Theodore J. Gaensbauer

Distorted affective communications in abused/neglected infants and their potential impact on caretakers

Abstract This report explores the ways in which personality traits of the child may contribute to disturbances in caretaker-infant interaction and lead to abuse and neglect. Forty-eight abused and/or neglected infants were observed in a structured laboratory setting. Compared with normal infants observed in the same setting, the abused/neglected infants showed a variety of distorted affective communications which interfered with mutual engagement and/or elicited negative responses in caretakers. The distortions are described under six different headings: affective withdrawal, lack of pleasure, inconsistency and unpredictability, shallowness, ambivalence/ambiguity, and negative affective communications. Clinical vignettes are presented, and the implications for therapeutic work with caretakers are discussed.

The effects of child maltreatment on security of infant-adult attachment

Thirty-two maltreated (abused and/or neglected) children (M = 18.4 months of age) were observed with their biological or foster mothers in a laboratory procedure designed to allow assessment of the security of infant-adult attachment. They were compared with 32 children and nonmaltreating mothers matched on sex, age, ethnic background, parental occupation, and parental education. Maltreatment by the mothers was associated with a marked increase in the number of insecure, particularly insecure-avoidant relationships, even toward foster mothers, but especially toward the maltreating biological mothers. By contrast, maltreatment by someone other than the mothers appeared not to affect the security of attachment between infants and mother-figures.

Regulation of emotional expression in infants from two contrasting caretaking environments.

This report addresses a series of questions concerning the reliability of ratings of emotion and the influence of age and caretaking environment on the regulation of emotional expression in infants. Three groups of 20 normal infants from middle-class backgrounds at 12-, 15-, and 18-months of age and 12 abused/neglected infants from low SES backgrounds were exposed to a playroom laboratory situation designed to elicit a range of emotional behavior. The intensities of six emotions—pleasure, interest, fear, anger, sadness, and distress—were rated at continuous intervals throughout the session. Results indicated that discrete emotions can be reliably identified, and that emotional responses show a dynamic and adaptive patterning in relation to stimulus events. Age effects were few. Differences between the normal and abused/neglected groups for almost every affect were noted, with the low SES, abused/neglected infants appearing to show less adaptive affective regulation. Journal of the American Academy of Child Psychiatry , 21, 2:163–171, 1982.

Developmental Stresses in Medical Education

In attempting to understand the nature of emotional disturbances in medical student populations, one inevitably is drawn to the study of the complex interactions between the demands of the medical school environment and the adaptive capacities of students. In our work as psychiatric consultants to the University of Colorado Medical Center Student Health Service, we have found it useful to conceptualize the four-year medical curriculum as presenting the student with a series of adaptive and development tasks. The appearance of emotional disturbance is seen to relate as much to the particular developmental stress confronting the student as to his long-standing character structure and psychopathology. In this paper, we will describe and illustrate with clinical material major developmental tasks likely to elicit emotional distress in students. Indicators of potentially adaptive versus maladaptive resolutions will be outlined, and some suggestions for helpful intervention offered. Unique issues faced by women medical students will also be reviewed.

Event Trauma in Early Childhood: Symptoms, Assessment, Intervention

Expanding research over the last two decades has documented that very young childrens responses to an event trauma will involve the same three basic categories of posttraumatic symptomatology observed in older children and adults that is, reexperiencing, numbing/avoidance, and hyperarousal. The ways in which these three symptom clusters will be manifested in very young children and recent progress in the establishment of developmentally sensitive and reliable criteria for the diagnosis of posttraumatic stress disorder (PTSD) in this age group are described. In addition to PTSD symptomatology, three additional factors that differentiate young childrens responses to a trauma from those of older children and adults-their cognitive immaturity, their developmental vulnerability, and the relational context of early trauma given young childrens dependence on caregivers-also are discussed. Principles of assessment and treatment are then described. These discussions emphasize the importance of normalizing traumatic responses, supporting the parent-child relationship and restoring trust, desensitizing the childs distress to traumatic reminders, helping the child and parents to process and develop a meaningful narrative of the traumatic event through expressive therapeutic techniques, and promoting effective strategies of restoration and repair.

Clinical Assessment in Infancy Utilizing Structured Playroom Situations

Abstract This paper describes our experience with structured playroom laboratory situations which have proven to be useful in the evaluation of social-emotional development in infants. We believe a reliable and valid clinical instrument for infants should (1) be standardized, (2) involve direct observation, (3) assess multiple lines of development, (4) represent an efficient use of time, (5) be amenable to objective measures, and (6) allow as much as possible for the expression of spontaneous and typical patterns of behavior. Major elements of the observation session include (1) free play involving the mother and her infant, (2) comparison of the infants response to a similar approach by the mother and an unfamiliar person, (3) a developmental testing situation during which the infants responses to mild frustration and his or her motivation to master the environment can be observed, and (4) a brief maternal separation and reunion. In addition to normal infants from middle and low socioeconomic backgrounds, clinical populations with which the authors have worked include abused and/or neglected and premature infants. Typical reactions of normal infants during each of the segments as well as behaviors which may be cause for clinical concern are described.

Supporting New Parents Through Home Visits Effects on Mother-Infant Interaction

In a study of family support through home visiting, paraprofessionals provided informal social support to low income parents during pregnancy and for 1 year afterward. Most infants were normal, but cases involving neurologic disorders are described as examples of the helping role of paraprofessional home visitors. Mother-infant interaction was better at 4 months in home-visited families than in controls, especially with teen and Hispanic mothers and other subgroups. Paraprofessionals can help families with developmentally disabled children in a variety of ways.

Attachment Behavior in Abused/Neglected and Premature Infants

Bowlby (1969) put forth the concept of “attachment” as a model of the mother—infant relationship which could account for clinical observations indicating that separation of the infant from its mother had quite detrimental short-term and potentially long-term effects. By integrating points of view derived from psychoanalysis, ethology, and systems theory, this construct has proved to be extremely fruitful in stimulating developmental research. The work of Bowlby, Ainsworth, Sroufe, and their respective colleagues has produced convincing evidence for viewing attachment as an organizational construct that reflects qualitative aspects of the parent—infant relationship (Ainsworth,Blehar, Waters, & Wall, 1978; Lamb, Chapter 14; Sroufe & Waters, 1977). Although originally formulated based on observations of clinical populations, most of the empirical work on attachment has been conducted on normal, middle-class groups of infants and their parents. In this chapter we would like to return to the clinical realm in order to emphasize the value of clinical study for broadening and clarifying the concept of attachment.

Patterning of emotional response in a playroom laboratory situation

The following questions are addressed in this report: (1) Can discrete emotions be rated in a meaningful and reliable manner? (2) To what extent may emotions be viewed as continuous processes which show dynamic, interacting patterns over time in relation to evocative stimuli, patterns which include the occurrence of affect “blends”? and (3) Is there evidence that emotions serve adaptive and regulatory functions in individual infants? Twenty 12-month-old infants were studied using a modified Ainsworth-Wittig paradigm. Six emotions— pleasure, interest, fear, anger, sadness, and distress were rated independently on a 9-point affect rating scale at continuous intervals over the course of the session. The patterning of affective behavior that emerged using this methodology is presented and discussed in the light of the three questions cited above.

Infant smiling at five and nine months: Analysis of heartrate and movement*

Forty infants at five months and forty infants at nine months of age were approached by a stranger in a standard experimental sequence which was monitored by motion pictures and cardiotachometer recording. Evidence supported a hypothesized relationship of cardiac acceleration during smiling but was equivocal for a hypothesized relationship of an increase in motoric activity during smiling. A third hypothesis of a cardiac-somatic coupling relationship did not receive support. Thus, it cannot be assumed that defensiveness and distress are the only elicitors of cardiac accelerations in infancy. Additional evidence is presented which suggests a “J”-shaped relationship between magnitude of heartrate (HR) change and ratings of intensity of facial expression, with the steep limb of the “J” being found in the distress part of a facial expression scale.