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The purpose of this study was to examine the moderating role of maternal sensitivity on the association between prenatal adversity and externalizing behaviors at 24 months of age in a diverse, high-risk sample. We hypothesized that among children with higher prenatal adversity, high maternal sensitivity would serve as a protective factor. Participants were 247 primarily low-income, diverse dyads. Results indicated a significant interaction effect of maternal sensitivity and prenatal adversity on externalizing problems. The association between prenatal adversity and externalizing behaviors was significant only among children who experienced low prenatal adversity, with higher maternal sensitivity associated with lower externalizing behaviors. These findings indicate that, in the absence of high prenatal risk, responsive and sensitive parenting can buffer children in an otherwise high-risk sample from the development of externalizing behaviors.El propósito de este estudio fue examinar el papel moderador que la sensibilidad materna tiene sobre la asociación entre adversidad prenatal y las conductas de externalización a los 24 meses de edad en un grupo muestra diverso y de alto riesgo. Nuestra hipótesis es que entre los niños con más alta adversidad prenatal (PA), una alta sensibilidad materna serviría como un factor de protección. Participaron 247 díadas diversas, primariamente de bajos recursos económicos (173 infantes expuestos a sustancias). Los resultados indicaron un significativo efecto de interacción de la sensibilidad materna y la adversidad prenatal sobre los problemas de externalización. La asociación entre la adversidad prenatal y las conductas de externalización fue significativa sólo entre niños que habían experimentado una adversidad prenatal baja, mientras que una más alta sensibilidad materna se asoció con más bajas conductas de externalización. Estos resultados indican que, en ausencia de un riesgo prenatal alto, una crianza receptiva y sensible puede amortiguar el desarrollo de conductas de externalización en niños que, de lo contrario, están dentro de un grupo muestra de alto riesgo.Le but de cette étude était d'examiner le rôle modérateur de la sensibilité maternelle sur l'association entre l'adversité prénatale et les comportements d'externalisation à l’âge de 24 mois chez un échantillon varié, et à haut risque. Nous avons pris comme hypothèse que chez les enfants avec une adversité prénatale élevée (PA), une sensibilité maternelle élevée servirait de facteur de protection. Les participants ont consisté en 247 dyades diverse et principalement issues de milieux défavorisés (173 bébés exposés à la toxicomanie). Les résultats indiquent un effet d'interaction important de la sensibilité maternelle et de l'adversité prénatale sur les problèmes d'externalisation. Le lien entre l'adversité prénatale et les comportements d'externalisation n’était important que chez les enfants ayant fait l'expérience d'une adversité prénatale peu élevée, avec une sensibilité maternelle plus élevée liée à des comportements d'externalisation moins élevés. Ces résultats indiquent que, en l'absence d'une risque prénatal élevé, le parentage réactif et sensible peut servir de tampon aux enfants contre le développement de comportements d'externalisation dans un échantillon qui est par ailleurs à haut risque.Die Auswirkung pränataler Belastung auf externalisierendes Verhalten im Alter von 24 Monaten in einer Stichprobe mit hohem Risiko: Mütterliche Sensibilität als Moderator Ziel dieser Studie war es, die moderierende Rolle mütterlicher Sensibilität im Zusammenhang zwischen pränataler Belastung und Externalisierungsverhalten im Alter von 24 Monaten in einer diversen Stichprobe mit hohem Risiko zu untersuchen. Die Hypothese bestand darin, dass bei Kindern mit höherer pränataler Belastung (prenatal adversity; PA) eine hohe Sensibilität der Mutter als Schutzfaktor dient. 247 hauptsächlich einkommensschwache, diverse Mutter-Kind Dyaden (173 davon substanzexponierte Säuglinge) nahmen an der Studie teil. Die Ergebnisse zeigten einen signifikanten Interaktionseffekt von mütterlicher Sensibilität und pränataler Belastung auf Externalisierungsprobleme. Der Zusammenhang zwischen pränataler Belastung und Externalisierungsverhalten war nur bei Kindern signifikant, bei denen eine geringe pränatale Belastung vorhanden war, wobei eine höhere Sensibilität der Mutter mit einem geringeren Externalisierungsverhalten assoziiert war. Diese Ergebnisse deuten darauf hin, dass, wenn kein hohes pränatales Risiko vorhanden ist, ein responsives und sensibles elterliches Verhalten Kinder in einer ansonsten risikoreichen Stichprobe vor der Entwicklung von Externalisierungsverhalten schützen kann.ハイリスク群の生後24ヶ月における外在化型の問題行動に対する出生前の困難な 課題の影響:緩和する役としての母親の感受性 本論文の目的は、多様でハイリスク群の出生前の困難な課題と生後24ヶ月における外在化型の問題行動の関連に対する母親の感受性の緩和する役割について調査することであった。我々は、より高い出生前の困難な課題(PA)のある子どもの中で、母親の高い感受性が予防要素として役立つのではないだろうかと仮定した。対象者は主に低収入で 多様な背景をもつ母子親子247組(173人の薬物曝露の新生児)である。結果は、外在化型の問題行動に対して母親の感受性と出生前の困難な課題との有意な相互作用の影響が示唆された。出生前の困難な課題と外在化型の問題行動の間の関連は、出生前の困難な課題を少なく体験した子どもの中で、外在化型の問題行動が低いことに関連した母親の感受性がより高いことのみ有意であった。これらの結果は、出生前の高いリスクがない場合において、応答的で感受性豊かな子育てが、それでもハイリスク群には入る子どもを外在化型の問題行動の発達から子どもを守ることができることを示唆している。.本研究的目的是在一个多样化的高风险样本中, 检验母亲敏感性在产前逆境与儿童24月龄时的外化行为之间的调节作用。我们假设处于更恶劣的产前逆境 (PA)中的儿童, 较高的母亲敏感性可以作为一个保护因素。研究参与者主要是247名低收入、多样化的母婴 (包含173名药物暴露的婴儿) 。结果表明, 母亲敏感性与产前逆境对儿童的外化问题有显著的相互作用。产前逆境与儿童外化行为之间的关联仅在经历过低程度的产前逆境的儿童中才有意义, 较高的母亲敏感性会导致较低的儿童外化行为。这些发现表明, 在没有经历高产前风险的情况下, 反应敏感的育儿可以缓冲儿童外化行为的发展, 否则他们会发展为高风险的样本。.تأثير الشدائد السابقة للولادة على السلوكيات السلبية في عمر 24 شهرًا في عينة عالية المخاطرة: حساسية الأمهات كعامل وسيط ملخص كان الغرض من هذه الدراسة هو دراسة الدور الوسيط للحساسية الأمومية في الارتباط بين الشدائد السابقة للولادة والسلوكيات السلبية في عمر 24 شهرًا في عينة متنوعة وعالية المخاطرة. افترضنا أنه بين الأطفال الذين يعانون من الشدائد ما قبل الولادة (PA) ، فإن الحساسية العالية للأمهات ستكون بمثابة عامل وقائي. وكان المشاركون 247 من الثنائيات المتنوعة ذات الدخل المنخفض (173 رضيع من المعرضين للمواد المخدرة). وأشارت النتائج إلى تأثير تفاعلي كبير لحساسية الأمهات والشدائد السابقة للولادة على مشاكل السلوكيات السلبية. كان الارتباط بين الشدائد السابقة للولادة والسلوكيات السلبية مهمًا فقط بين الأطفال الذين عانوا من الشدائد المنخفضة قبل الولادة ، بينما كان ارتفاع حساسية الأم مرتبطاَ بسلوكيات سلبية أقل. وتشير هذه النتائج إلى أنه في غياب مخاطر عالية قبل الولادة، يمكن الرعاية الوالدية المستجيبة والحساسة أن تشكل عامل وقائي للأطفال في عينة عالية الخطورة من تطور سلوكيات سلبية.

In the first year of life, an infant’s principal task is the development of an attachment to at least one primary caregiver. Attachment security is not a static, traitlike construct, and both stability and change in attachment is anticipated in attachment theory. The majority of earlier studies on attachment stability used the original attachment classifications developed by Ainsworth and Wittig (1969), and included only mother – infant dyads from middle-class, low-risk samples (e.g., Thompson, Lamb, & Estes, 1982; Waters, 1979). Calls for an increased focus on the father – infant relationship have prompted increasing study of paternal attachment relationships (Fitzgerald, Mann, & Barrett, 1999; Lamb, 1975). In addition, more recent research has expanded to include the more recently developed disorganized classification (Main & Solomon, 1990) and examine issues of stability and instability in high-risk samples. These studies have noted that instability is more characteristic of high-risk samples, especially increases in disorganized patterns of insecure attachment with increasing child age (e.g., Lyons-Ruth, Repacholi, McLeod, & Silva, 1991; Vaughn, Egeland, Sroufe, & Waters, 1979; Vondra, Hommerding, & Shaw, 1999); however, stability can be derived from secure patterns as well as insecure patterns. To date, very few studies have distinguished between these two patterns of stability and examined the possibility that infants with stable insecure attachment may display a different constellation of risk characteristics compared to infants with stable secure attachments (see Vondra et al., 1999 for an exception). Apart from rates of stability, per se, studies also have examined if changes in attachment security are a lawful process that can be explained by theoretically relevant variables. Theoretical models of parenting (Belsky, 1984; Snyder & Huntley, 1991) have emphasized the role of three sets of predictors in explaining variations in parent – child interactions and the quality of the parent – child relationship: parent characteristics, infant characteristics, and the context in which parenting takes place. The focus of this study was on explaining attachment stability, instability, or both in a sample characterized by fathers’ alcoholism. As such, the theoretical predictors of interest in this study, following the conceptual models of parenting articulated by previous researchers, included fathers’ alcoholism and associated risk characteristics in the three domains mentioned earlier. The first domain elucidated in various models of parenting is parental characteristics. In a sample characterized by fathers’ alcoholism, the primary parental characteristic of interest is fathers’ alcohol problems. Previous studies have demonstrated that mothers with alcoholic partners also tend to be heavier drinking and have more alcohol-related problems (Eiden & Leonard, 1996; Roberts & Leonard, 1997). While research on children of alcoholics has generally focused on early school age and adolescent children, infants and toddlers of alcoholics have been shown to experience more negative parenting and higher levels of insecure parent –infant attachment at 12 months (Eiden, Chavez, & Leonard, 1999; Eiden, Edwards, & Leonard, 2002). Other parental risk characteristics commonly associated with fathers’ alcohol problems, such as depression and antisocial behavior, also have been theoretically linked to parenting and the quality of the parent – child relationship (Campbell & Cohn, 1997; Eiden, et al., 1999; van den Boom, 1994). Maternal affective disorders in particular have been demonstrated to have a negative impact on the mother – infant relationship. Mothers’ depression, particularly when it is chronic or occurring in the context of family dysfunction, has been directly associated with an increased risk for insecure attachment (Carter, Garrity-Rokous, Chazan-Cohen, Little, & Briggs-Gowan, 2001; DeMulder & Radke-Yarrow, 1991; Martins & Gaffan, 2000). Much less is known about the effects of paternal depression on parenting; however, in one of the few studies examining paternal depression, fathers’ depression was found to have an indirect effect on the father – infant relationship. Specifically, paternal alcoholism was found to be associated with higher levels of paternal aggravation and decreased sensitivity in interactions with their children, an effect mediated by fathers’ depression (Eiden et al., 1999; Eiden & Leonard, 2000). While relatively little is known about the potential of antisocial behavior to influence the parent – infant relationship, Puttler, Zucker, Fitzgerald, and Bingham (1998) found that children of antisocial alcoholics had significantly more behavior problems than children of nonantisocial alcoholics as well as controls, suggesting that parental antisociality exacerbates children’s risk of maladaptive behavioral outcomes. The second domain of interest is the role of infant characteristics. It has been suggested that a biological predisposition for difficult temperament is present in infants with antisocial and alcoholic parents (see Tarter, Alterman, & Edwards, 1985; Windle, 1991), and in fact, young children of alcoholic fathers have been found to have more difficult temperaments than children of nonalcoholic fathers (Fitzgerald et al., 1993; Jansen, Fitzgerald, Ham, & Zucker, 1995). Although no direct relationship between infant temperament and attachment security has been reliably demonstrated in the literature (Bates, 1987; Sroufe, 1985), some studies have shown that the association between temperament and attachment security is mediated or moderated by maternal sensitivity during interactions (Mangelsdorf, Gunnar, Kestenbaum, Lang, & Andreas, 1990; O’Connor, Sigman, & Kasari, 1992; Susman-Stillman, Kalkose, Egeland, & Waldman, 1996; van den Boom & Hoeksma, 1994). Certainly, infant temperament influences the attachment relationship by the very nature of the reciprocity that characterizes parent – child interactions (Olson, O’Connor, & Fitzgerald, 2001). Similarly, observations of infant emotionality, while not directly predictive of attachment security, have been associated with the child’s position on the spectrum of attachment classifications, with resistant and highly aroused secure children showing more fear than both avoidant and less aroused secure children (Kochanska, 1998). The third source of influence in predicting the quality of the parent – infant relationship is the marital context. Indeed, poor marital quality has been found to be directly predictive of insecure infant attachment (Howes & Markman, 1989; Owen & Cox, 1997). Marital quality also is of relevance in studying alcoholic families because of the strong association between parental alcoholism and marital conflict (Leonard, 1993; Leonard & Quigley, 1999; Murphy & O’Farrell, 1996; Quigley & Leonard, 2000; Spaccarelli, Sandler, & Roosa, 1994). The importance of marital satisfaction as a predictor of parenting has been enumerated by models of parenting (e.g., Belsky, 1984) and may be particularly pronounced for fathers (e.g., Belsky, Fish, & Isabella, 1991; Goldberg & Easterbrooks, 1984). Keys to the development of secure attachment in Ainsworth’s (1973) original conception include parental sensitivity, acceptance, cooperation, and psychological accessibility, focusing attention on the contributions of the parent to the development of this relationship. For this reason, much of the research conducted on attachment has focused on parenting behavior, specifically parental sensitivity (Ainsworth, Blehar, Waters, & Wall, 1978; Cox, Owen, Henderson, & Margand, 1992; Eiden et al., 2002; Teti, Gelfand, Messinger, & Isabella, 1995; Volling & Belsky, 1992), and indeed, the theoretical link between parent – infant interactions and attachment security has been well validated (de Wolff & van IJzendoorn, 1997; van IJzendoorn & de Wolff, 1997); however, researchers emphasize that this relationship is complex and the association context dependent (de Wolff & van IJzendoorn, 1997). Similarly, in examining changes in attachment over time, evidence indicates instability may be associated with environmental changes and may be predictable (Egeland & Farber, 1984; Vondra et al., 1999). Thus, current environment as well as previous levels of security may affect current attachment classifications. This is a particularly relevant concept when studying children of alcoholics —a population in which risk aggregates much more highly and has the potential to markedly alter attachment over time. The purpose of this study was to examine attachment stability from 12 to 18 months in a sample characterized by paternal alcoholism. A strength of the current study is that it also allows study of fathers’ parenting and attachment relationships with their infants — an often overlooked area in a literature that has largely focused its attention on maternal variables. On the basis of results with other high-risk samples, we expected increases in insecurity in general and in disorganized classification in particular from 12 to 18 months within the alcoholic group. We also examined the role of three domains of family functioning in explaining stability or changes in attachment security from 12 to 18 months. These included parental characteristics such as alcohol problems, depression, and antisocial behavior; infant characteristics such as parent reports of infant temperament and observations of infant emotionality; and the marital context (marital aggression and marital adjustment). Finally, attachment theory highlights the proximal role of parent – infant interactions in the development of infant attachment. Thus, we examined the quality of parent and infant behaviors during parent – infant interactions in explaining stability and change in attachment security.

This study examined the association between paternal alcoholism and 12-month infant temperament and 18-month behavior problems. The role of associated parental psychopathology and maternal drinking in exacerbating risk for maladaptive behavioral outcomes was also examined. Participants were 213 families (102 control families, 94 paternal alcoholic families, and 17 families with alcoholic fathers and heavy drinking mothers) who were assessed when their child was 12 months old and reassessed again when their child was 18 months old. Infants of alcoholics displayed marginally more stubborn/persistent temperaments at 12 months of age, but significantly more internalizing problems at 18 months. Analyses suggested that internalizing problems in the infants of alcoholics could be attributed to the paternal depression concomitant with paternal alcoholism. In addition, an interaction was observed, indicating that paternal alcohol problems predicted 18-month externalizing problems among families with low maternal depression, but not among families with high maternal depression. Children of depressed mothers exhibited uniformly higher externalizing scores, but were not further impacted by paternal alcohol problems. However, children of nondepressed mothers were adversely affected by fathers’ drinking as reflected by higher externalizing behavior scores. The results highlight the necessity of addressing the overall contextual risks that occur with paternal alcoholism in studies of the development of children in alcoholic families.

Le but de cette etude etaient d'examiner l'impact de l'utilisation maternelle de la cocaine durant la grossesse et les facteurs de risque qui y sont lies, comme une psychopathologie maternelle et un temperament infantile negatif sur la qualite des interactions mere-nourrisson lors de la prise de biberon a l'âge de 2 mois pour le nourrisson. Les participantes etaient 45 dyades mere-nourrisson (19 exposees a la cocaine et 26 non-exposees a la cocaine) qui furent recrutees a la naissance et evaluees a nouveau lorsque les nourrissons avaient 2 mois. Les interactions mere-nourrisson durant la prise de biberon ont ete filmees a la video et codees en ce qui concerne la reciprocite dyadique, le manque de resources maternel et le conflit dyadique. Les resultats indiquerent que l'utilisation maternelle de la cocaine etait liees a des conflits dyadiques plus eleves. De plus, les meres utilisant de la cocaine etaient aussi plus a meme d'utiliser de la marijuana et de l'alcool, et l'utilisation de telles substances etait liee a une reciprocite dyadique inferieure ainsi qu'a un manque de resources plus eleve durant les interactions. Les resultats suggerent egalement qu'un des chemins menant a un conflit dyadique plus eleve pendant l'interaction, chez les meres utilisatrices de cocaine, etait l'impact de la cocaine sur les conditions de risques infantiles comme un âge gestationnel moins eleve et un temperament negatif (c'est-a-dire, un desarroi plus grand devant la nouveaute). Les interventions mettant l'accent sur la promotion de la qualite des interactions mere-nourrison combine a un traitement contre la drogue et l'alcoolisme peuvent s'avererparticulierement prometteuses pour cette population.

The primary goal of this study was to examine sleep problems in a sample of cocaine-exposed 7-month-old infants and to determine if maternal psychopathology mediated any existing association between substance exposure and sleep behaviors. We also examined the differences in sleep behaviors of cocaine-exposed infants in parental custody and cocaine-exposed infants in nonparental custody. Participants were 65 cocaine-exposed and 53 nonexposed infants and their primary caregivers who were recruited at delivery and assessed at 7 months of infant age. As expected, women who used cocaine during pregnancy had more psychiatric symptoms than nonusers. Prenatal exposure to heavier amounts of cocaine was significantly related to more severe sleep difficulties, and maternal anxiety mediated this association. Approximately 28% of cocaine mothers lost custody of their infants by 7 months of age. Nonmaternal caregivers had significantly fewer symptoms of psychopathology than the cocaine-using women who retained custody of their children. Infants who were in nonparental care at 7 months of age also had less severe sleep problems than did infants who remained in parental care.