Traumatized mothers can change their minds about their toddlers: Understanding how a novel use of videofeedback supports positive change of maternal attributions.

This study explored the use of a brief experimental intervention that integrates principles of infant-parent psychotherapy, videofeedback, controlled exposure to child distress in the context of parental posttraumatic stress disorder (PTSD), and stimulation of parental reflective functioning (RF). The Clinician Assisted Videofeedback Exposure Session (CAVES) was applied to 32 interpersonal violence-exposed mothers of very young children (8-50 months) with respect to change of maternal perception of her child. While we found no significant reduction over two videotaped assessment visits with a mental health professional, we did find a significant reduction in the degree of negativity of maternal attributions towards her child following the videotaped visit focused on the CAVES (p<.01). Maternal RF, a mother's capacity to think about mental states in herself and her child, accounted for 11% of the variance in reduction of maternal negativity after accounting for baseline levels of negativity. Clinician-assisted videofeedback appears to support emotional self-regulation of mothers with violence-related PTSD. Focusing with a therapist on videofeedback of child separation distress exposes mothers to avoided mental states of helplessness and perceived loss of protection. Negative maternal attributions may mark violent trauma-associated emotion dysregulation and projected self-representations of the maltreated mother.

Maternal reflective functioning, mother-infant affective communication, and infant attachment: exploring the link between mental states and observed caregiving behavior in the intergenerational transmission of attachment.

This study examines the link between mental representations and maternal behavior within the intergenerational transmission of attachment. Maternal reflective functioning was hypothesized to predict the quality of mother-infant affective communication based on the AMBIANCE measure. Each of these measures was also considered as a predictor of the quality of infant attachment. The subjects were 45 mothers and their 10-14-month-old infants. Results supported each of the study's major hypotheses. The AMBIANCE measure and the reflective functioning measure had a strong negative correlation. Thus, the level of disruption in mother-infant affective communication was inversely related to the level of maternal reflective functioning. The AMBIANCE measure was also shown to be a very good predictor of infant attachment. Mothers with high AMBIANCE scores were more likely to have infants classified as disorganized or resistant, whereas mothers with low AMBIANCE scores were more likely to have infants classified as secure. A linear regression analysis indicated that maternal behavior mediates the impact of maternal reflective functioning upon infant attachment. Implications for attachment theory and early intervention are explored.

Fits and Starts: A Mother-Infant Case-Study Involving Intergenerational Violent Trauma and Pseudoseizures Across Three Generations.

This case-study presents in detail the clinical assessment of a 29-year-old mother and her daughter who first presented to infant mental health specialists at age 16-months, with a hospital record suggesting the presence of a dyadic disturbance since age 8-months. Data from psychiatric and neurological assessments, as well as observational measures of child and mother are reviewed with attention to issues of disturbed attachment, intergenerational trauma, and cultural factors for this inner-city Latino dyad. Severe maternal affect dysregulation in the wake of chronic, early-onset violent-trauma exposure manifested as psychogenic seizures, referred to in the mother's native Spanish as "ataques de nervios," the latter, an idiom of distress, commonly associated with childhood trauma and dissociation. We explore the mechanisms by which the mothers' reexperiencing of violent traumatic experience, together with physiologic hyperarousal and associated negative affects, are communicated to the very young child and the clinician-observer via action and language from moment to moment during the assessment process. The paper concludes with a discussion of diagnostic and treatment implications by Drs. Marshall, Gaensbauer, and Zeanah.