Russell A. Isabella

Maternal Depression and the Quality of Early Attachment: An Examination of Infants, Preschoolers, and Their Mothers.

Relations between maternal depression and attachment security among 50 infant-mother and 54 preschool child-mother dyads were examined using the classification system of M. D. S. Ainsworth, M. C. Blehar, E. Waters, and S. Wall (1978) and M. Main and J. Solomon (1990) for infants and the Preschool Assessment of Attachment (P. M. Crittenden, 1992b) for preschoolers. Attachment insecurity was significantly associated with maternal depression among infants and preschoolers. Furthermore, children without unitary, coherent attachment strategies tended to have more chronically impaired mothers than did children with coherent, organized attachment strategies. Results stress the importance of severity-chronicity of parental illness in the study of depression and early attachment relations, and that differences between children with and without coherent, organized attachment strategies are as clinically informative as are differences between secure and insecure children.

Marital and Parent-Child Relationships in Family of Origin and Marital Change Following the Birth of a Baby: A Retrospective Analysis.

In order to explore the relationship between recollected experiences in ones family of origin and changes in marriage following the birth and rearing of a new baby, data collected as part of a larger and more extensive study of infant and family development were analyzed. Multiple regression analyses revealed that retrospective reports of how one was reared by parents and of how parents got along as husband and wife in ones family of origin reliably predicted changes in marriage from the last trimester of pregnancy through the time the baby was 9 months of age. Most significantly, results indicated that husband-wife differences in evaluations of marital adjustment increased over time when individuals recalled being reared in a cold-rejecting as opposed to warm-supportive manner, especially when individuals also recalled their own parents as not having an especially harmonious marital relationship. These findings are discussed in terms of potential processes by which experiences in ones family of origin may affect the way couples adjust to the birth and rearing of a new baby.

Origins of Attachment: The Role of Context, Duration, Frequency of Observation, and Infant Age in Measuring Maternal Behavior

A total of 32 Caucasian women and their first-born infants (16 male, 16 female) were observed in multiple naturalistic and single free-play interactions at 1-, 4- and 9-months infant age: setting and coding procedures were held constant. Infant-mother attachment quality was assessed at 1 year. Analyses examined similarities among and differences between data derived from the two interactional contexts, and the relative utility of each in explaining individual differences in attachment quality. Data from individual naturalistic observations were not as reliable as data consolidated across naturalistic observations. Additionally, maternal sensitivity, as measured by repeated naturalistic observations, was far superior to sensitivity measured in the free-play context in accounting for individual differences in attachment quality-securely attached infants experienced higher levels of maternal sensitivity than did insecurely attached infants. Conversely, it was difficult to distinguish between naturalistic and free-play measures of maternal rejection in terms of their ability to account for individual differences in attachment-at 1 month, insecure-resistant infants experienced the highest levels of maternal rejection.

Confidence in protection : Comment on Goldberg et al. (1999)

S. Goldberg, J. E. Grusec, and J. M. Jenkins (1999) presented a provocative and compelling argument for a narrow definition of infant-mother attachment that is true to J. Bowlbys (1969) original theory. In particular, S. Goldberg et al. emphasized protection as the central feature of attachment and considered the importance of such a narrow definition for empirical precision in studies of the interactional antecedents of attachment. This comment considers a number of questions raised by S. Goldberg et al.s article, including practical, theoretical, and developmental issues stemming from an attachment-as-protection perspective.

Children’s distress during intravenous placement: The role of child life specialists

ABSTRACT The purpose of this study was to assess the effectiveness of child life specialists’ intervention to minimize distress for children undergoing IV placement procedures. We hypothesized that regardless of child age or gender, children who received child life services during IV placement would exhibit less distress than would children undergoing the procedure absent a child life specialist (i.e., those with standard care). Ninety-five children were observed during IV placement at a children’s hospital, and children’s level of distress was rated by observers during the placement. Presence of child life specialist occurred randomly. Results indicated that children who had child life intervention during IV placement (n = 45) exhibited less distress than those children with standard care (n = 50), controlling for child age and typical distress during procedures. They were also more likely to have a J-Tip used during IV placement. The most common strategy employed by child life specialists was distraction, which was used for every IV placement. The results support the use of certified child life specialists (CCLS) for reducing children’s distress during painful and invasive procedures such as IV placement.

Play, Flow, and Tailoring Identity in Middle Adulthood

Identity provides a sense of meaning and direction in life by helping to clarify our role in the world and connection to others (Erikson EH: Identity: youth and crisis. Norton, New York, 1968). However, identity is not a static achievement; it evolves over time. As life circumstances change, so must the ensemble of goals, values, and beliefs that form the self and identity around which our lives revolve. There are numerous circumstances in midlife that can initiate identity change, including traumatic events (McAdams DP: The stories we live by: personal myth and the making of the self. Morrow, New York, 1993), debilitating illness (Ellis C: Qual Health Res 9(5):669–683, 1999), and challenges encountered at home or at work. In the absence of events that force change, however, identity growth depends on the willingness of the person to voluntarily step outside their comfort zone to engage in challenges sufficient to require a reorganization of priorities and goals. It is this self-initiated aspect of identity change that we focus on in this chapter, especially in relation to the use of intrinsically motivated leisure pursuits that are based on the human capacity for lifelong play (Graham KL, Burghhardt GM: Quart Rev Biol 85(4):393–418, 2010; Montagu A: Growing young. Bergin & Garvey, Boston, 1989). After articulating a framework for thinking about play, flow experience, and identity development, the chapter focuses on three men in middle adulthood who, despite having favorable life circumstances, elected to engage challenging leisure-play pursuits that helped tailor their identities and promote successful aging.

Medical professionals’ perceptions of the use of treatment rooms

ABSTRACT Although the use of treatment rooms (as opposed to the child’s hospital room) is considered the standard of care for many hospitals in the United States, little research has addressed medical professionals’ perceptions of this approach to treatment. This study examined medical professionals’ perceptions of the use of treatment rooms for intravenous (IV) procedures with young children. Physicians, nurses, child life specialists, and IV team members at a large, regional, children’s hospital completed a survey about their perceptions of the use of treatment rooms for IV insertions. Nurses and IV team members perceived greater administrative challenges and negative impacts and fewer benefits to children with the use of treatment rooms than did child life specialists. Specific concerns and challenges with the use of treatment rooms were identified. Features of an ideal treatment room were also noted. The results of this study provide valuable knowledge on how staff members perceive the use of treatment rooms and suggest greater education and explicit policies on the use of treatment rooms are needed. Furthermore, policies on the use of treatment rooms need to consider the administrative challenges identified, as well as the design features of an ideal treatment room.