The role of mentalizing in psychological interventions in adults: Systematic review and recommendations for future research

Mentalizing is the human capacity to understand actions of others and one's own behavior in terms of intentional mental states, such as feelings, wishes, goals and desires. Mentalizing is a transtheoretical and transdiagnostic concept that has been applied to understanding vulnerability to psychopathology and has attracted considerable research attention over the past decades. This paper reports on a pre-registered systematic review of evidence concerning the role of mentalizing as a moderator and mediator in psychological interventions in adults. Studies in adults were reviewed that address the following questions: (a) does pre-treatment mentalizing predict treatment outcome; (b) do changes in mentalizing across treatment predict outcome; (c) does adherence to the principles or protocol of mentalization-based treatment predict outcome; and (d) does strengthening in-session mentalizing impact the therapeutic process via improved alliance, alleviated symptoms, or improved interpersonal functioning? Results suggest that mentalizing might be a mediator of change in psychotherapy and may moderate treatment outcome. However, the relatively small number of studies (n = 33 papers based on 29 studies, totaling 3124 participants) that could be included in this review, and the heterogeneity of studies in terms of design, measures used, disorders included, and treatment modalities, precluded a formal meta-analysis and limited the ability to draw strong conclusions. Therefore, theoretical and methodological recommendations for future research to improve the quality of existing research in this area are formulated.

Is parental depression related to parental mentalizing? A systematic review and three-level meta-analysis

This systematic review and meta-analysis is aimed to summarize the state of research on the relation between parental depression and parental mentalizing. To account for the multifaceted nature of parental mentalizing, several conceptualizations and measures were included and compared. The last database search was conducted on March 13, 2023. Using three-level meta-analytic modelling, we analyzed a total of 12,665 participants from 63 studies with 233 effect sizes. Taken together, higher depression was only weakly associated with lower mentalizing (r = -0.06). Specifically, parents with higher depression scored lower on questionnaire measures of parental reflective functioning (r = -0.11). No significant correlations were found for interview measures of parental reflective functioning, the observational and interview measure of mind-mindedness, or insightfulness. The data showed substantial heterogeneity. The mean effect size for self-reported pre-mentalizing (r =  -0.23 for reverse-coded subscale scores) was significantly stronger compared to other self-report subscales. In studies including parents with diagnosis and controls, there was limited evidence suggesting a larger negative correlation between depression, mind-mindedness, and insightfulness. Therefore, more research is needed in clinical samples. Due to their correlational nature, our results do not allow causal inferences. Future studies should target moderators that explain variability (e.g., comorbid psychological problems, coparenting, child behavior).

Association of infants' feeding pattern up to 2 years postpartum with mothers' mental and physical health: the Japan Environment and Children's Study

BACKGROUND

Exclusive breastfeeding, a longer breastfeeding duration, and interaction with the baby during lactation improve mothers' mental health. However, few studies have targeted women around 2.5 years after childbirth, when women are still considered to have been in a period of mental and physical health vulnerability. This study examined this aspect in a large cohort of mother-child pairs.

METHODS

Data were obtained from 85,735 mothers in an ongoing nationwide birth cohort study in Japan. Exposures were exclusive breastfeeding (yes/no), continued breastfeeding up to 2 years (yes/no), and interaction with the baby during feeding (yes/no). Outcomes were mothers' mental and physical health 2.5 years after childbirth measured using Mental and Physical Component Summary scores (MCS and PCS scores, respectively) from the 8-item Short-Form Health Survey. Generalized additive mixed model analysis was used to derive each estimate for the three exposures and their interactions, with each "no" answer as reference.

RESULTS

Exclusive breastfeeding and interaction with the baby during feeding were associated with MCS score increases of 0.28 (95%CI: 0.10-0.47) and 0.41 (95%CI: 0.29-0.54), respectively. However, no associations were found for continued breastfeeding up to 2 years and no interactions were identified. No significant differences were observed for PCS scores.

LIMITATIONS

All variables were measured using a self-administered questionnaire.

CONCLUSIONS

Continued exclusive breastfeeding until 6 months and interaction with the baby during feeding may help to promote mother's mental health 2.5 years after childbirth. These findings further strengthen the rationale for the World Health Organization's recommended lactation practices.

Parental embodied mentalizing: Associations with maternal depression, anxiety, verbal mentalizing, and maternal styles of interaction

BACKGROUND

Maternal depression and anxiety in the perinatal period affect the quality of maternal sensitivity and mentalizing abilities. Few studies analyzed implicit mentalizing in relation to maternal distress. The aims of the study were: to examine the relation between nonverbal mentalizing - parental embodied mentalizing (PEM) - and maternal depression and anxiety, verbal mentalizing, and maternal styles of interaction; and to test PEM as a mediator of the effect of maternal distress on styles of interaction.

METHOD

81 mother-infant dyads have been recruited. At infant three months, maternal depression was assessed using the Edinburgh Postnatal Depression Scale, anxiety with State Trait Anxiety Inventory, and reflective functioning with Reflective Functioning Scale. Mother-infant interactions were coded with various approaches: PEM for nonverbal mentalizing, Mind-mindedness coding system for Mind-mindedness, and CARE-Index for maternal styles of interaction.

RESULTS

Maternal depression and state anxiety were negatively correlated with PEM. PEM was also negatively correlated to maternal controlling style. Mothers with psychopathological problems (vs. mothers with no psychopathological problems) had lower PEM and sensitivity and more controlling style. Moreover, maternal depression and anxiety had direct effects on maternal sensitivity and had indirect effects mediated by PEM on controlling style.

LIMITATIONS

The study evaluates interactions at three months; longitudinal studies will be able to examine maternal mentalizing and sensitivity in various stages and identify the effect on the child's attachment.

CONCLUSIONS

PEM is associated to maternal anxiety and depression and mediates the effects of depression and anxiety on mother controlling style. These results emphasize the importance of early prevention programs for mothers focused also on implicit mentalizing.

Promoting interactive skills and mind-mindedness among early childcare professionals: study protocol for a randomized wait-list controlled trial comparing the Circle of Security approach with care as usual in center-based childcare (the SECURE project)

Background

In countries where the majority of young children are enrolled in professional childcare, the childcare setting constitutes an important part of children’s caregiving environment. Research consistently shows that particularly the quality of the daily interactions and relationship between young children and their professional caregivers have long-term effects on a range of developmental child outcomes. Therefore, professional caregivers’ capacity for establishing high quality interactions with the children in their care is an important target of intervention.

Methods

A prospective, parallel, cluster-randomized wait-list controlled trial is used to test the efficacy of the attachment- and mentalization theory informed Circle of Security (COS) approach adapted to the childcare setting (COS-Classroom) on caregiver interactive skills and mind-mindedness. Participants are professional caregivers of children aged 0–2.9 years working in center-based childcare in Denmark. Approximately 31 childcare centers, corresponding to an estimated 113 caregivers, are expected to participate. The primary outcome is caregiver Sensitive responsiveness measured with the Caregiver Interactive Profile Scales (CIP-scales). Secondary outcomes include caregiver Mind-mindedness, the five remaining CIP-scales (Respect for autonomy, Structure and limit setting, Verbal communication, Developmental stimulation, and Fostering positive peer interactions), and caregivers’ resources to cope with work-related stress. Data on structural factors (e.g., staff stability, caregiver-child ratio, and level of pre-service education), caregiver attachment style, acceptability and feasibility of the COS-C together with qualitative data on how the participants experience the COS-C is additionally collected to investigate moderating and confounding effects.

Discussion

Examining the effectiveness of the COS-C in center-based childcare contributes to the knowledge of evidence-based intervention programs and can potentially improve the caregiver quality early childcare.

Trial registration: ClinicalTrials.gov: NCT04654533. Prospectively registered December 4, 2020, https://clinicaltrials.gov/ct2/show/NCT04654533.

Caregivers' mind-mindedness and rural left-behind young children's insecure attachment: The moderated mediation model of theory of mind and family status

BACKGROUND

China's rapid development and urbanization since the early 1980s have compelled many rural residents to move from rural to urban areas for work, leaving thousands of children at home.

OBJECTIVE

This study tested the mediating effect of children's theory of mind on the relationship between caregivers' mind-mindedness and their children's insecure attachment differently depending on the different family status (the moderator) of left-behind and non-left-behind.

PARTICIPANTS

The participants were 3 to 6 years old 74 left-behind children (LBHC) and 89 non-left-behind children (NLBHC).

SETTINGS

Participants were from rural counties of central China in Henan province that has experienced a large labor migration.

METHODS

A cross-sectional moderated mediation model linked mind-mindedness (independent variable) and insecure attachment (dependent variable) through the theory of mind (mediator) and family status (moderator: left-behind/non-left-behind), controlling for age, gender, and siblings.

RESULTS

First, LBHC scored higher on insecure-disorganized attachment than NLBHC. Second, the early childhood theory of mind mediated the relationship between the caregiver's mind-mindedness and young children's insecure attachment. Third, family status moderated the effects of the theory of mind on insecure attachment. The mediating role was established only for the left-behind family, and the lower theory of mind ability was associated with the greater insecure attachment of LBHC.

CONCLUSIONS

Our findings highlight the critical role of mind-mindedness, theory of mind, and family status in the attachment theory and clarify the association between different levels of young children's theory of mind and insecure attachment based on family status.

Non-verbal and verbal parental mentalization as predictors of infant attachment security: Contributions of parental embodied mentalizing and mind-mindedness and the mediating role of maternal sensitivity

Interest in studying the relative contributions of verbal (e.g., maternal mind-mindedness [MM]) and non-verbal dimensions (i.e., parental embodied mentalizing [PEM]) of parental mentalization to child socio-emotional development is relatively recent. To date, only one study has addressed this issue in relation to child attachment security, suggesting a complementary and unique contribution of each one. The purpose of the present study was to further examine the specific contribution of PEM to infant attachment security by considering MM. In addition, this study aimed to explore the mediating role of maternal sensitivity linking PEM, MM to infant attachment security within 110 mother-infant dyads at moderate psychosocial risk. The two dimensions of parental mentalization (PEM and MM) were assessed on the basis of observations made during a videorecorded sequence of mother-child interactions in a context of free play with and without toys when the infants were 8 months old. The Maternal Behavior Q-Sort was used to measure the mothers' sensitivity in a natural setting based on observations of daily mother-child interactions, also when the infants were about 8 months old. Attachment security was measured using The Strange Situation Procedure at infant age 16 months. The results showed positive correlations between maternal sensitivity and both verbal and non-verbal measures of parental mentalization. The mediation analyses first revealed that PEM had a significant indirect effect on attachment security, with sensitivity being identified as a mediator in this association. No indirect effect linking MM and attachment security via sensitivity was observed. These results highlight the contribution of PEM to maternal sensitivity and show maternal sensitivity to be a factor that partly explains the influence of PEM on attachment security in children.

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.

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.

Does Mothers' Self-Reported Mindful Parenting Relate to the Observed Quality of Parenting Behavior and Mother-Child Interaction?

Objectives

Growing academic interest in mindful parenting (MP) requires a reliable and valid measure for use in research and clinical setting. Because MP concerns the way parents relate to, and nurture, their children, it is important to evaluate the associations between self-reported MP and observed parenting and parent-child interaction measures.

Methods

Seventy-three mothers who experience difficulties with their young children aged 0–48 months admitted for a Mindful with your baby/toddler training (63% in a mental health care and 27% in a preventative context) were included. Mothers completed the Interpersonal Mindfulness in Parenting scale (IM-P) and video-observations of parent-child interactions were coded for maternal sensitivity, acceptance, mind-mindedness, and emotional communication (EC).

Results

The IM-P total score was positively associated only with mothers’ gaze to the child (EC). IM-P subscale Listening with Full Attention negatively predicted non-attuned mind-mindedness, Compassion with the Child positively predicted maternal sensitivity and positive facial expression (EC), and Emotional Awareness of Self positively predicted mothers’ gaze to the child (EC) and dyadic synchrony of positive affect (EC).

Conclusions

The current study provides support for the hypothesis that the IM-P total score is predictive of maternal actual attention for the child during a face-to-face interaction. When the IM-P is administered with the aim to gain understanding of different aspects of parenting behavior and the parent-child interaction, it is important not only to employ the IM-P total score but also to incorporate the individual IM-P subscales, as meaningful associations between IM-P subscales and observed parenting and parent-child interactions were found.

Prematurity and Maladaptive Mealtime Dynamics: the Roles of Maternal Emotional Distress, Eating-Related Cognitions, and Mind-Mindedness

Premature birth and maternal emotional distress constitute risk factors for feeding disorders. This study examined the roles of maternal cognitions in the link between prematurity, emotional distress and mother-infant maladaptive mealtime dynamics in a sample of 134 families (70 preterm, low medical risk; 64 full-term) followed longitudinally. Specifically, maternal cognitions related to eating and health (perception of child vulnerability and concerns about child's eating) and understanding of mental states (interactional mind-mindedness) were considered. A multiple-mediators model was tested, controlling for infants' weight and breastfeeding history. Although prematurity did not directly predict mealtime dynamics, multiple-mediation analyses revealed indirect pathways: mothers of preterm newborns reported higher emotional distress, which subsequently predicted perception of child vulnerability and concerns about child's eating at 6-months; perception of child vulnerability predicted more conflictual mealtime dynamics, whereas concern about child's eating predicted less reciprocal mealtime dynamics at 12-months. Mind-mindedness at 6-months predicted more reciprocal and less conflictual mealtime dynamics but did not act as a mediator. Implications for understanding pathways from prematurity to feeding disorders are discussed.

Children's theory of mind as a mechanism linking parents' mind-mindedness in infancy with children's conscience

Growing research on parental mind-mindedness has revealed significant positive associations between parents' appropriate mind-minded (MM) comments to their infants and children's future theory of mind (ToM). In turn, ToM has been broadly linked with a range of social-moral competencies. However, few (if any) studies have examined long-term paths from mothers' and fathers' mind-mindedness in infancy to conscience at early school age, with ToM serving as a mediator of those links. We tested such a model in a prospective longitudinal study of 102 community infants, mothers, and fathers. Parents' MM comments to their infants were coded in naturalistic interactions in snack and play contexts at 7 months. Children's ToM was assessed in false-belief tasks at 4.5 and 5.5 years, and two aspects of their conscience were assessed at 6.5 years: discomfort following transgressions and prosocial judgments in hypothetical moral dilemmas. We tested our model in a comprehensive path analysis that accounted for developmental continuity of both aspects of conscience. Children's ToM was positively associated with both measures of future conscience. The long-term paths from parental mind-mindedness in infancy to conscience were found for mother-child relationships only. For mothers and children, we supported the paths from maternal appropriate MM comments during a snack context in infancy to both aspects of children's conscience mediated by children's ToM. The findings extend earlier evidence suggesting the potentially important role of the parent-child interactive context for long-term effects of early parental mind-mindedness and highlight differences in the roles MM comments may play in mother-child and father-child relationships.

Parent mind-mindedness, sensitivity, and infant affect: Implications for attachment with mothers and fathers

Previous research examining links between parenting and attachment has focused on behavioral aspects of parenting such as sensitivity. However, by assessing how parents reflect on infants' mental states (mind-mindedness) we gain a broader understanding of parenting and how it impacts attachment. Mothers, fathers, and their infants (N = 135) participated in the Still Face Paradigm (SFP) at 3-, 5-, and 7- months of age, and the Strange Situation with mothers at 12 months and fathers at 14 months. Parent sensitivity and infant affect were coded from the SFP and all videos were transcribed and later coded for parents' use of appropriate and non-attuned mind-mindedness toward their infants. Attachment with each parent was coded from the Strange Situation. Mixed effects models examined trajectories of parents' mind-mindedness in relation to parent sensitivity and infant affect across attachment groups. Significant differences between parent gender and attachment category were detected. Specifically, parents who were less sensitive were also less mind-minded toward insecure-avoidant infants; parents used more non-attuned mind-mindedness when infants had higher negative affect. Findings suggest that, in addition to parent sensitivity, parents' use of appropriate and non-attuned mind-mindedness during a parent-infant interaction provides insight into the developing attachment relationship for mothers and fathers.

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.

The mindedness of maternal touch: An investigation of maternal mind-mindedness and mother-infant touch interactions

Increasing evidence shows that maternal touch may promote emotion regulation in infants, however less is known about how parental higher-order social cognition abilities are translated into tactile, affect-regulatory behaviours towards their infants. During 10 min book-reading, mother-infant sessions when infants were 12 months old (N = 45), we investigated maternal mind-mindedness (MM), the social cognitive ability to understand an infant's mental state, by coding the contingency of maternal verbal statements towards the infants' needs and desires. We also rated spontaneous tactile interactions in terms of their emotional contingency. We found that frequent non-attuned mind-related comments were associated with touch behaviours that were not contingent with the infant's emotions; ultimately discouraging affective tactile responses from the infant. However, comments that were more appropriate to infant's mental states did not necessarily predict more emotionally-contingent tactile behaviours. These findings suggest that when parental high-order social cognitive abilities are compromised, they are also likely to translate into inappropriate, tactile attempts to regulate infant's emotions.

Quality of maternal behaviour during infancy predicts functional connectivity between default mode network and salience network 9 years later

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The relation between parenting and children’s brain networks connectivity was examined.

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Higher-quality maternal behaviour during infancy predicted child DMN-SN connectivity.

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Maternal behaviour may affect brain maturation via experience-dependent processes.

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Experiences provided by positive maternal behaviour may promote DMN-SN connectivity.

Infants’ experiences are considered to determine to a large degree the strength and effectiveness of neural connections and fine tune the development of brain networks. As one of the most pervasive and potent relational experiences of infancy, parent-child relationships appear to be prime candidates to account for experience-driven differences in children’s brain development. Yet, studies linking parenting and functional connectivity are surprisingly scarce, and restricted to the connectivity of limbic structures. Accordingly, this longitudinal study explored whether normative variation in the quality of early maternal behaviour predicts the functional connectivity of large-scale brain networks in late childhood. Maternal mind-mindedness and autonomy support were assessed with 28 children when they were 13 and 15 months old respectively. When children were 10 years of age, children underwent a resting-state functional MRI exam. Functional connectivity was assessed between key regions of the default mode network (DMN), salience network (SN), and frontal-parietal central executive network (CEN). Results revealed that higher mind-mindedness and autonomy support predicted stronger negative connectivity between DMN and SN regions. These findings are the first to provide preliminary evidence suggestive of a long-lasting impact of variation within the normative range of early maternal behaviour on functional connectivity between large-scale brain networks.

Theory of mind as a link between oxytocin and maternal behavior

BACKGROUND

Oxytocin is a neuropeptide associated with maternal behavior. However the mechanisms underlying this link remain unclear. In a previous study we observed an indirect effect of increased plasma oxytocin during late pregnancy on early postpartum maternal interactive behavior via theory of mind, as assessed by the Reading the Mind in the Eyes Test (RMET). The current study aimed to extend these findings by testing whether this indirect effect would hold longitudinally for maternal behavior at 2-3 years postpartum, as well as for an additional observational measure of maternal mind-mindedness.

METHOD

The original sample of 316 pregnant women (M_age = 31.92 years) was assessed at 12-14 weeks gestation (T1), 32-34 weeks gestation (T2), and 7-9 weeks postpartum (T3). Follow-up measures were taken at 2-3 years postpartum (T4).

RESULTS

Mothers' RMET performance (T3) was associated with more structuring and less intrusive maternal behavior at 2-3 years (T4), while their tendency to use mind-related comments (T3) was associated with greater sensitivity (T4). Bootstrap estimates also revealed a significant indirect effect of plasma oxytocin levels during late pregnancy (T2) on maternal structuring and non-intrusive behavior at 2-3 years postpartum (T4) through RMET performance (T3).

CONCLUSIONS

Results: of the current study confirm and extend the previous findings, demonstrating that theory of mind may represent a social cognitive mechanism linking endogenous oxytocin and maternal behavior. Important changes in the oxytocinergic system during late pregnancy may help prepare for motherhood by promoting the awareness of social cues, which in turn promote maternal behavior from the early postpartum to the early childhood years.

Longitudinal relations among maternal depressive symptoms, maternal mind-mindedness, and infant attachment behavior

The relations among maternal depression risk, maternal mind-mindedness, and infants' attachment behavior were longitudinally examined in a community sample of mother-infant dyads. Maternal self-reported depression risk was measured at the infant ages of 6 weeks, 4 months, and 12 months. Maternal mind-mindedness, assessed from mothers' comments about infants' mental states (e.g., infants' thoughts, desires, or emotions), was measured during mother-infant interactions when infants were 4 months. Infants' attachment behavior was assessed at one year. Mothers' depression risk decreased over the infants' first year, with the sharpest decline between 6 weeks and 4 months. Mothers at risk for depression when infants were 6 weeks showed less appropriate mind-mindedness at 4 months. Mind-mindedness was not related to maternal depression risk at the infant age of 4 months or 12 months. Infants' degree of disorganized attachment behavior at one year was positively associated with maternal depression risk at 6 weeks and negatively associated with maternal appropriate mind-mindedness at 4 months. Mothers who are at risk for depression in their infants' early lives may be hampered in their capacity to respond appropriately to their infants' mental states. Infants with mothers who have difficulty responding appropriately to their mental states, as suggested by low appropriate mind-mindedness, may feel less known and recognized by their mothers, a key theme in the origins of disorganized attachment.

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.

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.

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

Maternal mind-mindedness, defined as the propensity to view one's child as an agent with independent thoughts and feelings, mitigates the impact of low maternal education on conduct problems in young children (Meins et al. 2013), but has been little studied beyond the preschool years. Addressing this gap, we applied a multi-measure and multi-informant approach to assess family adversity and disruptive behavior at age 12 for a socially diverse sample of 116 children for whom ratings of disruptive behavior at age 6 were available. Each mother was asked to describe her child and transcripts of these five-minute speech samples were coded for (i) mind-mindedness (defined by the proportion of child attributes that were mental rather than physical or behavioral) and (ii) positivity (defined by the proportion of child attributes that were positive rather than neutral or negative). Our regression results showed that, independent of associations with prior adjustment, family adversity, child gender and low maternal monitoring, mothers' mind-mindedness (but not positivity) predicted unique variance in disruptive behavior at age 12. In addition, a trend interaction term provided partial support for the hypothesis that pre-adolescents exposed to family adversity may benefit in particular from maternal mind-mindedness. We discuss the possible mechanisms underpinning these findings and their implications for clinical interventions to reduce disruptive behavior in adolescence.

The association between maternal-reported responses to infant crying at 4 weeks and 6 months and offspring depression at 18: a longitudinal study

The purpose of the present study is to examine the association between maternal response to infant crying and the psychological health of the child in later life. Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort, consisting of 15,247 pregnancies, 10,278 with exposure variables and 3201 complete cases were identified as having exposure, covariate and outcome data. Using a postal questionnaire, mothers were asked regarding their infant at 4 weeks and 6 months, 'If they cry what do you do?': (a) pick them up immediately; (b) if they cry, leave them for a while, and if they do not stop, pick them up; or (c) never pick them up until you are ready. Outcome was an International Statistical Classification-10th revision criteria (ICD-10) diagnosis of depression at 18 years for the infant. Offspring of mothers who at 4 weeks reported that they never picked their infants up until they were ready were more likely to have depression at 18 years (OR = 2.06, CI 0.95-4.47, adjusted for sociodemographic confounding variables). There was no evidence for an association at 6 months. Including adjustment variables reduced the strength of our association; an observed objective measure of maternal response rather than a self-report may have more accurately determined the mother's actual responses. There is some evidence for an association between maternal reporting of responses to infant crying at 4 weeks and risk of developing depression at 18 years. If this association is found to be causal, interventions encouraging mothers to represent and respond to their infants' emotional states may help prevent offspring depression.

Is mind-mindedness trait-like or a quality of close relationships? Evidence from descriptions of significant others, famous people, and works of art

The four studies reported here sought to explore the nature of the construct of mind-mindedness. In Study 1, involving 37 mothers of 5- to 8-year-old children, mothers' verbal mind-minded descriptions of their children were positively correlated with their mind-minded descriptions of their current romantic partner. Participants in Studies 2 (N=114), 3 (N=173), and 4 (N=153) were young adults who provided written descriptions of: a close friend and their current romantic partner (Study 2); two specified famous people, two works of art, and a close friend (Study 3); a specified famous person, a famous person of the participant's choice, and a close friend (Study 4). Study 2 obtained paper-and-pen written descriptions, whereas participants completed descriptions in electronic format in Studies 3 and 4. Mind-minded descriptions of friends and partners were positively correlated, but there was no relation between mind-minded descriptions of a friend and the tendency to describe famous people or works of art in mind-minded terms. Levels of mind-mindedness were higher in descriptions of friends compared with descriptions of famous people or works of art. Administration format was unrelated to individuals' mind-mindedness scores. The results suggest that mind-mindedness is a facet of personal relationships rather than a trait-like quality.