Quality of attachment, perinatal risk, and mother-infant interaction in a high-risk premature sample

• Published in: Infant mental health journal 2011-05, Vol.32 (3), p.305-318
• Main Authors: Udry-Jørgensen, Laura, Pierrehumbert, Blaise, Borghini, Ayala, Habersaat, Stephanie, Forcada-Guex, Margarita, Ansermet, François, Muller-Nix, Carole
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Couple and family; Family environment. Family history; Fundamental and applied biological sciences. Psychology; Medical sciences; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Psychopathology. Psychiatry; Social psychiatry. Ethnopsychiatry; Social psychology
• ISSN: 0163-9641; 1097-0355
• DOI: 10.1002/imhj.20298

Thirty‐three families, each with a premature infant born less than 33 gestational weeks, were observed in a longitudinal exploratory study. Infants were recruited in a neonatal intensive care unit, and follow‐up visits took place at 4 months and 12 months of corrected age. The severity of the perinatal problems was evaluated using the Perinatal Risk Inventory (PERI; A.P. Scheiner & M.E. Sexton, 1991). At 4 months, mother–infant play interaction was observed and coded according to the CARE‐index (P.M. Crittenden, 2003); at 12 months, the Strange Situation Procedure (SSP; M.D.S. Ainsworth, M.C. Blehar, E. Waters, & S. Wall, 1978) was administered. Results indicate a strong correlation between the severity of perinatal problems and the quality of attachment at 12 months. Based on the PERI, infants with high medical risks more frequently tended to be insecurely attached. There also was a significant correlation between insecure attachment and dyadic play interaction at 4 months (i.e., maternal controlling behavior and infant compulsive compliance). Moreover, specific dyadic interactive patterns could be identified as protective or as risk factors regarding the quality of attachment. Considering that attachment may have long‐term influence on child development, these results underline the need for particular attention to risk factors regarding attachment among premature infants. Treinta y tres familias, cada una con un infante nacido prematuramente con menos de 33 semanas de gestación, fueron observadas en un estudio exploratorio longitudinal. Los infantes fueron reclutados en una unidad neonatal de cuidado intensivo y se les visitó a manera de seguimiento a los 4 meses y a los 12 meses de la edad corregida. Se evaluó la severidad de los problemas perinatales usando el Inventario de Riesgo Perinatal (PERI). A los 4 meses se observó la interacción de juego entre la madre y el infante y se codificó de acuerdo con el Indice CARE, y a los 12 meses se administró el Procedimiento de la Situación Extraña (SSP). Los resultados señalan una fuerte correlación entre la severidad de los problemas perinatales y la calidad de la afectividad a los 12 meses. Basados en el PERI, los infantes con altos riesgos médicos tendieron a ser frecuentemente más inseguros en la unión afectiva. También se dio una correlación significativa entre la afectividad insegura y la interacción de juego de la díada a los 4 meses (por ejemplo, la conducta controlante de la madre y la obediencia compu