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This paper outlines the theoretical antecedents that contextualize parental insightfulness and examines this concept's value in assessing parental functioning and in monitoring treatment progress with parents and young children who experience mental health and relationship problems. As a concept, parental insightfulness provides a much-needed bridge linking important aspects of attachment theory with their psychoanalytic origins, including early contributions that conceptualize parenting as a developmental process that furthers the unfolding capacities of the adult self. The paper examines the compatibility between the dimensions of parental insightfulness and the criteria for a healthy adult sense of self. The empirical body of knowledge generated by the concept of parental insightfulness is briefly reviewed as the basis for using the concept as a valuable tool for the empirical exploration of intrapsychic, interpersonal, and clinical processes in parents and their children.

The current study investigated maternal sensitivity in a treatment-seeking sample of predominately Latina, low-income pregnant women with histories of interpersonal trauma exposure. Pregnant women (N = 52; M = 27.08 years, SD = 5.66) who enrolled in a study of a perinatal adaptation of child-parent psychotherapy reported on their posttraumatic stress symptoms and child-rearing attitudes at baseline and again at 6-months postpartum. Maternal sensitivity was measured via observational coding of a free-play episode at 6-months postpartum. Two thirds of mothers exhibited healthy levels of maternal sensitivity, M > 4.0 (range = 2.5-7.0). The results of multiple linear regression predicting maternal sensitivity, R(2) = .26, indicated that greater improvements in child-rearing attitudes over the course of treatment predicted higher levels of maternal sensitivity, β = .33, whereas improvements in posttraumatic stress symptoms over the course of treatment did not, β = -.10. Mothers' attitudes regarding parenting during the perinatal period may be a mechanism by which intervention fosters healthy mother-infant relationship dynamics. Thus, parenting attitudes are a worthy target of intervention in vulnerable families., (Copyright © 2015 International Society for Traumatic Stress Studies.)

This study examined links between mothers' Adult Attachment Interview ratings (AAI; Main, Goldwyn, & Hesse, 2003) and their preschool children's IQ among 70 families who had experienced domestic violence. As predicted, children displayed significantly stronger verbal and perceptual-organizational abilities when their mothers exhibited more secure, i.e. coherent, states of mind regarding attachment. Mothers' coherence of mind on the AAI explained 18% of the variance in children's Verbal IQ and 12% of the variance in children's Performance IQ, after controlling for maternal education. Mothers' attachment security also was related to children's total IQ score, but this association was accounted for by effects on children's Verbal IQ. Children whose mothers were rated as unclassifiable on the AAI and those whose mothers were unresolved/insecure had lower IQ scores. Although mothers who appeared more secure on the AAI were more sensitively responsive toward their children, mediational analyses suggested that there was a direct link between mothers' security and children's IQ that was not explained by sensitive parenting. This suggests that clinical interventions for children exposed to domestic violence should include helping their mothers achieve coherent ways of thinking about their own childhood experiences, including past trauma.

Anxiously attached 12-month-olds and their mothers as assessed in the Strange Situation were randomly assigned to an intervention and a control group to test the hypothesis that infant-parent psychotherapy can improve quality of attachment and social-emotional functioning. Securely attached dyads comprised a second control group. Intervention lasted 1 year and ended when the child was 24 months. ANOVAs were used to compare the research groups at outcome. Intervention group toddlers were significantly lower than anxious controls in avoidance, resistance, and anger. They were significantly higher than anxious controls in partnership with mother. Intervention mothers had higher scores than anxious controls in empathy and interactiveness with their children. There were no differences on the outcome measures between the intervention and the secure control groups. The groups did not differ in maternal child-rearing attitudes. Within the intervention group, level of therapeutic process was positively correlated with adaptive scores in child and mother outcome measures.

The relationship between infant pediatric care use in the first year of life and the quality of mother-infant attachment at 1-year of age was examined. Fifty-six mother and infant pairs were classified by the Ainsworth Strange Situation procedure as securely (n = 17) or anxiously attached (n = 39). Pediatric records for the first 12 months of life were reviewed for frequency and type of visit, diagnoses, treatment, and symptoms prompting the care visit. Anxiously attached infants used acute care services (walk-in and emergency room) significantly earlier and more often than infants with a secure attachment. Use of acute care services began at a mean age of 3.8 months for the anxiously attached infants compared with 6.5 months for the securely attached. Differences in utilization persisted through the year. Mean acute care use in the anxiously attached infants was 3.6 visits compared with 1.9 visits for the securely attached. Acute care use was associated with a variety of common infant illnesses in both groups. In contrast, there was no difference in the use of well-baby care (mean 6 visits). Utilization and attachment status were independent of birth or prenatal difficulties. High cumulative use of pediatric care during the first year of life may identify infant and mother pairs who are experiencing strain in their interactions and relationship. Early recognition would provide an opportunity for comprehensive assessment and preventive intervention in the pediatric setting.