Intrusive and withdrawn depressed mothers and their infants

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Abstract

This review of the literature on two different interaction styles of depressed mothers, intrusive and withdrawn, shows that withdrawn versus intrusive mothers typically have an EEG pattern that is associated with negative affect (i.e., greater relative right frontal EEG activation) as well as lower levels of the activating neurotransmitter, dopamine. These profiles also occur in their newborn infants. These prenatal effects together with the less stimulating interactive behavior of their withdrawn mothers might explain why infants of withdrawn mothers are less exploratory and have lower scores than infants of intrusive mothers on the Bayley Mental scale at one year. Interventions have been differentially tailored for intrusive and withdrawn mothers, such as interaction coaching which has been designed to decrease the behaviors of intrusive mothers (imitation) or increase the behaviors of withdrawn mothers (attention-getting). Similarly, different types of music have been tried as mood inductions for the different interaction style mothers. Although immediate positive effects have been noted, more intensive, long-term interventions may be needed to alter these negative interaction behaviors.

Section snippets

Baseline physiological and biochemical profiles of intrusive and withdrawn depressed mothers and their infants

After having documented these different behavior styles during mother–infant interactions when the infants were 3-months-old (Field et al., 1990), we argued that in addition to the behavioral differences in these different interaction style mothers, we might also see physiological and biochemical differences (Jones et al., 1997). In a model developed by Davidson (1988) and Fox (1991), directional differences in frontal EEG activation have been related to an individual’s approach or withdrawal

Differential EEG responses of infants of withdrawn and intrusive mothers to their mother’s and a stranger’s facial expressions

In the Jones et al. (1997) study just reviewed both the withdrawn mothers and infants had inferior facial expression ratings as compared to the intrusive mothers and infants. Two questions raised by these findings were: (1) Would infants of withdrawn mothers, by virtue of having less expressive mothers, show less differential responding to different facial expressions? and (2) Would they show greater differential responsivity to a nondepressed adult? In a study addressing these questions (Diego

Differential touching by intrusive and withdrawn mothers during early interactions with their infants

Most of the research on depressed mother–infant interactions has focused on facial expressions and vocalizations of the mothers. In these studies, the mothers’ vocalizations have been noted to lack intonation contour, and their facial expressions have been relatively unchanging. Although touching by the mother has been less often studied, it is one of the primary behaviors that differentiated intrusive and withdrawn mothers.

Positive touch appears to be a comforting kind of stimulation. In

Differential perceptions of self and their infants by intrusive and withdrawn mothers

In light of the many differences that have been observed between intrusive and withdrawn mothers in the studies just reviewed, we expected that intrusive and withdrawn mothers may have different self-perceptions as well as different perceptions of their infants. A surprising finding in the literature was that depressed mothers perceived their infants more negatively than other mothers perceived their infants, but they perceived their own behaviors more positively than other mothers perceived

Mothers’ self-perception of their behavior style as a potential screening measure

The fact that the mothers’ self-perceptions of their interaction styles were valid (even if the intrusive mothers saw themselves as being more intrusive than they appeared to be, and the withdrawn mothers saw themselves as being less withdrawn than they appeared to be) is perhaps not surprising given the extreme behaviors these two groups of depressed women seem to present. The validity of their self-perceptions is also not surprising given the stability of the behaviors noted in these

Using the BIS/BAS to classify mothers during pregnancy

The data from the BIS/BAS study (Diego et al., 2001) conducted when the infants were three-months-old, suggested that the scales could be used earlier during pregnancy to identify mothers who are likely to have intrusive or withdrawn interaction styles. Thus, we then gave the BIS/BAS scale to pregnant women during their first ultrasound session (Field et al., 1999). The mothers’ prenatal biochemistry was also assessed by urine assays, and fetal activity was recorded during the ultrasound

Depressed mothers who could not be classified as intrusive or withdrawn because of their “good” interaction behaviors

Some depressed mothers could not be classified as intrusive or withdrawn by their interaction style or by the BIS/BAS.In a one-year follow-up study of infants of intrusive and withdrawn mothers (Jones et al., 1997), we identified 41% of the depressed mothers as being intrusive and 38% as being withdrawn, but 21% of the mothers could not be classified as intrusive or withdrawn because their behaviors were “good” or not unlike those of nondepressed mothers (i.e., moderate smiling, sensitive

Interaction coaching for altering interaction behaviors

The importance of altering early interaction behaviors is highlighted by the fact that newborns of depressed mothers mirror their mother’s behavior and develop a depressed style of interacting as early as three months of age (Cohn et al., 1990, Field, 1984). The infants’ depressed interaction style generalizes to their interactions with nondepressed adults (Field et al., 1988). Interaction coaching was developed to improve disharmonious mother–infant interactions, including to enhance maternal

Summary

In summary, depressed mothers who can be classified by two extreme behavior interaction styles as intrusive or withdrawn or by the BIS/BAS scale as having approach or inhibited styles do not differ on their behavior and self-reports alone. They differ on many dimensions, as do their infants. Both the different style mothers and their infants have different physiological and biochemical profiles, with the withdrawn mothers and their infants typically having an EEG pattern that is indicative of

Acknowledgments

We thank the participants and the research assistants who helped with this research, supported by an NIMH Merit Award (#MH46586) and NIMH Senior Research Scientist Award (#MH00331) to Tiffany Field and funding from Johnson & Johnson to the Touch Research Institutes.

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