Poster #148 - Prenatal Attachment Predicts Parental Reflective Functioning Postpartum

• In Event: 3-053 - Poster Session 10
  In Poster Session: PS 10 Section - Parenting & Parent-Child Relationships

Integrative Statement

Parental reflective functioning, or the capacity to interpret one’s child’s mental states and associations with behavior, is associated with parenting behaviors, including greater tolerance of infant distress, increased parenting sensitivity, and infant secure attachment (Luyten, Mayes, Nijssens, & Fonagy, 2017; Rutherford, Goldberg, Luyten, Bridgett, & Mayes, 2013; Stacks et al., 2014). Parental reflective functioning is thought to have three key dimensions: (i) parental level of interest and curiosity in their child’s mental states, (ii) parental certainty in the recognition of their child’s mental states, and (iii) the extent to which parents evidence an inability to mentalize and instead adopt a pre-mentalizing stance, that may include developmentally insensitive or malevolent attributions surrounding the child’s intentions (Luyten et al., 2017). However, little is known regarding the perinatal origins of parental reflective functioning.

One candidate system that may influence the development of reflective functioning that can be measured during pregnancy is the attachment system. Prenatal attachment, or the establishment of a bond between a mother and her unborn child has been widely examined (Alhusen, 2008), and consists of multiple components including (i) women’s anticipation of interacting with the baby after birth, (ii) women’s current interaction with the fetus, such as stroking their abdomen, and (iii) whether women differentiate themselves from the fetus; for example, the extent to which women acknowledge that the fetus has a personality separate from their own (Muller, 1993; Pallant, Haines, Hildingsson, Cross, & Rubertsson, 2014). Prenatal attachment predicts positive postnatal maternal-child interactions (Siddiqui & Hagglof, 2000). However, it is unclear whether prenatal attachment predicts parental reflective functioning postpartum. Given associations between attachment and reflective functioning documented postpartum (Luyten et al., 2017), we hypothesized that higher levels of prenatal attachment would predict postpartum reflective functioning.

35 pregnant women in their third trimester completed the Prenatal Attachment Inventory (Muller, 1993), mood measures (depression, anxiety, stress), and demographic variables. At 3 months postpartum, mothers completed the Parental Reflective Functioning Questionnaire (Luyten et al., 2017) and repeated the mood measures. After examination and adjustment for demographics and mood, regression analyses evidenced in pregnancy: (i) reduced differentiation of the self from the fetus (β=-0.42, p=.015) predicted a greater tendency to pre-mentalize postpartum; and (ii) greater differentiation of the self from the fetus (β=0.39, p=.039) and higher education level (β=0.47, p=.016) predicted greater interest and curiosity in the infant’s mental states postpartum.

Taken together, our findings suggest that prenatal attachment may predict parental reflective functioning postpartum. Specifically, a mother’s capacity to differentiate herself from her fetus during pregnancy appears to help her both express interest in her child’s mind and avoid misconstruing her child’s intentions. Such an approach may promote more positive interactions and attachment security postpartum for the developing child. Our results also build on prior work affirming the importance of the maternal capacity to distinguish between self and the child in parental reflective functioning (Suchman, DeCoste, Leigh, & Borelli, 2010). Further, they suggest the value of studying maternal-fetal attachment on postpartum aspects of parenting and child development.

Authors

• Lucy Gao, Yale School of Medicine
  Presenting Author

• Helena JV Rutherford, Yale Child Study Center
  Non-Presenting Author