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Predicting infant social-emotional development

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Title:
Predicting infant social-emotional development maternal depressions, child responsiveness to father, and paternal attachment
Creator:
Gannon, Katharine A
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English
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x, 87 leaves : ; 28 cm

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Subjects / Keywords:
Infants -- Development ( lcsh )
Infant psychology ( lcsh )
Children of depressed persons ( lcsh )
Mother and child ( lcsh )
Father and child ( lcsh )
Attachment behavior in infants ( lcsh )
Attachment behavior in infants ( fast )
Children of depressed persons ( fast )
Father and child ( fast )
Infant psychology ( fast )
Infants -- Development ( fast )
Mother and child ( fast )
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bibliography ( marcgt )
theses ( marcgt )
non-fiction ( marcgt )

Notes

Bibliography:
Includes bibliographical references (leaves 80-87).
General Note:
Department of Psychology
Statement of Responsibility:
by Katharine A. Gannon.

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|University of Colorado Denver
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Auraria Library
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All applicable rights reserved by the source institution and holding location.
Resource Identifier:
464614619 ( OCLC )
ocn464614619
Classification:
LD1193.L645 2009m G36 ( lcc )

Full Text
PREDICTING INFANT SOCIAL-EMOTIONAL DEVELOPMENT:
MATERNAL DEPRESSION, CHILD
RESPONSIVENESS TO FATHER,
AND PATERNAL ATTACHMENT
by
Katharine A. Gannon
B.A. Marquette University, 2006
A thesis submitted to the
University of Colorado Denver
in partial fulfillment
of requirements for the degree of
Master of Arts
Clinical Psychology
2009


This thesis for the Master of Arts
degree by
Katharine A. Gannon
has been approved
by
Peter S. Kaplan


Gannon, Katharine A. (M.A., Clinical Psychology, University of Colorado Denver)
Predicting Infant Social-Emotional Development: Maternal Depression, Child
Responsiveness to Father and Paternal Attachment
Thesis directed by Department Chair Peter S. Kaplan.
ABSTRACT
Past research has shown a possible link between maternal depression and infant
social-emotional development, but very few studies have looked at infants prior to
preschool and kindergarten age. In the current study, 11-13 month old infants of
depressed and non-depressed mothers and fathers participated in a study that assessed
the possible effects maternal depression might have on infant social-emotional and
cognitive development, maternal and paternal infant attachment, the quality of
maternal and paternal interactions with the infant, paternal involvement and infant
associative learning. Infant social-emotional and cognitive development was assessed
using the Bayley Scales of Infant and Toddler Development, Third Edition. Maternal
depression was assessed by using several different measures including the Structured
Clinical Interview for the DSM-IV-TR Research version (SCID-I: First, Gibbon,
Spitzer, & Williams, 2001), the BDI-II (Beck, Steer, & Brown, 1996), the
Postpartum Depression Screening Scale (PDSS: Beck & Gable, 2002) and by looking
at maternal Global Assessment of Functioning (GAF: APA, 2000). Maternal and


paternal attachment were assessed using the Attachment Q-Set (AQS: Vaughan &
Waters, 1990), the quality of maternal and paternal interactions was assessed using
the Emotional Availability Scales (EAS: Infancy to Early Childhood; Biringen,
Robinson, & Emde, 1993), and paternal involvement was assessed using the Child
Care Activity Questionnaire (CCAQ: Montague & Walker-Andrews, 2002). Results
found indicate that infants of mothers with depression (according to SCID-I diagnosis
and GAF scores) scored significantly lower on the Bayley-III social-emotional
development percent than their counterparts of infants of non-depressed mothers. It
was additionally found that child responsiveness to the father and paternal attachment
were both significantly associated with infant social-emotional development percent.
This abstract accurately represents the content of the candidates thesis. I recommend
its publication.
Signed:
Peter S. Kaplan


DEDICATION
I dedicate this thesis to my entire family, especially my parents, Linda and Kevin
Gannon and my grandpa, Vincent DeTolve who believed in my success, even when I
did not, were always only a phone call away with encouraging words and loving
support, and were my never-ending morale boost and cheerleading section; and to my
sister, Stephanie Gannon, for her patience, dedication and ability to remind me of the
importance in breathing, smiling, and laughing in those final weeks before my
defense.


ACKNOWLEDGEMENT
I would like to thank my committee members, Peter Kaplan, Kevin Everhart and
Amanda Moreno for their help in completing this thesis. I would also like to thank the
members of the Infant Learning Lab for their help and support with data collection.


TABLE OF CONTENTS
Figures..........................................................viii
Tables...........................................................ix
CHAPTER
1. INTRODUCTION.....................................................1
Postpartum Depression........................................1
Infant Cognitive Development.................................4
Infant Social-Emotional Development..........................6
Infant-Maternal Attachment..................................11
Maternal Emotional Availability.............................13
Role of the Father..........................................19
Infant-Directed Speech......................................23
The Current Study...........................................25
2. METHOD..........................................................28
Participants................................................28
Measures....................................................30
Structured Clinical Interview for DSM-IV-TR...........30
Beck Depression Inventory-II..........................32
Postpartum Depression Screening Scale.................33
vii


Bayley Scales of Infant and Toddlers Development -
Third Edition.................................34
Attachment Q-Set....................................36
Emotional Availability Scales.......................37
Child Care Activity Questionnaire...................40
Associative Learning Paradigm.......................41
Procedure..................................................43
3. RESULTS.......................................................45
Demographic Data...........................................45
Social-Emotional Development and Maternal Depression.......49
Sensitivity, Structuring and Child Responsiveness..........55
Attachment.................................................58
Moderation Effects.........................................60
Father Involvement.........................................64
Infant Associative Learning Paradigm.......................65
Infant Cognition...........................................66
Stepwise Linear Regression.................................67
4. DISCUSSION....................................................70
REFERENCES..............................................................80
viii


LIST OF FIGURES
Figure
3.1 The association between infant social-emotional development percent and mothers
Global Assessment of Functioning scores......................................50
3.2 Mean infant differences between maternal depression diagnoses...............52
3.3 Mean infant differences between mothers without any depression post-natal, those
who are in full remission, those in partial remission, and those who are currently
suffering from depression..................................................53
3.4 Mean infant differences between mothers structuring categories................57
3.5 Mean infant differences between father attachment categories...................59
IX


LIST OF TABLES
Tables
3.1 Demographic and diagnostic data.............................................46
3.2 Demographic and diagnostic data: Sub-sample with father participation......48
3.3 Various measures of depression and their mean differences in infant social-
emotional development...................................................54
3.4 Zero-order correlations among demographic, diagnostic and infant social-emotional
development percent variables...........................................67
3.5 Stepwise linear regression.................................................69
x


CHAPTER 1
INTRODUCTION
Postpartum Depression
Ideally the birth of a new bom infant should be a joyous occasion, where
everyone involved is happy and excited about the new family member. However, this
stereotypical belief can often lead women to not only feel worse about themselves as a
mother, but be stricken with grief and guilt, when in actuality it is not uncommon for
women to suffer what has been termed the baby blues directly after giving birth
(Abrams & Curran, 2007). This occurs when a new mother often feels exhausted,
irritable, restless, guilty et cetera, and can last anywhere from several hours to a couple
of days (Bromberg, 2007). The baby blues in and of themselves naturally occur with
newborn mothers rather frequently due to the influx of different hormone levels mixing
throughout the mothers body including estrogen, progesterone, the follicle-stimulating
hormone, the lutenizing hormone, as well as a wide range of different cortisol levels
(Abrams & Curran, 2007) and usually causes little concern. However, when the baby
blues lasts longer than a couple of days, the symptoms continue to worsen and lack of
sleep settles in, there is much cause for concern regarding the possible development of
postpartum depression.
1


According to Grace, Evindar and Stewart (2003), postpartum depression can be
defined as an episode of major depressive disorder that begins anywhere within a year
after the infants birth. It is a serious disorder that effects as many as 10-15% of
women. Moreover, if the woman has had any previous history with a mood disorder,
her chances of developing postpartum depression increase nearly four-fold with an
estimate of a 40% risk (Rychnovsky & Brady, 2007). According to the Diagnostic and
Statistical Manual of Mental Disorders Fourth edition (DSM-IV-TR, 2000) however,
postpartum depression is not a separate diagnosis, but rather refers to an episode of
depression with onset within four weeks of the infants birth. Such discrepancies may
be the result of differential diagnoses, which may in turn lead to less-specific treatment
plans and less effective, positive outcomes. At a conference on postpartum depression,
Brian Stafford (2007) revealed that although 300 women in the state of Colorado are
treated for postpartum depression, more than 8,160 women actually suffer from this
disorder. This colossal discrepancy may be attributed to several different factors
including a lack of screening by pediatricians, obstetricians and other physicians, a
general lack of awareness, resources and training, as well as the negative connotation
and stigma surrounding the diagnosis that one may be considered a bad mother
(Curtis, Robertson, Forst, & Bradford, 2007).
Postpartum depression is not solely based on depressive symptomatology or
feelings of sadness. It can also present with symptoms of obsessive-compulsivity,
2


anxiety, psychosis, post-traumatic stress, as well as many others found within the DSM-
IV-TR (Stafford, 2007). As is common knowledge, postpartum depression affects the
mother in numerous aspects of her own life aside from the infant, but can also
negatively affect the maternal-infant interactions in the first year of the infants life and
beyond (Campbell, Cohn, & Meyers, 1995). Postpartum depression can also directly
have detrimental effects on her newborn infants social-emotional development
(Maughan, Cicchetti, Toth, & Rogosch, 2007), attachment styles (Teti, Gelfand,
Messinger, & Isabella, 1995), as well as on the infants cognitive and language
development (Cogill, Caplan, Alexandra, Robson, & Kumar, 1986).
Lyons-Ruth, Lyubchik, Wolfe and Bronfman (2002) discuss a study done by the
Commonwealth Fund that included 2,017 United States households with a child under
the age of three. In this study it was found that when controlling for all socio-economic
and pre-birth factors, children who had a depressed parent experienced several
detrimental effects. For example, for each depressive symptom that the mother
endorsed, the probability that deficient scheduling of daily routines would occur, such
as regular sleep and meal times for the child, rose 31%; the peril of not playing with the
child at least once a day rose by 33%; the risk of reading to the child less than a couple
of times each week increased by 21%; and the likelihood that the mother would engage
in less than two or more positive behaviors with the child increased by 40% (Lyons-
Ruth, et al., 2002). Similarly, as cited by Field (1984), several repeated studies found
3


that mothers who were symptomatically depressed were often less energetic, less likely
to play with their child, less responsive in face-to-face interactions with their 3-to-5
month-old infants and more inactive in general, compared to non-symptomatically
depressed mothers. The results of each of these different studies reinforce the
importance in identifying postpartum depression as a diagnosis in its early phases, as
nearly every aspect of the family environment can potentially be affected by this
disorder.
Infant Cognitive Development
Cognitive development begins immediately after birth, with the synapses within
an infants brain beginning to be affected by new experiences, which leads to the
creation or strengthening of existing pathways, and the weakening or loss of unused
pathways through a process called synaptic or neural pruning (Hay, 1997; Webb, Monk
& Nelson, 2001). Infants learn not only by direct interactions with their mother, or
primary caregiver, but also by observing how their mother interacts with and responds
to, specific situations within her environment (Sroufe, 1996). Unfortunately, it is
extremely difficult for a mother with postpartum depression to interact appropriately
and sensitively with her environment. This may be attributed to a possible bidirectional
cycle that begins early on within the infants life, where both the infants and mothers
actions cyclically affect one anothers future reactions. Perhaps it may be due to genetic
4


influences on the infant of a mother with a proclivity towards depression. This may also
be connected to the fact that infants of depressed mothers often display less playful and
exploratory behaviors, and are frequently characterized as more temperamental and
moody than infants with mothers not suffering from postpartum depression (Mezulis,
Shibley Hyde, & Clark, 2004). This has been accredited in numerous studies to the fact
that in general, mothers who suffer from postpartum depression have less sensitive
parent-child interactions with their child, and are unable to read their infants wants and
needs correctly, due to their preoccupation with depressive thoughts and symptoms
(Teti, Gelfand, Messinger & Isabella, 1995).
In turn, an infants cognitive development is often negatively impacted possibly
as early as two months after birth (Whiffen & Gotlib, 1989). Similarly, infants of 9 and
18 months with mothers suffering from postpartum depression were more likely to fail
the object permanence task in Murrays (1992) study than were infants of non-
depressed mothers. Several studies, including those discussed above, have shown the
possibility that an infants cognitive development can be negatively affected when their
mother suffers from postpartum depression. Interestingly, because an infants
development does not solely rely on their cognitive development, their language and
social-emotional development may be possibly affected, as well. In other words, the
younger the infant, the more globalized and enmeshed the domains of their
development are at this young age. This would make it more likely that having a
5


mother who is depressed would expose the infant to an overall negative impact on all
areas of the infants functioning.
Infant Social-Emotional Development
Over the past fifteen years, vast improvements have been made in focusing
assessments not only on an infants cognitive, language and motor development, but
also on an infants social-emotional development, which is now seen to be just as
important when screening for developmental delays (Carter, Briggs-Gowan, & Omstein
Davis, 2004). Recent research has shown delayed or inappropriate social-emotional
development to be a clear risk factor in the possible future development of emotional
and behavioral problems, as well as the development of certain psychopathologies such
as Post-traumatic Stress Disorder (PTSD), Depression, Anxiety, Attachment Disorders
and Disruptive Behavior Disorders later in the young childs life (Carter, Brigs-Gowan,
& Omstein Davis, 2004).
Social-emotional functioning can be defined as an individuals ability to express
their own thoughts or feelings in order to communicate their needs, as well as learn
how to understand others feelings (Greenspan, 2004). Additionally, Nancy Bayley
(2005) expanded on Greenspans definition of an infants social-emotional functioning
to include the ability to self-regulate ones emotions, engage in and establish
relationships with others, communicate ones needs by using appropriate signals or
6


gestures in order to resolve issues, and develop an interest in ones surrounding
environment. These functions can all be learned through the observation of how other
important figures within the infants immediate environment model the aforementioned
behaviors, but may also be affected by genetic predispositions. According to
Bronfenbrenners (1989) ecological systems theory, which looks at four different levels
of multidirectional interactions between an individual and their environment, the inner
most level, the micro-system. This would include the individuals family and other
childcare providers within the infants life. By closely watching and interacting with
their primary caregivers, which in most cases is often the mother, infants learn how to
interact with others in a relationship, as well as how to express their complex emotions
in order to determine social-emotional models for their own future (Bayley, 2005).
Hofer (2003) has more recently found that an infants social-emotional development is
more likely shaped by how regulated the infant feels when interacting with their
primary caregiver.
Similarly, Lev Vygotsky is well known for the notion of the zone of proximal
development, which can best be described as the space between the childs actual
independent developmental stage and the prospective developmental stage (Vygotsky,
1978). In other words, it is the ability of an infant to more easily move on to the next
developmental milestone or stage through the assistance of a caregiver or the modeling
of a more developmentally advanced peer through a process known as scaffolding.
7


Scaffolding can also take place in the social-emotional realm, where an infant
looks to their primary caregiver for emotional reactions to certain situations. If a
mother reacts inappropriately or with high levels of anxiety, fear, or sadness, an infant
interprets those reactions as normal in that type of specific situation because they
develop their internal working sense of themselves and ability to regulate their own
emotional reactions within the context of their primary caregiver (Hoffman, Cmic, &
Baker, 2006). Parents are constantly modeling behavior for their infants and teaching
them how to alter and adapt their arousal levels while experiencing difficult situations
(Hoffman, et al., 2006) whether or not they are fully aware they are doing this.
Likewise, it has been found that when infants experience love, acceptance and approval
from their parents, their self-worth and confidence increase; whereas if their parents are
rejecting, the infants grow up deeming themselves as unworthy of others love, and act
in ways that extract further rejection from others (Crockenberg & Leerkes, 2003).
Time and again infants and children who grow up with a mother who suffered
from postpartum depression have been found to develop less optimal socio-emotional
outcomes (Lyons-Ruth, Connel, Zoll & Stahl, 1987). When suffering from postpartum
depression, it is often difficult for a mother to get through necessary daily actions, let
alone model appropriate social-emotional behavior. This loss may be reflected within
the infants inability to self-regulate that will often follow them throughout their
childhood. Emotion regulation can best be delineated into individual feelings, the
8


explicit expression of these feelings and emotions, as well as the individuals
physiological arousal. Included is how intense the reaction is, how frequently it occurs,
the amount of time lapsed between the stressful situation and the subsequent response,
as well as the ability to rebound from a negative affect (Cummings, & Davies, 1999).
Therefore, the emotional security hypothesis examines how an infant or child responds
to a stressful event or situation emotionally, behaviorally and psychologically, and their
subsequent ability to utilize specific approaches that will enable them to reach a sense
of emotional security or emotional homeostasis (Maughan, Cicchetti, Toth & Rogosch,
2007). However, when the infants mother is suffering from postpartum depression,
their interactions often lack the quality that non-depressed mothers have with their
infants, leading the infant of the depressed mother to feel emotionally insecure and
overwhelmed when environmental stressors occur naturally throughout their life
(Maughan, et al., 2007). According to Sroufe (1996), this inability to regulate emotions
will hinder their capacity to develop peer relationships, leaving them open to rejection
at school and in other social settings.
When looking at 4 year old childrens ability to regulate their emotions
appropriately, Maughan, et al. (2007) found that for mothers who experienced
depression within the first 21 months of the infants life, 73% of their infants displayed
patterns of dysregulated emotion after witnessing anger, while only 43% of infants of
nondepressed caregivers demonstrated this reaction. Additionally, Carter, et al. (2001)
9


found that when 3 year old boys do not develop these appropriate social competencies
they are more likely to rely upon the typical externalizing behaviors that can be utilized
to self-soothe or gain attention from others; whereas girls are at a greater risk for
internalizing their problems and withdrawing from others. Interestingly enough, these
results mimic most of the sex differences that can be found throughout different
psychopathologies in later adulthood (Olweus, 1979). Although parental depression
has been found to negatively affect a childs social-emotional maturity (Bayley, 2005;
Maughan, Cicchetti, Toth, & Rogosch, 2007; Cummings & Davies, 1999) and the
development of specific psychopathologies later in life, very few studies have looked at
the effects maternal depression might have on an infants social-emotional
development. It is therefore imperative to assess whether an infants social-emotional
development can be affected at such an early age by the mothers postpartum
depression in hopes of providing early and effective treatment as soon as possible. This
would provide the infant with a secure base from which to model emotion-regulation,
appropriate facial expressions and how to interact socially, all skills that will be
necessary to have throughout the rest of their lives.
10


Infant-Maternal Attachment
Bonding between mothers and their infants begins immediately after birth and
can set the stage for the infant to develop a working model of not only themselves, but
one with other family members, peers and strangers, and how to subsequently interact
with others (Bowlby, 1969). A theory of attachment styles was first developed by
Mary Ainsworth in the 1960s through her Strange Situation paradigm. From this,
Ainsworth developed three main types of attachment styles: secure, anxious-ambivalent
insecure, and anxious-avoidant insecure. Mothers who belong to the secure attachment
type are often characterized as having a sensitive, understanding and compassionate
parenting style (Teti, Gelfand, Messinger & Isabella, 1995). A mother who has a secure
attachment style is often seen as available, and responsive as well as eager to meet the
infants needs; whereas a mother with an insecure attachment with her infant can
generally be labeled as having the tendency of an insensitive and unreceptive parenting
style (Teti, et al., 1995). Mothers with anxious-ambivalent insecure attachments often
attempt to meet the infants needs, but usually on their own terms, when they
themselves are emotionally ready to nurture, not necessarily when the infant needs it
(Berk, 2006). Mothers with an anxious-avoidant insecure attachment can be
characterized as extremely disengaged and rarely meeting the childs needs (Berk,
2006).
11


Several studies have already discovered a connection between insecure
attachment styles and maternal depression; however, few consider infant social-
emotional development as a piece in the puzzle. Teti, et al., (1995) found that early
insecure attachment has consistently been associated with maternal characteristics such
as unresponsiveness as well as rejecting and insensitive parenting. Interestingly enough,
when one considers what adjectives have been used to describe mothers who suffer
from depressioninsensitive, inactive, possibly more hostile and critical, helpless,
feelings of vulnerability, powerlessness and weakness, intrusive and/or disengaged
structuring, unorganized, unreceptive, less provoking, et cetera (Teti, et al., 1995)
many of these characteristics match up with those used to describe the traits of mothers
with insecure attachments. Subsequently, it has been found that having parental
depression increases the likelihood for an infant to develop an insecure attachment type
(Lyons-Ruth, et al., 1987). In 1995, Teti, et al., found that up to 80% of infants with
depressed mothers had developed an insecure attachment style, although he also
mentioned that most other studies found that percentage to be closer to 55-60%.
However, even 55% is a large percentage of insecure attachment styles being found in a
specific subgroup of women, as within the general population estimates are closer to
33% in insecure attachment style. Moore, Cohn and Campbell (2001) additionally,
found a significant link between insecure attachment styles in infants and an increased
risk of later developing a vast array of psychological, behavioral and cognitive
12


disabilities. Furthermore, Cummings and Davies (1999) found that attachment
disturbances have long been playing a role in the transmission of disorders, such as
depression across generations.
Maternal Emotional Availability
Emotional availability refers to an overall sense of empathy, sensitivity,
responsiveness and positive affect (Hoffman, et al., 2006). Coyne, Low, Miller, Siefer,
& Dickstein (2007) were able to delineate emotional availability even more specifically
as empathic understanding, defined as a parents capacity to look at different situations
from the childs point of view, to understand the childs motives, and the ability to
incorporate new information about the child into previously held notions. The
Emotional Availability Scales 2nd edition developed by Biringen, Robinson and Emde
(2000) rates parents on five different scales to assess parental emotional availability as
fully as possible, including: parental sensitivity, parental hostility, parental structuring,
child responsiveness to parent and child involvement of parent. Because Hofer (2003)
considers infant social-emotional development to be based on how the infant feels
throughout interactions with the caregiver, maternal emotional availability may play a
key role in predicting infant social-emotional skill development.
As would be expected, parental sensitivity plays a large role in appropriate
scaffolding for infants and young children. The parent must be sensitive to where the
13


child is at developmentally, what the child has already learned, what the child is ready
to learn, how to model that behavior and when to eventually pull back in order to allow
the child to do it on their own (Hoffman, et al., 2006). How the mother structures this
learning experience also contributes to how easily the child moves on to the next
developmental milestone. Although finding an appropriate level of structuring can be a
delicate and difficult process, the mother must be sensitive to the fact that the need for
structuring changes with each interactive situation, and must be attuned to that
necessary transition. When mothers provide appropriate structuring to their children,
they are more likely able to learn from their mothers support in dealing with future
stressors and develop goal-directed strategies at resolving conflicts, whereas children
who have not received appropriate scaffolding will lack these emotion regulation
competencies (Hoffman, et al., 2006). This reiterates the idea that emotional
availability is more than just providing sensitive interactions with ones child, but also
having the ability to read their childs developmental needs and scaffold appropriately.
Child responsiveness to the mother typically occurs when the infant feels safe
and at ease with the mother. This transpires when several different variables
consistently join together to establish a trusting and reliable relationship between the
infant and the mother. Maternal sensitivity, low intrusive behaviors and hostility, and
flexible and appropriate levels of structuring for the individual infants needs are
14


paramount to the infant responding in an involving manner initially to the mother, and
later to others within the infants life (Carter, Briggs-Gowan & Omstein Davis, 2004).
As reviewed above, when a mother suffers from postpartum depression,
scaffolding can be extremely difficult in and of itself, let alone trying to incorporate
sensitivity and proper structuring throughout each and every parent-child interaction.
Unfortunately for families who have a mother with postpartum depression, it has been
found that maternal scaffolding plays a significant role in a childs emotional
development when they get older. This then in turn, relates back to the detrimental
effect poor social-emotional development has on a child, as well.
For several years now, research has shown a clear connection between
postpartum depression and parental emotional unavailability and psychological
insensitivity, both of which are known to have detrimental effects on infants continual
development (Cummings & Davies, 1999). Even more recently, however, researchers
have been asking the question of whether it is the actual postpartum depression that
influences the maternal sensitivity and structuring, or whether it is a combination of
other confounding variables such as marital discord, financial problems, infants with
difficult temperaments, and any other significant life stressors. Campbell, Brownell,
Hungerfod, Spieker, Mohan and Blessing (2004) make note that just because a woman
experiences depressive symptomatology, does not automatically mean that she is
disengaged from and insensitive to her child. Therefore, if a mother suffering from
15


postpartum depression is able to sensitively respond to her infant, this may in fact act as
a buffer for the subsequent development of an insecure attachment style or the
predicted poor social-emotional possible outcomes. This research gives hope for
women who suffer from postpartum depression, that their infant can develop secure
attachments with them and in turn avoid the predicted detrimental effects within their
social-emotional and cognitive realms. It is thought that depressed mothers act less
sensitively during their interactions with their infants perhaps because they are
preoccupied with the negative thoughts and cognitions that coincide with depressive
symptoms (Crockenberg & Leerkes, 2003).
However, whether there are mediating and moderating factors involved in the
relationship between postpartum depression and emotional availability or not, it is
agreed upon that when interactions are negatively impacted by postpartum depression
these parent-child interactions can be divided into one of two categories: withdrawn or
intrusive behaviors or no effect. Some say that mothers suffering from depression may
automatically interpret their infants poor temperament as a form of rejection, and
therefore either react with anger or withdraw themselves from the relationship
(Crockenberg & Leerkes, 2003). This reaction can be assessed by observing how the
mother structures play interactions.
After videotaping specific interactions between mothers and their infants, Cohn,
Matias, Tronick, Connel & Lyons-Ruth (1986) recognized withdrawn mothers as
16


displaying behaviors that convey apathy such as not directly facing the infant,
slouching in their chairs and speaking to the infant without using a higher pitched
voice, slower speech, or any facial expressions. Lyons-Ruth, Lyubchik, Wolf, &
Bronfman (2002) state the withdrawn parents portray a sense of fearfulness and
helplessness that the infant often easily picks up on.
According to Cohn, Matias, Tronick, Connel & Lyons-Ruth (1986), mothers
who exhibit intrusive behaviors during their video-taped interactions with their infant
were often coded as having less positive and more negative expressions including
poking and pulling at their infant. In a completely different experiment, mothers who
exhibited intrusive behavioral interactions were found to vocalize fewer positive
affirmations and more negatively toned expressions to their infant (Murray, Fiori-
Cowley, Hooper, & Cooper, 1996).
It should be noted, however, that mothers who were characterized as intrusive
and appeared aversive only displayed this behavior when forced in a laboratory
situation to play with their child. When given the freedom to interact with their infant
at their own discretion, they generally behaved in a more withdrawn style by often
distancing themselves from their infant, at times even retreating to a different room
(Cohn, Matias, Tronick, Connel & Lyons-Ruth, 1986). This brings up the question as to
whether these subcategories are alternatively portrayed by all mothers with postpartum
depression, or whether each mother belongs to one or the other subgroup throughout
17


the majority of her interactions with her infant (Lyons-Ruth, Lyubchik, Wolf, &
Bronfman, 2002). Further research is needed to answer this question. However, Cohn,
et al. (1986) and Lyons-Ruth et al. (2002) point out that depressed mothers who are
feeling hostility either towards their infant or the situation at hand, may subconsciously
be coping with these negative feelings they know are bad by in fact limiting their
interactions with the infant, often by actually removing themselves physically from the
infants presence. This likely is more helpful to the infants development than if the
mother were to continue to interact with the infant in a hostile or aggressive manner
(Cohn, et al., 1986). Additionally, Lyons-Ruth, Lyubchik, Wolf, & Bronfman (2002)
found that these negative parent-child interactions do not subside along with depressive
symptomatolgy, inferring the need to identify them early in order to correct these
negative interactions.
18


The Role of the Father
The role of the father within the family has continued to change over time,
evolving from a role as the powerful family leader, to the moral teacher, to the
breadwinner, to a sex-role model, and finally now as a nurturer (Lamb & Tamis-
Lemonda, 2002). Recent research agrees that the role of a father is not unidimensional
as previously believed, but instead the father plays a significant part in many different
areas of the family including those aforementioned, as well as a positive role model, a
friend and companion, a spouse and social support for the mother, a teacher, a care
provider and several other roles that are too many to mention within this thesis.
Although most research has shown that the amount of time a father spends with
their infant compared to that of the mother is significantly less (even when the mother
is employed and the father is not), because of the type of interactions fathers have with
their children the direct engagement and involvement may appear more salient to the
child (Lamb, & Tamis-Lemonda, 2002). For example, most research has shown the
father-child interactions focus around play, which is often animated, rowdy and
stimulating for the infant or child, and therefore possibly influences the child more
powerfully than originally thought based on the amount of time spent directly with the
child (Lamb, Frodi, Hwang, & Frodi, 1983). Fortunately, Lamb & Tamis-Lemonda
(2002) conclude that the amount of time the father spends with the child is not as
important as how the father interacts with the child while they are together.
19


Additionally, research has exhibited time and again how important the father is
to the development of an infant. Not only does the father-infant interaction lead to a
specific attachment style, but when the father reacts sensitively to the child, their
cognitive and language outcomes are predicted nearly as strongly as it is for if the
mother acted in a sensitive manner (Cox, Owen, Henderson & Margand, 1992). It was
additionally found that infants who had fathers that were more sensitive, affectionate
and positive with them at 3 months of age successfully developed secure attachment
styles at the age of 9 months with their father (Cox, et al., 1992). Even more hopeful, is
the idea that according to Lamb (2002), if an infant is able to develop a secure
attachment with one parent, this partially compensates for the negative effects from the
development of the insecure attachment with the other parent. Moreover, Huth-Bocks,
Leendosky, Bogat, & von Eye (2004), found that when mothers with postpartum
depression had a high level of social support, they displayed significantly fewer anxious
behaviors and tendencies within the Strange Situation paradigm, and were less likely to
have insecurely attached infants. Furthermore, after controlling for socioeconomic
differences, infants who had fathers that were highly involved in their life achieved
higher IQs than infants whose fathers were less involved or absent (Lamb, 2002).
It then directly follows that if an infant has a highly involved and sensitive
father in addition to a mother who suffers from postpartum depression, the father may
in fact act as a buffer against the negative consequences in the realms of cognitive and
20


social emotional development, as well as attachment styles. Hosain, Field, Gonzalez,
Malphurs & Del Valle (1994) explain this phenomenon through the possibility that
these infants are seeking out positive interactions and relationships with their father, as
they are on some level aware that something is qualitatively missing from their
interactions with their mothers. Youngblade and Belsky (1992) took this hypothesis a
step further and concluded that if the child had not developed a secure attachment with
either parent during infancy, they then begin to look outside of their own family
structure for positive influences and relationships, generally to be found in peers. Lamb
& Temis-Lemonda (2002) hypothesize different reasons for the significantly more
positive outcomes of infants with highly involved and sensitive parents. First of all, if
an infant is influenced by two different parents, each of which more than likely have
different behavioral styles as well as different ways of interacting and relating to the
world, the infant then has two different perspectives to develop cognitively from.
Additionally, if the father is highly involved in the care-taking of the child, this
alleviates much extra stress from the mothers role, making the marital relationship
more positive, which in turn effects the relationship between the mother and infant as
well. However, Lamb and Temis-Lemonda (2002) note that when fathers are forced to
interact with their child against their will (say due to the loss of a job), these positive
outcomes for the infant are not present and this is likely because the father resents
having to do womens work and the wife may feel even more burdened by the fact
21


that her husband is not financially providing for the family anymore. Marital conflict
and dissatisfaction consistently correlate with child maladjustment in many of the
significant developmental areas (Lamb & Temis-Lemonda, 2002).
However, it is definitely worth mentioning that as motivation, self-confidence
and support from their spouse, other family members and community increase, so does
father involvement with their infant and child. In a study done 30 years ago by Quinn
and Staines (1979), it was found that 40% of fathers wanted to spend more time than
they were able to with their children. However, motivation to spend more time with
their infants is not enough. The mother needs to encourage the father to help out with
the infant; as well as being positive and avoiding criticism in both the verbal and
physical forms (grimacing when he is unable to soothe an upset infant) which will help
to boost the fathers self-confidence in his own parenting abilities (Lamb & Temis-
Lemonda, 2002). The fathers role, although always important in an infants cognitive,
social-emotional and attachment style development, is especially important when the
mother suffers from postpartum depression.
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Infant-Directed Speech
Infant-directed speech differs in very specific, predictable ways from adult-
directed speech. When an adult talks to an infant they naturally shorten sentences to
phrases, increase their pitch, utilize a sense of rhythm, repetition and rhyme, exaggerate
vowel sounds, as well as slow down the pace in order to catch and retain an infants
attention (Femald & Simon, 1984).
This lab has previously done several different experiments related to infant
associative learning paradigms. In its most basic form, classical conditioning is utilized
to pair a conditioned stimulus (CS) with an unconditioned stimulus (UCS) in order to
produce the expectation for an infant that the two will appear together. Associative
learning can then be observed in the infant when the CS appears alone, the infant
responds more strongly or looks longer at the visual stimulus, then when the CS and
UCS were paired together previously (Kaplan, Fox, & Huckeby, 1992). One of the first
findings in this lab used the infant-directed versus adult-directed speech as the original
CS, and the UCS was the presentation of a smiling face. The result was that infant-
directed speech was more effective in infant learning rather than adult-directed speech
(Kaplan, Jung, Ryther & Zarlengo-Strouse, 1996). In 1999, Kaplan, Bachorowski, and
Zarlengo-Strouse found that there was a key difference in infant-directed speech when
produced by mothers suffering from depression, and that as a result their four-month
old infants did not have as high of learning scores as infants of non-depressed mothers
23


in the infant associative learning paradigm experiment. In 2001, Kaplan, Bachorowski,
Smoski and Zinser discovered that if a depressed mother was on anti-depressants and
received a diagnosis of at least partial remission from her depressive episode, her
infant-directed speech was comparable to that of non-depressed mothers. Later,
Kaplan, Bachorowski, Smoski and Hudenko (2002) expanded their experiment to
include infants listening to non-depressed unfamiliar female voices and found that
although they failed to learn the associative learning paradigm with their own depressed
mothers infant-directed speech, they were able to do so with an unfamiliar non-
depressed womans infant-directed speech. In 2004, Kaplan, Dungan and Zinser
discovered that infants of depressed mothers failed to learn the conditioned-attention
learning paradigm in response to their own mothers or that of non-depressed unfamiliar
voices, but were in fact able to learn the paradigm better when exposed to an unfamiliar
non-depressed male voice than infants of non-depressed mothers. It will be interesting
to see if these results are at all mirrored in regards to infant social-emotional
development, in that infants of depressed mothers do more poorly on the questionnaire,
or that the relationship with the father buffers the infants social-emotional
development score.
Hay (1997) concludes that intelligence is really just an individuals ability to
leam. Similarly, Stevenson and Lamb (1981) propose that intelligence on infant tests is
likely to be significantly adversely affected by detrimental social-emotional factors that
24


in essence remove the infants innate motivation to do well on tests. If these are both
true, infant-social emotional development should be somewhat related to infant learning
scores in the conditioned-attention learning paradigm.
Current Study
The objectives of this study were to observe the relationship between
postpartum depression and infant social-emotional development. The majority of
studies published on how postpartum depression may have an effect on a childs social-
emotional development have been using children in preschool, kindergarten and
grammar school. This study, therefore, explores the possibility that social-emotional
development may be affected much sooner in a childs development, around 11-13
months. This will show how important early intervention can be in infant development,
especially in the social-emotional realm. Other factors such as attachment, sensitivity,
structuring, child responsiveness, cognitive Bayley-III scores, infant associative
learning scores and father involvement were explored in relation to infant social-
emotional development.
The main hypothesis of this study was that maternal depression would have a
significant effect on infant social-emotional development, with the specific prediction
that infants of depressed mothers would score lower than infants of non-depressed
mothers on the Bayley-III social-emotional questionnaire.
25


This study also assessed whether maternal and paternal sensitivity, as well as
the childs responsiveness to the mother and father, were positively associated with
infant social-emotional development. It was also predicted that optimal levels of
maternal structuring would lead to higher infant social-emotional developmental
percent, whereas under-structuring (withdrawn) and over-structuring (intrusive) scores
would both have infants with lower social-emotional developmental percents.
It was hypothesized that there would be a positive association between both
maternal and paternal secure attachment and higher infant-social-emotional
developmental percent; whereas lower infant social-emotional percent would be related
to maternal and paternal insecure attachment.
Moderation effects between maternal depression and infant social-emotional
development percent would be explored with maternal and paternal attachment,
sensitivity and structuring scores. Multiple studies have shown a link between maternal
depression and insecure attachment development (Cummings & Cicchetti, 1990;
Cummings & Davies, 1999; Teti, et al., 1995; Murray, Fiori-Cowley, Hooper and
Cooper, 1996), and it would be interesting to see if there is an interaction effect along
with infant social-emotional development within this study. Additionally, because
Campbell, Brownell, Hungerforf, Spieker, Mohan and Blessing (2004) found a link
between maternal depressive symptoms, lower sensitivity and insecure attachment,
within this study it will be interesting to see if infant attachment, maternal sensitivity
26


and infant social-emotional development interact significantly together. Finally,
differentiating between withdrawn versus intrusive maternal structuring behavior as
Cohn, Matias, Tronick, Connel and Lyons-Ruth (1986) did and exploring the
possibility as a moderator between infant attachment and infant social-emotional
development will be explored also.
It was predicted that as father involvement in both care-taking and play-time
activities went up, so too would infant social-emotional development percent.
A positive relationship was also predicted between infant social-emotional
development percent and infant associative learning scores, as well as infant cognitive
scores from the Bayley-III.
27


CHAPTER 2
METHOD
Participants
A sample of 77 depressed and non-depressed mothers and their infants between
the ages of 11-13 months participated in the study, and were paid for their participation.
Most participants were recruited through an advertisement in a free, local parenting
magazine called Colorado Parent that is available at newsstands and supermarkets.
Others were recruited through the distribution of flyers at several different Early Head
Start centers throughout the Denver area. Infant age at the time of testing ranged from
308 days to 429 days, with a mean age of 363.92 days (SD = 31.50). Thirty-seven
(48.1%) of the infants were boys and forty (51.9%) were girls. The age for mothers
ranged from 20 to 40 years, with the mean age at 30.27 years (SD = 5.06). Forty-eight
(62.3%) of the infants were Caucasian, twelve (15.6%) were Latina, four (5.2%)
reported being part Caucasian, part Latina, five (6.5%) were African American, one
(1.3%) reported being part Latina, part African American, one woman (1.3%) reported
being part Latina, part Asian, four (5.2%) were Asian, and 2 (2.6%) were Native
American. Household income varied from a range of $0-$6,000 to more than $50,000
with the modal income falling into the more than $50,000 range. Sixty-one (79.2%) of
the women were married and sixteen (20.8%) were not. Mothers education ranged
28


from no high school to having an advanced degree, with the modal and median of
mothers being categorized as having a four-year college degree (33.8%). Participants
in this study had anywhere from one to five children in the family, with the modal
number of kids falling at one (46.8%).
Of the 77 women who participated in this study, between 44 and 49 of the
women also participated in a related study that required involvement of the childs
father. Within this subsample, the mothers age ranged from 20-40 years, with a mean
age of 30.40 (SD = 5.19). Infant age ranged from 319-420 days, with a mean age of
366.50 days (SD = 23.44). Twenty-seven (56.3%) of the infants were girls and twenty-
one (43.8%) were boys. The fathers age ranged from 21-47 years, with a mean age of
31.81 (SD = 5.65). Thirty-four (70.8%) of the infants were Caucasian, three (6.3%)
were Latina, three (6.3%) reported being part Caucasian, part Latina, three (6.3%) were
African American, four (8.3%) were Asian, and one (2.1%) was Native American. The
household income varied from a range of $0-$6,000 to more than $50,000 with the
median income falling into the more than $50,000 range with 56.3% of the participants.
Mothers education ranged from no high school to having an advanced degree, with the
median of mothers being categorized as having a four-year college degree (29.2%).
Fathers education ranged from no high school to having an advanced degree, with the
median of fathers being categorized as having a four-year college degree (45.8%).
29


Participants in this study had anywhere from one to four children in the family, with the
median number of kids falling at one (52.1%).
Measures
Structured Clinical Interview for the DSM-IV-TR Research version (SCID-D
The Structured Clinical Interview for the DSM-IV-TR Research version (SCID-
I), is a semi-structured interview that takes approximately 30-60 minutes to administer.
It utilizes both closed and open-ended questions in order to make a well-informed
clinical diagnosis if necessary. Because of its in-depth information seeking nature, the
SCID-I allows administrators to assess level of severity, course specifiers, past mood
disturbances, and subtypes of each disorder (First, Gibbon, Spitzer, & Williams, 2001).
Much research has been done on the SCID-I, and its validity and reliability have been
fully supported through test-retest reliability values of 0.70 to 1.00 (First, et al., 2001).
Each mother was interviewed using the SCID-I by a M.A. level, trained, clinical
psychology graduate students in order to obtain a DSM-IV Axis-I diagnosis. Within
this data set, there were six mothers who met DSM-IV criteria for a Major Depressive
Disorder, eleven mothers who were classified as in partial remission from a Major
Depressive Disorder episode and fourteen mothers who were classified as in full
remission from a Major Depressive Disorder episode. Overall, thirty-one mothers
30


experienced a Major Depressive Disorder episode at some point after the birth of their
child.
After the completion of the SCID, the administrator must assign a numerical
representation of the mothers overall daily functioning level, at the time of assessment
from a scale of 1-100 based on their opinion (APA, 2000); this is called the Global
Assessment of Functioning or GAF. It then follows that the GAF score can vary from
assessment date to assessment date, depending upon the womans current functioning
regarding her mental health diagnoses. It falls under the DSM-IV-TR Axis-V scale
and is included in all official diagnoses. Although the scale ranges from 1-100, these
ratings are divided into 10 different categories of functioning, with the lower scores
symbolizing poor daily functioning. The GAF score takes into consideration both the
severity of current symptoms and the individuals functioning ability within social,
occupational and psychological realms (Sadock & Sadock, 2003).
31


Beck Depression Inventory-II (BDI-II)
The Beck Depression Inventory II (BDI-II) is a 21 item, self-report measure that
assesses affective, cognitive, motivational and physiological symptoms (Groth-Mamat,
2003). Because it assesses depressive symptomatology on a scale of 0-3 for each item,
the BDI-II is able to assess the degree or severity of the depression in increments of
mild, moderate or severe (Groth-Mamat, 2003). Similar to the SCID-I, the BDI-II has
been shown to have good reliability and validity, with internal consistency ratings
ranging from 0.89 to 0.94 as well as test-retest reliability of 0.93 spanning one week
(Groth-Mamat, 2003). Additionally, the BDI-II has been shown to have both
acceptable concurrent validity as well as discriminate validity (Groth-Mamat, 2003).
Because only six of the mothers within this study actually met criteria for a
DSM-IV, Axis I diagnosis of Major Depressive Disorder currently, the scores from the
BDI-II were used instead to distinguish between mothers with an elevated score which
was 14 or higher, versus mothers within the non-elevated category scoring 13 or lower
on the BDI-II (Beck, Steer, & Brown, 1996). Within the elevated BDI-II category, there
were 25 mothers (M = 19.84, SD = 5.88) and 52 mothers within the non-elevated BDI-
II category (M = 5.0, SD = 3.92). All six mothers who met criteria for a DSM-IV, Axis
I clinical diagnosis of current episode of Major Depressive Disorder had a BDI-II score
of 19 or higher. The BDI-II was used in this study as a supplement to the SCID-I in
order to assess women who were experiencing depressive symptomatology, but whose
32


symptoms were not necessarily numerous or severe enough to qualify for a DSM-IV-
TR diagnosis of Major Depressive Disorder.
Post-partum Depression Screening Scale (PDSS)
The Post-partum Depression Screening Scale (PDSS) consists of 35-items that
have specifically been screened for new mothers focusing on seven key areas (with
alpha reliabilities): sleeping/eating disturbances (.83), anxiety/insecurity (.83),
emotional lability (.89), mental confusion/cognitive impairment (.91), loss of self (.94),
guilt/shame (.89) and thoughts of harming oneself or suicide (.93) (Beck & Gable,
2001; Beck & Gable, 2000). The PDSS is scored on a 5-point Likert Scale with scores
falling within the ranges of: normal adjustment, significant symptoms of PDD, and
positive screen for PDD (Beck & Gable, 2000) is written at a third grade reading level
and can be completed by the mother within 5-10 minutes (Rychnovsky & Brady, 2007).
By using the confirmatory factor analysis, construct validity was assessed with a
minimum t-value of 14.79 (Beck & Gable, 2001).
33


Bavlev Scales of Infant and Toddler Development Third Edition ('Bavlev-IID
The Bayley-III is an instrument that measures the developmental functioning of
infants and toddlers who are between the ages of one and forty-two months, by
specifically assessing their cognitive, motor, language, social-emotional and adaptive
behavior (Albers & Grieve, 2006). Through these assessments, it can be determined
whether an intervention is necessary for each individual infant or toddler, and exactly
what that intervention needs to focus on.
The cognitive scale of the Bayley contains 91 items total, although testing is
stopped after a child misses five items in a row. During the cognitive portion of this
assessment, the infant usually sits on the lap of the primary caregiver and is seated
across from the lab administrator. This portion of the Bayley-III is purely interactive,
where the lab administrator introduces an item and then assesses whether the infant is
able to complete the presented task. Administration time varies depending on the
childs temperament and present mood, but averaged approximately one hour for
infants.
The social emotional portion is assessed by administering a questionnaire
booklet to the mother to identify which social-emotional milestones the infant has
achieved to date. The questionnaire consists of 35 items of which the primary caregiver
selects one of six ratings: 0 (cant tell), 1 (none of the time), 2 (some of the time), 3
(half of the time), 4 (most of the time), or 5 (all of the time) (Albers & Grieve, 2006,
34


p. 181). The social emotional segment includes feedback on the childs level of interest
in things such as colors, lights or bright things, how easily they are able to get the
infants attention, how easily the infant is soothed or calmed down after irritability, and
how often the infant responds to other people by making noises and facial expressions
(Bayley, 2005).
The cognitive scales reliability was tested using the split-half method with a
composite average reliability coefficient of 0.91 showing great reliability. Similarly,
the social-emotional portion of the Bayley-III also has great reliability with internal
consistency coefficients ranging from 0.83 to 0.94 (Albers & Grieve, 2006). Validity
for the cognitive scale of the Bayley-III was confirmed through a three factor model
analysis across all ages (with the exception of 1 -6 month olds). When compared to the
BSID-II Mental Index, a correlation was found to be 0.60. Additionally, when the
cognitive portion was compared to the Wechsler Preschool and Primary Scale of
Intelligence a correlation was found to range from 0.72-0.79. Validity of the social-
emotional scale is overall rated as good, based on research comparing it to previously
validated measures such the Greenspan Social-Emotional Growth Chart (Bayley,
2005). However, when compared to the BSID-II Behavior Rating Scale, the correlation
composite was only 0.38, which was more than likely due to the new items inserted and
the overall format changes (Albers & Grieve, 2006). The Bayley-II only consisted of
three scales (Mental, Motor and Behavior), and the social-emotional scale in the
35


Bayley-III replaced the Behavior Rating Scale from the Bayley-II. Additionally, a
significant number of items were excluded from the Bayley-III from previous versions
based on being (a) difficult to administer or score, (b) unpleasant for the child, (c)
redundant with other items, (d) potentially biased toward a racial or ethnic group, and
(e) lacking in value (Albers & Grieve, 2006, p. 185).
Attachment Q-Set (AQS)
The Attachment Q-Set (AQS) assesses the infants security of attachment to a
primary caregiver. Researchers attended two different hour and a half home visits and
video-taped them. One home visit assessed the mothers attachment relationship with
the infant, while the other did so with the father. After observing the two interact for
the designated time period, two researchers return to the lab and set up three piles of
cards with items characterizing behaviors which are broken down into: Insecure, Did
Not See/Not Sure and Secure. Each of these three piles is then broken down again
numerically into three additional piles:: 1-3, 4-6, 7-9 (9= saw and completely sure, 7 =
mother reports it, but did not actually see it), resulting in nine total piles with ten cards
in each pile. Correlations are run between the researchers AQS findings along with
what the experts refer to as the ideal score, to achieve the infants attachment score.
The AQS must have at least a 0.70 inter-rater reliability between the two researchers or
else a third researcher is brought in to discuss and settle discrepancies. The AQS has
36


shown significant cross validation several times with the strange situation paradigm
(Vaugn & Waters, 1990).
Emotional Availability Scales (EAS)
The Emotional Availability Scales (EAS) are designed to provide a global
assessment of the quality of care-infant interactions. They are comprised of five global
categories that rate both the emotional availability of the mother toward the child
(Maternal Sensitivity, Maternal Structuring/Intrusiveness and Maternal Overt/Covert
Hostility) and that of the child towards the mother (Child Responsiveness towards
Mother and Child Involvement of Mother). In general, the EAS take into consideration
the dyad as a whole, rather than coding occurrences of specific behaviors.
Additionally, although the categories contain the word maternal in them, all of the
scales are applicable to the father figure as well. A trained, M.A. level clinical
psychology graduate student coded 10-15 minute video play interactions.
Maternal sensitivity encompasses several different traits that allow for the
mother to interact and respond affectively with appropriate warmth, emotion and
conflict resolution, all of which depend on the mothers ability to accurately interpret
the infants nonverbal cues (Biringen, Robinson, & Emde, 1993). While rating an
interactions sensitivity score, the rater must take into account several different and
equally relevant aspects of the relationship. For example, as mentioned before affect is
37


extremely important to the rating, as is the clearness of maternal perceptions and
responsiveness, how appropriately the mother judges timing throughout the interaction
(i.e.: is she aware of how transitions may effect the infant at certain times), how flexible
the mother is and whether she is tuned in to the infants nonverbal cues and needs,
how creative she is during play routines, and how she attends to the infant in general
(Biringen, Robinson, & Emde, 1993). The Maternal Sensitivity scale ranges from a 10
or hyper-sensitive (characterized by an anxious atmosphere as though the mother was
putting on a performance) to a 1 or highly insensitive (where it appears the mother may
not have any knowledge of crucial child-rearing techniques) with around a 9 being
optimal (Biringen, Robinson, & Emde, 1993).
Maternal Structuring/Intrusiveness attempts to observe the extent to which the
mother constitutes a play session with her infant. The rater must ask themselves if the
mother is following the childs lead and setting appropriate boundaries and limits. An
overprotective mother is in complete control and rarely follows the infants lead,
receiving a rating of 9; whereas the mother who sets no limits and seems more like a
peer than a parent would receive a scale of 1. An optimal maternal
structuring/intrusiveness rating falls around a 5 where the mother is able to read what
the infant is interested in doing, and provides appropriate developmental scaffolding for
her infant (Biringen, Robinson, & Emde, 1993).
38


The Child Responsiveness to the Mother category can only be rated post
maternal bid and is based on whether the infant is clearly enjoying themselves with
their mother, and how willing and open the infant is to respond to the mothers bid.
Although affect is taken into consideration when coding for this variable, negative
affective responses from the infant are not to be coded as responsive, and child
behaviors (i.e. laughing, smiling, babbling, et cetera) are to only be considered so if it is
clearly in reaction to the mothers bid. This scale ranges from a 9 or overly responsive,
(where although the infant is clearly enjoying the interaction with the mother, the
infants autonomy is at stake because it appears the infant does everything in response
to what the mother asks) to a 1 or unresponsive (characterized by the infant being void
of pleasure within the interaction, and rarely responding to the mothers bids so far as
avoidant behaviors frequently occurring). An optimal rating for child responsiveness to
the mother would fall at a 7 which is highly responsive. Here the infant is able to
balance their own autonomy appropriate for their age-level, with clear pleasure when
interacting with the mother that is not urgent (Biringen, Robinson, & Emde, 1993).
The EAS has been found to have inter-rater reliability scoring greater than 0.80,
as well as good construct validity due to the fact that parent and child emotional
availability has shown a strong relationship with attachment styles, as well as other
significant characteristics of parent-child relationships (Biringen, et al., 1993).
39


Child Care Activity Questionnaire (CCAQ)
The Child Care Activity Questionnaire (CCAQ) is a 19-item scale that assesses
the percentage of time from 0-100% the mother, the father, the two parents together and
any other significant family member spends performing child care and play activities,
according to the mothers report. Five of the items were scored by finding the mean
percentage that specifically related to play time with the infant (i.e. spend time talking
to the baby, play with the baby, reading baby a story, et cetera). Fourteen of the items
were scored similarly but specifically related to time spent taking care of the infant (i.e.
take baby to preventative health care clinic, drop baby off at sitter, change diapers, et
cetera).
The CCAQ has been found to have strong internal consistency for both mothers
and fathers in both the play time (Cronbachs alpha: m = 0.88 f = 0.80) and child care
time (Cronbachs alpha: m = 0.72, f = 0.72) (Montague & Walker-Andrews, 2002).
40


Associative Learning Paradigm
The associative learning paradigm assesses the infants ability to acquire
associations in a situation which a 10-second segment of infant-directed speech signals
a 10-second presentation of a smiling female face. In order to obtain speech samples
from both the mother and father, a hand-held SONY microphone and a SONY TCM
5000EV tape recorder/player were used. The parents were instructed to attempt to gain
their infants interest in a stuffed gorilla while saying the phrase Pet the gorilla, and
then later to ask and tell their infants to pet the gorilla. These speech samples
were then edited to include two questions, followed by one declarative statement as
follows, Will you pet the gorilla? Can you pet the gorilla? Pet the gorilla, which after
being repeated once completed a 10-second speech segment that was similar across
mothers and fathers within the study.
The associative learning paradigm was broken up into two different sessions
that were each approximately five minutes in duration. During the first visit, the infant
heard an unfamiliar non-depressed male voice in one session and an unfamiliar non-
depressed females voice for the other. During the second visit, however, the infant
heard their own mothers and fathers previously recorded speech sample.
While listening to the 10-second speech segments of the familiar and unfamiliar
voices (CS), the infant was seated on the mothers lap, facing a translucent Plexiglas
projection screen situated at the infants eye level in which a picture of a smiling
41


woman (US) immediately followed for 10 seconds during the first six conditioning
training sessions. During the inter-stimulus interval (ISI) 10-seconds of no sound and a
uniformly illuminated screen followed each face, and preceded the next presentation of
infant-directed speech. The post-conditioning test began 10-seconds after the end of the
sixth trial, with four 10-second intervals in which a black and white checkerboard was
presented instead of the face of the smiling woman. Again a 10-second ISI break
followed each of the trials. The same previously heard speech segment was paired with
the checkerboard for the first and fourth post-conditioning segments, whereas there was
no speech segment for the second and third post-conditioning segments. Two
independent observers recorded when the infants pupils matched up to the center of the
screen through a video-camera that was set up in the room with the infant, located
directly to the left of the projection screen (Kaplan, Bachorowski, Smoski, & Hudenko,
2002).
42


Procedure
After the mother and infant arrived in the Infant Lab, a researcher explained the
study and consent form, asked for questions regarding either and obtained consent from
the mother to participate in the study. There were four different possible interactions
with the lab over the course of the entire experiment. During this first visit, the mother
filled out several different surveys, some of which include demographic questionnaires,
the BDI-II, the PDSS and the Social-Emotional Development Questionnaire. A
researcher then administered the Bayley-III Cognitive and Language Scales.
Dependent upon the infants temperament, the mothers schedule and other possible
time-constraints, the researcher would administer the SCID-I to the mother, completing
their first lab visit.
If the mother agreed to participate in the second study that involved the father,
both came in, were again explained to about the study and consent forms, consent was
obtained. Each parent was first instructed to attempt to interest their child in playing
with a stuffed gorilla, in order to obtain voice recordings for the associate learning
paradigm portion of the experiment. Next, the mother, father and infant participated in
two different five minute associative learning paradigms. The parents were then each
instructed to play with their infant the way they normally would at home for 10-15
minutes, while it was videotaped through a two-way mirror. Later, an unbiased, trained
graduate student watched the tapes of both the mother and father interacting with the
43


infant, and rated them according to the EAS manual which was previously described
above.
Finally, the researcher called the parents to schedule two different home visits
within 24 hours of one another. During home visits, the research assistants would
video tape the mother interacting with her infant at home the first day, and then the
fathers interactions with the infant the following day. After each videotaped
observation, the research assistants would then rate the level of attachment using the
AQS system previously discussed above and discuss any discrepancies before reaching
a final attachment score. All research participants were financially reimbursed for each
lab and home visit they participated in to thank them for their time.
44


CHAPTER 3
RESULTS
Demographic and diagnostic data for mothers with elevated (BDI > 13) and
non-elevated (BDI < 13) BDI-1I scores and their infants are displayed in table 3.1.
Mothers with elevated BDI-II scores (M = 19.84, SD 5.88; M = 5.0, SD = 3.92),
(F(l,76) = 172.84, p = .000) were significantly less likely to be married according to the
Fischers exact test (64%), p<.035, had more children (M = 2.24, SD = 1.16; M = 1.69,
SD = .88), (F(l,76) = 5.30, p = .024) and a lower GAF score (M = 71.38, SD = 10.62;
M = 79.12, SD = 6.67), (F(l,75) = 14.97, p = .000), from mothers with non-elevated
BDI-II scores. Maternal age, infant age, family income, maternal education and
ethnicity were not significantly different as a function of maternal BDI-II categories.
45


Table 3.1 Demographic and Diagnostic Data
Variable Elevated BDI 19.84 (5.88) Non-elevated BDI 5.0 (3.92)**
N 25 52
Maternal age (years) 30.52 (6.04) 30.15 (4.57)
Infant age (days) 365.76 (32.01) 363.04 (31.53)
Family income 5.64 (2.93) 6.57(1.91)
Mothers Education 5.20 (1.32) 5.79(1.40)
Ethnicity
White 13 (52%) 35 (67.3%)
White/Latina 2 (8%) 2 (3.9%)
Latina 4(16%) 8 (15.4%)
Latina/African American 0 1 (1.9%)
Latina/Asian 1 (4%) 0
African American 2 (8%) 3 (5.8%)
Asian 1 (4%) 3 (5.8%)
Native American 2 (8%) 0
Percent married 64% 87%**
Gender
Female 11 (44%) 29 (55.8%)
Male 14 (56%) 23 (44.2%)
Number of children 2.24(1.16) 1.69 (.88)*
GAF score 71.38 (10.62) 79.12 (6.67)**
Note: Income (family yearly), 1.0 = $0-6,000, 2.0 = $6,000-10,000, 3.0 = $11,000-20,000,
4.0 = $21,000-25,0000, 5.0 = $26,000-30,000, 6.0 = $31,000-40,000, 7.0 = $41,000-
50,000; Education, 3.0 = no high school degree, 4.0 = high school degree, 5.0 = 2-year
degree, 6.0 = 4-year college degree, 8.0 = advanced degree. Parenthesis indicate standard
deviations. Ethnicity is a categorical variable in the remainder of the analyses (0 = absence
of minority status, 1 = presence of minority status). *p<.05, **p<.01.
46


Demographic and diagnostic data for the sub-sample that included fathers
participation of mothers with elevated BDI-II scores versus non-elevated BDI-II scores
and their infants are displayed in table 3.2. Within this sub-sample, both maternal
education (M = 5.29, SD = 1.35; M = 6.23, SD = 1.38), (F(l,47) = 5.042, p = 030) and
maternal GAF scores (M = 74.24, SD = 9.80; M = 80.81, SD = 5.30), (F(l,43) = 8.37, p
= .006) differed significantly between the maternal elevated BDI-II scores versus the
maternal non-elevated BDI-II scores. Maternal age, paternal age, infant age, family
income, father education level, ethnicity, percent married, gender of the infant, number
of children and BDI scores were not significantly different as a function of the
maternal elevated versus non-elevated BDI-II categories.
47


Table 3.2 Demographic and Diagnostic Data: Sub-sample with Father Participation
Variable Elevated BDI 18.41 (4.29) Non-elevated BDI 5.10(3.28)
N 17 31
Maternal age (years) 30.29 (6.52) 30.45 (4.43)
Paternal age (years) 33.0(6.86) 31.16(4.87)
Infant age (days) 365.65 (25.70) 366.97(22.54)
Family income 6.18(2.35) 7.13 (1.71)
Mothers Education 5.29 (1.35) 6.23 (1.38)*
Fathers Education 5.00(1.15) 5.64(1.25)
Ethnicity White 12 (70.6%) 22 (71%)
White/Latina 1 (5.9%) 2 (6.5%)
Latina 2(11.8%) 1 (3.2%)
African American 1 (5.9%) 2 (6.5%)
Asian 0 4(12.9%)
Native American 1 (5.9%) 0
Percent married 82.4% 98%
Gender Female 8(47.1%) 19(61.3%)
Male 9 (52.9%) 12 (38.7%)
Number of children 2.0 (.87) 1.61 (.95)
GAF score 74.24 (9.80) 80.81 (5.30)**
Note: Income (family yearly), 1.0 = $0-6,000, 2.0 = $6,000-10,000, 3.0 = $11,000-20,000,
4.0 = $21,000-25,0000, 5.0 = $26,000-30,000, 6.0 = $31,000-40,000, 7.0 = $41,000-
50,000; Education, 3.0 = no high school degree, 4.0 = high school degree, 5.0 = 2-year
degree, 6.0 = 4-year college degree, 8.0 = advanced degree. Parenthesis indicate standard
deviations. Ethnicity is a categorical variable in the remainder of the analyses (0 = absence
of minority status, 1 = presence of minority status). *p<.05, **p<.01.
48


Social-Emotional Development and Maternal Depression
Complete data was provided for the social-emotional subscale of the Bayley-III
for the 77 infants that participated in the study. To test the hypothesis that Bayley-III
social-emotional development percent would be lower in infants of depressed in
comparison to non-depressed mothers, several different measures of depression were
utilized, including maternal BDI-II categories, maternal PDSS scores, maternal Global
Assessment of Functioning (GAF) scores, current maternal depression diagnosed
through the SCID-I, and whether the mother has ever experienced a depressive episode
at anytime post-birth of her infant.
Although there was no significant difference in BDI-II categories of elevated
(BDI > 13) and non-elevated (BDI < 13) scores related to infant social-emotional
development, the mean difference scores were within the predicted direction. Mothers
within the elevated BDI-II category, on average had infants score more poorly on the
Bayley-III social-emotional scale than did mothers within the non-elevated BDI-II
category (M = 38.68, SD = 24.66; M = 43.65, SD = 24.83), (F(l,76) = .679, p = .412).
Similarly, with the Postpartum Depression Screening Scale (PDSS), although
there were no significant results found in relation to maternal depression and infant
social emotional development, results did find in general a negative correlation in that
the higher the mothers symptoms were on the PDSS, the lower the infants social-
emotional development was (r = -. 183, p = 114).
49


There was a significant correlation when looking at maternal global assessment
of functioning (GAF) related with infant social-emotional development, in that mothers
who had a higher GAF score, also had infants that scored higher on the social-
emotional development scale (r = .246, p = .042).
100.00-
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111
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ra
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o o
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o oooo oo
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50.00 60.00 70.00 80.00 90.00
Mom Global Assessment of Functioning Score
i
100.00
Figure 3.1 The association between infant social-emotional development percent and
mothers Global Assessment of Functioning score.
50


When assessing maternal depression by using the SCID-I for a clinical
diagnosis of depression, results approached significance related to mothers currently
suffering from depression and infant social emotional development (M = 43.56, SD =
24.73, M = 24.02, SD = 17.58) (F(l,76)= 3.58, p=.063). Additionally, when running a
univariate ANOVA using the raw social-emotional development score (not calculated
into a percentage score), there was a significant difference in the means found related to
current maternal depression (M= 9.73, SD = 2.96, M = 7.0, SD = 3.16), (F(l,76) = 4.67,
p = .034). This shows that infants whose mothers were currently clinically depressed
according to the SCID-I scored lower on the social-emotional development portion of
the Bayley-III than did infants whose mothers were not currently clinically depressed.
51


Mom Depression Diagnosis
Fig. 3.2 Mean infant differences (i.e. social-emotional development raw score) between
mothers with a current clinical diagnosis of depression and those without.
It was also tested whether maternal depression at any point after the infants
birth affected the infants social-emotional development. Although no significant
differences were found in social-emotional data as a function of the mother having a
major depressive episode at some point after the birth of the child, there was a tendency
in the data for infants of mothers with longer duration of remission from depression
52


showing better infant social-emotional development (No depression: M = 45.89, SD =
23.67; Full remission, but experienced depression post-natal: M = 40.80, SD = 23.36;
Partial remission currently: M = 41.55, SD = 30.32; Current depression: M = 24.02, SD
= 17.58), (F(l,74) = 1.169,p=.328).
Figure 3.3 Mean infant differences (i.e. social-emotional development percent) between
mothers without any depression post-natal, those who are in full remission, those in
partial remission, and those who are currently suffering from depression.
53


Table 3.3
Various Measures of Depression and their Mean Differences in Infant Social Emotional
Development
Measure of Depressed Depression (Mean) Non-Depressed (Mean) Formula
BDI-II (SE%) 38.68 (24.06) 43.65 (24.83) F(1,76) = 6.79, p = .412
Current Diagnosis 24.02 (17.58) (SE%) 43.56 (24.73) F(l,76) 3.58, p = .063
Current Diagnosis 7.0(3.16) (SE raw score) 9.73 (2.96) F(l,76) = 4.67, p = .034 !
Anytime Post- Natal Diagnosis No Depression: Full Remission: 40.80 (23.36) Partial Remission: 41.55 (30.32) Current Diagnosis: 24.02 (17.58) 45.89 (23.67) F(l,74) = 1.169, p = .328
Note: Numbers in parenthesis are standard deviations. Due to the continuous nature of
the PDSS and GAF variables, means as a function of these measures of depression were
not calculated. *p < .05
54


Sensitivity. Structuring and Child Responsiveness
Sensitivity
The sub-sample was used to assess maternal sensitivity. Two of the mothers
were not included in the analysis due to their rating of being considered oversensitive,
which is not only extremely rare, but also has been removed as a rating option from the
most recent version of the EAS. Although there was no significant difference, infants
who scored lower on the Bayley-III social emotional development percent in general
had mothers who were rated as having lower sensitivity (M = 36.06, SD = 26.15),
versus infants whose mothers were rated as having a more optimal level of sensitivity
scored higher on the Bayley-III social-emotional development percent (M = 42.70, SD
= 21.50), (F(l,44) = .868, p = .357).
The sub-sample was again used to assess paternal sensitivity related to infant
social-emotional development percent. One of the fathers was not included in the
analysis due to his rating of being considered oversensitive. Again, there was no
significant difference between fathers who were rated as having lower sensitivity (M =
42.79, SD = 27.81) and fathers who were rated as having a more optimal level of
sensitivity (M = 40.21, SD = 19.87) regarding their infants social-emotional
development percent on the Bayley-III questionnaire (F(l,42) = .116, p = .735).
55


Maternal Structuring
The sub-sample was used to assess maternal structuring which was divided into
three separate categories in order to examine the effects of intrusive versus withdrawn
maternal behaviors. Structuring scores 4.5 and below resulted in being categorized as
under-structured (withdrawn), whereas structuring score that fell between 5-6.5 were
categorized as optimally structured, and scores that were 7 or higher were termed over-
structured (intrusive). Although the maternal structuring categories had no significant
effect on infant social-emotional development (F(l,44) = 1.37, p = .266), mean
differences were as predicted with optimal structuring mothers having the infants with
the highest social-emotional development percent (M = 43.8, SD = 24.20), differing
from both under-structuring or withdrawn mothers (M = 28.0, SD = 20.71) and over-
structuring or intrusive mothers (M = 35.56, SD = 20.96).
56


Infant Social-Emotional Development Percent
Mom Structuring Categories
Figure 3.4 Mean infant differences (i.e. social-emotional development percent) between
mothers structuring categories
57


Child Responsiveness
The sub-sample was used to assess child responsiveness to the mother. The
correlation between the Bayley-III social-emotional development percent and child
responsiveness to the mother reached near significance (r=.286, p = .057).
The sub-sample was again used to assess child responsiveness to the father. The
correlation between child responsiveness to the father and infants social-emotional
development percent was significant (r = .391, p = .01).
Attachment
Attachment was assessed using the subsample of mothers, fathers and their
infants, along with the Attachment Q-set (AQS). The top two-thirds of both maternal
and paternal AQS scores were categorized as being securely attached, whereas the
bottom third for each parent was classified as being insecurely attached, corresponding
to percentages found within the normal population of attachment distributions (Teti, et
al., 1995). In regards to maternal attachment, infant social-emotional development
percent was not found to be correlated (r = .169, p = .255). Paternal attachment,
however, was significantly found to be correlated with social-emotional development
percent (r = .387, p = .007). After running a univariate ANOVA, the mean differences
were found to be significant, as well (M = 31.31, SD = 18.74, M = 51.22, SD = 24.69),
(F(l,47)=8.048, p=.007).
58


Infant Social-Emotional Development Percent
Dad Attachment
Figure 3.5 Mean infant differences (i.e. social-emotional development percent) between
father attachment categories
59


Moderation/Interaction Effects
Infant Attachment and Maternal Depression
Several different studies have found that maternal depression very likely
contributes to insecure attachment development (Cummings & Cicchetti, 1990;
Cummings & Davies, 1999; Murray, Fiori-Cowley, Hooper, & Cooper, 1996; Teti, et
al., 1995). To explore attachment as a possible moderating variable between the
relationship of maternal depression and infant social-emotional development, a few
different 2x2 univariate ANOVAs were run. The first looked at maternal BDI-II scores
(elevated vs. non-elevated) in relation to attachment (secure vs. insecure), using infant
social-emotional development percent as the dependent variable. There was no
significant main effect for attachment (F(l,51) = .165, p = .686, nor a main effect for
maternal BDI-II category (F(l, 51) = 2.132, p = .151). Additionally, there was no
interaction effect between attachment and BDI-II categories either (F(l ,51) = .439, p =
.511).
The second 2x2 univariate ANOVA looked at included current maternal
depression (depressed vs. non-depressed) related to attachment (secure vs. insecure)
again using infant social-emotional development percent as the dependent variable.
There was again no significant main effect for attachment (F(l,51) = .044, p = .834, nor
a main effect for maternal depression (F(l, 51) = 1.372, p = .247). Additionally, there
60


was no interaction effect between attachment and SCID-I diagnoses either (F(l,51) =
.014, p = .907).
Paternal attachment was also explored as a moderating variable between
maternal depression and infant social-emotional development percent. When assessing
this possible moderating variable while using maternal BDI-II categories, a significant
main effect was found for paternal attachment (F(l,47) = 8.286, p = .006), but not for
maternal BDI-II categories (F(l,47) = 1.872, p = .178). A significant interaction effect
between the two was not discovered either (F(l,47) = 1.305, p = .260). Because only
one infant fell within the group of mothers who were currently depressed and was still
considered to be securely attached to their father, exploring paternal attachment as a
possible moderating variable while using current maternal depression was not a
possibility.
61


Infant Attachment and Maternal Sensitivity
Recall that it has been found that having a higher level of sensitivity may in fact
be a protective factor for the infant developing a secure attachment (Campbell,
Brownell, Hungerford, Spieker, Mohan, & Blessing, 2004), so we tested the
relationship between maternal sensitivity and infant attachment but found no significant
mean differences nor correlations. Additionally, a 2x2 univariate ANOVA was run to
assess whether there was an interaction effect between maternal attachment (secure vs.
insecure) and sensitivity (high vs. low), with social-emotional development percent as
the dependent variable. Significant main effects were not found for either maternal
attachment (F(l,44) = .679, p = .415), maternal sensitivity (F(l,44) = .471, p = .496),
nor an interaction effect between the two (F(l,44) = .635, p = .430).
Another 2x2 univariate ANOVA was run assessing maternal sensitivity (high
vs. low) with paternal attachment (secure vs. insecure), while the dependent variable
remained the infant social-emotional development percent. There was no significant
main effect for maternal sensitivity (F(l, 40) = 2.117, p = .154), but as discussed
previously there was a main significant effect for paternal attachment (F(l,40) = 7.137,
p = .011). No significant interaction effect was found between the two, however
(F(l,40) = .056, p = .814).
62


Infant Attachment and Maternal Structuring
Given how Cohn, Matias, Tronick, Connel and Lyons-Ruth (1986) differentiate
between withdrawn and intrusive structuring styles, exploratory analyses were run to
see if structuring type moderated the relationship between infant attachment and social
emotional development. Therefore, a 2x3 univariate ANOVA of maternal attachment
(secure vs. insecure), maternal structuring (high vs. optimal vs. low), and infant social-
emotional development percent as the dependent variable in the analysis. No significant
main effects were found for either maternal structuring (F(l,44) = 1.965, p = .154), nor
for the maternal attachment (F(l,44) = .071, p = .791). There was no significant
interaction effect found between the two variables either (F(l,44) = 1.472, p = .242).
63


Father Involvement
The amount of time the father spent with the infant performing care-taking
duties, as well as amount of time spent playing was assessed in relation to the Bayley-
III social-emotional development percent. Although neither of the correlations were
significant, both were in the opposite direction of the prediction made above. There was
a negative correlation between both time spent taking care of the infant (r = -.233, p =
.148) and time spent playing with the infant (r = -.201, p = .214) in relation to social-
emotional development percent; so that the more time the father spent care-taking and
playing with the infant, the lower the social-emotional development score was for the
infant on the Bayley-III.
64


Infant Associative Learning Paradigm
Complete data from the sub-sample was available for 69 of the 77 infants
assessed using an unfamiliar females voice (89.6%). Missing data for eight of the
infants was due to extreme fussiness and crying that did not allow for the conditioning
trials to be accurate depictions of the infants learning abilities or completed. Although,
there was no significant relationship found between the infant social-emotional
development percent from the Bayley-III and the unfamiliar female voice within the
associative learning paradigm (r = -.103, p = .398), the negative correlation between the
two suggests that as infant learning score gets higher with the unfamiliar female voice,
infant social-emotional development percent gets lower.
Complete data from the sub-sample was available for 63 of the 77 infants
assessed using an unfamiliar males voice (81.8%). Again, missing data for fourteen of
the infants was due to the fact that the conditioning test could not be completed or
considered accurate due to extreme fussiness and crying. No significant relationship
was found between the infant social-emotional development percent from the Bayley-
III and the unfamiliar male voice within the associative learning paradigm (r = .002, p =
.987).
There was complete data available for the conditioning trials for 51 of the
infants using their own, familiar mothers voice, and for 49 of the infants using their
65


own, familiar fathers voice. Although there was no significant relationship between
infant social-emotional development percent and the infants own, familiar mothers
infant-directed speech recording used within the associative learning paradigm, a
negative correlation was found (r = .099, p = .490). In other words, as the infants
associative learning scores in relation to their mothers own voice went up, the infants
social-emotional development percent went down. Additionally, there was no
significant relationship found between the associative learning score with the infants
own, familiar fathers infant-directed speech and the infants social-emotional
development percent (r = .167, p = .257).
Infant Cognition
Previous research has shown the possibility that certain aspects of an infants
social-emotional development may in fact affect their cognitive testing abilities
(Stevenson & Lamb, 1981). Therefore, it was hypothesized that there would be a
significant positive relationship between infant cognitive development percent and
infant social-emotional development percent, both of which are from the Bayley-III.
The correlation between cognitive and social-emotional development did near
significance (r = .205, p = .076).
66


Stepwise Linear Regression
Table 3.4 shows the zero-order correlations among the demographic and
diagnostic predictors and the infant social-emotional development percent variable to
be entered as the outcome variable in a regression equation.
Table 3.4
Zero-Order Correlations Among Demographic, Diagnostic and Infant Social-
Emotional Development Percent Variables
Variable Ethnicity Gender Mom Age Kids Dep SE%
Ethnicity .218* -.234* .235* .274** -.258*
Gender .000 .255* .205 -.237*
Mom Age .232* .110 -.229*
# of Kids .329** -.234*
Mom Depression -.213
Infant SE %
Note: Ethnicity, infant gender and depression are categorical (0 = absence of minority
status, 1 = presence of minority status; 0 = female, 1 = male; 0 = not depressed, 1 =
depressed). *p < .05, **p<.01
A stepwise linear regression was used (See Table 3.5) to assess whether any of
the demographic variables and/or depression diagnosis were significant predictors of
infant social-emotional development. The variables of ethnicity (r = .258, p = .024),
67


gender (r = -.216, p = .058), maternal age (r = -.228, p = .045), and number of children
(r = -.233, p = .040) were chosen due to their significant correlation with infant social-
emotional development percent. Each was entered in order according to each variables
likelihood to change (i.e. ethnicity and gender are least likely to change, whereas mom
age and number of children are more likely to change). Ethnicity was entered first,
followed by infant gender, maternal age, number of children and finally maternal
depression. Zero-order correlations are shown in Table 3.4 and the subsequent
regression results are shown in Table 3.5. The stepwise regression determined that the
ethnicity variable was significantly responsible for explaining much of the variance
increment in infant social-emotional development percent (6.6%), AR = .066, p = .024.
The stepwise regression also determined that the demographic variable of maternal age
was responsible for a significant increment in the variance of infant social-emotional
development percent (18.4%), AR2 = .083, p = .008 with the older the mothers age, the
worse. The overall model was significant F(5,71) = 3.35, p = .009. Both ethnicity,
/(75) = -2.31, p = .024 and maternal age, r(75) = -2.72, p = .088 were significant
predictors of infant social-emotional development that resulted in a significant
coefficient [3.
68


Table 3.5
Stepwise Linear Regression
Step Variable Standardized |3 AR2 AF dfl df2 Sig. AF
1 Ethnicity -.258 .066 5.33 1 75 .024
2 Gender -.191 .035 2.87 1 74 .094
3 Mom Age -.296 .083 7.40 1 73 .008
4 # of Children -.064 .003 .300 1 72 .586
5 Depression -.065 .003 .306 1 71 .582
69


CHAPTER 4
DISCUSSION
This study examined the relationship between postpartum depression and infant
social-emotional development. It was hypothesized that infants of depressed mothers
would score lower than infants of non-depressed mothers on the Bayley-III social-
emotional questionnaire. A significant difference was found between the two groups
when looking at current mother depression and maternal Global Assessment of
Functioning scores. Additionally, infants who were rated by EAS coders with higher
child responsiveness scores to the father, did significantly better on the social-
emotional development percent than those who were not as likely to be responsive to
their fathers. Paternal attachment was also found to have a significant association with
infant social-emotional development percent. Interestingly enough, the time fathers
spent taking care of and playing with the infant were both negatively correlated with
infant social-emotional development percent. No other effects were found to be
significant in this study.
As stated previously, it was hypothesized that maternal depression would have a
significant negative effect on infant social-emotional development percent. To test this
hypothesis, several various measures of depression were examined. Although no
significant results were found when using elevated vs. non-elevated maternal BDI-II
categories, PDSS scores or when looking at whether the mother had a major depressive
70


episode at some point after the birth of the child, all three of these functions of maternal
depression were within the predicted direction. For example, mothers within the
elevated BDI-II category and who scored higher on the PDSS were more likely to have
infants that scored lower on the social-emotional development percent than were
mothers within the non-elevated BDI-II category or who scored lower on the PDSS.
Additionally, when examining the different levels of remission from maternal major
depressive episodes, a trend was found to show that the longer the duration of remission
the mother had been experiencing, the better the infant had done on the social-
emotional development percent. As discussed previously, significant differences in the
social-emotional development percent were found between infants of mothers who
were currently diagnosed with major depressive disorder, and those infants whose
mothers had no current diagnosis. Additionally, a significant relationship was found
with the maternal global assessment of functioning, whereas the higher the mothers
daily functioning according to the SCID-I Axis-V, the higher the infant social-
emotional development percent.
Overall, these findings linking maternal depression negatively to infant social-
emotional development were consistent with those found in other studies (Cummings &
Davies, 1999; Maughan, Cicchetti, Toth & Rogosch, 2007). However, these other
studies within the field that also showed this link, examined the social-emotional
71


development of children much older than 11-13 months, usually toddlers and children
in preschool or kindergarten.
Although a significant correlation was found between maternal GAF scores and
higher infant social-emotional development, it is important to keep in mind that GAF
scores are more about the mothers current daily functioning at the time of the SCID-I
interview, and not necessarily indicators of clinical depression. GAF scores have the
possibility and are likely to vary considerably depending on how the mothers is
currently coping with her own mental health diagnosis at the time of the SCID-I
interview.
Another important limitation to keep in mind regarding the tendency for infants
of mothers who have been in remission for a longer duration after the infants birth to
score better on the Bayley-III social-emotional development percent is related to that
fact that this statistic was observing comparisons between groups, which is not
necessarily indicative of what would happen to an individual infant as their mother
comes out of a depressive episode. This finding, however, conflicts with what
Maughan, Cicchetti, Toth and Rogosch (2007) found regarding detrimental effects of
early occurring maternal depression. They discovered that the earlier the depressive
episode within the infants life, the worse the infant did regulating their emotions at
four years old, regardless of onset of remission within the first two years of life.
72


Additionally, because the infants social-emotional development was assessed
strictly through use of a questionnaire, the possibility that parental responses were
biased may be actually unrepresentative of the infants true score. It is therefore
important to consider Becks cognitive triad theory in which people with depression
tend to view themselves, their world and their future through a negative lens (Beck,
1967). This may be applicable to this study in respect to the fact that mothers suffering
from depression may have under-reported their infants social-emotional skill
development on the Bayley-III questionnaire, due to their overall negative bias within
the triad, versus how non-depressed mothers reported their infants social-emotional
development.
In regards to the hypotheses predicting a positive relationship with maternal and
paternal sensitivity, optimal maternal structuring levels and child responsiveness to the
mother, in relation to infant social-emotional development, none were found to be
significant. Three of these variables (excluding paternal sensitivity) were however,
within the predicted direction. Child responsiveness to the father was found to be
significantly correlated with higher infant social-emotional development percent. This
may be connected to the research done regarding infant learning paradigms, showing
that infants of depressed mothers had the tendency to ignore female voices, and pay
more attention than infants of non-depressed mothers to male voices. (Kaplan, Dungan,
Zinser & 2004; Kaplan, Bachorowski, Smoski, & Hudenko, 2002) Further research
73


deciphering a possible connection between these variables is needed to confirm this
idea, however.
It was also hypothesized that secure attachment with both mothers and fathers
would be positively related to higher infant social-emotional development. Although
maternal attachment had no significant findings, paternal attachment was significantly
associated with higher infant social-emotional development percent.
A possible explanation as to why maternal attachment was not significantly
related to increased infant social-emotional development percent may be related to the
fact that the mothers attachment state of mind, referring to her own trans-generational
attachment style, was not considered in this study. According to McMahon, Barnett,
Kowalenko, and Tennant (2006), the secure state of mind regarding attachment acts as
a moderator and buffer between maternal depression and actual insecure attachment
with the infant. If the mothers state of mind is secure in her attachment with her
infant, the chance of her actually having a secure attachment with her infant
significantly increases, whereas mothers with an insecure state of mind regarding their
attachment to their infant, are more likely to have an actual insecure attachment. This
study emphasizes the possibility that if mothers with postpartum depression develop a
secure state of mind, in spite of their diagnosis by going through intense psychotherapy
and training to correct their insecure attachment predisposition, their infants
subsequently may in fact develop a secure attachment with their mother and in turn
74


avoid many of the risk factors insecure attachment leave children prone to developing,
as well as ending the trans-generational cycle of insecure attachment.
Fortunately for the infants in this study, as mentioned above, infants who were
securely attached to their father did significantly better on the social-emotional
development percent. Herring and Kaslow (2002) found that having a secure
attachment with a parent may act as a buffer to the infants future psychological
stressors throughout their lifetime, as they gain from this secure relationship the
awareness and effectiveness of drawing upon social support, and in turn have a better
sense of self because of this relationship. Similarly, Benvenuti, Guerrinini
DeglInnocenti, Favini, Hipwell and Pazzagli (2001) found that by having a secure
attachment with at least one caregiver, benefits within the infants first year of life are
found regarding appropriate socialization and education.
As has been found in this research lab previously, often infants of mothers with
postpartum depression begin to ignore female voices and tend more than infants with
mothers who do not have postpartum depression to male voices (Kaplan, et al., 2002;
2004). Similarly, the attachment style with the father, as this may have served as a
protective factor, or buffer, in the infants development, allowing them to score within
the appropriate developmental range on the Bayley-III Social-Emotional Scale.
Another possible limitation to consider regarding the attachment results from
this study is the possibility that infants who have developed an insecure-avoidant
75


attachment style may have learned at this point they are unable to rely on others and
may subsequently score better on the Bayley-III social-emotional questionnaire than
insecure anxious-ambivalent infants. It is possible that infants who develop insecure
anxious-avoidant attachment styles have learned long ago they are unable to rely on
their mothers, and therefore have developed a coping method of expanding on their
social-emotional skills alone. Because the AQS does not distinguish between the two
different types of insecure attachment types, this may result in mixed results (Vaughan
& Waters, 1990). Future research should try to narrow this differentiation down to
determine whether it affects attachment scores for both mother and father.
Finally, it should be considered that while collecting data for the AQS on home
visits, the infant may be having an off-day or was possibly not feeling well which may
also affect their attachment scores. For this very reason, an open discussion should be
had with the parents revealing whether the video-taped home visits could be considered
a typical interaction between the two.
Exploratory analyses were done to see whether there were interaction effects
between social-emotional development and maternal depression with maternal and
paternal attachment and sensitivity, as well as with maternal structuring. However no
significant results were discovered and therefore none are considered to be moderating
variables.
76


It was also hypothesized that as father involvement increased, more specifically
the amount of time spent care taking for the infant and playing with the infant, the
higher the social-emotional development percent on the Bayley-III for the infant would
be. However, this result ended up revealing a negative relationship among them. In
other words, as the more time the father spent taking care of and playing with his child,
the lower the infants social-emotional development percent ended up being. This may
be due to the fact that quantity of time spent with the infant does not equate to the
quality of the interaction with the father (Lamb, 2002; &Lamb & Temis-Lemonda,
2002). In other words, if the father is being forced to stay at home with the infant,
because of job-loss, it financially being better for the woman to be at work instead, or
because of scheduling conflicts, the interaction the father has would not be as beneficial
to the infant if the father were responding and interacting in a sensitive and meaningful
way with the infant. In future research, it would be interesting to inquire the reason for
the increased father time spent with the infant, in order to delve into this possible
reason more deeply.
It was additionally hypothesized that infant learning according to the associative
learning paradigm and infant cognitive scores on the Bayley-III would positively
correlate with infant social-emotional development percent. Hay (1997) believes that
intelligence is in its most simplistic form, the ability to learn. He argues that the nature
of the social and emotional experiences that the infant experiences early on in life set
77


the stage for their ability to learn, and therefore their intelligence throughout the rest of
their childhood. Stevenson and Lamb (1981) similarly argue that cognitive abilities
very well may be adversely affected by social-emotional factors, because as a result of
these factors, the infants have little to no inherent motivation to do well on a test.
However, in this study, no significant relationship was found between infant social-
emotional development with infant cognitive scores on the Bayley-III or with the
associate learning paradigm learning scores. This may be attributable to the fact that
social-emotional development at such an early age of development may be nothing
more than the infants temperament. Further research should be done to explore this
possibility.
The external validity of this study may be compromised due to the small overall
sample size, however the fact that 37.7% of the participants in the main study were of
minority status increases the generalizability of the study some. Internal validity may
also be at stake due to the correlational design of the study, as correlation does not
automatically equal causation. Finally, because it is impossible to randomly assign
participants to groups, confounding variables such as the possible effect dual-diagnoses
might have on the results, as well as any unforeseen variables by researchers may affect
portions of the results. In order to disentangle any possible effects that other
psychological disorders may have on the infants social-emotional development,
measures that assess for anxiety, sleep, eating, personality disorders, et cetera might be
78


considered useful in the future. Medication, therapy and homeopathic remedies should
also be considered as possible confounding variables that should be assessed in future
studies.
This study found that maternal depression did in fact negatively affect infant
social-emotional development. Interestingly enough however, paternal attachment and
child responsiveness to the father both positively affected infant social-emotional
development. Future research should perhaps examine in more depth how the father
figure may in fact compensate for the detrimental effects maternal depression was
foiund to have on infant social-emotional development. Further research is needed
however, to determine whether infant social-emotional development is merely another
measure of depression, as directionality and causal mechanisms from this study are
unknown.
79


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