Maternal Mind-Mindedness Provides a Buffer for Pre-Adolescents at Risk for Disruptive Behavior

Expectant mothers' not fathers' mind-mindedness predicts infant, mother, and father conversational turns at 7 months

Parental mind-mindedness (MM), defined as the propensity to view one's child as an agent with thoughts, feelings, and desires, is associated with positive child outcomes (McMahon & Bernier, 2017) and can be assessed in expectant parents by using five-minute speech samples (Magaña et al., 1986). Individual differences in MM appear stable across the transition to parenthood (Foley et al., in press), offering an exciting intervention opportunity, as expectant mothers' thoughts and feelings about their unborn infants are associated with the quality of mother-infant interactions. To assess prenatal MM as a predictor of parent-infant conversation at 7 months, we followed 93 low-risk British heterosexual couples across the transition to parenthood. Mothers' and fathers' MM was measured both in the third trimester of pregnancy and at 4 months. Wearable LENA devices were used to gather detailed measures of mother-, father-, and infant-initiated conversations at 7 months. Prenatal MM in both parents was associated with more frequent infant-initiated conversations at 7 months, while prenatal maternal (not paternal) MM was also associated with more mother- and father-initiated conversations. While longitudinal research with more diverse samples is needed, these findings highlight the importance of parental mentalizing in the prenatal period for early family interactions.

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.

A Cohort Study on the Effect of Parental Mind-Mindedness in Parent-Child Interaction Therapy

Parent-child interaction therapy (PCIT) is a short-term, evidence-based intervention for caregivers with children aged between 2 and 7 who exhibit behavioral problems. PCIT is effective, but has a high attrition rate ranging from 27% to 69%. We hypothesize that a low level of parental mind-mindedness-the parent's propensity to treat the child as an intentional agent with its own thoughts and emotions-might contribute to premature attrition or cause families to profit less from treatment. To test these hypotheses, we performed a retrospective cohort study in a time-limited, home-based PCIT sample (n = 19) and in a clinic-based PCIT sample (n = 25), to investigate whether parents with a medium-high level of mind-mindedness differ from parents with a medium-low level of mind-mindedness in the outcome measures of PCIT (child's behavioral problems, parenting skills and stress and mothers' anxious and depressed symptoms). Furthermore, we examined if mind-mindedness was related to attrition and (for clinic-based PCIT only) number of sessions. Repeated measures ANOVA showed that mothers with a medium-high level of mind-mindedness displayed more improvement in two parenting skills benefiting a positive parent-child interaction. Furthermore, we found a group effect of mind-mindedness in the PCIT-home sample, with mothers with a medium-high level of mind-mindedness showing better results on most outcome measures. Our findings suggest that adding a mind-mindedness improving intervention prior to or during PCIT could benefit mothers with a medium to low level of mind-mindedness.

Mind-Mindedness and Stress in Parents of Children with Developmental Disorders

Relations between mind-mindedness (assessed using the describe-your-child interview) and stress were investigated in parents of children with developmental disorders (ADHD, n = 51, ASD, n = 23, Down's Syndrome, n = 38, and 22q11.2 Deletion Syndrome, 22q11.2DS, n = 32) and typically-developing children (n = 89). Mind-mindedness did not differ across diagnostic groups, and mind-mindedness predicted parenting stress across groups. Parenting stress was lowest in the typically-developing and Down's Syndrome groups. Across all groups, mind-minded and positive descriptions predicted lower parenting stress, and negative descriptions predicted higher stress. In the developmental disorder groups, describing the children with reference to their disorder was negatively correlated with mind-mindedness. Results are discussed with regard to interventions for families where children have developmental disorders.

Mind-mindedness in out-of-home Care for Children: Implications for caregivers and child

Most out-of-home placed children have experienced early adversities, including maltreatment and neglect. A challenge for caregivers is to adequately interpret their foster child’s internal mental states and behavior. We examined caregivers’ mind-mindedness in out-of-home care, and the association among caregivers’ mind-mindedness (and its positive, neutral, and negative valence), recognition of the child’s trauma symptoms, and behavior problems. Participants (N = 138) were foster parents, family-home parents, and residential care workers. Caregivers’ mind-mindedness was assessed with the describe-your-child measure. Caregivers’ recognition of the child’s trauma symptoms, their child’s emotional symptoms, conduct problems, prosocial behavior, and quality of the caregiver-child relationship were assessed using caregivers’ reports. Foster parents produced more mental-state descriptors than did residential care workers. General mind-mindedness, as well as neutral and positive mind-mindedness, related negatively to conduct problems. Besides, positive mind-mindedness was associated with prosocial behavior and neutral mind-mindedness with a better quality of the caregiver-child relationship and fewer child conduct problems. Negative mind-mindedness related positively to the caregiver’s recognition of the child’s trauma symptoms, and indirectly, to emotional symptoms. In conclusion, mind-mindedness seems to be an essential characteristic of out-of-home caregivers, connected to the understanding of their child’s behavior problems and trauma symptoms, as well as to the relationship with the child. The findings suggest a possible use of mind-mindedness in out-of-home care evaluation and intervention.

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.

Parental Emotion Regulation and Mentalization in Families of Children With ADHD

Objective: The aim of this study is to examine the role of parental emotion regulation (ER) and parental mentalization as possible contributors to hostile and coercive parenting in families of children with ADHD. Method: Seventy-four Israeli families (64 mothers and 48 fathers) seeking parent training for child ADHD completed measures during the intake session. Measures included parental ER; parental mentalization; hostile, coercive, and submissive parenting; and child symptoms. Results: Findings suggested a relationship between parental ER and coercive parenting independent of child age, symptom level, and parental mentalization. Parental mentalization appeared to buffer against hostility specifically among parents with low ER capacities. Patterns were parallel for mothers and fathers. Conclusion: Study findings highlight the importance of evaluating and addressing parental ER in interventions attempting to reduce coercive parenting. The findings also highlight the potential role of parental mentalization as a protective mechanism against hostile parenting in families of children with ADHD.

'Caring for children who have experienced trauma' - an evaluation of a training for foster parents

BACKGROUND

Foster children, mostly maltreated in their birth families, may be fostered by parents who know little about the impact of traumatic experiences.

OBJECTIVE

The present study investigated whether the training Caring for Children who Have Experienced Trauma for foster parents can break the negative circle of traumatic stress. The hypothesis was that improvement in parents' knowledge on trauma and mind-mindedness would be associated with a reduction of their parenting stress, children's post-traumatic stress symptoms, and behaviour problems.

METHOD

Forty-eight foster parents (n female = 35) participated in a pre-test (T1), post-test (T2), and follow-up (T3) assessment. Questionnaires on knowledge on trauma, parenting stress, child post-traumatic stress symptoms, the child's behaviour, and the evaluation of the training were administered. Parents' mind-mindedness was assessed using the describe-your-child interview.

RESULTS

Foster parents highly appreciated the training, their knowledge on child trauma increased at T2 and this growth persisted at T3. The parents who gained most knowledge experienced a small decrease in parenting stress at T2. Although the general mind-mindedness did not significantly change, foster parents' mind-mindedness with positive valence substantially increased at T2 and T3, while their mind-mindedness with neutral valence decreased. Foster parents' report on child PTSS declined at T3 compared to T2, but not compared to T1. No changes were found in children's behaviour as reported by the foster parents. The proportion of foster children receiving trauma-focused treatment increased at T2 and T3.

CONCLUSION

This study provides evidence that training in trauma-informed parenting can be effective in improving foster parents' knowledge on the impact of traumatic experiences and in increasing a positive mental representation of their foster child as well as in reducing children's post-traumatic symptoms.

The Connecting and Reflecting Experience (CARE): theoretical foundation and development of mentalizing-focused parenting groups

In underserved communities with limited resources and disproportionately high morbidity and mortality rates, attachment-based, short-term, group interventions that are effective yet simple to disseminate can have a profound public health impact. This paper describes the implementation of a mentalizing-focused group parenting intervention. The Connecting and Reflecting Experience (CARE) serves primary caregivers of children from birth to 18 years within a diverse and impoverished community setting. Families living in communities facing health disparities are at heightened risk for intergenerational cycles of trauma which give rise to myriad public health crises at high societal cost. CARE's mission is to facilitate the intergenerational transmission of secure attachment which can profoundly reduce rates of psychiatric illness for future generations. The theoretical and empirical bases for the intervention and the evidence base for existing mentalizing-focused parenting interventions are reviewed. The program's structure and treatment goals are presented in the context of clinical case material.

Parent-child mentalizing in pediatric epilepsy

BACKGROUND

Child psychopathology involves inappropriate or biased attributions of others' mental states (mentalizing), and parents' assessment of their children's mentalizing significantly predicts the latter's psychosocial outcomes. Behavioral difficulties are frequent in children with epilepsy (CWE) yet biased mentalizing and parental accuracy in understanding their child's mental states reasoning have not been addressed.

METHODS

This study compared the performance of 34 CWE aged 9 to 16 years with 67 language age-matched controls on a biased mentalizing task. The task required children to infer on the mental states of peers in stories involving social scenarios. Responses were scored as positive, negative, or rational mentalizing attributions. To measure parental accuracy, a parent version was administered in the patient group that required a parent to identify their child's responses correctly. Relationships with the child's cognitive, behavioral, and epilepsy-related factors were examined.

RESULTS

Patients made greater negative mental states attributions compared with control children. This negative mentalizing bias was accurately identified by parents and was associated with children's behavioral problems. Parental accuracy was reduced for patients with lower cognitive abilities. Parents did not accurately identify an overly positive (OP) bias in their child's mental states attributions. Children's positive response bias correlated with their lower executive function (EF) skills. Epilepsy factors predicted cognitive deficits but not biased mentalizing or behavioral problems.

CONCLUSION

Biased mentalizing characterizes social cognition in CWE with behavioral problems. Further investigation of the mentalizing biases and parental awareness of children's mental states reasoning is required to fully understand the greater psychosocial and behavioral difficulties found in CWE.

What's going on in my baby's mind? Mothers' executive functions contribute to individual differences in maternal mentalization during mother-infant interactions

Maternal mentalization refers to a mother's capacity to understand mental-states of herself and her child and to regard her child as a psychological agent. In mother-infant interactions, this capacity is commonly conceptualized as maternal mind-mindedness, which can be divided into two dimensions: appropriate and nonattuned interpretations of the infants' mental-states. Appropriate mind-mindedness refers to interpretations that seem to be compatible with the infant's behaviors, whereas nonattuned mind-mindedness refers to noncompatible interpretations. The aim of this study was to investigate the cognitive mechanisms that contribute to mind-mindedness. Specifically, we investigated the role of executive functions in appropriate and nonattuned mind-mindedness, and the moderating roles of two infant-related factors, prematurity (as a stressful context) and child temperament (as a context of unpredictability and negative emotionality). To this end, mother-infant free play interactions were coded for mind-mindedness in a sample of 102 mothers and their 6-month-old infants (61 preterm, 41 full-term). When children were 66-months old, mothers completed cognitive tasks that assessed working memory updating, resistance to interference, response inhibition, and shifting. Appropriate mind-mindedness was positively associated with updating, and this link was stronger when infant temperament was rated as more difficult. Furthermore, among mothers of full-term infants, mothers' resistance to interference was negatively associated with nonattuned mind-mindedness. This link was not evident in the stressful context of premature birth. Mothers' response inhibition and shifting were not associated with either of the mind-mindedness dimensions. Implications on understanding variability in maternal mentalization during mother-infant interactions and the roles of executive functions in parenting are discussed.

Preterm birth enhances the contribution of mothers' mind-mindedness to infants' expressive language development: A longitudinal investigation

Maternal mind-mindedness has been shown to be a powerful predictor of many developmental outcomes and to buffer the impact of psychosocial risk conditions, but no study has investigated whether this parental feature might support child development in the presence of biological risk, such as preterm birth. The present study addresses this gap, by investigating whether early maternal mind-mindedness contributes to the growth of a child's linguistic abilities in the following two years of life, and if the contribution of this maternal feature might be stronger in the presence of preterm birth. Forty mother-child dyads (twenty with a preterm infant) were followed longitudinally, with maternal mind-mindedness assessed at 14 months of age and child's expressive linguistic abilities at 24 and 36 months through observational measures. Multilevel models showed that linguistic abilities increased from 24 to 36 months of age, but that this increase was stronger in full-term infants. Maternal mind-mindedness also contributed to this growth, playing a stronger role in preterm infants than in full-term infants. Altogether, these findings contribute more deeply to the understanding of language development in preterm infants and of the joint contribution made by biological risk and environmental factors; from a practical standpoint, they suggest the importance of addressing mother's mind-mindedness in order to support child's language development.

Disciplinary Practices, Metaparenting, and the Quality of Parent-Child Relationships in African-American, Mexican-American, and European-American Mothers

Coercive responses to children's behavior are well recognized to be problematic for children's adjustment. Less well understood is how parental social cognition is linked to discipline. In this study we sought to link metaparenting - parents' thoughts about their parenting - to the use of coercive discipline. We predicted that mothers who engaged in more metaparenting, thus reflecting more deliberate parenting, would use corporal punishment less frequently and instead engage in non-coercive discipline. We also expected that mothers who engaged in more metaparenting would report closer relationships with their children. In order to assess a diverse sample, data were collected from approximately equal numbers of African-American, European-American, and Mexican-American mothers. Participants included 113 mothers with target children in three age groups, ranging from 2 to 12 years. The results indicated reports of corporal punishment as well as non-coercive discipline did not significantly differ across child sex and child age groups, but did differ significantly across race/ethnicity. Reports of frequency of metaparenting also differed across racial/ethnic groups; African-American mothers reported more metaparenting than European-American mothers on three of four subscales. Metaparenting was significantly related to reports of the mother-child relationship but in the opposite direction than predicted. Based on these results, future research directions linking parental social cognition to discipline are proposed.