de las agencias de servicio a las familias después de un breve entrenamiento. Los proveedores (N = 46) de tres lugares de agencias participaron en un entrenamiento de dos días sobre AMBAIANCE-Abreviado y, al final del entrenamiento, codificaron ocho interacciones madre-niño grabadas en video. Se comparó la forma de codificar de los novatos con el puntaje consenso de los expertos usando correlaciones dentro de clases. El acuerdo entre los evaluadores fue bueno (ICC media = .84, SD = 0.10), con un 89% de los participantes que lograron el estándar de confiabilidad de ICC > .70. En respuesta a preguntas, el 100% de los participantes indicó que ellos recomendarían el entrenamiento de AMBIANCE-Abreviado a sus colegas, 85% reportó que la medida AMBIANCE-Abreviado sería útil o muy útil en su práctica clínica, y 56% creían que los progenitores encontrarían la medida aceptable o muy aceptable para ser integrada en la intervención o el planeamiento de apoyo. En conjunto, estos resultados hablan de la factibilidad de usar AMBIANCE-Abreviado en el marco comunitario.

L'Instrument d'Evaluation et de Classification-Brève du Comportement Maternel Atypique (AMBIANCE-Bref; Madigan, Bronfman, Haltigan, & Lyons-Ruth, 2018) a été développé afin d'offrir une évaluation du comportement de parentage perturbé, cliniquement utile et saine du point de vue psychométrique, pour les acteurs communautaires. Avec des preuves préalables de la fiabilité et de la validité de cet outil en laboratoire (Cooke, Eirich, Racine, Lyons-Ruth, & Madigan, 2020), cette étude s'est donné pour but de déterminer si les prestataires des agences de service à la famille pouvaient devenir fiables pour son utilisation après une formation courte. Des prestataires (N = 46) de trois sites d'agence ont participé à une formation AMBIANCE-Bref de deux jours et à la fin de la formation ont codé huit interactions mère-enfant filmées. Le codage du participant débutant a été comparé aux évaluations par consensus d'expertes en utilisant des corrélations intraclasses. Le coefficient d'objectivité était bon (moyenne des coefficient de corrélation intraclasse [ICC] = 84, SD = 0,10), avec 89% des participants remplissant les standards de fiabilité d'ICC ICC ³,70. En répondant aux questions, 100% des participants ont indiqué qu'ils ou elles recommanderaient la formation AMBIANCE-bref à leurs collègues, 85% ont indiqué que la mesure AMBIANCE-bref serait utile ou très utile pour leur pratique clinique, et 56% ont déclaré qu'ils ou elles croyaient que les parents trouveraient cette mesure acceptable ou très acceptable pour une intégration à une intervention ou le plan de soutien. Au total, ces résultats parlent de la viabilité de l'utilisation de l'AMBIANCE-bref dans des contextes communautaires.

Intervening with Attachment and Biobehavioral Catch-Up to decrease disrupted parenting behavior and attachment disorganization: The role of parental withdrawal.

This randomized controlled trial investigated the efficacy of Attachment and Biobehavioral Catch-up (ABC; Dozier, Bick, & Bernard, 2011) in reducing disrupted parenting behavior (affective communication errors, role/boundary confusion, fearful/disoriented, intrusive/negativity, and withdrawal) and its association with disorganized attachment. Participants were 105 mother-child dyads randomized to receive either ABC or a control intervention (a 10-session home-visiting intervention focused on improving children's cognitive abilities, gross and fine motor abilities, and language development). At the time of study enrollment, mothers were approximately 26.7 years old (SD = 7.8) and predominantly Black or African American (73.9%). At the first follow-up visit, children were approximately 20.7 months old (SD = 6.3) and most were identified as Black or African American (61.9%). Fifty-two percent of children were male (n = 55). Assessments of disrupted parenting behavior and child attachment quality were assessed approximately 7 months postintervention (SD = 5.8). A one-way analysis of variance revealed that parents who received ABC demonstrated lower levels of parental withdrawal than parents who received the control condition. A structural equation model revealed a significant indirect effect of intervention group on attachment quality through lower levels of parental withdrawal. Results add to the efficacy of the ABC intervention and identified parental withdrawal as a mediator of change.

Development of atypical parental behavior during an inpatient family preservation intervention program.

Since failed reunification is a detrimental outcome for children, particularly infants and toddlers, the aim of this study was to gain insight into support to families in multiple-problem situations to help them achieve sustainable good-enough parenting. Therefore, we examined outcomes of an assessment-based inpatient family preservation program. We prepared a thorough target-population description (n = 70) using file analysis. Next, we examined atypical parental behavior during the intervention using the Atypical Maternal Behavior Instrument for Assessment and Classification with a repeated measures design (n = 30). The family files revealed a great number of issues at the family, parent, and child levels, such as practical matters, problems in parent functioning and between parents, and difficulties in the broader environment. We found a significant decline in three dimensions of atypical parental behavior over time. This program has great potential in supporting vulnerable families in their pursuit of family preservation.

Debido a que un fracasado intento de reunificación es un resultado perjudicial para los niños, particularmente los infantes y niños muy pequeñitos, la meta de este estudio fue adquirir percepciones en cuanto al apoyo a familias en situaciones de problemas múltiples para ayudarles a lograr una crianza sostenible suficientemente buena. Examinamos, por tanto, resultados de un programa de paciente interno para la preservación de la familia (FP) basado en evaluación. Preparamos una detallada descripción de la población de enfoque (n = 70) usando análisis de registros. Examinamos conductas atípicas de los padres durante la intervención usando el Instrumento de Conducta Materna Atípica para Evaluación y Clasificación (AMBIANCE) con un diseño de medidas repetidas (n = 30). Los registros familiares revelaron un gran número de asuntos al nivel de la familia, los padres y los niños, tales como asuntos prácticos, problemas en el funcionamiento de los padres y entre padres, y dificultades en el más amplio entorno. Encontramos una baja significativa en tres dimensiones de conducta atípica de los padres a lo largo del tiempo. El programa FP tiene un enorme potencial para apoyar a familias vulnerables en su esfuerzo por preservar la familia.

Puisque la réunification échouée est un résultat détrimentaire pour les enfants, en particulier les nourrissons et les jeunes enfants, le but de cette étude était d'explorer le soutien aux familles dans des situations avec de nombreux problèmes afin de les aider à atteindre un parentage durable et suffisant. Nous avons donc examiné les résultats d'un programme de maintien familial (abrégé ici MF en français) fondé sur l'évaluation et en hospitalisation. Nous avons préparé une description approfondie de la population cible (n = 70) en utilisant une analyse par dossier. Nous avons examiné le comportement parental atypique durant l'intervention en utilisant AMBIANCE, l'instrument de comportement maternel atypique pour l'évaluation et la classification avec une conception à mesures répétées (n = 30). Les dossiers familiaux ont révélé un grand nombre de problèmes au niveau de la famille, du parent et de l'enfant, tels que des problèmes pratiques, des problèmes dans le fonctionnement du parent ou entre les parents, et des difficultés dans le milieu plus large. Nous avons trouvé une baisse importante sur trois dimensions du comportement atypique parental au fil du temps. Le programme MF offre de grandes possibilités dans le soutien aux familles vulnérables dans leur quête de maintien familial.

Refining the assessment of disrupted maternal communication: Using item response models to identify central indicators of disrupted behavior.

The Atypical Maternal Behavior Instrument for Assessment and Classification (AMBIANCE; Bronfman, Madigan, & Lyons-Ruth, 2009-2014; Bronfman, Parsons, & Lyons-Ruth, 1992-2004) is a widely used and well-validated measure for assessing disrupted forms of caregiver responsiveness within parent-child interactions. However, it requires evaluating approximately 150 behavioral items from videotape and extensive training to code, thus making its use impractical in most clinical contexts. Accordingly, the primary aim of the current study was to identify a reduced set of behavioral indicators most central to the AMBIANCE coding system using latent-trait item response theory (IRT) models. Observed mother-infant interaction data previously coded with the AMBIANCE was pooled from laboratories in both North America and Europe (N = 343). Using 2-parameter logistic IRT models, a reduced set of 45 AMBIANCE items was identified. Preliminary convergent and discriminant validity was evaluated in relation to classifications of maternal disrupted communication assigned using the full set of AMBIANCE indicators, to infant attachment disorganization, and to maternal sensitivity. The results supported the construct validity of the refined item set, opening the way for development of a brief screening measure for disrupted maternal communication. IRT models in clinical scale refinement and their potential for bridging clinical and research objectives in developmental psychopathology are discussed.

Patterns of Maternal Childhood Maltreatment and Disrupted Interaction Between Mothers and Their 4-Month-Old Infants.

Maternal childhood maltreatment (MCM) is associated with parenting disruptions which may contribute to the intergenerational transmission of negative health and social outcomes. Most prior work has used variable-centered approaches to assess MCM. Complementary person-centered approaches can identify groups of participants characterized by similar patterns of maltreatment. The current study assessed both types and patterns of MCM in relation to disrupted parenting among 179 mothers and their 4-month-olds. In variable-centered analyses, physical abuse was related to negative-intrusive maternal behavior and physical neglect to role-confused behavior. Person-centered analyses derived three classes of MCM, which differed in disrupted parenting. For example, mothers who experienced multiple types of maltreatment displayed more withdrawal than mothers in both other classes. Results document the differential effects of particular types and patterns of MCM on aspects of parenting and reveal that mother's history of maltreatment can affect the quality of mother-child interaction as early as 4 months of age.

Prenatal Identification of Risk for Later Disrupted Parenting Behavior Using Latent Profiles of Childhood Maltreatment.

A history of maltreatment during childhood (e.g., physical and sexual abuse, neglect) can threaten the fundamental human need to form and maintain relationships across development, which ensure safety and security. Furthermore, parental maltreatment history presents considerable risk for the emergence of disrupted parenting behaviors (i.e., contradictory communication, sexualized/role-reversed behavior, disorientation, intrusiveness/negativity, and severe withdrawal), which in turn are associated with children's social-emotional development. The purpose of the present study was to examine whether experiences of childhood maltreatment during pregnancy can predict risk for disrupted parenting behavior before the birth of the child. Given the inherent variability in parenting behaviors, we were interested in how different types or combinations of experiences of maltreatment during childhood are associated with later parenting behaviors. Data were drawn from 120 women from a longitudinal study that spanned from the third trimester of pregnancy through 3-year postpartum. In the current study, mothers' experiences of childhood maltreatment were assessed during pregnancy, and disrupted parenting behaviors were coded from videotaped mother-infant interactions 1-year postpartum. Four profiles of childhood maltreatment were identified using latent profile analysis: low exposure, high exposure, high sexual maltreatment, and high physical and emotional maltreatment. Results revealed that high exposure to multiple types of childhood maltreatment most strongly predicted later disrupted parenting behavior. Women with multiple exposures to different types of maltreatment during childhood may require more intense intervention during pregnancy to prevent risk for the development of disrupted parenting behavior.

How mothers with borderline personality disorder relate to their year-old infants.

BACKGROUND: Women with borderline personality disorder have conflictual interpersonal relations that may extend to disrupted patterns of interaction with their infants. AIMS: To assess how women with borderline personality disorder engage with their 12 to 18-month-old infants in separation-reunion episodes. METHOD: We videotaped mother-infant interactions in separation-reunion episodes of the Strange Situation test. The mothers were women with borderline personality disorder, with depression, or without psychopathological disorder. Masked ratings of maternal behaviour were made with the Atypical Maternal Behavior Instrument for Assessment and Classification. RESULTS: As predicted, a higher proportion (85%) of women with borderline personality disorder than women in the comparison groups showed disrupted affective communication with their infants. They were also distinguished by the prevalence of frightened/disoriented behaviour. CONCLUSIONS: Maternal borderline personality disorder is associated with dysregulated mother-infant communication.

Infant genotype may moderate sensitivity to maternal affective communications: attachment disorganization, quality of care, and the DRD4 polymorphism.

Disorganized attachment is an early predictor of the development of psychopathology in childhood and adolescence. Lyons-Ruth et al. (1999) developed the AMBIANCE coding scheme to assess disrupted communication between mother and infant, and reported the link between maternal behavior and disorganized attachment. The Hungarian group found an association between a polymorphism of the DRD4 gene and disorganized attachment (Lakatos et al., 2000; 2002; Gervai et al., 2005). The present collaborative work investigated the interplay between genetic and caregiving contributions to disorganized attachment. 138 mother-infant dyads, 96 from a Hungarian low-social-risk sample and 42 from a US high-social-risk sample, were assessed for infant disorganized attachment behavior, for DRD4 gene polymorphisms, and for disrupted forms of maternal affective communication with the infant. In accord with literature reports, we found a robust main effect of maternal AMBIANCE scores on infant disorganization. However, this relation held only for the majority of infants who carried the short form of the DRD4 allele. Among carriers of the 7-repeat DRD4 allele, there was no relation between quality of maternal communication and infant disorganization. This interaction effect was independent of degree of social risk and maternal DRD4 genotype.