Reflective functioning in mothers with drug use disorders: Implications for dyadic interactions with infants and toddlers

Abstract

In this study, we examined maternal reflective functioning as a bi-dimensional construct in a sample of 47 mothers with drug use disorders and caring for infants and toddlers. We first tested a two-factor solution with scale items from the Parent Development Interview and confirmed the presence of two related but distinct dimensions – self-mentalization and child-mentalization. We then tested predictions that (a) self-mentalization would be associated with overall quality of maternal caregiving and that (b) child-mentalization would be associated with (i) maternal contingent behavior and (ii) child communication. Results partially supported hypotheses (a) and (bii). Unexpectedly, self-mentalization alone was associated with maternal contingent behavior. Findings suggest that self-mentalization may be a critical first step in improving mother-child relations involving mothers with drug use disorders. Implications for theory and practice are discussed.

Interventions to address parenting and parental substance abuse: Conceptual and methodological considerations

“…Reflective functioning is generally low in SA parents as they struggle to separate their feelings of anger towards their situation from anger towards their child (Borelli et al, 2012). Such parents are more likely to attribute negative intentionality towards their children and respond with hostility (Dunn et al, 2002; Suchman, DeCoste, Leigh et al, 2010). Lack of emotional regulation combined with drug states limit parents’ abilities to focus on alternative explanations for their children’s negative behavior or anticipate the negative consequences of their own violent reactions (Kelley, 1998; Jansson & Velez, 1999; Miller et al, 1999).…”

“…Studies have shown that parents with SA spend less time interacting with their children (Clausen et al, 2012; Suchman, De Cosete, Leigh et al, 2010), report lower levels of satisfaction in their parental relationships (Lussier et al, 2010), initiate fewer interactions with their children in behavioral observation paradigms (Pajulo et al, 2006) and exhibit diminished bonding behaviors towards their children starting in infancy (Dunn et al, 2002). Furthermore, when mother-child dyads do interact, their exchanges are characterized by less enthusiasm or mutual enjoyment, and more conflict (Pajulo et al).…”

“…SA mothers in the U.S. are more than twice as likely to lose custody of their children than non-SA mothers (Suchman, DeCoste, Leigh, & Borelli., 2010) and when children are taken into protective services, SA mothers are least likely to comply with court orders and most likely to lose custody permanently (Barnard & McKeganey, 2004; Grella, Needell, Shi, & Hser, 2009). Parents with SUD often do not seek out SA treatment or leave treatment early for fear that they will lose custody of their children or face criminal prosecution (Niccols & Sword, 2005).…”

Advancing Optimal Development in Children: Examining the Construct Validity of a Parent Reflective Functioning Questionnaire (Preprint)

“…The application of PRF measures has expanded to different contexts such as drug-use disorders [25], mothers with childhood maltreatment [26,27], infant distress [28], and parenting programs [12,[29][30][31][32][33].…”

Socio-demographic and clinical characteristics of pregnant and puerperal crack-cocaine using women: preliminary data

“…One of the most relevant findings was the high rate of absence in the prenatal care of the users (75%), as well as the high rate of infectious diseases. Our data highlights the need for a more active process in the engagement of this special population in both prenatal care and drug treatment, favoring post-partum conditions, such as trying to avoid motherbaby separation, stimulating breast feeding, in order to build secure attachment 15 . This approach, rarely offered by public health care worldwide, could help to promote primary prevention in childhood.…”