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Lyons-Ruth, Karlen

The current paper expands on Ainsworth’s seminal construct of maternal sensitivity by exploring the developmental pathways associated with one particular form of insensitivity: maternal withdrawal. Drawing on longitudinal data from infancy to age 20 in a high-risk cohort, we highlight how maternal withdrawal over the first eight years of life is associated with child caregiving behavior and with maternal role confusion, as well as with features of borderline and antisocial personality disorders. We also present evidence for the specificity of this pathway in relation to other aspects of maternal insensitivity and other aspects of child adaptation. To illuminate these pathways we both review recent published work and report new findings on the middle childhood and adolescent components of these trajectories. Finally, we consider the implications for assessment of maternal behavior in high-risk samples and indicate directions for productive future work.

Few studies have evaluated the separate contributions of maltreatment and ongoing quality of parent–child interaction to the etiology of antisocial personality features using a prospective longitudinal design. One hundred twenty low-income young adults (aged 18–23) were assessed for extent of antisocial personality disorder (ASPD) features on the Structured Clinical Interview for Diagnosis (M.B. First, R.L. Spitzer, M. Gibbon, & J.B.W. Williams, 1997) for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (American Psychiatric Association, 1994) Axis II, for presence of maltreatment on the Conflict Tactics Scale (M.A. Straus, S.L. Hamby, D. Finkelhor, D.W. Moore, & D. Runyan, 1998), Traumatic Experiences Scale (L. Dutra, J.F. Bureau, B. Holmes, A. Lyubchik, & K. Lyons-Ruth, 2009), and Adult Attachment Interview (C. George, N. Kaplan, & M. Main, 1984), and for referral in infancy to parent–infant clinical services. Fifty-six of these families had been studied longitudinally since the first year of life. In infancy, attachment disorganization and disrupted mother–infant interaction were assessed; in middle childhood, disorganized-controlling attachment behaviors were reliably rated. In kindergarten and second grade, behavior problems were assessed by teacher report. In cross-sectional analyses, maltreatment was significantly associated with ASPD features, but did not account for the independent effect of early referral to parent–infant services on ASPD features. In longitudinal analyses, maternal withdrawal in infancy predicted the extent of ASPD features 20 years later, independently of childhood abuse. In middle childhood, disorganized attachment behavior and maladaptive behavior at school added to prediction of later ASPD features. Antisocial features in young adulthood have precursors in the minute-to-minute process of parent–child interaction beginning in infancy.

In this investigation we examined the developmental correlates and predictors of maternal emotional availability in interactions with their 7-year-old children among a sample of families at psychosocial risk. We found developmental coherence in maternal interactive behavior, and in the relations between maternal emotional availability and children's functioning in middle childhood. Mothers and children were observed at home and in a laboratory playroom in infancy to assess maternal interactive behavior and child attachment security. When children were 7 years of age, dyads were observed in the lab; maternal emotional availability was coded using the Emotional Availability Scales, and children's disorganized and controlling attachment behavior was assessed. Classroom teachers reported on children's behavior problems; at age 8, children reported on their depressive symptoms. Results showed that aspects of maternal emotional availability (sensitivity, nonhostility, nonintrusiveness [passive/withdrawn behavior]) were associated with children's functioning in middle childhood: (a) controlling and disorganized attachment behavior, (b) behavior problems in school, and (c) self-reported depressive symptoms. Maternal emotional availability in childhood was predicted by early mother-infant relationship dysfunction (maternal hostility, disrupted communication, and infant attachment insecurity).

This prospective 20-year study assessed associations between maternal depressive symptoms in infancy, childhood, and adolescence, and child and adolescent depressive symptoms in a sample of families at high psychosocial risk. Maternal symptomatology was assessed with the Center for Epidemiological Studies Depression Scale (CES-D) when children were infants (12 months), school-aged (age 8), and adolescents (age 19). Children's depressive symptoms were measured at age 8 (Dimensions of Depression Profile for Children and Adolescents) and age 19 (CES-D). Maternal depressive symptoms during infancy contributed to the prediction of child depressive symptoms at age 8, after controlling for concurrent maternal depressive symptoms, clinical risk in infancy, and gender. Clinical risk in infancy marginally contributed to the prediction model. Disorganization of attachment in infancy and maternal hostility were independent predictors of depressive symptoms at age 8 and did not mediate the relation between maternal and child depressive symptoms. Depressive symptoms in adolescence were predicted by gender, children's depressive symptoms at age 8, maternal depressive symptoms in adolescence, and maternal depressive symptoms in infancy. There was no moderating effect of gender. Adding to previous evidence on the importance of early maternal depression, maternal depressive symptoms during infancy were related to the development of depressive symptoms in childhood and adolescence even when other variables of potential relevance were controlled.

The objective of this study was to assess whether a mediated model of change could account for the long-term effects of infant home-visiting services observed at ages 5 and 7 years in a high-risk cohort. Participants were 41 mothers and infants from low-income families who were referred to parent–infant home-visiting services during the first 9 months of life due to concerns about the caretaking environment. Services ended when infants reached 18 months of age. Families received between 0 and 18 of weekly home visits based on infant age of entry into the study. During childhood (ages 5 and 7 years), teachers rated children's behavior problems using standardized instruments. Early home-visiting services accounted for positive child outcomes at 18 months, 5 years, and 7 years of age; however, earlier positive outcomes related to intervention did not account for intervention-related effects at later ages. Further inspection of the data revealed that two additional principles, one of escalating morbidity among less intensively served groups and one of generalized family problem-solving skills, were needed to account for the pattern of effects over time. We conclude that the “domino models” assessed by mediational analyses may be too simple to capture the intervention-related change processes occurring in high-risk cohorts over time.