 |
|
Attachment Classifications Among 18-Month-Old Children of Adolescent Mothers
Lynne Andreozzi, PhD;
Patricia Flanagan, MD;
Ronald Seifer, PhD;
Susan Brunner;
Barry Lester, PhD
Arch Pediatr Adolesc Med. 2002;156:20-26.
ABSTRACT
| |
Objectives To determine (1) patterns of secure vs insecure attachment relationships
in infants of adolescent and nonadolescent mothers and (2) if these patterns
are mediated by parenting characteristics, including depression, self-esteem,
parenting stress, child abuse potential, psychological distress, rating of
infant temperament, and the caregiving environment.
Participants Fifty-one adolescent mothers and their 18-month-old infants were compared
with 76 nonadolescent mothers and their 18-month-old infants.
Main Outcome Measures Infant attachment classifications were assessed via the Ainsworth Strange
Situation. Maternal and infant characteristics were obtained through self-report
measures.
Results There were no differences in attachment classification between infants
of adolescent mothers and nonadolescent mothers. Secure attachment classification
was found in 67% of the infants of adolescent mothers and 62% of the infants
of nonadolescent mothers. There were significant differences in the self-reported
maternal characteristics. Adolescent mothers reported lower self-esteem (P<.05), more parenting stress (P<.05),
more child abuse potential (P<.05), and provided
a lower quality of home environment (P<.05) than
nonadolescent mothers. Adolescent mothers also rated their infants as having
a higher activity level (P<.05) than infants born
to nonadolescent mothers. In multivariate analysis, none of these variables
or social classes were found to affect attachment classification.
Conclusions Infants of adolescent and nonadolescent mothers show similar patterns
of attachment. Adolescent and nonadolescent mothers show substantial differences
in parenting characteristics and in how they rate their infants' temperaments.
However, these differences do not seem to impair the infant-mother attachment
relationship.
INTRODUCTION
ADOLESCENT mothers are thought to lack the skills to adequately mother
their infants. Findings suggest that adolescent mothers provide less optimal
caregiving, less sensitivity to their infants' cues, less interactive sensitivity,
and less emotional and verbal responsiveness than nonadolescent mothers.1-4 Observation
of the home environment suggests that adolescent mothers provide a less than
optimal setting for their children, including less stimulation, inconsistent
learning environments, more negative interaction, more restrictive, irritable,
hostile, and punitive responses, and a tendency to choose physical rather
than verbal modalities during interaction with their children.1, 4-8
These concerns about the parenting abilities of adolescent mothers have
been attributed to their lack of knowledge about child development in general,
a poor understanding of their infants' developmental abilities, and, probably
related, the tendency to rate their infants' behavior or temperament as being
more difficult.6, 9-10
The offspring of adolescent mothers are thought to be at risk for poor outcome
in childhood, including behavior problems, poor communicative skills, cognitive
impairment, and school failure.11-17
One possible source of later problems in the offspring of adolescent mothers
is early impairment in the mother-child attachment relationship. If adolescent
mothers provide less optimal and/or less sensitive caregiving to their infants,
it is reasonable to hypothesize that the quality of the attachment relationship
would be compromised in adolescent mother-infant dyads.
Despite nearly 3 decades of research since the advent of the Ainsworth
Strange Situation18 to qualify the attachment
relationship in a behavioral observation setting, surprisingly little is known
about attachment between adolescent mothers and their infants. Only 5 studies
have been reported19-23
but the small sample sizes used19, 21-22
and the lack of an appropriate nonadolescent comparison group makes interpreting
the results problematic.19-20,22-23
Of these 5 studies, 2 compared their adolescent sample with the Ainsworth
sample.19-20 One study found no
differences with the Ainsworth sample when insecure attachment categories
A and C were combined19; yet, another found
higher incidences of insecure attachment when compared with the Ainsworth
sample.20 Of the remaining 3, 1 study compared
attachment classifications of infants of adolescent mothers with infants of
adult mothers and no significant differences were found.21
Another study, in which a modified Strange Situation was used, compared subjects
with another sample of infants of adolescent mothers, although it is unclear
whether this second sample used the same version of the Strange Situation.22 When comparing secure vs insecure classifications
between these 2 samples, significant differences were found. In the remaining
study, which did not include a comparison group, most infants were seen as
securely attached.23
In other populations, the quality of the mother-infant attachment relationship
has been related to maternal factors, including self-esteem,24
mental illness,25-27
and stress in the family.28 Also, maternal
perceptions of infant temperament have been associated with infant behavior
in the Strange Situation.29
The purposes of this study were 2-fold. First, we wanted to study the
attachment relationship in infants of adolescent mothers in a sample with
an appropriate comparison group of older mothers and with sufficient statistical
power to detect hypothesized differences. Second, we wanted to study maternal
factors thought to differentiate adolescent mothers from older mothers that
might be related to hypothesized differences in attachment. The factors included
depression, self-esteem, parenting stress, child abuse potential, psychological
distress, mother's perception of infant behavior, socioeconomic status (SES),
and the quality of the home environment.
SUBJECTS AND METHODS
SUBJECTS
One hundred forty pairs of mothers and their 18-month-old infants (80
nonadolescent mother-infant pairs enrolled in the Providence, RI, site of
the National Institutes of Health Maternal Lifestyle Study [MLS] and 60 adolescent
mother-infant pairs) participated in the study. All subjects were initially
recruited to be part of a prospective study aimed at examining the effects
of maternal lifestyles during pregnancy on a variety of infant outcomes. The
MLS is a multisite (Providence, Miami [Fla], Memphis [Tenn], and Detroit [Mich])
longitudinal study of the effects of prenatal cocaine/opiate exposure on child
outcome conducted under the auspices of the National Institute on Child Health
and Human Development Neonatal Research Network. Adolescent mothers (<18
years) were excluded from MLS. Therefore, we recruited a separate cohort of
adolescent mothers for the current study. Recruitment of the adolescent cohort
occurred in parallel to recruitment for MLS and followed the same study protocol.
The MLS sample includes a group of infants exposed to cocaine/opiates and
a comparison group of infants not exposed. Exposure was determined by a meconium
toxicology screen followed by gas chromatography/mass spectrometry confirmation
and/or self-report.30 Only mothers who denied
cocaine/opiate use and whose infants showed negative meconium results were
included in the comparison group. This comparison group formed the older mother
group for the current study. Maternal report and meconium testing were also
used to verify that mothers in the adolescent group did not use cocaine and/or
opiates during this pregnancy. In addition, because we were interested in
the mother-infant attachment relationship, only biological mothers who had
been living with the paired infants since birth and had been the primary caretakers
of these infants were included. Primary caretaker was determined by maternal
responses to the following questions: "Who makes decisions about the baby's
care?" "Who bathes and changes the baby?" "Who feeds the baby during the day
and at night?" "Who plays with the baby the most?" This information was collected
at various time periods throughout the study. Information regarding the amount
of care provided by other caretakers, such as relatives or day care centers,
was not collected. Subjects from the adolescent group were not included if
they did not complete the research procedure (9 subjects), technical problems
were experienced during videotaping (7), the mother was not present for the
assessment and another caregiver was used (1), or the mother was not the primary
caregiver (1). The remaining 51 subjects comprised the adolescent sample.
Subjects were excluded from the sample of older mothers because the mother
was not the primary caregiver (1) or data were incomplete (3). The total number
of subjects in the nonadolescent sample was 76. The mother-infant dyads were
seen when the infants were aged 1, 4, 8, 10, and 18 months.
MEASURES
One Month Old
Demographic and medical information included maternal education, race,
parity, number of prenatal care visits, birth weight, gestational age, sex,
1- and 5-minute Apgar scores, and the amount of alcohol, marijuana, and cigarette
use during this pregnancy. Because of the nature of obtaining information
via self-report, sample sizes reflected in the tables may not total N. A continuous
measure of SES or index of social position was computed. This measure was
derived from a variety of factors, including occupation, contribution to household
income, and education. A higher score reflects higher SES.
Four Months Old
Parenting stress was measured using the Parenting Stress Inventory (PSI).31 This 36-item short-form PSI measures stress related
to parenting. The mother rates each item on a 5-point Likert scale ranging
from "strongly agree" to "strongly disagree." The PSI yields 3 subscales and
a summary index of total stress. This was the only summary index used in this
study. Higher scores reflect more parenting stress.
Maternal depression was assessed using the Beck Depression Inventory.32 The Beck Depression Inventory is a 21-item self-report
scale that measures symptoms of depression. Scale item responses range from
zero to 3 and items are summed to obtain an overall score. A higher score
reflects more depressive symptoms.
Maternal psychological distress was measured with the Brief Symptom
Inventory,33 a 53-item questionnaire that is
the short form of the Revised 90-item Symptom Checklist. The Brief Symptom
Inventory yields 9 primary symptom dimensions as well as a global severity
index. Higher scores reflect more psychological distress. Only the global
score was used.
Infant temperament was assessed with the Infant Behavior Questionnaire.34 The Infant Behavior Questionnaire is a 90-item questionnaire
administered to the mother to measure her perceptions of the infant's temperament
and behavior in everyday situations. This measure yields 6 summary scales:
Activity Level, Smiling and Laughter, Distress to Approach Sudden or Novel
Stimuli, Distress to Limitations, Soothability, and Duration of Orienting.
Eight Months Old
The Child Abuse Potential Inventory35
is a 77-item self-report scale that examines maternal psychological difficulties
such as distress, rigidity, and unhappiness, and also interactional problems
experienced by the mother, such as problems with self, family, or others.
Scores are generated for each of the factors and a total score. Only the total
score was used.
Ten Months Old
Maternal self-esteem was assessed via the Maternal Self-Report Inventory.36 The Maternal Self-Report Inventory is a 26-item scale
that yields a total score that reflects the mother's self-esteem. A higher
score indicates increased self-esteem.
The Home Observation for Measurement of the Environment (HOME)37 was administered during a home visit. This instrument
is useful for measuring the social and emotional support available within
the infant's home.37 The 45 scale items are
scored on the basis of observations of the home and on interviews with the
mother. Only the total score was used.
Eighteen Months Old
Mothers brought their children to the hospital clinic for assessment
of attachment using the Ainsworth Strange Situation.18
The Strange Situation is a laboratory procedure consisting of 8 episodes in
which the mother and child interact with each other and with a stranger unknown
to the infant, and then they are separated from and reunited with each other.
The procedure is videotaped and infant attachment classifications are assigned
based on coding of the videotape.
Infants are classified as secure (B) or 1 of 2 categories of insecure
attachment: insecure-avoidant (A) or insecure-resistant (C).18
Infants in the B category derive comfort from their mothers as evidenced by
seeking proximity to her. At the same time, B infants display a willingness
to explore the environment. Infants in the A category may ignore or snub the
mother on reunion. Infants in the C category may show a mixture of seeking
and resisting contact with the mother. These infants may display much distress
and anger regarding the mother's departure. In addition, some infants are
classified as disorganized (D).38 Infants in
the D category lack a clear attachment strategy and may display odd or disoriented
behavior such as freezing, stilling, affective instability, or apprehension
of the mother. D is not a mutually exclusive category. Infants may be classified
into 1 of the above 3 categories and also as D. Some infants may display a
mixture of both avoidant and resistant strategies and are classified as A/C.
These infants also receive a D classification. Occasionally, infants may not
be able to be classified into one of the above categories and are deemed unclassifiable
(U).
DATA ANALYSIS
Our hypothesis was that infants of adolescent mothers would more often
be classified as insecure than secure. Therefore, consistent with previous
research, for data analysis to compare secure vs insecure, we combined the
number of infants in the A and C categories and compared them with the number
of infants in the B category. Infants classified as either A/C or U were omitted
from the analyses. Separate analyses that included A/C and U categories (data
not shown) were conducted and yielded the same results included in this report.
This classification scheme is well established and was implemented by the
first author after training and certification by the third author. Interrater
reliability of the adolescent sample was evaluated on 20% of the sample with
another independent certified coder (S.B.) and was 94%. The older mother sample
was coded by either of the 2 certified coders.
We recognized the difficulty of maintaining blindness in this study
due to the physical appearance of the adolescent mothers. To help address
this issue and strengthen the study findings, we included 11 additional Strange
Situation tapes that had been previously scored from another group of mothers
aged 18 to 20 years with the tapes of the adolescent sample. These tapes were
not identified but were recoded as part of the pool of adolescent tapes and
were found to have classifications identical to their original scoring, suggesting
that scoring bias may not have occurred.
Power analysis was conducted to determine if a statistically significant
(P<.05) difference in the proportion of infants
of adolescent vs older mothers classified as secure (B) vs insecure (A or
C) could be detected with this sample size. The power was .87, which was adequate.39
Statistical analyses included t tests for continuous
data and  2 tests for categorical data to compare demographic,
medical (Table 1 and Table 2), and maternal psychological characteristics
(Table 3) between the 2 groups.
A 2 test was used to compare the distribution of attachment
classification categories between the 2 groups (Table 4) and logistic regression to predict attachment classification
from maternal age group, sociodemograhic, and maternal psychological characteristics
(Table 5).
|
|
|
|
Table 1. Maternal Demographic Characteristics by Group*
|
|
|
|
|
|
|
Table 2. Infant Demographic Characteristics by Group
|
|
|
|
|
|
|
Table 3. Tests of Significance of 6 Self-report and Observation Measures*
|
|
|
|
|
|
|
Table 4. Attachment Classification Categories for Infants of Adolescent
and Nonadolescent Mothers*
|
|
|
|
|
|
|
Table 5. Parameter Estimates for Logistic Regression Model*
|
|
|
RESULTS
DEMOGRAPHICS
Maternal demographic characteristics for the adolescent and older mother
groups are presented in Table 1.
Mothers in the nonadolescent sample were more likely to have more than 1 living
child (parity) than mothers in the adolescent sample. Mothers in the older
sample were more likely to have a higher SES than the mothers in the younger
sample. Most mothers in the adolescent sample had an index of social position,
which reflected that they were primarily in the lower and middle to lower
socioeconomic groups. Most subjects in the nonadolescent sample fell in the
middle to upper-middle class range. Similarly, level of education as measured
by number of years of school completed was significantly lower in the adolescent
group. A higher proportion of the nonadolescent mothers were married, there
were more black women in the nonadolescent group, and more Hispanics in the
adolescent group. Alcohol use during pregnancy was more common in the nonadolescent
group.
INFANT CHARACTERISTICS
Infant characteristics are presented in Table 2. There were no significant differences between the 2 groups
on birth weight, gestational age, Apgar scores, or sex. There were also no
differences in proportions of infants with birth weight less than 2500 g or
gestational age less than 37 weeks between the 2 groups.
ATTACHMENT CLASSIFICATION
Table 4 presents the distribution
of attachment category for the adolescent and adult mothers. In the adolescent
sample, 66.7% of the infants were classified as B, 17.7% were classified as
A, and 7.8% were classified as C. In the nonadolescent sample, 61.8% of the
infants were classified as B, 11.8% were classified as A, and 11.8% were classified
as C. One infant in the adolescent sample and 6 infants in the nonadolescent
sample were unable to be classified. There were 3 infants in the adolescent
group and 5 infants in the nonadolescent group that showed a mixed (A/C) classification.
In addition, 10% of the infants in the adolescent group and 19.7% of the infants
in the nonadolescent group were rated as D.
There were 13 infants (25.4%) classified as insecure (A or C) in the
adolescent group and 18 infants (23.6%) classified as insecure (A or C) in
the nonadolescent group. There were no differences in the number of secure
vs insecure infants between the 2 groups (2 = .003, P = .99). Similarly, there were no differences in the number
of disorganized infants between the 2 groups (2 = 2.27, P = .13). Neither of these 2 test results
was significant, indicating that there was no difference in the proportion
of insecurity or disorganization between the 2 groups. Additional analyses
were conducted to determine if attachment classifications differed according
to other variables of interest, such as race/ethnicity, sex, birth weight,
and gestational age. There were no differences between each of these variables
and attachment classification.
MATERNAL PSYCHOLOGICAL CHARACTERISTICS
Table 3 presents the means
and SDs for the maternal self-report and the home observation measures. There
were no differences between adolescent and nonadolescent mothers in symptoms
of depression (Beck Depression Inventory) or level of psychological distress
(Brief Symptom Inventory). However, compared with nonadolescent mothers, adolescent
mothers showed more parenting stress (PSI), lower maternal self-esteem (Maternal
Self-Report Inventory), a higher child abuse potential (Child Abuse Potential
Inventory), a higher activity level in their infant's temperament (Infant
Behavior Questionnaire), and provided a less adequate home environment (HOME).
Results of the logistic regression predicting secure vs insecure attachment
classification are presented in Table 5. As planned, variables used in the logistic regression, in addition
to the adolescent or the nonadolescent group, were those variables that differentiated
between these 2 groups, which might "explain" attachment. The logistic regression
showed a nonsignificant 2 test (2 = 5.6, P>.05) and no significant odds ratios for any of the individual
predictor variables, suggesting that none of these factors were related to
attachment classification.
COMMENT
Three of 5 previously published studies found no increase in secure
vs insecure attachment classification using the Ainsworth Strange Situation
in infants of adolescent mothers.19, 21, 23
One study that found differences used another sample of adolescent mothers
as the comparison group.22 The remaining study
used the Ainsworth sample18 for comparison.20 In findings from cross-cultural normative studies,
the modal classification is noted as secure (B).40
The previously mentioned meta-analysis40 identified
the Ainsworth sample18 as the criterion standard.
In this sample, approximately 66% of infants were classified as securely attached.18 This is virtually identical to our finding of 66.7%
secure attachment in the adolescent group. Ours is the largest study to date,
to our knowledge, with sufficient power to suggest that lack of differences
between adolescent and nonadolescent mothers was probably not due to a type
II error. Moreover, ours is the only study, of adolescent mothers to deal
with the issue of examiner blindness. Our findings suggest that infants of
adolescent mothers may resemble normative samples in the prevalence of secure
attachments to their mothers.
We did find, consistent with other findings, differences between adolescent
and nonadolescent mothers on demographic and parenting factors. Differences
on demographic factors, such as SES, marital status, parity, and education
are, of course, to be expected. Others have found lower self-esteem,41-42 higher levels of depression,42 higher child abuse potential scores,11
and poorer quality home environments among adolescent mothers.5
Differences in how adolescent mothers perceive their infant's temperament
have also been reported.10 Our findings were
similar. We found more parenting distress, lower maternal self-esteem, higher
child abuse potential scores, and poorer quality home environment in adolescent
mothers. In addition, these mothers perceived their infants as having a more
active temperament than nonadolescent mothers perceived. Although there is
reason to suspect that these factors would contribute to infant attachment
classification, we found no such relationships. The combination of adolescent
or nonadolescent mother group, sociodemographic, and parenting factors in
the logistic regression was unrelated to secure or insecure attachment classification.
To our knowledge, this is the first study to determine if parenting factors
predict attachment classification in adolescent mothers. It is interesting
that factors theoretically shown or assumed to affect the quality of the attachment
relationship, such as maternal self esteem, parenting stress, SES, and psychological
distress, were unrelated to attachment in this study. These findings support
the robustness of the attachment relationship and the results reported herein.
The Ainsworth Strange Situation18 has
been widely used and is acknowledged as the criterion standard method for
measuring attachment.40 In addition to normative
studies, this procedure has been found to differentiate among other areas
of study, including abuse and neglect,43-44
childhood aggression,45 clinical depression
in mothers,25, 27 and cross-cultural
differences in Israel,46 Japan,47
and Germany.48 Therefore, we do not attribute
our lack of differences between adolescent and nonadolescent mothers to problems
with the procedure. In addition, our coders were well trained, and as mentioned
earlier we did attempt to determine if there was bias due to the appearance
of the adolescent mothers.
A more likely explanation for our findings is that the attachment system
is robust and difficult to impair and may not be compromised by factors such
as adolescent parenting or the maternal factors that we studied. This is consistent
with attachment theory, in which attachment is viewed as a proximity promoting
system important for survival.49
We did find important differences between adolescent and nonadolescent
mothers. Adolescent mothers showed more parenting distress, lower maternal
self-esteem, higher child abuse potential scores, poorer quality home environments,
and perceived their infants as being more active. In other studies, similar
factors have been shown to affect child outcome.50-51
The differences found in the adolescent sample may affect aspects of the child
(ie, behavior and development) that we did not measure. Therefore, these factors
may still affect offspring of adolescent mothers even if they do not affect
the attachment relationship.
We did not measure other aspects of adolescent mothers that could have
influenced our results, such as social support and the adolescent mother's
developmental level and knowledge of child development. It has been
suggested51 that adolescent parenting may not invariably be associated with adversity.
The developmental process may affect the mothering experience of adolescents
and provide opportunities for intervention.51
Although the Strange Situation and the HOME were based on direct observation,
other measures were based on self-report (stress, depression, temperament,
etc). It is possible that study findings would differ with more objective
measures of some of these factors.
Although adolescent mothers are often portrayed as disadvantaged and
they clearly differ from nonadolescent mothers in potentially important areas
of parenting, our findings add to a growing body of literature suggesting
that the ability of these mothers to maintain a secure attachment relationship
with their infants is similar to that of mothers in the general population.
This and other research suggest that adolescent mothers may not be a homogeneous
group—that there are important individual differences in the parenting
ability of these mothers. If we are going to understand how these mothers
parent, how their parenting affects the outcome of their children, and how
to develop effective interventions, we will need to pay more attention to
patterns of individual differences in parenting.
| What This Study Adds
This study contributes to the knowledge of adolescent parenting and
outcome of infants of adolescent parents. Our research attempts to supplement
a weak literature base regarding the attachment relationship of infants of
adolescent mothers. Little is known about this relationship. One of the strengths
of this examination is the comparison of the target population with a demographically
similar sample, one of older nonadolescent mothers and their infants.
Here, infants of adolescent and nonadolescent mothers show similar patterns
of attachment. Adolescent and nonadolescent mothers show substantial differences
in parenting characteristics; however, these differences do not seem to impair
the attachment relationship with their infants. Therefore, there may be important
individual differences in the parenting ability of adolescent mothers.
|
|
AUTHOR INFORMATION
Accepted for publication August 7, 2001.
This study was supported in part by grant 1U10-HD27904-1 and contract
N01HD2-3159 from the Institute of Child Health and Human Development.
Presented as a poster at the Pediatric Academic Society/American Academy
of Pediatrics joint meeting, Boston, Mass, May 12, 2000.
Corresponding author and reprints: Lynne Andreozzi, PhD, Infant Development
Center, Women and Infants' Hospital, 101 Dudley St, Providence, RI 02905-2499
(e-mail: landreozzi{at}lifespan.org).
From the Infant Development Center, Women and Infants' Hospital (Drs
Andreozzi and Lester and Ms Brunner); Departments of Pediatrics (Drs Flanagan,
Seifer, and Lester) and Psychiatry and Human Behavior (Drs Seifer and Lester),
Brown Medical School, Rhode Island Hospital; and Bradley Hospital (Drs Seifer
and Lester), Providence, RI.
REFERENCES
| |
1. De Lissovoy V. Child care by adolescent parents. Child Today. 1973;2:22-25.
2. Ragozin A, Basham R, Crnic K, Greenberg M, Robinson N. Effects of maternal age on parenting role. Dev Psychol. 1982;18:627-634.
FULL TEXT
|
WEB OF SCIENCE
3. Barratt M, Roach M. Early interactive processes: parenting by adolescent and adult single
mothers. Infant Behav Dev. 1995;18:97-109.
4. Garcia Coll C, Vohr B, Hoffman J, Oh W. Maternal and environmental factors affecting developmental outcome
of infants of adolescent mothers. J Dev Behav Pediatr. 1986;7:230-236.
FULL TEXT
|
WEB OF SCIENCE
| PUBMED
5. Garcia Coll C, Hoffman J, Oh W. The social ecology and early parenting of Caucasian adolescent mothers. Child Dev. 1987;58:955-963.
FULL TEXT
|
WEB OF SCIENCE
| PUBMED
6. Parks P, Arndt E. Differences between adolescent and adult mothers of infants. J Adolesc Health Care. 1990;11:248-253.
FULL TEXT
| PUBMED
7. Culp R, Appelbaum M, Osofsky J, Levy J. Adolescent and older mothers: comparison between prenatal maternal
variables and newborn interaction measures. Inf Behav Dev. 1988;11:353-362.
8. Lawrence R, McAnarney E, Aten M, Iker H, Baldwin C, Baldwin A. Aggressive behaviors in young mothers: markers of future morbidity? Pediatric Res. 1981;15:443.
9. Roosa M, Vaughan L. A comparison of teenage and older mothers with preschool children. Fam Relat. 1984;33:259-265.
10. Field T. Interactions of preterm and term infants with their lower and middle
class teenage and adult mothers. In: Field T, Goldberg S, Stern D, Sostek A, eds. High Risk Infants and Children: Adult and Peer Interactions. New York.
NY: Academic; 1980.
11. McCullough M, Scherman A. Adolescent pregnancy: contributing factors and strategies for prevention. Adolescence. 1991;26:809-816.
WEB OF SCIENCE
| PUBMED
12. Zuravin S. Child maltreatment and teenage first births: a relationship mediated
by chronic sociodemographic stress? Am J Orthopsychiatry. 1988;58:91-103.
WEB OF SCIENCE
| PUBMED
13. Baldwin W, Cain V. The children of teenage parents. Fam Plann Perspect. 1980;12:34-43.
FULL TEXT
|
WEB OF SCIENCE
| PUBMED
14. Becker P. Sensitivity to infant development and behavior: a comparison of adolescent
and adult single mothers. Res Nurs Health. 1987;10:119-127.
PUBMED
15. Furstenberg F, Brooks-Gunn J, Morgan S. Adolescent mothers and their children later in life. Fam Plann Perspect. 1987;19:142-151.
FULL TEXT
|
WEB OF SCIENCE
| PUBMED
16. Whitman T, Borkowski J, Schellenbach C, Nath P. Predicting and understanding developmental delay of children of adolescent
mothers: a multi-dimensional approach. Am J Ment Defic. 1987;92:40-56.
WEB OF SCIENCE
| PUBMED
17. Flanagan P, Coppa D, Riggs S, Alario A. Communication behaviors of infants of teen mothers: an exploratory
study. J Adolesc Health. 1994;15:169-175.
PUBMED
18. Ainsworth M, Blehar M, Waters E, Wall S. Patterns of Attachment: A Psychological Study of
the Strange Situation. Hillsdale, NJ: Erlbaum; 1978.
19. Lamb M, Hopps K, Elster A. Strange situation behavior of infants with adolescent mothers. Inf Behav Dev. 1987;10:39-48.
20. Spieker S, Bensley L. Roles of living arrangements and grandmother social support in adolescent
mothering and infant attachment quality. Dev Psychol. 1994;30:102-111.
FULL TEXT
21. Frodi A, Grolnick W, Bridges L, Berko J. Infants of adolescent and adult mothers: two indices of socioemotional development. Adolescence. 1990;25:363-374.
PUBMED
22. Broussard E. Infant attachment in a sample of adolescent mothers. Child Psychiatry Hum Dev. 1995;25:211-219.
FULL TEXT
|
WEB OF SCIENCE
| PUBMED
23. Ward M, Carlson E. Associations among adult attachment representations, maternal sensitivity,
and infant mother attachment in a sample of adolescent mothers. Child Dev. 1995;66:69-79.
FULL TEXT
|
WEB OF SCIENCE
| PUBMED
24. Tronick EZ, Ricks M, Cohn J. Maternal and infant affective exchange: patterns of adaptation. In: Field T, Fogel A,eds. Emotion and Early Interaction. Hillsdale, NJ: Erlbaum; 1982.
25. Seifer R, Sameroff A, Dickstein S, et al. Parental psychopathology, multiple contextual risks, and one year outcomes
in children. J Clin Child Psychol. 1996;25:423-435.
FULL TEXT
|
WEB OF SCIENCE
26. Van Ijzendoorn M, Goldberg S, Kroonenberg P, Frenkel O. The relative effects of maternal and child problems on the quality
of attachment: a meta-analysis of attachment in clinical samples. Child Dev. 1992;63:840-858.
WEB OF SCIENCE
| PUBMED
27. Teti D, Gelfand D, Messinger D, Isabella R. Maternal depression and the quality of early attachment: an examination
of infants, preschoolers, and their mothers. Dev Psychol. 1995;31:364-376.
FULL TEXT
28. Vaughn B, Egeland B, Sroufe LA, Waters E. Individual differences in infant-mother attachment at twelve and eighteen
months: stability and change in families under stress. Child Dev. 1979;50:971-975.
FULL TEXT
|
WEB OF SCIENCE
| PUBMED
29. Vaughn B, Lefever G, Seifer R, Barglow P. Attachment behavior, attachment security, and temperament during infancy. Child Dev. 1989;60:728-737.
FULL TEXT
|
WEB OF SCIENCE
| PUBMED
30. Lester BM, ElSohly M, Wright LL, et al. The maternal lifestyle study: drug use by meconium toxicology and maternal
self-report. Pediatrics. 2001;107:309-317.
FREE FULL TEXT
31. Abidin R. The Parenting Stress Index Manual. Virginia: Pediatric Psychology Press; 1983.
32. Beck A, Ward C, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561-571.
33. Derogatis L. Brief Symptom Inventory (BSI): Administration, Scoring,
and Procedures Manual, Third Edition. Minneapolis, Minn: National Computer Systems Inc; 1993.
34. Rothbart M. Measurement of temperament in infancy. Child Dev. 1981;52:569-578.
FULL TEXT
35. Milner J. The Child Abuse Potential Inventory Manual. 2nd ed. DeKalb, Ill: Psytec; 1980.
36. Shea E, Tronick E. The maternal self-report inventory: a research and clinical instrument
for assessing maternal self esteem. In: Fitzgerald H, Lester B, Yogman M, eds. Theory
and Research in Behavioral Pediatrics. Boston, Mass: Plenum; 1984.
37. Caldwell B, Bradley R. Administration Manual (Revised Edition): Home Observation
for Measurement of the Environment. Little Rock, Ark: University of Arkansas;1984.
38. Main M, Solomon J. Procedures for identifying infants as disorganized-disoriented during
the Ainsworth Strange Situation. In: Greenberg M, Cicchetti D, Cummings EM, eds. Attachment in the Preschool Years: Theory, Research, and Intervention.
Chicago, Ill: University of Chicago Press; 1990:121-160.
39. Cohen J. Statistical Power Analysis for the Behavioral Sciences. New York, NY: Academic Press; 1977.
40. Van Ijzendoorn M, Kroonenberg P. Cross cultural patterns of attachment: a meta-analysis of the strange
situation. Child Dev. 1988;59:147-156.
WEB OF SCIENCE
41. Hurlbut N, Culp A, Jambunathan S, Butler P. Adolescent mother's self esteem and role identity and their relationship
to parenting skills knowledge. Adolescence. 1997;32:639-655.
WEB OF SCIENCE
| PUBMED
42. Hubbs-Tait L, Osofsky J, Hann D, Culp A. Predicting behavior problems and social competence in children of adolescent
mothers. Fam Relat. 1994;43:439-446.
FULL TEXT
|
WEB OF SCIENCE
43. Egeland B, Sroufe LA. Attachment and early maltreatment. Child Dev. 1981;52:44-52.
FULL TEXT
|
WEB OF SCIENCE
| PUBMED
44. Schneider-Rosen K, Cicchetti D. The relationship between affect and cognition in maltreated infants:
quality of attachment and the development of visual self recognition. Child Dev. 1984;55:648-658.
FULL TEXT
|
WEB OF SCIENCE
| PUBMED
45. Lyons RK. Attachment relationships among children with aggressive behavior problems:
the role of disorganized early attachments. J Consult Clin Psychol. 1996;64:64-73.
FULL TEXT
|
WEB OF SCIENCE
| PUBMED
46. Sagi A, Lamb M, Lewkowicz KS, Shoham R, Dvir R, Estes D. Security of infant-mother, father, metapelet attachments among kibbutz-reared
Israeli children. In: Bretherton I, Waters E, eds. Growing Points
of Attachment Theory and Research: Monographs of the Society for Research
in Child Development. 1985;50:257-275.
47. Miyake K, Chen SJ, Campos JJ. Infant temperament, mother's mode of interaction, and attchment in
Japan: an interim report. In: Bretherton I, Waters E, eds. Growing Points
of Attachment Theory and Research: Monographs of the Society for Research
in Child Development. 1985;50:276-297.
48. Grossmann K, Grossmann KE, Spangler G, Suess G, Unzner L. Maternal sensitivity and newborn's orientation responses as related
to quality of attachment in northern Germany. In: Bretherton I, Waters E, eds. Growing Points
of Attachment Theory and Research: Monographs of the Society for Research
in Child Development. 1985;50:233-256.
49. Bowlby J. Attachment and Loss: Vol 1: Attachment. New York, NY: Basic Books; 1969.
50. Hann D, Osofsky J, Culp A. Relating the adolescent mother-child relationship to preschool outcomes. Inf Mental Health J. 1996;17:302-309.
FULL TEXT
51. Flanagan P. Teen mothers: countering the myths of dysfunction and developmental
disruption. In: Garcia Coll C, Surrey J, eds. Mothering Against
the Odds: Diverse Voices of Contemporary Mothers. New York, NY: Guilford;
1998.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Measurement of Maternal-Infant Interaction
Horowitz et al.
J Am Psychiatr Nurses Assoc 2005;11:164-172.
ABSTRACT
Attachment Between Adolescent Mothers and Their Infants: The More We Look, the More Truth We Find
JWatch Pediatrics 2002;2002:6-6.
FULL TEXT
|
