Mind-mindedness and maternal responsiveness in infant–mother interactions in mothers with severe mental illness

• Published in: Psychological medicine 2010-11, Vol.40 (11), p.1861-1869
• Main Authors: Pawlby, S., Fernyhough, C., Meins, E., Pariante, C. M., Seneviratne, G., Bentall, R. P.
• Format: Article
• Language: English
• Subjects: Admissions; Adolescent; Adult; Adult and adolescent clinical studies; Babies; Behavior; Biological and medical sciences; Bipolar Disorder - psychology; Case-Control Studies; Depressive Disorder - psychology; Female; Hospitalization; Humans; Infant; Infant Behavior - psychology; Infant-mother interaction; Infants; Male; Medical sciences; Mental depression; Mental Disorders - psychology; Mentally ill mothers; Middle Aged; mind-mindedness; Miscellaneous; Mood disorders; Mood Disorders - psychology; Mother-Child Relations; Mothers; Mothers - psychology; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychoses; Psychotic Disorders - psychology; Schizophrenia; Schizophrenic Psychology; severe mental illness; Theory of Mind; Young Adult
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S0033291709992340

Previous cross-diagnosis studies of interaction between mothers with severe mental illness and their babies have concluded that mothers with schizophrenia have deficits in interaction, but these studies have not included healthy controls. In-patients on a mother and baby unit, with diagnoses of schizophrenia (n=15), depressive mood disorders with or without psychosis (n=23), or mood disorders where mania was the predominant feature, with or without psychosis (n=12), were observed interacting with their infants on admission and discharge. Mothers' mind-mindedness and other measures of the quality of maternal and infant behaviour were coded. Findings from this sample were compared with those from healthy mothers and their infants (n=49). Compared with healthy controls, on admission depressed mothers were marginally less likely to comment appropriately on their infants' mental states. Both the depressed and mania groups were more likely to touch their babies and engage in attention-seeking behaviours. Interactional behaviours of mothers in the schizophrenia group were not markedly different from healthy controls. On discharge there were fewer differences between the clinical and healthy groups, although the depressed group continued to engage in more attention-seeking and touching behaviour and the mania group continued to touch their infants more. Only mothers in the schizophrenia group showed changes in interactional behaviours between admission and discharge, talking more to their infants. The findings challenge previous conclusions that mothers with schizophrenia have deficits in their interactions with their babies, and demonstrate that mothers with severe mental illness are able to respond appropriately to their infants' cues.