Failure to thrive: Risk for clinical disturbance of attachment?

Abstract

This study tests the hypothesis that infants with failure to thrive (FTT) are at risk for a clinical disturbance of attachment (defined as a combination of: (1) nonautonomous caregiver state of mind with respect to attachment, measured by the Adult Attachment Interview (AAI); (2) nonbalanced caregiver representation of the infant, measured by the Working Model of the Child Interview (WMCI); (3) problematic play interactions; and (4) problematic feeding interactions). Participants were 57 infants (30 FTT, 27 non‐FTT) and their primary caregivers, recruited from outpatient pediatric clinics. Caregivers were interviewed with AAI and WMCI and observed interacting with their infants during play and feeding. Results show that more infants with FTT than infants without FTT met some of the criteria for risk for a clinical disturbance of attachment —nonautonomous AAI and nonbalanced WMCI classifications, and less dyadic reciprocity during feeding. However, there were no group differences in play. Future directions for research are discussed.

The child as held in the mind of the mother: The influence of prenatal maternal representations on parenting behaviors

“…While there is a relative paucity of research linking prenatal representations with postnatal relationship quality, current research is beginning to document the influence of concurrentlyassessed parental (postnatal) representations of individual children on the parent-child relationship and parenting behaviors within these relationships (Benoit, Zeanah, Parker, Nicholson, & Coolbear, 1997;Button, Pianta, & Marvin, 2001;Coolbear & Benoit, 1999;Sayre, Pianta, Marvin, & Saft, 2001). Although these studies do not explicate the causality of the relationship, they do begin to shed light on the nature of maternal representations of individual children as they manifest in a relational context.…”

Communicating Feelings: Links Between Mothers' Representations of Their Infants, Parenting, and Infant Emotional Development

“…The WMCI has also been found to reliably discriminate clinical versus nonclinical samples of infants (e.g., Coolbear & Benoit, 1999;Benoit, Zeanah, Parker, Nicholson, & Coolbear, 1997). For example, reviewed results from a series of studies comparing the WMCI classifications of a sample of mothers of infants with sleep disorders, failure-to-thrive, or mothers of infants being seen in a general psychiatric clinic to the WMCI classifications of a matched, non-psychiatric control group.…”

Failure to Thrive as a Manifestation of Child Neglect

“…Because infants with FTT may be at risk of clinical disturbances of attachment, pediatricians should consider consultation with mental health professionals who can assist in evaluating infant-caregiver attachment. [18][19][20] Psychosocial short stature, a variant of FTT, has been described as short stature out of proportion to the decreased weight. This syndrome is thought to result from major emotional and psychological trauma.…”