Elsevier

Developmental Review

Volume 48, June 2018, Pages 145-177
Developmental Review

Review
Contextual stress and maternal sensitivity: A meta-analytic review of stress associations with the Maternal Behavior Q-Sort in observational studies

https://doi.org/10.1016/j.dr.2018.02.002Get rights and content

Highlights

  • Maternal age explains up to 10.2% of variance in maternal sensitivity.

  • Maternal stress domains include sociodemography, parenting stress and mental health.

  • Ecological stressors exert small-to-moderate significant effects on sensitivity.

  • Prospective research is needed to show developmental stress effects on sensitivity.

Abstract

Maternal sensitivity is a modifiable determinant of infant attachment security and a precursor to optimal child development. Contextual stressors undermine sensitivity, but research was yet to be synthesized. We aimed to identify (i) types of stress associations analyzed in studies of maternal sensitivity and (ii) the strength of effects of various stress factors. A systematic search identified all studies that used the Maternal Behavior Q-Sort (MBQS) to code sensitivity in dyadic observations and that reported a coefficient for MBQS associations with contextual stress. Identified stressors cohered around three spheres: sociodemography (maternal education, family income, composite SES, maternal age and cohabitation status); parenting stress (perceived maternal stress related to parenting); and mental health (specifically maternal internalizing symptoms). Seven meta-analyses (combined ns range 223–1239) of a subset of 30 effects from 20 articles, and a multi-level meta-analysis (N = 1324) assessed aggregated correlations with sensitivity. Significant mean effects emerged in expected directions, whereby all stress indicators were negatively associated with sensitivity. Small effects were found for associations with parenting stress (r = −0.13) and mental health indicators (r = −0.12). Generally moderate effects were found for associations with socio-demographic indicators (range r = −0.12 to r = 0.32). Emerging findings support the proposition that in various contexts of stress, maternal sensitivity to infant needs can be undermined. Implications and research directions are discussed.

Section snippets

Background

Maternal sensitivity is a critical determinant of healthy infant development (Moran, Forbes, Evans, Tarabulsy, & Madigan, 2008). It predicts infant attachment security (Bailey et al., 2016, Bernier et al., 2014, De Wolff and van IJzendoorn, 1997, Moran et al., 1992, Pederson et al., 1990, Posada et al., 2004, Whipple et al., 2011a), thereby laying foundations for socio-emotional competence across the life-course (Hazan and Shaver, 1994, Waters et al., 2000). Sensitivity is also relevant to a

Measurement of maternal sensitivity

The Maternal Behavior Q Sort (MBQS) is an observational coding instrument based on Q-methodology used to assess maternal sensitivity in dyadic interactions. Versions of the MBQS have been developed for infants (Pederson et al., 1990) and more recently pre-schoolers (Pederson, Moran, & Bento, 2004). The MBQS can be used to code observations from both in-home and lab settings and is often applied to video-taped observational data.

Key behavioral indicators of maternal sensitivity coded by the MBQS

Identified contextual stress factors

We identified a range of effects reported in the eligible literature that represented indicators of the social ecology theoretically relevant to caregiving behavior. These contextual stress factors cohered around three main clusters: indicators of the sociodemographic ecology (specifically maternal education, family income, composite SES, maternal age, and absence of the infant’s father from the home), perceived parenting stress, and maternal internalizing symptoms (specifically unipolar

General findings

This review addresses an identified gap in understanding ecological contributions to maternal sensitivity. We found clear associations between increased levels of contextual stress or adversity and reduced levels of maternal sensitivity across three clusters: the sociodemographic ecology, perceived parenting stress, and maternal internalizing symptoms. Significant mean associations emerged in each of the seven meta-analyses. We report aggregated effects indicating that contextual factors are

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