Study of mother-infant attachment patterns and influence factors in Shanghai

Relationship between attachment style of 4-7-year-old children and their behavior during dental visit

Background

The general health and quality of life are directly correlated with oral health. Oral health is one of the unique health concerns that apply to all children. Pediatric dentistry is built on effective communication with children, which is also a requirement for providing pediatric dental care. Many pediatric dentists find it difficult to anticipate children's behavior and how they will respond to therapeutic procedures. The purpose of this study was to evaluate children's attachment types in order to forecast their behavior during a dentist appointment.

Materials and Methods

The participants were 120 children between the ages of 4 and 7 who were reported to the Department of Pediatric and Preventive Dentistry, Institute of Dental Sciences, Bareilly. The youngsters were evaluated by a dental graduate student. While they waited in the waiting area, the parents were asked to complete the Kinship Center Attachment Questionnaire regarding their kids. In the second visit, dental work was scheduled for the kids who had met the requirements for inclusion in the first visit. Another pediatric dentistry postgraduate student evaluated the children's conduct during the dental procedure using a predefined questionnaire and the Frankl scale. The Chi-squared test, t-test, Pearson's correlation coefficient, and linear regression were used to examine the data.

Results

According to the findings, 55.8% of the total children were cooperative, among which 59.1% were female and 52.0% were males. The average age of the kids was 6.2 ± 0.95. Moreover, 21.3% of kids had insecure attachment styles and 78.7% of kids had secure attachment types. The child-dentist communication and the insecure ambivalent attachment pattern were significantly correlated. As a result, our study demonstrated that children's safe attachment styles varied with age. Our results showed that there is an inverse relationship between children's collaboration and age, with cooperation rising as age increases.

Conclusions

According to the findings of this study and considering its limitations, in young ages, the attachment style of the mother plays an important role in behavior of children. The significant correlations existed between the insecure ambivalent attachment style and child-dentist communication, as well as the secure attachment type and mother-child separation.

Evidence for cultural differences in affect during mother-infant interactions

Maternal care is considered a universal and even cross-species set of typical behaviors, which are necessary to determine the social development of children. In humans, most research on mother-infant bonding is based on Western cultures and conducted in European and American countries. Thus, it is still unknown which aspects of mother-infant behaviors are universal and which vary with culture. Here we test whether typical mother-infant behaviors of affect-communication and affect-regulation are equally represented during spontaneous interaction in Palestinian-Arab and Jewish cultures. 30 Palestinian-Arab and 43 Jewish mother-infant dyads were recruited and videotaped. Using AffectRegulation Coding System (ARCS), we behaviorally analyzed the second-by-second display of valence and arousal in each participant and calculated the dynamic patterns of affect co-regulation. The results show that Palestinian-Arab infants express more positive valence than Jewish infants and that Palestinian-Arab mothers express higher arousal compared to Jewish mothers. Moreover, we found culturally-distinct strategies to regulate the infant: increased arousal in Palestinian-Arab dyads and increased mutual affective match in Jewish dyads. Such cross-cultural differences in affect indicate that basic features of emotion that are often considered universal are differentially represented in different cultures. Affect communication and regulation patterns can be transmitted across generations in early-life socialization with caregivers.

The effects of a nurse-led couples intervention on marital quality of couples with gynecological cancer: A clinical randomized controlled trial

OBJECTIVE

To evaluate the effectiveness of a nurse-led couples intervention on the marital quality of couples coping with gynecological cancer.

METHODS

Couples coping with gynecological cancer were randomly allocated to the intervention (n = 51) and the control (n = 53) group. The intervention group received the nurse-led couples intervention developed based on the Preliminary Live with Love Conceptual Framework plus routine nursing care. The control group received only routine nursing care. Marital quality, including marital satisfaction, marital communication, and sexual life, were measured using Olson Marital Quality Questionnaire at 3 timepoints (baseline, 2- and 3-months following baseline). Generalized estimating equation was used to examine the effectiveness of the intervention in improving marital quality.

RESULTS

Patients and husbands in the intervention group had significantly improved marital satisfaction scores (Waldχ² = 11.109, P = 0.001; Waldχ² = 4.849, P = 0.028); the interaction between intervention and time had a significant effect on the marital communication of both patients and their husbands (Waldχ² = 6.214, P = 0.045; Waldχ² = 15.460, P < 0.001). Patient-reported and husband-reported sexual life was not significantly influenced by the intervention (Waldχ² = 0.167, P = 0.683; Waldχ² = 3.215, P = 0.073).

CONCLUSIONS

The nurse-led couples intervention based on the Preliminary Live with Love Conceptual Framework improved marital satisfaction and marital communication, but not sexual life, of couples coping with gynecological cancer. The provision of professional sexual health psychology training for nurses may be crucial if nurse-led models are to truly support the sexual health of couples coping with gynecological cancer.

REGISTRATION

Registered with www.chictr.org.cn (ChiCTR2000034232).

The role of infant attention and parental sensitivity in infant cognitive development in the Netherlands and China

Infant attention and parental sensitivity are important predictors of later child executive function (EF). However, most studies have investigated infant and parent factors in relation to child EF separately and included only mothers from Western samples. The current study examined whether both infant attention at 4 months and parental sensitivity at 4 and 14 months were related to infant EF (i.e., inhibition, working memory, and cognitive flexibility) at 14 months among 124 Dutch and 63 Chinese first-time mothers and fathers and their infants. Findings revealed that parental sensitivity at 4 months was not correlated with infant EF abilities at 14 months. However, infant attention at 4 months was significantly related to 14-month working memory, but not to inhibition and cognitive flexibility. Maternal sensitivity at 14 months was significantly related to 14-month inhibition, but not to working memory and cognitive flexibility). No country differences were found in the relation among 4-month infant attention, parental sensitivity, and EF outcomes. Results show that both infant and parent factors are associated with early EF development and that these correlates of early EF skills may be similar in Western and non-Western samples.

Role of attachment style in prediction of behavior of 3 to 6-year-old children

PURPOSE

Efficient communication with children is the basis of pediatric dentistry and is a prerequisite for provision of pediatric dental care. Prediction of the behavior of children and their reaction to therapeutic procedures is a challenge for many pediatric dentists. This study aimed to assess the attachment styles of children to predict their behavior during a dental visit.

METHODS

The participants included 117 healthy children aged 3 to 6 years presented to the Department of Pediatric Dentistry, Tehran University of Medical Sciences, in 2017-2018. A postgraduate dental student examined the children. The parents were requested to fill out the Kinship Center attachment questionnaire (KCAQ) regarding their children, while waiting in the waiting room. The children who met the inclusion criteria in the first visit were scheduled for a dental procedure in the second visit. Another postgraduate student of pediatric dentistry assessed the behavior of children during the dental procedure according to the designed questionnaire and based on the Frankl scale. A third examiner along with the second examiner evaluated the behavior of children on a random basis to determine the inter-examiner agreement. Data were analyzed using the Chi-squared test, t test, Pearson's correlation coefficient, and linear regression.

RESULTS

The results showed that 67.5% of the children were cooperative, including 54.7% of boys. The mean age of children was 5.1 ± 0.95 years. Also, 80.3% of children had secure and 19.7% had insecure attachment styles (11.97% insecure avoidant and 7.69% insecure ambivalent). A significant association existed between the insecure ambivalent attachment style and child-dentist communication. A significant inverse correlation was also noted between the total score of the questionnaire and parent-child separation in dental office.

CONCLUSIONS

The current findings revealed no significant difference in the attachment styles of cooperative and uncooperative children. Significant associations only existed between the insecure ambivalent attachment style and child-dentist communication, and also between mother-child separation and secure attachment style. Thus, the children's behavior in dental office cannot be predicted based on their attachment style.

New brief temperament guidance program for parents of infants: A pilot evaluation

PROBLEM

Intensive temperament guidance programs have been successfully utilized to improve caregiver understanding of temperament and teach strategies for appropriately responding to temperament traits. However, the effects of providing brief psychoeducational temperament information to parents have not been previously examined.

METHODS

Mothers of 3-12-month infants (n = 35) participated in an intervention examining the impact of a comprehensive temperament brochure on temperament knowledge, program attitudes, and parent-child interactions.

FINDINGS

Mothers demonstrated increased temperament knowledge and were generally accepting of the program. Behavioral changes in mother-child interactions were observed. Sensitivity increased, and interactions shifted from more parent-directed to more balanced following the intervention. Infant gender functioned as a moderator of intervention effects for two mother-infant interaction dynamics. A significant increase in reciprocity was observed between mothers and boys, largely as a function of significantly lower levels of reciprocity preintervention. Child gender also interacted with directedness, in that interactions became more balanced for girls, but remained more mother-directed with boys. Finally, maternal education functioned as a moderator of tempo, as mothers in the higher education group shifted from slower to moderate tempo following the intervention.

CONCLUSIONS

Promising results suggest the need for continued implementation and evaluation of brief temperament interventions.

Are There Differences in Marital-Role Quality between Women and Their Male Partners Who Conceived Via IVF and Those Who Did Not?

OBJECTIVES

Marital-role quality (MRQ) is a predictor of mental well-being, sexual intimacy, and maternal attachment. Data on differences in MRQ during pregnancy between women and their male partners who conceived spontaneously or via IVF are inconclusive. This study compared MRQ across pregnancy in these two groups.

METHODS

The sample's two groups: (a) 26 women and 26 male partners who conceived via IVF; and (b) 25 women and 20 male partners who conceived spontaneously. All 97 participants completed a MRQ scale during each trimester of pregnancy. Trajectory analyses were conducted to test for between-group differences in the changes in subscales across pregnancy within dyads.

RESULTS

Scores did not reveal any significant differences in subscales in those who conceived via IVF compared to non-IVF groups across the three trimesters in each dyad. The observed effect sizes were small, with exception that males in the non-IVF comparison group had greater concerns during the first trimester than did males in the IVF group (Cohen d= 0.51, moderate effect size).

CONCLUSIONS

Though the IVF population perceives pregnancy differently and experiences more anxiety than those who conceive spontaneously, their marital-role quality during pregnancy does not seem to be affected. Their perceptions before conception and in early parenting are worthy of investigation.

The influence of CHRNA4, COMT, and maternal sensitivity on orienting and executive attention in 6-month-old infants

Despite claims concerning biological mechanisms sub-serving infant attention, little experimental work examines its underpinnings. This study examines how candidate polymorphisms from the cholinergic (CHRNA4 rs1044396) and dopaminergic (COMT rs4680) systems, respectively indicative of parietal and prefrontal/anterior cingulate involvement, are related to 6-month-olds' (n=217) performance during a visual expectation eye-tracking paradigm. As previous studies suggest that both cholinergic and dopaminergic genes may influence susceptibility to the influence of other genetic and environmental factors, we further examined whether these candidate genes interact with one another and/or with early caregiving experience in predicting infants' visual attention. We detected an interaction between CHRNA4 genotype and observed maternal sensitivity upon infants' orienting to random stimuli and a CHRNA4-COMT interaction effect upon infants' orienting to patterned stimuli. Consistent with adult research, we observed a direct effect of COMT genotype on anticipatory looking to patterned stimuli. Findings suggest that CHRNA4 genotype may influence susceptibility to other attention-related factors in infancy. These interactions may account for the inability to establish a link between CHRNA4 and orienting in infant research to date, despite developmental theorizing suggesting otherwise. Moreover, findings suggest that by 6months, dopamine, and relatedly, the prefrontal cortex/anterior cingulate, may be important to infant attention.

Relationship among temporary separation, attachment styles, and adjustment in first-grade Iranian children

If mothers work outside the home, some degree of mother–child separation will be experienced and mother–child attachment will be affected. In this study, regarding the attachment styles, sociobehavioral problems in first-grade children with experience of preschool and in those taught by their mothers at-home are compared. A casual-comparative method was used to compare children in the two groups. A total of 320 first-grade children participated in the study. The study measures included a separation anxiety test, an adaptive behavior scale, and a children’s symptom inventory. Data were analyzed using multivariate statistics. Secure attachment in the group with experience of preschool was significantly higher than that in the at-home group. None of the variables, including parents’ education and father’s income, significantly affected attachment style. Neither father’s education, father’s income, or attachment significantly influenced adjustment. Father’s education significantly influenced children’s symptoms. Attachment style and hours of preschool attendance had no effect on Child Symptom Inventory scores. Associations among age at joining preschool, attachment style, and behavioral and adaptive problems in first-grade children were nonlinear and multivariate. By taking into account parents’ awareness, sensitivity, and responsiveness, relative welfare, appropriate quality of child-care centers, and having fewer hours of preschool attendance, the risk factors for early parent–child separation and institutional care can be reduced.

Infant temperamental reactivity, maternal and grandparental sensitivity: Differential susceptibility for behavior problems in China

BACKGROUND

The differential susceptibility hypothesis suggests that children's innate characteristics and their rearing experiences interact differentially during development. Recently, the study of interactions between infants' temperament and rearing experiences has become a research hotspot. In China, grandparental care is a very common phenomenon, with many infants taken care of by grandparents while mothers are out for work.

AIM

To investigate whether the associations between maternal and grandmaternal sensitivity, and behavior problems were moderated by infant temperamental reactivity, while the infants were raised by both their mothers and grandmothers.

SUBJECTS

A total of 71 infants (average age of 17.6months), their mothers and grandmothers were included in this study.

OUTCOME MEASURES

Maternal sensitivity and grandmaternal sensitivity were assessed with the Maternal Behavior Q-sort-Chinese Version, infants' temperamental reactivity was measured with Carey's Toddler Temperament Questionnaire-Chinese Revision, and infants' behavior problems were measured with the Infant-Toddler Social and Emotional Assessment-Chinese Version.

RESULTS

Maternal sensitivity significantly predicted infants' impulsivity and aggression. Infants' temperamental reactivity moderated the effect of maternal sensitivity on infants' general anxiety. In addition, infant temperamental reactivity moderated the impact of grandmaternal sensitivity on infants' separation distress.

CONCLUSIONS

Our results support the differential susceptibility hypothesis to some extent. Infants with high temperamental reactivity not only suffer more from low maternal and grandmaternal sensitivity, but also benefit more from high maternal and grandmaternal sensitivity as compared to those infants with low temperamental reactivity.

Is the ideal mother a sensitive mother? Beliefs about early childhood parenting in mothers across the globe

In this article, we test the hypothesis that beliefs about the ideal mother are convergent across cultures and that these beliefs overlap considerably with attachment theory’s notion of the sensitive mother. In a sample including 26 cultural groups from 15 countries around the globe, 751 mothers sorted the Maternal Behavior Q-Set to reflect their ideas about the ideal mother. The results show strong convergence between maternal beliefs about the ideal mother and attachment theory’s description of the sensitive mother across groups. Cultural group membership significantly predicted variations in maternal sensitivity belief scores, but this effect was substantially accounted for by group variations in socio-demographic factors. Mothers living in rural versus urban areas, with a low family income, and with more children, were less likely to describe the ideal mother as highly sensitive. Cultural group membership did remain a significant predictor of variations in maternal sensitivity belief scores above and beyond socio-demographic predictors. The findings are discussed in terms of the universal and culture-specific aspects of the sensitivity construct.

Attachment between infants and mothers in China

The first distribution of Chinese infant–mother ( n = 61) attachment classifications categorised by trained and reliability-tested coders is reported with statistical comparisons to US norms and previous Chinese distributions. Three-way distribution was 15% insecure-avoidant, 62% secure, 13% insecure-resistant, and 4-way distribution was 13% insecure-avoidant, 58% secure, 16% insecure-resistant,13% disorganised. These findings support the hypotheses that: (1) consistent with global norms the majority of infants will show secure attachments to mother; (2) insecure-resistant attachments will be greater than insecure-avoidant attachments in this interdependent cultural setting; and (3) disorganised attachments will be comparable to Western norms. Pooled samples from previously reported Chinese samples demonstrate deviations from US norms on all categories including relatively low proportions of avoidant and disorganised classifications, especially among samples from the South. Culture-specific childrearing practices and the role of training and reliability-testing for coders are suggested as possible contributors to these differences.

The relation of infant attachment to attachment and cognitive and behavioural outcomes in early childhood

BACKGROUND

In China, research on the relation of mother-infant attachment to children's development is scarce.

AIMS

This study sought to investigate the relation of mother-infant attachment to attachment, cognitive and behavioural development in young children.

STUDY DESIGN

This study used a longitudinal study design.

SUBJECTS

The subjects included healthy infants (n=160) aged 12 to 18 months.

OUTCOME MEASURES

Ainsworth's "Strange Situation Procedure" was used to evaluate mother-infant attachment types. The attachment Q-set (AQS) was used to evaluate the attachment between young children and their mothers. The Bayley scale of infant development-second edition (BSID-II) was used to evaluate cognitive developmental level in early childhood. Achenbach's child behaviour checklist (CBCL) for 2- to 3-year-olds was used to investigate behavioural problems.

RESULTS

In total, 118 young children (73.8%) completed the follow-up; 89.7% of infants with secure attachment and 85.0% of infants with insecure attachment still demonstrated this type of attachment in early childhood (κ=0.738, p<0.05). Infants with insecure attachment collectively exhibited a significantly lower mental development index (MDI) in early childhood than did infants with secure attachment, especially the resistant type. In addition, resistant infants were reported to have greater social withdrawal, sleep problems and aggressive behaviour in early childhood.

CONCLUSION

There is a high consistency in attachment development from infancy to early childhood. Secure mother-infant attachment predicts a better cognitive and behavioural outcome; whereas insecure attachment, especially the resistant attachment, may lead to a lower cognitive level and greater behavioural problems in early childhood.

Negative attachment cognitions and emotional distress in mainland Chinese adolescents: a prospective multiwave test of vulnerability-stress and stress generation models

The present study examined the relation between attachment cognitions, stressors, and emotional distress in a sample of Chinese adolescents. Specifically, it was examined whether negative attachment cognitions predicted depression and anxiety symptoms, and if a vulnerability-stress or stress generation model best explained the relation between negative attachment cognitions and internalizing symptoms. Participants included 558 adolescents (310 females and 248 males) from an urban school in Changsha and 592 adolescents (287 female, 305 male) from a rural school in Liuyang, both in Hunan province located in mainland China. Participants completed self-report measures of negative attachment cognitions at baseline, and self-report measures of negative events, depression symptoms, and anxiety symptoms at baseline and at regular 1-month intervals for an overall 6-month follow-up (i.e., six follow-up assessments). Higher levels of negative attachment cognitions predicted prospective depression and anxiety symptoms. Furthermore, support was found for a stress generation model that partially mediated this longitudinal association. No support was found for a vulnerability-stress model. Overall, these findings highlight new developmental pathways for development of depression and anxiety symptoms in mainland Chinese adolescents.