Affect recognition and the quality of mother-infant interaction: understanding parenting difficulties in mothers with schizophrenia

Abstract

This study investigated the quality of mother-infant interaction and maternal ability to recognise adult affect in three study groups consisting of mothers with a diagnosis of schizophrenia, mothers with depression and healthy controls. Sixty-four mothers were recruited from a Mother and Baby Unit and local children's centres. A 5-min mother-infant interaction was coded on a number of caregiving variables. Affect recognition and discrimination abilities were tested via a series of computerised tasks. Group differences were found both in measures of affect recognition and in the mother-infant interaction. Mothers with schizophrenia showed consistent impairments across most of the parenting measures and all measures of affect recognition and discrimination. Mothers with depression fell between the mothers with schizophrenia and healthy controls on most measures. However, depressed women's parenting was not significantly poorer than controls on any of the measures, and only showed trends for differences with mothers with schizophrenia on a few measures. Regression analyses found impairments in affect recognition and a diagnosis of schizophrenia to predict the occurrence of odd or unusual speech in the mother-infant interaction. Results add to the growing body of knowledge on the mother-infant interaction in mothers with schizophrenia and mothers with depression compared to healthy controls, suggesting a need for parenting interventions aimed at mothers with these conditions. While affect recognition impairments were not found to fully explain differences in parenting among women with schizophrenia, further research is needed to understand the psychopathology of parenting disturbances within this clinical group.

Parents’ Descriptions of How Their Psychosis Affects Parenting

“…Some parents also expressed that their children's need for comfort made them distressed and anxious. These results are consistent with previous studies indicating that symptoms such as delusions, hallucinations, depression, and fatigue affect parents' attention and ability to meet the child's emotional needs (Healy et al 2016;Kahl and Jungbauer 2014). Grusec and Davidov (2010) also stress that unneeded protection and comfort are inappropriate responses (Grusec and Davidov 2010).…”

Mental Health Professionals’ Perceptions of Parenting by Service Users with Psychosis

“…There is also scientific support for an association between a history of abuse and neglect and lower parental RF (Berthelot et al 2015). Clinical interventions designed to improve parental RF could usefully be offered to parents with psychosis for several reasons: the strong associations between schizophrenia and low levels of mentalization (Schiffman et al 2004;Sprong et al 2007); parents' difficulties in recognizing and coping with the child's needs and emotions (Healy et al 2016); and the negative affect of neglect and abuse on parental RF (Berthelot et al 2015).…”

“…Parents with mental illness also often have low educational attainment, unemployment, and poverty, which affect the chances of the child's practical and social needs being met (Campbell et al 2012). Symptoms such as delusions, hallucinations, cognitive impairment, and fatigue can also affect parents' attention, communication, and ability to meet the child's emotional needs (Healy et al 2016;Kahl and Jungbauer 2014). As a result of symptoms and guilt, some parents can be unaware of how their illness affects their parenting, and the child's everyday life and development (Pihkala et al 2012).…”

Looking at Intergenerational Risk Factors in Schizophrenia Spectrum Disorders: New Frontiers for Early Vulnerability Identification?

“…Within the early intervention paradigm in psychiatry (72), special attention is paid to modifiable risk factors (73,74), i.e., factors that can be manipulated by early specific and preventive interventions moderating their longitudinal role in contributing to the risk of psychosis and schizophrenia (75). With respect to intergenerational liability, one of the most important modifiable risk factors includes parenting, whose quality is strongly correlated with severity and chronicity of mother mental illness (76,77), including SSD (78)(79)(80)(81). In particular, troubled or highrisk parenting related to serious mental illness may be implicated in increased rates of insecure or disorganized attachment patterns (82)(83)(84); these specific attachment patterns, combined with an underlying neurobiological (schizotaxic) vulnerability, may exert a non-protective role for the development of SSD (85)(86)(87).…”