MATERNAL MIND-MINDEDNESS: RELATIONS WITH MATERNAL-FETAL ATTACHMENT AND STABILITY IN THE FIRST TWO YEARS OF LIFE: FINDINGS FROM AN AUSTRALIAN PROSPECTIVE STUDY

Maternal mind-mindedness and infant oxytocin are interrelated and negatively associated with postnatal depression

Previous studies show that maternal mind-mindedness positively impacts children's social development. In the current studies, we examine the relation between mind-mindedness during parent-child interaction, oxytocin (OT), and postnatal depression in a sample of mothers (N = 62, ages 23-44) and their infant (ages 3-9 months). In Study 1, infant salivary OT was positively correlated with mothers' appropriate mind-related comments, and negatively correlated (at trend level) with maternal depression scores. Mothers experiencing symptoms of depression used fewer appropriate mind-related comments than controls. Study 2 was a double-blind, placebo-controlled, experimental study, in which the same women who participated in Study 1 were administered nasal OT. This did not significantly influence levels of mind-mindedness. Study 2 warrants a larger trial to investigate the effect of OT on mind-mindedness further. Study 1 is the first to demonstrate an association between maternal mind-mindedness and variation in children's OT levels. Since both OT and mind-mindedness have been repeatedly implicated in processes of maternal-infant attachment, this association highlights the centrality of mothers' caregiving representations in facilitating the parent-child relationship and children's early development.

Prenatal mental health and emotional experiences during the pandemic: associations with infant neurodevelopment screening results

BACKGROUND

This study determined whether parental mental health and emotional experiences during the prenatal period were linked to infant developmental outcomes through the Ages and Stages Questionnaire (ASQ-3) at 8-10 months.

METHODS

Participants included 133 individuals who were living in the US and were pregnant or had given birth within 6 months prior to enrollment. Respondents were majority White with high education and income levels. Online surveys were administered from May 2020 to September 2021; follow-up surveys were administered from November 2020 to August 2022.

RESULTS

Parent generalized anxiety symptoms were positively associated with infant communication (β = 0.34, 95% CI [0.15, 1.76], p < 0.05), while parent-fetal bonding was positively associated with infant communication (β = 0.20, 95% CI [0.05, 0.76], p < 0.05) and personal-social performance (β = 0.20, 95% CI [0.04, 0.74], p < 0.05). COVID-19-related worry was negatively associated with infant communication (β = -0.30, 95% CI [-0.75, -0.12], p < 0.05) and fine motor performance (β = -0.25, 95% CI [-0.66, -0.03], p < 0.05).

CONCLUSION

Parent mental health and emotional experiences may contribute to infant developmental outcomes in high risk conditions such as a pandemic.

IMPACT STATEMENT

Maternal SARS-CoV-2 infection has been evaluated in relation to child outcomes, however, parent psychosocial experiences should not be overlooked when considering pandemic risks to child development. Specific prenatal mental health and pandemic-related emotional experiences are associated with infant developmental performance, as assessed by the Ages and Stages. Questionnaire (ASQ-3) at 8 to 10 months old. Findings indicate that parental prenatal anxiety and emotional experiences from the pandemic should be assessed when evaluating child developmental delays.

The effect of self-evaluation of foetal movement and position tracking on prenatal attachment and distress

OBJECTIVES

To determine the effect of self-evaluation of foetal movement and position tracking on prenatal attachment and distress.

METHODS

The study was a randomised controlled study . The study included women who came to the Kahramanmaraş Maternity and Children's Hospital for prenatal examination. The data were collected using a questionnaire form, the prenatal attachment inventory (PAI), and the Tilburg pregnancy distress scale (TPDS). The pregnant women in the intervention group were trained to count the foetal movements and track the position of the foetus. Data were evaluated using paired samples t-test, independent samples t-test, chi-square test, Pearson correlation analysis, and linear regression analysis. This trial was registered at ClinicalTrials.gov under the process NCT05313113.

RESULTS

Although the mean PAI pre-test scores were similar in the intervention and control groups (t = -0.811; p = 0.420), a significant difference was observed in the mean post-test scores between the two groups (t = 6.404; p < 0.001). The mean TPDS pre-test scores were similar in both groups (t = 0.933; p = 0.453), but a significant difference was observed in the mean post-test scores (t = -3.345; p < 0.001).

CONCLUSION

Thus, self-evaluation of foetal movement and foetal position tracking increased the prenatal attachment.

A smartphone app effectively facilitates mothers' mind-mindedness: A randomized controlled trial

The efficacy of a smartphone app intervention (BabyMind©) in facilitating mind-mindedness was investigated in a randomized controlled trial, assigning mothers and their 6-month-olds (N = 152; 72 girls, 146 White) to intervention or active control conditions. Mothers who had received the BabyMind© app intervention scored higher for appropriate (d = .61, 95% CI .28, .94) and lower for non-attuned (d = -.55, 95% CI -.92, -.18) mind-related comments at follow-up (age 12 months), compared with their control group counterparts. Adjusting for missing data did not alter this pattern of findings. Mothers' baseline parental reflective functioning did not moderate these relations. Results are discussed in terms of the benefits of early intervention and exploring the efficacy of the app in more diverse populations.

Mind-mindedness and preschool children's behavioral difficulties: The moderating role of maternal parenting distress

Mind-mindedness (MM) is a caregiver's tendency to appreciate their infant's internal mental states. This longitudinal study investigated whether maternal MM (10 months) was linked with children's later behavioral problems (51 months) and the moderating role of maternal parenting distress (PD; 36 months) in a sample of 91 mother-infant dyads. Appropriate MM comments were coded from video-recorded, semi-structured play interactions between mothers and their infants; PD was obtained from maternal completion of the PD subscale of the Parenting Stress Index - Short Form (PSI-SF); and child internalizing and externalizing behavior problems were gathered from maternal report on the Strengths and Difficulties Questionnaire (SDQ). Moderated regression analyses revealed higher early appropriate MM was associated with significantly fewer internalizing emotional problems at 51 months among mothers with lower PD at 36 months, and higher early appropriate MM was associated with lower conduct problems at 51 months in mothers with higher PD at 36 months. Findings demonstrated the importance of considering nuanced contexts such as at-risk mothers and differential presentations of child difficulties in the analysis of the relationship between MM and child behavioral difficulties and the development of MM interventions.

Antenatal mind-mindedness and its relationship to maternal-fetal attachment in pregnant women

In this study, researchers aimed to investigate whether a relationship exists between maternal-fetal attachment (MFA) and antenatal mind-mindedness in a sample of Australian pregnant women (n = 43). Participants completed the Maternal Fetal Attachment Scale (MFAS) in their second and third trimester, and a modified 'describe your baby' interview with the inclusion of general prompts as a measure of antenatal mind-mindedness in their third trimester. Positive correlations were observed between mental comments, but not total predictions, made by women during the modified antenatal mind-mindedness task and MFAS scores at the second and third trimesters. An average of 6.07 total predictions and 1.30 mental predictions were made before prompts, increasing to 17.65 total comments and 6.58 mental comments after prompts. Prompts within the mind-mindedness task resulted in 42 participants making at least one mental prediction (M = 6.58). Our findings provide the first evidence for a relationship between MFA and antenatal mind-mindedness, and highlight the importance of considering mind-mindedness during pregnancy in the developing bond from mother to baby.

Maternal mind-mindedness over infants' first three months

Maternal mind-mindedness refers to mothers' ability to reflect upon their infants' mental states and respond appropriately. The present study assessed mind-mindedness longitudinally from the newborn period to the infant age of three months. The study is the first to assess maternal mind-mindedness in the infant's early life prior to three months (one week, one month, two months, three months). To measure maternal mind-mindedness, mothers' speech to their infants is coded for mental state comments about the infants' thoughts, desires, and emotions. Appropriate mind-minded comments are judged to accurately reflect the infants' mental states; non-attuned mind-minded comments are judged to misinterpret the infants' mental states. Mothers' individual stability (rank order stability) and group level continuity (mean level of stability across the infant ages) were assessed. Mothers showed modest temporal stability in both appropriate and non-attuned mind-mindedness over the infants' first three months. The continuity of mind-mindedness showed that appropriate mind-mindedness increased over the infant ages, but non-attuned mind-mindedness showed no change. In infants' early lives, mothers' ability to accurately interpret their infants' mental states is enhanced as the mother-infant relationship develops and infants become more communicative partners.

Envisioning motherhood: Mental-state language in caregiving narratives across the perinatal period

Nancy Suchman's work highlighted the fundamental role of maternal mentalization in maternal addiction, mental health, and caregiving challenges. In this study, we aimed to examine the role of mental-state language (MSL) as a measure of mentalization in prenatal and postnatal narratives and their sentiment in a sample of 91 primarily White mothers from the western United States, followed from the second trimester of pregnancy, through the third trimester, to 4 months postpartum. Specifically, we investigated the use of affective and cognitive MSL in prenatal narratives when mothers visualized caring for their baby and postnatal narratives when mothers compared their prenatal visualization to the current caregiving reality. Results indicated moderate consistency in MSL between the second and third trimesters, but prenatal and postnatal MSL was not significantly correlated. Across all time points, higher use of MSL was related to more positive sentiment, indicating an association between mentalization and positive caregiving representations across the perinatal period. Women used more affective than cognitive MSL in prenatal imagination of caregiving, but this pattern was reversed in their postpartum reflection. Implications on assessing parental mentalization prenatally and considering the relative dominance of affective and cognitive mentalizing are discussed while considering study limitations.

Paternal mind-mindedness and infant-toddler social-emotional problems

A growing body of evidence suggests that paternal behaviors are influential in child development. However, few studies have focused on paternal mind-mindedness, that is, the tendency of fathers to view their child as having mental agency, which is manifested as a propensity to name the child's mental states while they are interacting with the child. The purpose of this study was to better understand the role of paternal mind-mindedness in the development of social-emotional problems during infancy. 131 families (father-mother-child) were recruited from the community and assessed when children were 6, 12, and 18 months old. Paternal and maternal mind-mindedness was assessed through observation of father-child and mother-child dyads at 6 months. Children's social-emotional problems were measured with a questionnaire completed by both parents at 12 and 18 months. Results indicate that maternal mind-mindedness at 6 months predicts fewer social-emotional problems at 12 months, while fathers' mind-mindedness at 6 months predicts fewer social-emotional problems at 18 months. This study highlights the unique contribution of paternal mind-mindedness to children's early social-emotional development.

Demographics, health literacy and health locus of control beliefs of Australian women who take complementary medicine products during pregnancy and breastfeeding: A cross-sectional, online, national survey

Background

Pregnant and breastfeeding women's use of complementary medicine products (CMPs) is common, and possibly associated with autonomous health care behaviours. However, the health literacy levels and health locus of control (HLOC) beliefs of women who use CMPs in pregnancy and lactation have not been previously assessed in a large Australian sample.

Aim

The aim of this study is to determine the health literacy levels and HLOC beliefs of women who use CMPs in pregnancy and lactation and determine the types of CMPs used.

Methods

A cross‐sectional, national, online survey of Australian pregnant or breastfeeding women aged 18 years and older, and currently using CMPs was conducted.

Results

A total of 810 completed surveys (354 pregnant and 456 breastfeeding women) were analysed. Most had adequate functional health literacy levels (93.3%). Health care practitioners (HCPs) HLOC mean scores were the highest for the sample, followed by Internal HLOC beliefs mean scores. Almost all (n = 809) took at least one dietary supplement, the most popular being pregnancy and breastfeeding multivitamins, iron supplements and probiotics. Use was generally in line with clinical recommendations, except for low rates of iodine supplementation. Herbal medicine use was lower for the total sample (57.3%, n = 464), but significantly higher (p < .0001) for the breastfeeding cohort, with consumers taking one to four herbal medicines each. The most popular herbs were raspberry leaf, ginger, peppermint and chamomile (pregnant respondents) and chamomile, ginger and fenugreek (breastfeeding respondents).

Conclusions

Respondents were health literate, with high scores for Internal and HCP HLOC scales, suggesting that they are likely to demonstrate self‐efficacy, positive health behaviours and work well in partnership with HCPs. HCPs can facilitate discussions with pregnant and breastfeeding women using CMPs, while considering women's health literacy levels, health beliefs and goals.

Imagining the baby: Neural reactivity to infant distress and mind-mindedness in expectant parents

Neural and psychological processes in pregnancy may be important antecedents for caregiving postpartum. Employing event-related potentials, we examined neural reactivity to infant emotional faces during the third trimester of pregnancy in expectant mothers (n = 38) and expectant fathers (n = 30). Specifically, expectant parents viewed infant distress and infant neutral faces while electroencephalography was simultaneously recorded. As a psychological measure, we assessed prenatal mind-mindedness towards the unborn child and examined whether neural processing of infant cues was associated with levels of mind-mindedness. Expectant fathers evidenced greater P300 reactivity to infant distress, relative to neutral, faces than expectant mothers. Furthermore, P300 reactivity to infant distress, relative to infant neutral, faces was associated with levels of prenatal mind-mindedness in expectant fathers but not expectant mothers. These findings indicate significant sex differences in the prenatal neural processing of infant cues and relations between neural reactivity to infant distress and the emergence of parental mind-mindedness.

What factors are most important for the development of the maternal-fetal relationship? A prospective study among pregnant women in Danish general practice

Background

Development of the maternal antenatal attachment (MAA) constitutes an important aspect of the transition into motherhood. Early identification of women at risk of developing a poor MAA provides possibilities for preventive interventions targeting maternal mental health and the emerging mother-infant relationship. In this study, we investigate the relative importance of an extensive set of psychosocial, pregnancy-related, and physiological factors measured in the first trimester of pregnancy for MAA measured in third trimester.

Methods

A prospective study was conducted among pregnant women in Danish general practice (GP). Data were obtained in the first and the third trimester from pregnancy health records and electronic questionnaires associated with routine GP antenatal care visits. The Maternal Antenatal Attachment Scale (MAAS) was used to assess maternal antenatal attachment. The relative importance of potential determinants of maternal antenatal attachment was assessed by the relative contribution of each factor to the fit (R²) calculated from multivariable regression models.

Results

The sample consisted of 1328 women. Low antenatal attachment (Total MAAS ≤ 75) was observed for 513 (38.6%) women. Perceived social support (having someone to talk to and having access to practical help when needed) emerged as the most important determinant. Furthermore, scores on the MAAS decreased with worse self-rated health, poor physical fitness, depression, increasing age, having given birth previously, and higher education.

Conclusion

Pregnant women reporting lack of social support and general low physical and mental well-being early in pregnancy may be at risk for developing a poor MAA. An approach targeting both psychosocial and physiological well-being may positively influence expectant mothers’ successful adaptation to motherhood.

Mind-mindedness versus mentalistic interpretations of behavior: Is mind-mindedness a relational construct?

Mind-mindedness is a measure of the tendency to represent significant others in internal state terms and is central to supportive parent-infant relationships. The two studies reported here explored whether mind-mindedness generalizes to representations of unknown individuals, using a novel task that assessed individual differences in adults' tendency to interpret others' behavior with reference to their internal states: the Unknown Mother-Infant Interaction Task (UMIIT). We compared UMIIT performance with measures of mind-mindedness from (a) adults' descriptions of close friends and partners (Study 1, N = 96) and (b) mothers' appropriate versus nonattuned comments on their infants' internal states (Study 2, N = 56). In line with the proposal that mind-mindedness is a relational construct, UMIIT performance was unrelated to mind-mindedness in both studies.

Mind-Mindedness and Parenting Stress: A Cross-Sectional Study in a Cohort of Mothers of 3-Month-Old Full-Term and Preterm Infants

The preterm birth of a child is a sudden event that can disturb the overall family system and its functioning. Many studies have been conducted with the aim of exploring how and the degree to which this event affects the early mother–infant dyadic relationship and maternal well-being, with often mixed findings. The present study investigates the combined effect of preterm birth and parenting stress on mind-mindedness, a parenting dimension that captures how parents represent and treat their children as separate individuals with their own mental states and activities. A hundred and ten mothers and their three-month-old infants (preterm = 54; full-term = 56) participated in the study. Mind-mindedness was assessed by coding mothers’ comments about infant’s mental states during dyadic face-to-face interaction. Parenting stress was evaluated with the Parenting Stress Index Short Form questionnaire. Mothers of preterm infants reported similar levels of appropriate and non-attuned mind-related comments to mothers of full-term infants. The reported parenting stress levels were also comparable. Interestingly, only mothers of preterm infants who reported higher stress in parenting showed more non-attuned comments during the interaction. The results underline the need to address preterm birth as a complex event, going beyond group differences and considering its interplay with other risk or protective factors in shaping children’s and parents’ adjustments and well-being.

Mind-mindedness and parenting stress in mothers of preterm and full-term infants: The moderating role of perceived social support

The goal of this study was to examine the effects of preterm birth and maternal childbirth-related posttraumatic stress and parenting stress on maternal mind-mindedness (MM). The study also investigated the effects of perceived social support on parenting stress and MM. Sixty-five preterm (N = 32) and full-term (N = 33) mother-infant dyads were observed at 6 months. Measures of maternal MM were obtained from observations of mother-infant interaction. Mothers also provided ratings of their posttraumatic stress disorder (PTSD) symptoms, parenting stress, and perceived social support via an online survey. Experiencing a preterm birth did not affect mothers' use of mental state descriptors during mother-infant interaction. Neither childbirth-related posttraumatic stress nor parenting stress directly affected maternal ability to comment on the child's mental states appropriately. However, at medium and high levels of perceived social support, a negative association between parenting stress and MM was observed. Maternal perception of being emotionally supported by significant others promoted MM in mothers showing low or mild levels of parenting stress, but not in mothers experiencing high stress in parenting their infants. Results suggest that a proclivity to MM might be affected by the interaction between parenting stress and social support, rather than by childbirth-related variables, such as prematurity.

A randomized controlled trial comparing parent child interaction therapy - toddler, circle of security- parenting™ and waitlist controls in the treatment of disruptive behaviors for children aged 14-24 months: study protocol

BACKGROUND

It is common for toddlers to display disruptive behaviors (e.g., tantrums, aggression, irritability) but when these become severe and persistent they can be the start of a trajectory towards poor outcomes in childhood and adolescence. Parent Child Interaction Therapy - Toddler is an intervention model designed to meet the specific developmental needs of toddlers aged 12-24 months presenting with disruptive behaviors.

METHODS

This study will use a randomized controlled design to evaluate the efficacy of the Parent Child Interaction Therapy - Toddler intervention for children aged 14-24 months with disruptive behaviors. Ninety toddlers with parent-reported disruptive behavior will be randomly allocated to either Parent Child Interaction Therapy - Toddler, Circle of Security- Parenting™ or a waitlist control group. Key parenting capacity outcome variables will include positive and negative parenting, parenting sensitivity, parental sense of competence in managing negative toddler emotions, parent sense of caregiving helplessness, parent mentalizing about the child, parent emotion regulation, child abuse potential and parental stress. Key outcome variables for children will include child social-emotional functioning (initiative, relationship functioning, self-regulation), child emotion regulation, child attachment security, and child behavior.

DISCUSSION

Delivered in the early intervention period of toddlerhood, Parent Child Interaction Therapy - Toddler has the potential to bring about significant and lasting changes for children presenting with early onset behavioral issues.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry (ANZCTR), 12618001554257 . Registered 24 September 2018 - retrospectively registered.

Exploring the relation between maternal mind-mindedness and children's symbolic play: A longitudinal study from 6 to 18 months

Relations between mothers' mind-mindedness (appropriate attunement to their infants' internal states) at 6 and 12 months and infants' early symbolic play during infant-mother pretense at 12 and 18 months were investigated in a sample of 43 mothers and infants. Mothers' appropriate mind-related comments were associated with average level, length, complexity, and maturity level of symbolic play. Specific sub-categories of appropriate mind-related comments were identified as independent predictors of children's symbolic play. Appropriate comments about desires and cognitions at 6 months were associated with average level and length of episodes, as well as with maturity level of symbolic play at 12 months. Longitudinal stability in the appropriateness and content of mothers' mind-related comments was also investigated. The results are discussed in terms of the proposal that attunement to specific types of internal state should vary as a function of infant age in order to index mind-mindedness.

Fathers' and Mothers' Early Mind-Mindedness Predicts Social Competence and Behavior Problems in Childhood

Parental mind-mindedness, the parent's propensity to treat the child as an intentional agent, has repeatedly shown to promote children's development of social understanding and secure attachment. Less is known about whether the impact of maternal and paternal mind-mindedness extends to children's social and behavior problems. We investigated the combined effect of mothers' and fathers' (N = 104) mind-mindedness at 4, 12, and 30 months on children's social competence and externalizing and internalizing behavior problems at 4.5 years. Besides, we examined the stability, continuity, parental concordance, and inter-parental differences in the use of mind-related comments. Appropriate mind-mindedness (i.e., correct interpretations of the child's mental states) and nonattuned mind-mindedness (i.e., misinterpretations of the child's mental states) were observed during parent-child free-play interactions. Social competence, internalizing and externalizing behavior problems were assessed using both parents' reports. Hierarchical multiple regression analyses showed that, at 12 months, infrequent use of appropriate mind-related comments of both parents predicted children's externalizing problems, while their frequent use of nonattuned comments predicted children's low social competence. Furthermore, mothers' frequent use of nonattuned comments at 12 and 30 months and fathers' nonattuned comments at 30 months predicted children's externalizing behavior. The findings suggest that both parents' low use of mind-related comments, and frequent misinterpretations of their child's mind, may act as risk factors for later social and behavior problems of their child.

Proof of concept of a smartphone app to support delivery of an intervention to facilitate mothers' mind-mindedness

The present study reports on the first evaluation of a parenting intervention utilizing a smartphone app, BabyMind. The intervention aimed to facilitate mothers' mind-mindedness-attunement to their infants' internal states. Mothers in the intervention group (n = 90) used the BabyMind app from their infants' births and were followed up at age 6 months (n = 66). Mothers in the control group (n = 151) were recruited when their infants were age 6 months and had never used the BabyMind app. Mind-mindedness when interacting with their infants was significantly higher in intervention group mothers than in control group mothers. The intervention was equally effective in facilitating mind-mindedness in young and older mothers. These findings are discussed in terms of the potential for interventions utilizing smartphone apps to improve parenting and children's developmental outcome in vulnerable and hard-to-reach groups.

Mothers' Early Mind-Mindedness Predicts Educational Attainment in Socially and Economically Disadvantaged British Children

Relations between mothers' mind-mindedness (appropriate and nonattuned mind-related comments) at 8 months (N = 206), and children's educational attainment at ages 7 (n = 158) and 11 (n = 156) were investigated in a British sample. Appropriate mind-related comments were positively correlated with reading and mathematics performance at both ages but only in the low-socioeconomic status (SES) group. Path analyses showed that in the low-SES group, appropriate mind-related comments directly predicted age-11 reading performance, with age-4 verbal ability mediating the relation between appropriate mind-related comments and age-7 reading. In contrast, maternal sensitivity and infant-mother attachment security did not predict children's educational attainment. These findings are discussed in terms of genetic and environmental contributions to reading and mathematics performance.

Maternal communicative functions and mind-mindedness at 16 months as predictors of children's internal and non-internal language at 20 months

The effects of Communicative functions and Mind-Mindedness on children's language development have been typically investigated in separate studies. The present longitudinal research was therefore designed to yield new insight into the simultaneous impact of these two dimensions of maternal responsiveness on the acquisition of expressive language skills in a sample of 25 mother-child dyads. The frequencies of five communicative functions (Tutorial, Didactic, Conversational, Control and Asynchronous) and two types of mind-related comments (attuned vs. non-attuned) were assessed from a 15-min play session at 16 months. Children's expressive language was examined at both 16 months (number of word types and tokens produced, and number of words attributed to the child in the Questionnaire for Communication and Early Language development) and 20 months (number of internal and non-internal words attributed to the child in the Italian version of the Mac Arthur-Bates Communicative Development Inventory). The main finding was that mothers' use of attuned mind-related comments at 16 months predicted internal state language at 20 months, above and beyond the effects of CFs and children's linguistic ability at 16 months; in addition, mothers' Tutorial function at 16 months marginally predicted non-internal state language at 20 months, after controlling for MM and children's linguistic ability at 16 months. These results suggest that different expressions of maternal responsiveness influence distinct aspects of children's expressive language in the second year of life, although the effects of MM appear to be more robust.

War trauma and maternal-fetal attachment predicting maternal mental health, infant development, and dyadic interaction in Palestinian families

Optimal maternal-fetal attachment (MFA) is believed to be beneficial for infant well-being and dyadic interaction, but research is scarce in general and among risk populations. Our study involved dyads living in war conditions and examined how traumatic war trauma associates with MFA and which factors mediate that association. It also modeled the role of MFA in predicting newborn health, infant development, mother-infant interaction, and maternal postpartum mental health. Palestinian women from the Gaza Strip (N = 511) participated during their second trimester (T1), and when their infants were 4 (T2) and 12 (T3) months. Mothers reported MFA (interaction with, attributions to, and fantasies about the fetus), social support, and prenatal mental health (post-traumatic stress disorder, depression, and anxiety) at T1, newborn health at T2, and the postpartum mental health, infant's sensorimotor and language development, and mother-infant interaction (emotional availability) at T3. Results revealed, first, that war trauma was not directly associated with MFA but that it was mediated through a low level of social support and high level of maternal prenatal mental health problems. Second, intensive MFA predicted optimal mother-reported infant's sensorimotor and language development and mother-infant emotional availability but not newborn health or maternal postpartum mental health.

Mind-Mindedness of Male and Female Caregivers in Childcare and the Relation to Sensitivity and Attachment: An Exploratory Study

Mind-mindedness refers to the caregiver's ability to be attuned to the child's mental states. Within the parent-child relationship, mind-mindedness relates to parents' sensitive caregiving, and to children's secure attachment. However, the same relations are still unexplored in out-of-home care settings. We investigated the associations between childcare professionals' mind-mindedness, sensitive responsiveness and respect for autonomy, and child-caregiver attachment security. Moreover, we examined whether these relations are influenced by caregivers' and children's gender. Participants were 17 caregiver couples (17 males, 17 females) and 34 three-year-old children (17 boys, 17 girls), recruited in childcare centers. Mind-mindedness toward the boy or the girl (dyadic) or both children (non-dyadic), sensitive responsiveness and respect for autonomy were assessed during a semi-structured play. Attachment security was assessed through observations. Male and female caregivers had equivalent scores of mind-mindedness, sensitive responsiveness, and respect for autonomy. Similarly, children were securely attached to male and female caregivers. Girls' and boys' secure attachment was predicted by caregivers' use of non-dyadic mind-related comments. For girls, but not for boys, the relation was partially mediated by caregivers' respect for autonomy. The results are discussed in terms of their relevance for the quality of child-caregiver relationships, and children's socio-emotional development.