Intrinsic motives for companionship in understanding: Their origin, development, and significance for infant mental health

Maternal perception of infant's intersubjectivity: a questionnaire

INTRODUCTION

Intersubjectivity is a fundamental dimension of the mother-infant relationship.

OBJECTIVE

Design of a questionnaire to assess maternal perception of the infant's intersubjectivity.

DESIGN

After running a focus group with mothers of infants within their first year of life, items related to maternal perception of the infant's intersubjectivity were generated. These items were applied to a sample of 125 mothers and the results were submitted to principal components analysis.

RESULTS

Principal components analysis (forced extraction to 3 factors, KMO = .752, Bartlett = 976.202, p = .000; explained variance = 42.12%) identified 22 items grouped in three factors: a) F1, 'Interactive Competence' (α = .817); b) F2, 'Emotional States' (α = .749), and c) F3, 'Initiative' (α = .647). Positive and significant correlations were observed among all MPIIQ factors (p ≤ .01). Maternal perception of infant's intersubjectivity varied according to the number of gestational weeks at birth (T = -1.15, p ≤ .05) and according to the infant´s age (F = 7.834, p ≤ .001). Mothers of preterm infants reported lower perception of infant's intersubjectivity whereas mothers of older infants reported higher perception of infant's intersubjectivity.

CONCLUSION

The Maternal Perception of Infant's Intersubjectivity Questionnaire (MPIIQ) seems to be a sensitive instrument, able to discriminate different levels of maternal perception about the infant's intersubjective competences.

When do toddlers point during mealtime?: Pointing in the second year of life in everyday situations

The present study aimed to gain insight into the development of the infant's awareness of others' attention that takes place in everyday contexts. We examined the relation between the toddler's pointing, the toddler's visual attention to the caregiver, and the context of the action of the caregiver in the same child-caregiver dyads at two time points (13 and 17 months of age) during lunchtime at a Japanese daycare center, in which toddlers ate lunch with the help of caregivers. Specifically, we focused on the question of whether the timing of the toddler's pointing reflected the ongoing context of the action of the caregiver, based on the analysis of what the caregiver was doing when a toddler exhibited pointing behavior. Our analysis revealed several interrelated results. First, the toddler's pointing behavior was related to the visual exploration of the face of the caregiver at 17 months of age, which was not obvious at 13 months of age. Second, toddlers were more likely to point when the caregivers were just looking at them without being engaged in other salient goal-directed activities. Third, toddlers were less likely to exhibit pointing behavior when the caregivers were manipulating objects or feeding the toddlers. Taken together, the results suggested that toddlers were increasingly aware of the dynamic context of social partner's engagement, differentiating the right time to modulate the attention of others by pointing in everyday situations. The present study supplemented the existing knowledge about pointing and the development of shared intentionality based on controlled experiments by providing a description of the context in which toddlers tend to point in the naturalistic situation of lunchtime within a specific cultural setting during the second year of life.

Once upon a Pandemic: 'Online' Therapeutic Groupwork for Infants and Mothers Impacted by Family Violence

This case study describes the transition to an 'online' delivery of an evaluated infant mental health group work intervention for infants/mothers impacted by family violence during the COVID 19 pandemic. The imperative to provide early intervention to infants and their mother is outlined. The model and practice principles integral to this intervention are provided and described are four separate groups run online within two different Australian cities. Facilitators of the groups found that they were able to hold the infants and mothers safely in the online space despite the unexpected presence of others in the families' homes. The home-based nature of the work caused by lockdown restrictions revealed a transparency not found in office-based work, whilst simultaneously, evoking some discomfort. The ease with which infants and young children embraced technology worked in favor of using the online space. Playful, restorative, and creative ways of engaging with a highly vulnerable cohort of families were achieved; enhancing relational repair following both family violence and the isolation created by restrictions imposed by lockdowns. Despite an initial hesitancy to move online, the authors discovered meaningful ways through which to engage, treat and provide safe relational repair work with infants and their mothers impacted by family violence.

An integrative perspective on the role of touch in the development of intersubjectivity

Touch concerns a fundamental component of sociality. In this review, we examine the hypothesis that somatomotor development constitutes a crucial psychophysiological element in the ontogeny of intersubjectivity. An interdisciplinary perspective is provided on how the communication channel of touch contributes to the sense of self and extends to the social self. During gestation, the transformation of random movements into organized sequences of actions with sensory consequences parallels the development of the brain's functional architecture. Brain subsystems shaped by the coordinated activity of somatomotor circuits to support these first body-environment interactions are the first brain functional arrangements to develop. We propose that tactile self-referring behaviour during gestation constitutes a prototypic mode of interpersonal exchange that supports the subsequent development of intersubjective exchange. The reviewed research suggests that touch constitutes a pivotal bodily experience that in early stages builds and later filters self-other interactions. This view is corroborated by the fact that aberrant social-affective touch experiences appear fundamentally associated with attachment anomalies, interpersonal trauma, and personality disorders. Given the centrality of touch for the development of intersubjectivity and for psychopathological conditions in the social domain, dedicated research is urged to elucidate the role of touch in the evolution of subjective self-other coding.

Maternal History of Adverse Experiences and Posttraumatic Stress Disorder Symptoms Impact Toddlers’ Early Socioemotional Wellbeing: The Benefits of Infant Mental Health-Home Visiting

Background

The present study examined the efficacy of the Michigan Model of Infant Mental Health-Home Visiting (IMH-HV) infant mental health treatment to promote the socioemotional wellbeing of infants and young children. Science illuminates the role of parental “co-regulation” of infant emotion as a pathway to young children’s capacity for self-regulation. The synchrony of parent–infant interaction begins to shape the infant’s own nascent regulatory capacities. Parents with a history of childhood adversity, such as maltreatment or witnessing family violence, and who struggle with symptoms of post-traumatic stress may have greater challenges in co-regulating their infant, thus increasing the risk of their children exhibiting social and emotional problems such as anxiety, aggression, and depression. Early intervention that targets the infant–parent relationship may help buffer the effect of parental risk on child outcomes.

Methods

Participants were 58 mother–infant/toddler dyads enrolled in a longitudinal randomized control trial testing the efficacy of the relationship-based IMH-HV treatment model. Families were eligible based on child age (<24 months at enrollment) and endorsement of at least two of four socio-demographic factors commonly endorsed in community mental health settings: elevated depression symptoms, three or more Adverse Childhood Experiences (ACEs) parenting stress, and/or child behavior or development concerns. This study included dyads whose children were born at the time of study enrollment and completed 12-month post-baseline follow-up visits. Parents reported on their own history of ACEs and current posttraumatic stress disorder (PTSD) symptoms, as well as their toddler’s socioemotional development (e.g., empathy, prosocial skills, aggression, anxiety, prolonged tantrums).

Results

Maternal ACEs predicted more toddler emotional problems through their effect on maternal PTSD symptoms. Parents who received IMH-HV treatment reported more positive toddler socioemotional wellbeing at follow-up relative to the control condition. The most positive socioemotional outcomes were for toddlers of mothers with low to moderate PTSD symptoms who received IMH-HV treatment.

Conclusion

Results indicate the efficacy of IMH-HV services in promoting more optimal child socioemotional wellbeing even when mothers reported mild to moderate PTSD symptoms. Results also highlight the need to assess parental trauma when infants and young children present with socioemotional difficulties.

Music Therapy with Neonatal Intensive Care Unit-Discharged Mother-Infant Dyads: Developing a Method for Nurturing Communicative Parental Efficacy (CoPE with Music)

While much advancement has been documented in the practice of music therapy in the neonatal intensive care unit (NICU) environment, there is currently a shortage of music therapy-based methods for NICU-discharged dyads. Back in their homes, mothers might feel alone, lacking guidance, and possibly losing their parental efficacy and their ability to communicate with their baby. In this article, we present a method for nurturing the communicative parental efficacy (CoPE) that was successfully practiced with several NICU-discharged dyads. In eight weekly sessions, the music therapist improvises with the dyad and focuses on (1) containing the mother's emotions; (2) modeling musical interactions with the baby; and (3) practicing these musical interactions with the mother, enabling her to gain communicative parental efficacy. The basic ideas of CoPE are outlined, and a short case study is then described, to demonstrate how it is used. Finally, suggestions for future directions for the development of CoPE are provided.

Developing Pretend Play in Autistic Children Using the Playboxes Joint Play Approach as Part of Ongoing Practice

A repeated measures single subject design was used to examine the effectiveness of a joint play approach embedded in professional practice, in supporting pretend play for autistic children. Seven autistic children, aged 5–8 years, with a placement within a specialist educational provision, and who demonstrated restricted play, participated in weekly sessions using the Playboxes approach over a period of 3 months. Pre- and post-approach pretend play abilities were assessed using the Symbolic Play Test and the Test of Pretend Play. Every child gained increased age-equivalent scores on the Test of Pretend Play, ranging from + 8 to + 30 months. Pretend Play abilities can support developmental outcomes and incorporation of this approach into regular practice could be of value for autistic children.

Understanding and helping children who have experienced maltreatment

Children who experience maltreatment from within their families can suffer trauma that is devastating to their physical and psychological development. The label developmental trauma has developed to describe this trauma and to guide diagnosis. This has been expanded to describe seven domains of impairment. Together these help the clinician to provide a formulation of a child's difficulties which avoids multiple diagnoses and can guide treatment planning. Dyadic Developmental Psychotherapy and Practice (DDP) is an intervention model that can meet the therapeutic needs of the children alongside the support needs of parents and practitioners caring for them. The attitude of PACE (playfulness, acceptance, curiosity and empathy) is central within DDP interventions, used by therapists, parents and practitioners who together make up the network around the child. Tailoring DDP interventions can be guided by a pyramid of need developed by the author. This helps clinicians develop flexible intervention packages tailored to the needs of the child, family and practitioner. Within the paper these ideas are explored illustrated by the fictional example of Janice. She was maltreated in early childhood and now lives in foster care with Mary and Simeon.

Infant-directed speech as a simplified but not simple register: a longitudinal study of lexical and syntactic features

Infant-directed speech (IDS) is a specific register that adults use to address infants, and it is characterised by prosodic exaggeration and lexical and syntactic simplification. Several authors have underlined that this simplified speech becomes more complex according to the infant's age. However, there is a lack of studies on lexical and syntactic modifications in Italian IDS during the first year of an infant's life. In the present study, 80 mother-infant dyads were longitudinally observed at 3, 6, 9, and 12 months during free-play interactions. Maternal vocal productions were subsequently coded. The results show an overall low lexical variability and syntactic complexity that identify speech to infants as a simplified register; however, the high occurrence of complex items and well-structured utterances suggests that IDS is not simple speech. Moreover, maternal IDS becomes more complex over time, but not linearly, with a maximum simplification in the second half of the first year.

Identidade dialógica, alteridade e afetividade

Resumo Neste artigo teórico, partimos do princípio de que os processos humanos de significação e de conhecimento se consubstanciam e se desenvolvem em interdependência com os outros, para abordarmos a identidade pessoal como um espaço dialógico entre um Eu e um Outro (uma pessoa, um grupo, uma comunidade, uma sociedade), dinamicamente regulado por afetos. A inerência dialógica da vida psicológica é abordada - i.e., o papel dos outros na constituição da subjetividade humana - e, particularmente, as dimensões afetivas e motivacionais desse processo.

The Human Nature of Music

Music is at the centre of what it means to be human - it is the sounds of human bodies and minds moving in creative, story-making ways. We argue that music comes from the way in which knowing bodies (Merleau-Ponty) prospectively explore the environment using habitual 'patterns of action,' which we have identified as our innate 'communicative musicality.' To support our argument, we present short case studies of infant interactions using micro analyses of video and audio recordings to show the timings and shapes of intersubjective vocalizations and body movements of adult and child while they improvise shared narratives of meaning. Following a survey of the history of discoveries of infant abilities, we propose that the gestural narrative structures of voice and body seen as infants communicate with loving caregivers are the building blocks of what become particular cultural instances of the art of music, and of dance, theatre and other temporal arts. Children enter into a musical culture where their innate communicative musicality can be encouraged and strengthened through sensitive, respectful, playful, culturally informed teaching in companionship. The central importance of our abilities for music as part of what sustains our well-being is supported by evidence that communicative musicality strengthens emotions of social resilience to aid recovery from mental stress and illness. Drawing on the experience of the first author as a counsellor, we argue that the strength of one person's communicative musicality can support the vitality of another's through the application of skilful techniques that encourage an intimate, supportive, therapeutic, spirited companionship. Turning to brain science, we focus on hemispheric differences and the affective neuroscience of Jaak Panksepp. We emphasize that the psychobiological purpose of our innate musicality grows from the integrated rhythms of energy in the brain for prospective, sensation-seeking affective guidance of vitality of movement. We conclude with a Coda that recalls the philosophy of the Scottish Enlightenment, which built on the work of Heraclitus and Spinoza. This view places the shared experience of sensations of living - our communicative musicality - as inspiration for rules of logic formulated in symbols of language.

Is Our Self Related to Personality? A Neuropsychodynamic Model

The concept and the assessment of personality have been extensively discussed in psychoanalysis and in clinical psychology over the years. Nowadays there is large consensus in considering the constructs of the self and relatedness as central criterions to assess the personality and its disturbances. However, the relation between the psychological organization of personality, the construct of the self, and its neuronal correlates remain unclear. Based on the recent empirical data on the neural correlates of the self (and others), on the importance of early relational and attachment experiences, and on the relation with the brain's spontaneous/resting state activity (rest-self overlap/containment), we propose here a multilayered model of the self with: (i) relational alignment; (ii) self-constitution; (iii) self-manifestation; and (iv) self-expansion. Importantly, these different layers of the self can be characterized by different neuronal correlates-this results in different neuronally grounded configurations or organizations of personality. These layers correspond to different levels of personality organization, such as psychotic (as related to the layer of self-constitution), borderline (as related to the layer of self-manifestation) and neurotic (as related to the layer of self-expansion). Taken together, we provide here for the first time a neurobiologically and clinically grounded model of personality organization, which carries major psychodynamic and neuroscientific implications. The study of the spontaneous activity of the brain, intrinsically related to the self (rest-self overlap/containment) and the interaction with stimuli (rest-stimulus interaction) may represent a further advance in understanding how our default state plays a crucial role in navigating through the internal world and the external reality.

Inside the black box: Modeling "Life Writing" for lifelong health and well being

We articulate the lifespan theory of change by which an attachment-focused integrative reminiscence intervention, "Life Writing", is expected to interrupt the continuing problem of insecure attachment in adults and reverse associated reduced health and well-being outcomes. Based on preliminary studies and previous research, Life Writing is expected to foster earned-secure attachment in adults who work through subjective memories of unresolved attachment trauma. Roughly two decades of research on integrative reminiscence interventions like Life Writing show their consistent and wide-ranging positive impact. However, the bulk of this research demonstrates that such programs work, without also clarifying how they work, leaving unanswered questions as to how change occurs and how benefits might continue to accrue to participants through the lifespan. This represents what are known as "black box" effects. A program and evaluation planning tool, The Netway, was used to 1) identify hypothesized links between program inputs, activities, outputs, outcomes, and long-term impacts; 2) to clarify the underlying assumptions related to the program's success; and 3) to consider the appropriate contexts for the program. The logic model presented here articulates the hypothesized causal pathway from insecure to earned-secure attachment, in preparation for rigorous empirical tests of the program's lifespan theory of change.

A Conceptual Framework: The Musical Self as a Unique Pathway to Outcomes in the Acute Pediatric Health Setting

This article reports on a project at the Royal Children's Hospital Melbourne in which the music therapy team synthesized their practice and related theories to propose a new conceptual framework for music therapy in their acute pediatric setting. The impetus for the project was the realization that in the process of producing key statements about the non-musical benefits of music therapy, the cost was often the suppression of information about the patient's unique musical potential as the major (mediating) pathway from referral reason, to music therapy, and to effective outcomes. The purpose of the project was to articulate how this team of clinicians conceive of the patient's musical self as the major theoretical pathway for music therapy in an evidence-based acute medical setting. The clinicians' shared reflexive process across six months involved robust directed discussion, annotation of shared reading, and documentation of all engagement in words and diagrams. The outcome was a consensus framework including three constructs: the place of music in the life of the infant, child, and young people, Culture and Context, and Musical Manifestations. The constructs were tested in a clinical audit, and found to be robustly inclusive. In addition to the conceptual framework, this project serves to demonstrate a process by which clinical teams may reflect on their individual practice and theory together to create a consensus stance for the overall service they provide in the one setting.

Affective facial expression in sub-clinically depressed and non-depressed mothers during contingent and non-contingent face-to-face interactions with their infants

BACKGROUND

Depression in the postpartum period involves feelings of sadness, anxiety and irritability, and attenuated feelings of pleasure and comfort with the infant. Even mild- to- moderate symptoms of depression seem to have an impact on caregivers affective availability and contingent responsiveness. The aim of the present study was to investigate non-depressed and sub-clinically depressed mothers interest and affective expression during contingent and non-contingent face-to-face interaction with their infant.

METHODS

The study utilized a double video (DV) set-up. The mother and the infant were presented with live real-time video sequences, which allowed for mutually responsive interaction between the mother and the infant (Live contingent sequences), or replay sequences where the interaction was set out of phase (Replay non-contingent sequences). The DV set-up consisted of five sequences: Live1-Replay1-Live2-Replay2-Live3. Based on their scores on the Edinburgh Postnatal Depression Scale (EPDS), the mothers were divided into a non-depressed and a sub-clinically depressed group (EPDS score≥6).

RESULTS

A three-way split-plot ANOVA showed that the sub-clinically depressed mothers displayed the same amount of positive and negative facial affect independent of the quality of the interaction with the infants. The non-depressed mothers displayed more positive facial affect during the non-contingent than the contingent interaction sequences, while there was no such effect for negative facial affect.

CONCLUSIONS

The results indicate that sub-clinically level depressive symptoms influence the mothers' affective facial expression during early face-to-face interaction with their infants. One of the clinical implications is to consider even sub-clinical depressive symptoms as a risk factor for mother-infant relationship disturbances.

Structural and Functional Plasticity in the Maternal Brain Circuitry

Parenting recruits a distributed network of brain structures (and neuromodulators) that coordinates caregiving responses attuned to the young's affect, needs, and developmental stage. Many of these structures and connections undergo significant structural and functional plasticity, mediated by the interplay between maternal hormones and social experience while the reciprocal relationship between the mother and her infant forms and develops. These alterations account for the remarkable behavioral plasticity of mothers. This review will examine the molecular and neurobiological modulation and plasticity through which parenting develops and adjusts in new mothers, primarily discussing recent findings in nonhuman animals. A better understanding of how parenting impacts the brain at the molecular, cellular, systems/network, and behavioral levels is likely to significantly contribute to novel strategies for treating postpartum neuropsychiatric disorders in new mothers, and critical for both the mother's physiological and mental health and the development and well-being of her young.

OUTLINING THE WINDOWS OF ACHIEVEMENT OF INTERSUBJECTIVE MILESTONES IN TYPICALLY DEVELOPING TODDLERS

Babies are born with an innate drive or intrinsic motive formation with which to communicate and share meanings with others and that some authors have called intersubjectivity (S. Bråten & C. Trevarthen, 2007; C. Trevarthen, 1974, 2001). Around the ninth month of life, this motivation changes and passes from a person-to-person dyadic (primary intersubjectivity) to a person-person-object relationship (secondary intersubjectivity). S. Bråten and C. Trevarthen (2007) also proposed a third form or layer of intersubjectivity known as tertiary intersubjectivity. One hundred fifteen free-play sessions of 27 mother-child dyads (13 girls and 14 boys ages 9-37 months) were filmed and categorized using the Level of Intersubjective Attunement Scale (LISA-T; M. Pérez Burriel & M. Sadurní Brugué, 2014; M. Sadurní Brugué & M. Pérez Burriel, 2012). Results from these nine hierarchical levels are presented, following a developmental sequence or population trajectory around an interindividual variability. In this article, we propose viewing these age-related levels as windows of achievement of intersubjective milestones. The statistical analysis suggested a redesign of the LISA-T levels of intersubjectivity; thus, results from this redesign and the debate on the implications of these transitions in infant mental health development are presented.

Neuroanatomical and neurochemical basis of parenting: Dynamic coordination of motivational, affective and cognitive processes

This article is part of a Special Issue "Parental Care". Becoming a parent is arguably the most profound transforming experience in life. It is also inherently very emotionally and physically demanding, such that the reciprocal interaction with the young changes the brain and behavior of the parents. In this review, we examine the neurobiological mechanisms of parenting primarily discussing recent research findings in rodents and primates, especially humans. We argue that it is essential to consider parenting within a conceptual framework that recognizes the dynamics of the reciprocal mother-young relationship, including both the complexity and neuroplasticity of its underlying mechanisms. Converging research suggests that the concerted activity of a distributed network of subcortical and cortical brain structures regulates different key aspects of parenting, including the sensory analysis of infant stimuli as well as motivational, affective and cognitive processes. The interplay among these processes depends on the action of various neurotransmitters and hormones that modulate the timely and coordinated execution of caregiving responses of the maternal circuitry exquisitely attuned to the young's affect, needs and developmental stage. We conclude with a summary and a set of questions that may guide future research.

The Embodied Attunement of Therapists and a Couple within Dialogical Psychotherapy: An Introduction to the Relational Mind Research Project

In dialogical practice, therapists seek to respond to the utterances of clients by including in their own response what the client said. No research so far exists on how, in dialogs, therapists and clients attune themselves to each other with their entire bodies. The research program The Relational Mind is the first to look at dialog in terms of both the outer and the inner dialogs of participants (clients and therapists), observed in parallel with autonomic nervous system (ANS) measurements. In the ANS, the response occurs immediately, even before conscious thought, making it possible to follow how participants in a multiactor dialog synchronize their reactions and attune themselves to each other. The couple therapy case presented in this article demonstrates how attunement is often not a simple "all at the same time" phenomenon, but rather a complex, dyadic or triadic phenomenon which changes over time. In the case presented, there was strong synchrony between one therapist and one client in terms of their arousal level throughout the therapy session. It was also observed that high stress could occur when someone else was talking about something related to the participant, or if that person mirrored the participant's words. Overall, it seems that in evaluating the rhythmic attunement between therapists and clients it is not enough to look at single variables; instead, integrated information from several channels is needed when one is seeking to make sense of the embodiment.

“A great moment . . . because of the music”: An exploratory study on music therapy and early interaction with children with visual impairment and their sighted caregivers

The focus of this article is on how musical interaction can contribute to bonding and early interaction. This article is based on a music therapy project in a pedagogical institution for people with visual impairment. The study is qualitative and exploratory, where children with visual impairments (aged 1–4 years) and their caregivers participated in music therapy sessions over 10 weeks. Data have been collected by participant observation, video recordings, and interviews. Moments of positive interactions in music were selected and analyzed, and the selections were triangulated by interviews with the caregivers. The data material indicates that music therapy promotes positive bonding patterns and enhances early interaction. Musical interaction facilitates elements of early interaction that can be challenging for children with visual impairments and their sighted caregivers. Both caregivers and children seemed to experience one another as a source of joyful interaction. This article discusses the findings in the broader perspective of disability studies and community music therapy and argues that music therapy promotes positive interactions and empowerment of children with visual impairment and their caregivers.

Shared pleasure in early mother-infant interaction: predicting lower levels of emotional and behavioral problems in the child and protecting against the influence of parental psychopathology

Shared pleasure (SP) was analyzed in fifty-eight 2-month-old infants and their mothers in face-to-face interaction (T1, at 2 months). The association of SP with child's emotional and behavioral outcome at 2 years (T2) was examined. SP as a possible protecting factor in the presence of parental psychopathology also was studied. Mean duration of SP moments (SP-MD) was related to subsequent socioemotional outcome of the child: Infants of dyads with longer SP-MD showed fewer internalizing and externalizing problems 2 years later. In hierarchical linear regressions, SP-MD uniquely and significantly contributed to internalizing problems after adjusting for infant and maternal factors and mother's interactive behavior. SP protected the child against the influence of parental psychopathology. Father's mental health problems during the follow-up increased the child's risk for higher externalizing and internalizing problems, but only among children with short SP-MD at T1. Internalizing symptoms at T2 increased when moving from the category "no mental health problems" to "mental health problems in one parent" and further to "mental health problems in both parents," but this increase was found only among those with short SP-MD at T1. SP in parent-child interaction is an important feature that fosters positive psychological development and moderates the health effects of other risks such as parental psychopathology.

The 'Self' and Borderline Personality Disorder: Conceptual and Clinical Considerations

Some concept of self has been used by many, although not all, researchers and clinicians as an 'organising construct' for borderline personality disorder (BPD). There is considerable variation in this usage and how clearly researchers have defined the self. Given this diversity, and that 'self' is often used interchangeably with parallel concepts (e.g., psyche, brain-mind, 'person') or with features of self (e.g., self-awareness, identity), unqualified use of the term is problematic. This is further complicated by the heterogeneity and 'comorbidity' of BPD and the limitations of syndromally based psychiatric nosology. Still, BPD remains in current classification systems and can be reliably diagnosed. A considerable body of research on self and BPD has accrued, including a recent profusion and confluence of neuroscientific and sociopsychological findings. These have generated supporting evidence for a supra-ordinate, functionally constituted entity of the self ranging over multiple, interacting levels from an unconscious, 'core' self, through to a reflective, phenotypic, 'idiographic' and relational self constituted by interpersonal and sociocultural experience. Important insights have been generated regarding emotional and social-cognitive dysregulation, disorder of self-awareness, relationality, identity, and coherence and continuity of the self. Many of these are shared by various trauma-related, dissociative disorders. A construct of the self could be useful as an explanatory principle in BPD, which could be construed as a 'self-state' (and relational) disorder, as opposed to a less severe disorder of aspects of the self (e.g., mood or memory). We offer a tentative description of 'Self' in this context, noting that any such construct will require a clear definition and to be evaluable.

Do you hear the same? Cardiorespiratory responses between mothers and infants during tonal and atonal music

This study examined the effects of tonal and atonal music on respiratory sinus arrhythmia (RSA) in 40 mothers and their 3-month-old infants. The tonal music fragment was composed using the structure of a harmonic series that corresponds with the pitch ratio characteristics of mother–infant vocal dialogues. The atonal fragment did not correspond with a tonal structure. Mother–infant ECG and respiration were registered along with simultaneous video recordings. RR-interval, respiration rate, and RSA were calculated. RSA was corrected for any confounding respiratory and motor activities. The results showed that the infants’ and the mothers’ RSA-responses to the tonal and atonal music differed. The infants showed significantly higher RSA-levels during the tonal fragment than during the atonal fragment and baseline, suggesting increased vagal activity during tonal music. The mothers showed RSA-responses that were equal to their infants only when the infants were lying close to their bodies and when they heard the difference between the two fragments, preferring the tonal above the atonal fragment. The results are discussed with regard to music-related topics, psychophysiological integration and mother-infant vocal interaction processes.

In praise of a doctor who welcomes the newborn infant person

This article recalls how Dr. Berry Brazelton, in the past 50 years, has transformed pediatrics and childcare and supported parents' understanding of their young children. Berry's work as a pediatrician and basic research in the psychobiology of childbirth and infant communication and care have proved to be richly complementary. Brazelton and the author were fortunate to meet in the context of the wide exploration of human nature and adaptations of human intelligence for cooperative life encouraged by Jerome Bruner's vision of how cultural awareness of meaning may be generated in affectionate relations from infancy. This opened a new awareness of the adaptations of the human mind for sharing the creation of a meaningful world by exploring playful imagination with companions.

Subclinical levels of maternal depression and infant sensitivity to social contingency

The aim of the study was to investigate how young infants respond to contingent and non-contingent interaction in relation to maternal level of depressive symptoms in a non-clinical sample of mothers and infants. Two groups of three-month-olds interacted with their mother who was assessed as either non-depressed or sub-clinically depressed, based on self-reported scores on the Edinburgh Postnatal Depression Scale (EPDS). The infants were presented with a continuous image and voice of their mother in a closed circuit computer system, using the double video procedure. The experiment comprised five sequences, alternating between contingent (Live) and non-contingent (Replay) maternal behaviur in a fixed Live1-Replay1-Live2-Replay2-Live3 sequence. The infants of the sub-clinically depressed mothers showed a high gaze focus at their mother independently of the quality of interaction, while the infants of the non-depressed mothers showed a preference for looking at the mother only when the interaction with their mother was contingent. Further, the infants of the sub-clinically depressed mothers showed no differentiation in affective expression between contingent and non-contingent interactions, while the infants of the non-depressed mothers expressed more positive affect than negative affect only when the interaction with their mother was contingent. Finally, there was a significant relation between the infant's preference for looking at the mother and the infant's amount of positive affect, but this was only found for the infants of the non-depressed. These results indicate that young infants' sensitivity to social contingency is related to maternal level of depression, even in a non-clinical sample. This expands the implications of earlier findings on the impact of maternal depression on infant sensitivity to social contingency, demonstrating that even sub-clinical levels of maternal depression may effect early interaction and child development.

Predictors of diagnosis of child psychiatric disorder in adult-infant social-communicative interaction at 12 months

To establish which social interactive behaviours predict later psychiatric diagnosis, we examined 180 videos of a parent-infant interaction when children were aged one year, from within the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort. Sixty of the videos involved infants who were later diagnosed with a psychiatric disorder at seven years, and 120 were a randomly selected sex-matched control group. Interactive behaviours for both the caregiver and the one year old infant were coded from the videos according to eight holistic categories of interpersonal engagement: Well-being, Contingent Responsiveness, Cooperativeness, Involvement, Activity, Playfulness, Fussiness, and Speech. Lower levels of adult activity and speech in interaction at one year significantly predicted overall diagnosis of child psychiatric disorder.

Competência social, inclusão escolar e autismo: um estudo de caso comparativo

A presente pesquisa analisou o perfil de competência social (CS) de uma criança pré-escolar com autismo, na escola comum comparado a uma criança com desenvolvimento típico e investigou a influência do ambiente escolar (sala de aula ou pátio) no perfil de CS de ambas. As interações sociais com seus pares foram filmadas, na escola, e a codificação dos vídeos foi realizada por um avaliador independente. Utilizou-se como instrumento a versão adaptada da Escala Q-sort de CS. Os resultados demonstraram que enquanto o perfil de competência social da criança com desenvolvimento típico pouco variou entre os contextos, a criança com autismo demonstrou maior frequência de comportamentos de cooperação e asserção social e menor frequência de agressão e desorganização do self, no pátio.

Music therapy with hospitalized infants-the art and science of communicative musicality

Infants seek contingent, companionable interactions with others. Infants in a Neonatal Intensive Care Unit (NICU), while receiving care that optimizes their chances of survival, often do not have the kind of interactions that are optimal for their social development. Live music therapy (MT) with infants is an intervention that aims for contingent, social interaction between therapist and infant. This study, with a limited numbers of infants, examined the effectiveness of an MT intervention in the NICU at The Royal Children's Hospital Melbourne. Two groups of late pre-term and full-term infants were recruited to the study; one was given MT and the other was not. A healthy group of infants not given MT served as an additional control. The effect of MT was indexed using two measures reflecting infant social engagement: the Neurobehavioral Assessment of the Preterm Infant (NAPI) and the Alarm Distress Baby Scale (ADBB). Results suggest that the MT intervention used at The Royal Children's Hospital Melbourne supports infants' neurobehavioral development. In particular, hospitalized infants who received MT were better able to maintain self-regulation during social interaction with an adult, were less irritable and cried less, and were more positive in their response to adult handling, when compared with infants who did not receive the intervention. These are important prerequisites for social interaction and development. Further and larger scale research using MT with this population is indicated.