Relationship between maternal pathology and infant social withdrawal: Analysis of a 268-outpatient population

Maria Lucia Maulucci, Vincenzo Currò, Silvia Maulucci, Emilia de Rosa, Livia De Giovanni

Department of Neuroscience, Catholic University Hospital, Rome, Italy.
Statistic Department, Lumsa University, Rome, Italy.

DOI: 10.4236/ojpsych.2013.33031                

Abstract

Objective: Sustained withdrawal is a sign of infant distress and may be determined by extreme conditions like organic pathology or relationship problems. The Alarm Distress Baby Scale is the best instrument to identify withdrawal in infants between 2 and 24 months of age. The aim of this study was to assess the association between infant social withdrawal behavior and maternal pathology in the perinatal period. Method: The target sample of the study was 134 mother-child couples examined at the Policlinico Agostino Gemelli General Pediatric Outpatient Clinic and Psychiatric Outpatient Clinic, in Rome. We analyzed the relationship between withdrawal behavior and psychological and organic prenatal/postnatal pathology, using the Chi Square exact test. Results: When the mother suffers from both organic and psychological pathologies in the perinatal period, the risk of withdrawal is increased: the probability of infant withdrawal behavior is increased by maternal organic postnatal pathology by 14 times, by maternal psychological postnatal pathology by 9 times, and by maternal psychological postnatal depression, measured by Edinburgh Postnatal Depression Scale, by almost 4 times. Conclusion: Increased or sustained withdrawal reactions can be observed in unsatisfactory mother-child interaction. Maternal risk factors should be strictly considered in the pediatric clinical evaluation.

Keywords

Maternal Pathology; Infant Social Withdrawal Early Prevention; Alarm Distress Baby Scale

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Brazelton, T.B. (1973) Neonatal behavioral assessment scale. Clinics in Developmental Medicine, WM. Heinemann Medical Books, London.
[2]	Marty, P. (1968) La depression essentielle. Revue Fran?aise de Psychanalyse, 33, 395-603.
[3]	Dollberg, D., Feldman, R., Keren, M. and Guedeney, A. (2006) Sustained withdrawal behavior in clinic-referred and nonreferred infants. Infant Mental Health Journal, 27, 292-309. doi:10.1002/imhj.20093
[4]	Engel, G.L and Schmale, A.H. (1972) Conservation withdrawal: A primary regulatory process for organismic homeostatas. Physiology, emotion and psychosomatic illness. Excerpta Medica CIBA Foundation, Amsterdam, 57-85.
[5]	Guedeney, A., Foucault, C., Bougen, E., Larroque, B. and Mentré, F. (2008) Screening for risk factors of relational withdrawal behaviour in infants aged 14-18 months. European Psychiatry, 23, 150-155. doi:10.1016/j.eurpsy.2007.07.008
[6]	Behrman, R.E., Vaughan, V. and Nelson, W. (1983) Nelson textbook of pediatrics. W.B. Saunders, Philadelphia.
[7]	Guedeney, A. (1987) Les aspects psychosomatiques des malnutritions proteinocaloriques de la première enfance. Psychiatrie de l’Enfant, 1, 155-190.
[8]	Guedeney, A. (1995) Kwashiorkor depression and attachment disorders. Lancet, 346, 1293. doi:10.1016/S0140-6736(95)91890-6
[9]	Guedeney A. (1997) From early withdrawal reaction to infant depression. A baby alone does exist. Infant Mental Health Journal, 18, 339-349. doi:10.1002/(SICI)1097-0355(199724)18:4<339::AID-IMHJ2>3.0.CO;2-G
[10]	Powell, G.F. and Low, J. (1983) Behavior in nonorganic failure to thrive. Developmental and Behavioral Pediatrics, 4, 26-33. doi:10.1097/00004703-198303000-00006
[11]	Powell, G.F. and Bettes, B.A. (1992) Infantile depression, non organic failure to thrive, and DSM-III-R: A different perspective. Child Psychiatry and Human Development, 22, 185-198. doi:10.1007/BF00705891
[12]	Menahem, S. (1984) Possible conservation withdrawal reaction in two infants. Developmental and Behavioral Pediatrics, 5, 361-363. doi:10.1097/00004703-198412000-00014
[13]	Spitz, R.A. (1946) Anaclitic depression. Psychoanalytical Study of the Child, 2, 313-341.
[14]	Solomon, J. and George, C. (1999) Attachment disorganization. Guilford, New York.
[15]	Zeanah, C.H. (1993) Handbook of infant mental health. Guilford, New York.
[16]	Zero To three (2005) National Center for Infant Clinical Programs. Diagnostic classification of mental health and developmental disorders of infancy and early childhood. Zero To Three Press, Washington.
[17]	Murray, L. and Cooper, P.J. (1997) Postpartum depression and child development. Guilford, New York.
[18]	Robertson, J. and Bowlby, J. (1952) Responses of young children to separation from their mothers. Courrier de la Centre International de l’Enfance, 2, 131-142.
[19]	Fraiberg, S. (1982) Pathological defenses in infancy. The Psychoanalytical Quarterly, 4, 612-635.
[20]	Beebe, B., Jaffe, J., Buck, K., Chen, H., Cohen, P., Feldstein, S. and Andrews, H. (2007) Six-week postpartum maternal depressive symptoms and 4-month motherinfant selfand interactive contingency. Infant Mental Health Journal, 29, 442-471. doi:10.1002/imhj.20191
[21]	Guedeney, A. and Fermanian, J. (2001) A validity and reliability study of assessment and screening for sustained withdrawal reaction in infancy: The alarm distress baby scale. Infant Mental Health Journal, 22, 559-575. doi:10.1002/imhj.1018
[22]	Matthey, S., Guedeney, A., Starakis, N. and Barnett, B. (2005) Assessing the social behaviour of infants: Use of the ADBB Scale and relationship to mother’s mood. Infant Mental Health Journal, 26, 442-458.
[23]	De Rosa, E., Currò, V., Wendland, J., Maulucci, S., Maulucci, M.L. and De Giovanni, L.(2010) Propriétés psichométriques de l’échelle Alarme Détresse Bébé (ADBB) appliquée à 81 enfants italiens. Devenir, 22, 209-223. doi:10.3917/dev.103.0209
[24]	Missonier, S. (2003) La consultation thérapeutique périnatale. éditions érès.
[25]	Mellier, D., Rochette, J., Coulet, P., Grisi, S., Marguier L., Marandet, A. and Lefebvre, I. (2007) The ADBB scale used in preventive strategies for working in network between baby clinic and child mental health service. Devenir, 19, 81-108.
[26]	Hartley, C., Pretorius, K., Mohamed, A., Laughton, B., Madhi, S., Cotton, M.F., Steyn, B. and Seedat, S. (2010) Maternal postpartum depression and infant social withdrawal among human immunodeficiency virus (HIV) positive mother-infant dyads. Psychology, Health & Medicine, 15, 278-287.