| Summary: |
A robust body of evidence suggests that mother-infant quality of attachment is linked with later developmental and academic outcomes. In relatively healthy infants from well-educated middle class samples, premature birth (>32 gestational weeks; GW) is not typically associated with a higher rate of attachment insecurity. However, when samples are characterized by additional risk factors (such as low socio-economic status or maternal education, co-morbid infant health problems or maternal depression, parenting stress), premature birth is associated with a higher prevalence of insecure attachment. Recent advances in perinatal and neonatal medical care have significantly increased survival rates of very preterm (<32 GW), very low (<1500g birthweight) and extreme preterm infants (<28 GW). To date, mother-infant attachment in these samples is understudied. The very few studies concerning attachment in very and extreme preterm infants indicate a higher risk for insecure or disorganized attachment compared to full-term infants. In these studies, only maternal sensitivity was retained as a predictor of attachment status. Many other
predictors, however, have been found in other populations. A meta-analytic study indicates that infant emotional regulation in Tronick´s and colleagues Face-to-Face-Still-Face paradigm (FFSF) predicted infant attachment security, including in preterm infants (>32 GW). In the present study, we will consider both maternal sensitivity and infant self-regulation effects on mother-infant attachment, in very and extreme preterm infants. In a sample of healthy preterm infants (>32 GW), Fuertes, Santos, Beeghly and Tronick (2006; 2009) modified the IRSS microanalytic scoring system and were able to describe three styles of infant coping
behavior: a Positive Other-Directed Coping; a Negative Other-Directed Coping and a Self-Directed Coping. These types of coping were related to future outcomes and predicted attachment security. Firstly, coping st  |
Summary
A robust body of evidence suggests that mother-infant quality of attachment is linked with later developmental and academic outcomes. In relatively healthy infants from well-educated middle class samples, premature birth (>32 gestational weeks; GW) is not typically associated with a higher rate of attachment insecurity. However, when samples are characterized by additional risk factors (such as low socio-economic status or maternal education, co-morbid infant health problems or maternal depression, parenting stress), premature birth is associated with a higher prevalence of insecure attachment. Recent advances in perinatal and neonatal medical care have significantly increased survival rates of very preterm (<32 GW), very low (<1500g birthweight) and extreme preterm infants (<28 GW). To date, mother-infant attachment in these samples is understudied. The very few studies concerning attachment in very and extreme preterm infants indicate a higher risk for insecure or disorganized attachment compared to full-term infants. In these studies, only maternal sensitivity was retained as a predictor of attachment status. Many other
predictors, however, have been found in other populations. A meta-analytic study indicates that infant emotional regulation in Tronick´s and colleagues Face-to-Face-Still-Face paradigm (FFSF) predicted infant attachment security, including in preterm infants (>32 GW). In the present study, we will consider both maternal sensitivity and infant self-regulation effects on mother-infant attachment, in very and extreme preterm infants. In a sample of healthy preterm infants (>32 GW), Fuertes, Santos, Beeghly and Tronick (2006; 2009) modified the IRSS microanalytic scoring system and were able to describe three styles of infant coping
behavior: a Positive Other-Directed Coping; a Negative Other-Directed Coping and a Self-Directed Coping. These types of coping were related to future outcomes and predicted attachment security. Firstly, coping styles were associated with Heart Rate variability across FFSF episodes. Moreover, the Positive Other-Directed Coping predicted mother-infant secure attachment at one year of age, whereas Negative Other-Directed Coping predicted insecure-resistant and Self-Directed Coping predicted insecure-avoidant attachment. Based on the description of infants' behavior across FFSF, a descriptive system to classify infant coping was developed by the team (Infant COPing in FFSF scale; COP) that has already been tested and validated with independent samples (in press).
Furthermore, a few studies found that patterns of coping and infant self-regulation are associated with perinatal factors, such as the number of days that infants stayed in the neonatal intensive care unit, infant birthweight and gestational age, in healthy preterm
infants. The effect of perinatal factors on infant self-regulation and infant coping patterns in FFSF remains unclear.
In the present study, we aim to explore the predictive influence of two main independent variables on infant attachment (at 12 and 18 months): i) infant behavioral (analyzed micro-analytically through the IRSS, ICEP, and COP) and autonomic (through cardiac
variability) self-regulation in FFSF at 6 months; and ii) mother-infant interaction in free play at 6 months (with Crittenden`s CAREIndex CARE-Index), in 60 infants born at less than 32 GW. We expect both factors to contribute independently to the outcome.
Moreover, we intend to test perinatal factors, family demographics and child development effects on independent variables and on attachment status. Perin |