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Graduate Masters Theses
Doctoral Dissertations and Masters Theses
8-1-2012
Maternal Depressive Symptoms and
Responsiveness to Infant Distress: Contingency
Analyses of Home Mother-Infant Interactions at 3
Months
Fernanda Lucchese
University of Massachusetts Boston
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Recommended Citation
Lucchese, Fernanda, “Maternal Depressive Symptoms and Responsiveness to Infant Distress: Contingency Analyses of Home Mother-
Infant Interactions at 3 Months” (2012). Graduate Masters Theses. Paper 126.
MATERNAL DEPRESSIVE SYMPTOMS AND RESPONSIVENESS TO INFANT
DISTRESS: CONTINGENCY ANALYSES OF HOME MOTHER-INFANT
INTERACTIONS AT 3 MONTHS
A Thesis Presented
by
FERNANDA LUCCHESE
Submitted to the Office of Graduate Studies,
University of Massachusetts Boston,
in partial fulfillment of the requirements for the degree of
DOCTOR OF PHILOSOPHY
August 2012
Clinical Psychology Program
© 2006 by Fernanda Lucchese
All rights reserved
MATERNAL DEPRESSIVE SYMPTOMS AND RESPONSIVENESS TO INFANT
DISTRESS: CONTINGENCY ANALYSES OF HOME MOTHER-INFANT
INTERACTIONS AT 3 MONTHS
A Thesis Presented
by
FERNANDA LUCCHESE
Approved as to style and content by:
________________________________________________
Ed Tronick, University Distinguished Professor
Chairperson of Committee
________________________________________________
Alice Carter, Professor
Member
________________________________________________
Karen Olson, Research Faculty
Children’s Hospital Boston, Harvard Medical School
Member
_________________________________________
Alice Carter, Program Director
Clinical Psychology Program
_________________________________________
Jane Adams, Chairperson
Psychology Department
iv
ABSTRACT
MATERNAL DEPRESSIVE SYMPTOMS AND RESPONSIVENESS TO
INFANT DISTRESS: CONTINGENCY ANALYSES OF HOME MOTHER-
INFANT INTERACTIONS AT 3 MONTHS
August 2012
Fernanda Lucchese, B.A., Duke University
M.A., New York University
Directed by University Distinguished Professor Ed Tronick
Maternal depressive symptoms during the postnatal period have been
shown to be detrimental to the socio-emotional, cognitive, and motor development
of infants. Studies indicate that one of the mediators of these detrimental effects is
decreased maternal responsiveness, a maternal characteristic that may hinder infant
emotion-regulation development and infant secure attachment. Although previous
research has shown the impact of infant cries on the behavior and physiology of
mothers with elevated depressive symptoms in laboratory-based contexts, little is
known about the quality and timing of maternal responsive behaviors to infant
negative affect in mothers with elevated or non-elevated depressive symptoms in
the naturalistic environment. The general aim of this study was to evaluate the
contingencies between infant distress displays and maternal responsive behaviors
v
during home observations of mothers with elevated and non-elevated depressive
symptoms and their 3-month-old infants. Specifically, the goal was to analyze
differences in the quality and timing of maternal response to infant distress among
mothers with high depressive symptoms compared to mothers with low depressive
symptoms during observations of mothers and their infants at home. To evaluate
maternal responsiveness, a variety of maternal behaviors were coded from 30-
minute videotapes of home interactions in 83 low-risk Caucasian mother-infant
dyads. Maternal behavioral responses, non-responsiveness, latency of response,
and number of responses per episode of infant distress did not differ significantly
between the no or low depression symptom groups and the high symptom group.
After controlling for maternal and infant individual differences, CESD scores did
not predict maternal responsive behaviors. Maternal responsiveness rates and
infant affectivity levels were congruent with those found in previous studies of
mothers with non-elevated depressive symptoms. The small differences found
between CESD groups in this sample may suggest that maternal depressive
symptoms, without other comorbid or environmental risk factors, may not impact
the way in which mothers respond to infant distress at 3-months.
vi
ACKNOWLEDGEMENTS
I would like to thank all my committee members for providing me support
and guidance throughout this process. In particular, I would like to thank my
master’s thesis mentor and committee chair, Ed Tronick for taking me into his
laboratory and granting me intellectual freedom to develop as a researcher. In
addition, I would like to thank Alice Carter for helping me frame the discussion of
psychological symptoms in a sensitive way. I would also like to thank Karen Olson
for her input regarding the management and analysis of the data used in this study.
Finally, I would like to thank my family and friends for the endless support of my
academic pursuits.
vii
TABLE OF CONTENTS
ACKNOWLEDGEMENTS
……………………………………………………………….
iv
LIST OF TABLES
……………………………………………………………………………
viii
LIST OF FIGURES …………………………………………………………………………..
ix
LIST OF ABBREVIATIONS
……………………………………………………………..
x
CHAPTER Page
1. INTRODUCTION ………………………………………………………………
1
2. METHODS ………………………………………………………………………..
25
3. RESULTS ………………………………………………………………………….
38
4. DISCUSSION …………………………………………………………………….
67
APPENDIX
CODE SYSTEM
…………………………………………………………………….
75
BIBLIOGRAPHY
…………………………………………………………………………….
77
viii
LIST OF TABLES
Table
Page
1. Demographics …………………………………………………………………….
28
2. Coding Scheme …………………………………………………………………..
32
3. Descriptives and ANOVA results
………………………………………….
40
4. Behavior Descriptives and ANOVA results ……………………………
51
5. Yule’s Q Descriptives and ANOVA results …………………………….
53
6. Regressions: Predicted values by CESD accounting for
independent differences ………………………………………………..
61
ix
LIST OF FIGURES
Figure
Page
1. A 2 by 2 odds ratio table ………………………………………………………
20
2. Duration of crying in minutes per hour throughout the first year
of life
…………………………………………………………………………
25
3. Sample 2 by 2 contingency table used for each maternal
Behavior
…………………………………………………………………….
34
4. Coding System Diagram ………………………………………………………
35
5. Incidence of Global Behavior Responses to Cry …………………….
47
6. Incidence of Global Behavior Responses to Fuss
…………………….
48
7. Incidence of Global Behavior Responses to Total Infant
Negative Affect
……………………………………………………………
48
x
LIST OF ABBREVIATIONS
1. CES-D – Center for Epidemiologic Studies – Depression Scale
1
CHAPTER 1
INTRODUCTION
Maternal depressive symptoms during the postnatal period have been shown to be
detrimental to the socio-emotional, cognitive, and motor development of infants (Murray,
1992; Sharp et al., 1995; Maughan, Cicchetti, Toth, & Rogosch, 2007; Abrams, Field,
Scafidi, & Prodromidis, 1995). Studies indicate that one of the mediators of these
detrimental effects is decreased maternal responsiveness (Drake, Humenick, Amankwaa,
Younger, & Roux, 2007; Gondoli & Silverberg, 1997); a maternal characteristic that may
hinder infant emotion-regulation development and infant secure attachment (Gianino &
Tronick, 1988; Moehler, Brunner, Wiebel, Reck, & Resch, 2006). Although previous
research has shown the impact of infant cries on the behavior and physiology of mothers
with elevated depressive symptoms in laboratory-based contexts, little is known about the
quality and timing of maternal responsive behaviors to infant negative affect in mothers
with elevated or non-elevated depressive symptoms in the naturalistic environment home.
The general aim of this study is to evaluate contingencies between infant distress displays
and maternal responsive behaviors during home observations of mothers with elevated
and non-elevated depressive symptoms and their 3-month-old infants. Specifically, the
goal is to analyze differences in the quality and timing of maternal response to infant
2
distress among mothers with high depressive symptoms compared to mothers with low
depressive symptoms during observations of mothers and their infants at home.
To accomplish this goal, maternal responsive behaviors and their latency of
response immediately following infant distress were coded from 30-minute videotaped
mother-child home interactions. A detailed coding system (see appendix) was used to
capture the behaviors observed during the home interactions of low-risk mostly
Caucasian (N=83) mothers and their 3-month-old infants. Maternal depressive symptoms
were measured with self-reported symptoms with the Center for Epidemiologic Studies-
Depression Scales during the home visit (CES-D; Radloff, 1977). To assess how the
intensity of infant distress would affect maternal responsiveness in mothers with elevated
and non-elevated depressive symptoms, intensity of infant distress was differentiated
between fussiness and cry (see appendix for code descriptions). The data were drawn
from a larger longitudinal study of maternal depression, called the HOME study. Dyads
were recruited at the time of child’s birth from two major Massachusetts hospitals. Home
interactions from the 3-month visit from the HOME study were coded.
Maternal Depression and Child Development
The postpartum is a crucial time for the development of the mother-child
relationship. During this period, infants are dependent on their caregivers to meet their
needs, and mothers’ responsiveness is necessary for them to achieve different forms of
engagement with people and the inanimate world (Tronick, Als, & Adamson, 1979).
However, when proximal risk factors such as maternal psychopathology are present, the
development of this relationship may be at risk.
3
Maternal postnatal depression afflicts about 10-15% of all women in the first 6
months after birth (Beck, 2001; O’Hara & Swain, 1996). Recent studies show, however,
that these rates may be even higher in different ethnic cultures (reaching up to 60%;
Halbreich & Karkun, 2006). These rates highlight the relevance of this problem to
women and children throughout the world.
Women of child-bearing ages show the highest levels of depression rates (Eaton
& Kessler, 1981). More recent epidemiological studies have shown a significant age
difference in women, where women of 18-34 years had a 13.6% incidence of depression;
35-49 years had a 11.3% incidence of depression; 50-65 years had a 9.1% incidence of
depression, and 65 and over had an incidence of only 3.7% (Kessler, Birnbaum, Bromet,
Hwang, Sampson, et al., 2009). Increased rates of depression are observed in women
when there are increased child-rearing burdens, such as three or more of children under 6
years in the home, or the presence of an ill child (Klerman & Weissman, 1989; Brown &
Harris, 1978).
Infants demand relatively constant care and attention from their caretakers,
especially in the first months of life. When mothers have elevated depressive symptoms,
it may be harder for them to be attentive to their infants’ cues and needs. Studies show
that mothers with elevated depressive symptoms are less contingent and affectionately
attuned to their infants (Charles, Murray, & Stein, 2004). This quality affects the early
mother-infant interaction, which in turn may result in the impairment of the mother-child
relationship (Moehler et al., 2006). And relational impairment has long been associated
with long-lasting effects on the development of the infant. For example, maternal
4
postpartum depression has been linked to negative effects on cognitive, socio-emotional,
and motor development (e.g. Murray, 1992; Sharp et al., 1995; Maughan, Cicchetti, Toth
& Rogosch, 2007; Abrams, Field, Scafidi, & Prodromidis, 1995).
The socio-emotional development of children of mothers with elevated depressive
symptoms in the postpartum period, compared to children of mothers with non-elevated
depressive symptoms in the puerperium, has been shown to have increased negative
affectivity and self-regulatory difficulties. Children who were exposed to maternal
depression in the first months of life have been shown to have maladaptive emotion
regulation patterns at age 4 and lower perceived competence ratings at age 5 (Maughan,
et al., 2007). Furthermore, higher rates of insecure attachment have been shown in
children of mothers who had elevated depressive symptoms in the postpartum period
compared to children of mothers who did not have elevated symptomatology. For
example, children of women who had chronic symptoms in the postpartum period up to
36 months after birth were more likely to have preschoolers who were classified as
insecure D; and intermittent symptomatology in the first 36 months was associated with
insecure C or D in preschoolers (Campbell, Brownell, Hungerford, Spieker, Mohan, et
al., 2004). Furthermore, mothers with comorbid symptomatology (e.g. depression and at
least one other psychopathological condition) have also been shown to have infants with
higher risk of developing insecure attachment with their mothers at 14 months (Carter,
Garrity-Rokous, Chazan-Cohen, Little, & Briggs-Gowan, 2001).
Motor issues can also be observed in children whose mothers had elevated
depressive symptoms in the first months postnatally. For example, Abrams et al. (1995)
5
showed that newborns of mothers with elevated depressive symptoms had decreased
motor tone, lower activity levels and less robustness on the Brazelton Neonatal
Behavioral Assessment Scale, compared to those born to mothers with non-elevated
depressive symptoms. Similarly, activity levels were shown to be lower in early
childhood in children whose mothers had elevated depressive symptoms during the first
year postnatally. A recent study has shown that children whose mothers had high
depressive symptomatology at 15 months had lower activity levels at ages 4 through 6
years when compared to their peers whose mothers did not show elevated depressive
symptoms at 15 months (Fernald, Jones-Smith, Ozer, Neufeld, & DiGirolamo, 2008).
Although the evidence focuses on the influence of maternal depression on the
child, there are infant factors that might affect maternal behavior and symptomatology.
Murray, Stanley, Hooper, King, et al. (1996) have shown that high infant irritability is
predictive of onset of maternal depression in the first 8 weeks postpartum. Infant
irritability has also been shown to predict parenting, sensitivity, and mother-infant
attachment. For example, irritable infants receive less sensitive care and have less secure
relationships than non-irritable infants (Crockenberg, 1994; van den Boom, 1994;
Thompson, 1997; van den Boom, 1997). Furthermore, studies have shown that infant
genetic factors may influence parenting, and maternal sensitivity (Mills-Koonce, Propper,
Gariepy, Blair, Garrett-Peters, et al., 2007; O’Connor, Deater-Deckard, Fulker, Rutter, &
Plomin, 1998).
6
Maternal Depression and Responsiveness
Postpartum depression may impact parenting in significant ways. Responsiveness
to infants’ needs may be particularly impaired due to depression. Feelings of
hopelessness, low self-esteem, and self-efficacy, which are associated with depression
and emotional distress, may also cause mothers to be less responsive to their infants (e.g.
Drake et al., 2007; Gondoli & Silverberg, 1997). Another facet of depression is
psychomotor retardation, which might prevent mothers from responding in a consistent
and timely fashion to their infants’ needs. Alternatively, Stein, Lehtonen, Harvey, Nicol-
Harper, & Craske (2009) propose that it is maternal preoccupation, or the cognitive
distortions of psychopathology, in particular thought rumination and attention, that might
impact maternal responsiveness in postpartum depression.
Another way that maternal depression may affect responsiveness is on the type of
soothing responses that mothers with elevated depressive symptoms are more likely to
have. Studies done with American samples have shown that mothers with elevated
depressive symptoms may act withdrawn or understimulating, or intrusive and
overstimulating (Cohn & Tronick, 1983; Cohn, Matias, Tronick, Lyons-Ruth, & Connell,
1986; Field, Healy Goldstein, & Guthertz, 1990; Malphurs, Larrain, Field, Pickens,
Pelaez-Nogueras, et al. 1996; Beebe, Jaffee, Buck, Chen, Cohen, et al., 2008). As Cohn et
al. (1986) point out, withdrawn mothers are more likely to be disengaged from their
infants and only respond to infant negative affectivity, while intrusive mothers interact
with their infants in a rough manner, especially when infant is distressed.
7
On the other hand, it is important to keep in mind that not all mothers suffering
from post-natal depression are inadequately responding to their infants. Most studies
presented above emphasize mean differences, without highlighting the fact that some
women suffering from depression in the puerperium do not show decreased
responsiveness towards their infants. There seems to be some sort of parallel, but
independent, process between depressive symptoms and maternal responsiveness, where
depression may be present but responsiveness (or parenting quality) may or may not be
impaired. For example, intervention studies targeting infant development or parent-infant
mental health with women who had elevated depressive symptoms in the postpartum
period and their infants have shown that, while maternal responsiveness to infant’s cues,
and mother-infant interactions and child outcomes improve, depressive symptomatology
may remain unchanged (Lyons-Ruth, Connell, Grunebaum, & Botein, 1990; Heinicke,
Fineman, Ruth, Recchia, Guthrie, et al. 1999; Cicchetti, Rogosh, & Toth, 2000). The
reverse has also been observed, where mothers with elevated depressive symptoms
already receiving pharmaceutical or other standard form of mental health care to treat
depressive symptoms still presented less than optimal parenting practices (Weissman,
Prusoff, Gammon, Merikangas, Leckman, et al., 1984; Gordon, Burge, Hammen, Adrian,
Jaenicke, et al., 1989; Weinberg & Tronick, 1998).
Additionally, infant factors may also play an important role in modulating
maternal responsiveness and parenting quality. Infants who are more difficult to soothe
may impose greater challenges for the parents, which may, in turn, impact maternal self-
esteem, self-efficacy and mood symptomatology. A child’s difficult temperament and
8
diminished ability to self-regulate may increase parental stress and diminish maternal
sense of competence (Cutrona & Troutman, 1986). Studies have shown that increased
stress and depression is associated with decreased self-efficacy (Coleman & Karraker,
1998; Jackson & Huang, 2000; Scheel & Rieckmann, 1998; Teti, O’Connell, & Reiner,
1996). Hence, maternal responsiveness and parenting quality may be negatively impacted
by mother’s perceived efficacy as a parent and sense of agency, especially in the first
year of the infant (Teti & Gelfand, 1991).
Responsiveness and Child Development
Although it is important to consider the effect of infant irritability on maternal
responsiveness, researchers have also studied the opposite direction of causality, where
maternal depression may negatively impact infant and child development through
reduced maternal responsiveness. According to this view, maternal depression may
disrupt communication feedback loops in the early mother-child relationship. The
potential lack of maternal responsiveness in mothers with elevated depressive symptoms
may prevent these mothers from providing proper emotion regulation for their infant
(Moehler, et al., 2006). Over time, the lack or delay of maternal responsiveness during
infant distress may have repercussions for the child’s development of self-regulatory
skills (Tronick & Gianino, 1988).
According to Bornstein and Tamis-LeMonda (1989), maternal responsiveness,
especially around the middle of the infant’s first year, may be essential for cognitive
development. They show that maternal responsiveness at 4 months is highly correlated
9
with faster non-verbal discrimination-learning and with higher IQ scores on the Wechsler
Preschool and Primary Scale of Intelligence (WIPPSI) at four years of age. In terms of
generalizability of this phenomenon, similar trends have been observed in Japanese
mother-infant dyads, where mothers who were more responsive at 4-5 months postnatally
had toddlers who were more likely to obtain higher scores on the Catell Infant test
(MCC), and young children who scored higher on the Peabody Picture Vocabulary Test
(PPVT; Bornstein, Miyake, Azuma, Tamis-LeMonda, et al., 1990). However, it should be
noted that long-term consistent maternal responsive patterns may play a role in the child
cognitive outcomes found in these studies.
In addition, Milgrom, Westley, and Gemmill (2004) have shown that lower
cognitive performance on the WIPPSI at 42 months of infants of mothers with elevated
depressive symptoms was explained by the mediation of lower maternal responsiveness
(based on frequency of response to cues) at 6 months—although, as mentioned earlier,
long-term maternal responsive patterns may also have contributed to these outcomes.
Furthermore, though the measurement of temperament is still questioned by some authors
(e.g. Kagan, 1994), this study also showed that temperamental difficulties observed in the
children of mothers with elevated depressive symptoms —through the STSI and STST
parent-report questionnaires on approach, cooperation-manageability, persistence,
rythmicity, distractibility, irritability and reactivity—was not associated with maternal
responsiveness.
However, some researchers argue that individual differences in infants may
impact the extent to which maternal responsiveness will be detrimental to child
10
development. For example, irritable infants may be more sensitive to parental behaviors
because they might be more dependent on it to self-regulate emotions and behaviors (Ziv
& Cassidy, 2002). Hence, their well-being seems to be more dependent on parental
responsiveness than in their peers. Such regulatory issues may be especially true for boys
(Weinberg, Olson, Beeghly, & Tronick, 2006).
Furthermore, Belsky, Rovine, and Taylor (1984) explored the importance of
maternal parenting patterns on infant affectivity and mother-infant interaction, while
accounting for infant individual differences. According to their findings, they suggest that
fussiness is caused by mothering, instead of predicting mothering behaviors. The authors
found that mothers’ behaviors had a greater influence in determining individual
differences in attachment. For example, they propose that fussy infants, who are more
difficult to care for, elicit over- and understimulating maternal interaction patterns, which
may lead to insecure relationships. They assert that, “while the infant most certainly
makes a contribution to the care it receives, …, it is the care provided by the mother that
plays a relatively greater role in determining individual differences in the quality of
infant-mother attachment.”
Responsiveness to Infant Distress
Many studies have observed how mothers respond to their crying infants. Some
focus on response quality (e.g. types of behaviors used), while others focus on the latency
of time of maternal response to infant distress. To date, most studies of descriptive
maternal responsive behaviors to infant distress have been done with low-risk mothers,
11
and have focused on general types of maternal responsive behaviors (e.g. looking,
holding, feeding, etc). However, to our knowledge, no studies have focused on the
number of strategies or responses mothers use to respond to each infant distress bout, or
the use of multiple behaviors in each response (e.g. vocalizing + holding + looking at the
same time vs. solely vocalizing) to soothe their distressed infant.
Bornstein and Tamis-LeMonda (1989) found that low-risk mothers in the
laboratory setting respond to distress by vocalizing 58% of the time, by picking up,
patting or feeding 22% of the time, and by orienting infants to the environment about
10% of the time (in the attempt to comfort or distract infant).
In cross-cultural comparisons, Richman, Miller, and LeVine (1992), found that
Gusii mothers were more likely to respond to their 4-month-old infant’s cry by holding
(40% of the time) or touching (20% of the time), then by vocalizing, feeding, or looking
at the infant (10%, 9%, and 3% of the time, respectively). On the other hand, the
Bostonian counterparts in this study responded to cry in their 4-month-olds more
prevalently by holding (30% of the time), looking (22%), and vocalizing (21%), and less
often, by touching and feeding (8% and 2%, respectively).
Latency of time to respond to infant distress has also been studied across cultures.
For example, it has been observed in the Efe Pygmy caretakers that the latency time for
responding to fuss or cry was about 10 seconds after onset of negative affect, 85% of the
time in the first 7 weeks of the infant, and 75% of time at 18 weeks (Tronick, Morelli, &
Winn, 1987). Studies have shown that European caregivers have similar latency rates of
response to infant distress; where the latency time span for low-risk mothers to respond to
12
infant behavior is between 200 to 800 milliseconds (Papousek & Papousek, 1987, 1989,
1991).
These findings indicate that there may be some variability in the ways mothers
respond to their infants’ distress according to culture. However, low-risk white middle-
class U.S. mothers seem to primarily use holding and vocalizing to soothe their infants.
In contrast, latency of time to respond to infant distress seems to be similar among
caregivers across different cultural backgrounds.
Maternal Depression and Responsiveness to Infant Distress
Even though studies have focused on responsiveness to infant positive affect in
mothers with elevated or non-elevated depressive symptoms (Dix, Cheng, & Day, 2008;
Feng, Shaw, Skuban, & Lane, 2007), or more generally, the responsiveness to infant cues
in mothers with elevated or non-elevated depressive symptoms (Milgrom, et al., 2004), to
our knowledge, no study has analyzed maternal responsiveness to infant distress in
mothers with elevated or non-elevated depressive symptoms.
Infant cry is a signal that infants rely on to get their needs met and intentions
scaffolded by their caregivers. Although some parents may take solace in their infant’s
cry (i.e. indication of infant’s liveliness and robustness), crying and fussing more often
arouses displeasure and elicits a response from the parents that is motivated by a desire to
terminate it. Yet, the infant’s negative state is crucial in promoting proximity between
mothers and infants. Studies have shown that there might be psychophysiological
mechanisms that are related to the triggering of parental responses to infant distress and
13
cry. For example, Stallings, Fleming, Corter, Worthman, et al. (2001) showed that first-
time mothers, who felt more sympathy for infant distress, especially in response to
hunger cries, had higher baseline salivary cortisol levels and higher heart rate than non-
postpartum women, or multiparous mothers, who showed lower sympathy for infant
distress. These findings may suggest some underlying bio-chemical mechanism to
parental responsiveness to infant distress signals. However, it should be noted that
elevated stress and anxiety levels of primiparous mothers may affect psychophysiological
factors, thus leading to the observed results in Stallings, et al.’s study.
According to some authors, parents who consistently ignore distress signals may
threaten the well-being of their infants (Bell & Ainsworth, 1972; Lester¸ Boukydis,
Garcia-Coll, & Hole; 1990). Parental emotional state plays an important role in the way
parents make meaning of different cry sounds. As mentioned earlier, some mothers with
high depressive symptoms may respond to infants in a withdrawn/avoidant and
understimulating manner, while other mothers with elevated depressive symptoms may
be intrusive and overstimulating. Studies of maternal perceptions of, and physiological
responses to, infant cry have shown both types of behavioral patterns in response to
infant cries.
Avoidant Maternal Behaviors
Some researchers argue that mothers with elevated depressive symptoms may use
avoidance of their infants in order to decrease their feelings of inadequacy (or their
negative perception of efficacy) as mothers (Donovan & Leavitt, 1989; Rotter, Chance, &
14
Phares, 1972; Seligman, 1975). In addition, others argue that maternal depression causes
difficulty responding to or discerning between higher and lower pitched infant cries
(Hubbard & van IJzendoorn, 1991). Compared to mothers with low depressive
symptoms, mothers with elevated depressive symptoms have been shown to perceive
high-pitch cries (i.e., recordings of newborn infant’s hunger cry digitally altered to
increase in fundamental frequency in 100 Hz increments) as less arousing and less
necessary of urgent response (Schuetze & Zeskind, 2001).
Avoidant behaviors in response to infant distress may be observed in terms of
physical distance. For example, proximity between mother and infant has been inversely
associated with onset of crying (Bell & Ainsworth, 1972; Keller, Chasiotis, Risau-Peters,
Volkner, Zach, et al., 1996). These findings indicate that mothers who have elevated
depressive symptoms might present more distal behaviors in response to infant distress
(e.g. just looking at the infant from a distance and/or vocalizing); whereas mothers with
low depressive symptoms will respond to infant distress with more proximal behaviors
(e.g. approaching infant’s visual field, and using physical contact to respond to distress–
touching, patting, or picking up the infant).
Intrusive Maternal Behaviors
On the other hand, mothers with elevated depressive symptoms may also respond
to infant cry with heightened attunement and physiological arousal. While low-risk
caregivers, who are attentive to infant hyperphonated cries (indicative of the infant
sounding sick), have heart rate decelerations, caregivers who are inattentive, or who show
