Hervé Tissot

Family interactions in IVF families: change over the transition to parenthood

Objective: This article presents a study of the change over time in the family interactions of couples who conceived through in-vitro fertilisation (IVF). Background: Observational methods are rarely used to study family interactions in families who used assisted reproductive techniques, but these methods are crucial for taking account of the communication that occurs in interactions with infants. Methods: Thirty-one couples expecting their first child were seen during the fifth month of pregnancy and when the child was nine months old. Family interactions were recorded in pre- and postnatal versions of the Lausanne Trilogue Play situation. Measures of marital satisfaction and parent-to-foetus/baby attachment or ‘bonding’ were also used to assess family relational dynamics. Results: Results showed that family alliance, marital satisfaction and parental attachment scores in the IVF sample were all similar to or higher than those in the reference sample during pregnancy. However, at nine months postnatally, the family alliance scores were lower. While marital satisfaction decreased over the period and parent–baby attachment increased, the family alliance scores were unstable, as no association was observed between the pre- and postnatal scores. In addition, neither prenatal marital satisfaction nor parent–foetus attachment predicted the postnatal family alliance. Conclusion: The change in the family alliance over the transition to parenthood appears to be specific to our IVF sample. Given that postnatal family functioning could not be predicted by prenatal family functioning, our observational data underline the importance of offering postnatal support to these families.

Are parents doing better when they are together? A study on the association between parental sensitivity and family-level processes

The aim of this study was to evaluate the influence of one parents presence on the quality of the interaction between the other parent and their three-month-old infant. Family interactions were observed in a sample of 69 two-parent families. Parental sensitivity was assessed during two sessions, first in a ‘dyadic’ context (D) and then in a ‘dyad within the triad’ context (DT). Subsequently, we compared maternal and paternal sensitivity in the D and DT contexts according to the quality of family functioning (‘high coordination’ versus ‘low coordination’). The results showed that parents were significantly more sensitive in the DT context than in the D context. This effect appeared to vary according to the quality of family alliance. Moreover, family alliance was globally associated with sensitive parenting. This study helps clarify the role of the triad as a protective factor for early infant–parent dyads.

Is it typical? The ecological validity of the observation of mother-father-infant interactions in the Lausanne Trilogue Play

Abstract The Lausanne Trilogue Play (LTP) is a widely used laboratory situation designed for the systematic observation of mother-father-infant interactions for clinical and research purposes. Nevertheless, its ecological validity has never been tested. In this exploratory study, 49 primiparous parents with their 3-month-old infants were assessed by questionnaires to determine the extent to which their behaviour in the LTP was typical, that is, representative of everyday interactions. Results show that (a) most of the parents assessed their behaviour as typical and (b) the quality of triadic interactions was linked with parents’ assessment of the typicality of the infant’s behaviour.

Coparenting Behaviors as Mediators between Postpartum Parental Depressive Symptoms and Toddler’s Symptoms

Postpartum parental depression, even of mild intensity and short duration, has negative consequences on child development, including increased externalizing and internalizing symptoms. Studies revealed that the links between parental depression and child development are mediated by parenting difficulties. On the other hand, the mediating role of problematic family-level relationships, such as low coparenting support and high conflict between the parents, has rarely been considered, although coparenting difficulties have been linked with both increased depressive symptoms in parents and increased symptoms in toddlers. In the present study, we proposed testing a comprehensive mediation model linking parental depression, coparenting, and child symptoms. At 3 months postpartum, a convenience sample of 69 parental couples completed the Edinburgh Postnatal Depression Scale. In addition, we assessed levels of coparenting support and conflict during a mother–father–infant play situation, the Lausanne Trilogue Play. At 18 months postpartum, both parents assessed child symptoms with the Symptom Checklist Questionnaire. The results showed that coparenting support mediated the links between parental depressive symptoms and child symptoms, but only for mothers: Maternal depressive symptoms were linked with lower coparenting support, which in turn predicted increased psychofunctional symptoms and behavior problems assessed by mothers. Although coparenting conflict behaviors were not predicted by parents’ depressive symptoms, higher conflict was unexpectedly linked with fewer behavior problems assessed by both parents. The present study allowed us to unveil complex pathways between mild parental mood disturbances, family-level relationships, and child development in the first months of the child’s life.

Leaving Distress Behind: A Randomized Controlled Study on Change in Emotional Processing in Borderline Personality Disorder

Objective: The marked impulsivity and instability of clients suffering from borderline personality disorder (BPD) greatly challenge therapists’ understanding and responsiveness. This may hinder the development of a constructive therapeutic relationship despite it being of particular importance in their treatment. Recent studies have shown that using motive-oriented therapeutic relationship (MOTR), a possible operationalization of appropriate therapist responsiveness, can enhance treatment outcome for BPD. The overall objective of this study is to examine change in emotional processing in BPD clients following the therapist’s use of MOTR. Method: The present paper focuses on N = 50 cases, n = 25 taken from each of two conditions of a randomized controlled add-on effectiveness design. Clients were either allocated to a manual-based psychiatric-psychodynamic 10-session version of general psychiatric management (GPM), a borderline-specific treatment, or to a 10-session version of GPM augmented with MOTR. Emotional states were assessed using the Classification of Affective-Meaning States (Pascual-Leone & Greenberg, 2005) at intake, midtreatment, and in the penultimate session. Results: Across treatment, early expressions of distress, especially the emotion state of global distress, were shown to significantly decrease (p = .00), and adaptive emotions were found to emerge (p < .05). Between-condition differences of change were found, including a significant increase in emotional variability and stronger outcome predictors in the MOTR condition. Conclusions: The findings indicate initial emotional change in BPD clients in a relatively short time frame and suggest the addition of MOTR to psychotherapeutic treatments as promising. Clinical implications are discussed.

Family Alliance as a Moderator of the Link Between Maternal Postpartum Depression and Child Symptoms Assessed by Both Parents

We investigated the moderating effect of family relationships on the links between maternal postpartum depression and child symptoms in a low-risk community sample of families with 3-month-old infants (n = 57). The level of maternal depression was assessed by the Montgomery-Åsberg Depression Rating Scale from a clinical interview, child symptoms by the Symptom Check List completed by both parents, and family relationships by direct observation of father–mother–baby interactions (Lausanne Trilogue Play). Families were categorized as high coordination or low coordination from their overall coordination level throughout the play. Results showed no significant links between maternal depression level and child symptoms reported by both parents. Mothers with a high depressive level in high coordination families tended to report more symptoms in their child than did mothers with lower depressive scores, whereas this link was not found in low coordination families. Prevention perspectives and clinical implications of these results are discussed.

Parents’ representations of mother–child and father–child relationships as predictors of early coparenting interactions

ABSTRACT The aim of this study was to assess the influence of maternal and paternal representations of mother–child and father–child relationships on coparenting interactions during the first two years of the child’s life. The sample constituted 69 families whose mothers’ and fathers’ representations were assessed when their child was 3, 9, and 18 months old with a self-reported questionnaire. Coparenting support and conflict were assessed in our laboratory with the Lausanne Trilogue Play, a standardized situation of observation. Questionnaires were used to control for variables known to influence coparenting: marital satisfaction and child temperament. Results show that (i) parental representations are stable through time; (ii) both parents tend to see themselves and the other parent as less tolerant as the child gets older; (iii) representations explain coparenting support over and above other variables of influence; and (iv) there is an interaction effect between representations and the child’s gender.

Mothers’ and Fathers’ Sensitive Parenting and Mother–Father–Child Family Alliance During Triadic Interactions:

Observing parent–child dyadic interactions has helped researchers understand how maternal and paternal parenting contributes to child development, whereas the study of mother–father–child triads has documented the role of family-level relations. Dyadic and triadic interactions have rarely been observed, however, within the same families in a single study. This study aimed to investigate how the quality of parenting, in terms of parental sensitivity, influenced or was influenced by the quality of family alliance (FA), with repeated measures at 3 (T1), 9 (T2), and 18 months postpartum (T3). Results showed that sensitivity was greater in cooperative FAs and improved over time, with no difference between mothers and fathers. Moreover, both parents’ sensitivity was a key determinant for reaching a cooperative FA at T1, but its importance decreased later in the postpartum period. These findings stress the need to study parent–child relations in different contexts.

The Family Alliance Model: A Way to Study and Characterize Early Family Interactions

The aim of this paper is to present the family alliance (FA) model, which is designed to conceptualize the relational dynamics in the early family. FA is defined as the coordination a family can reach when fulfilling a task, such as playing a game or having a meal. According to the model, being coordinated as a family depends on four interactive functions: participation (all members are included), organization (members assume differentiated roles), focalization (family shares a common theme of activity), affect sharing (there is empathy between members). The functions are operationalized through the spatiotemporal characteristics of non-verbal interactions: for example, distance between the partners, orientation of their bodies, congruence within body segments, signals of readiness to interact, joint attention, facial expressions. Several standardized observational situations have been designed to assess FA: The Lausanne Trilogue Play (with its different versions), in which mother, father, and baby interact in all possible configurations of a triad, and the PicNic Game for families with several children. Studies in samples of non-referred and referred families (for infant or parental psychopathology) have highlighted different types of FA: disorganized, conflicted, and cooperative. The type of FA in a given family is stable through the first years and is predictive of developmental outcomes in children, such as psychofunctional symptoms, understanding of complex emotions, and Theory of Mind development.

Shared parental care in the first 18 months as a context for sensitivity and coparenting

The present study was aimed at assessing the links between shared parental care and maternal and paternal sensitivity and coparenting over the first 2 years of the childs life. The sample consiste...