What helps the mother of a preterm infant become securely attached, responsive and well-adjusted?
Abstract
Objective To investigate the relationship between the predictor variables of experiential avoidance, relationship satisfaction, prenatal expectations (compared to postnatal experience) and postpartum support, and the criterion variables of maternal attachment, maternal psychological symptoms and maternal responsiveness, after controlling for birth weight.Design A quantitative survey study.Method The participants were 127 mothers of preterm infants (delivery prior to 37 weeks gestation, <24 months corrected age) recruited through parent support organisations. The web-based survey included measures of: demographics, postpartum support and prenatal expectations (compared to postnatal experience)-all designed for this study, as well as maternal attachment, (MPAS) maternal responsiveness (MIRI), experiential avoidance (AAQ), maternal psychological symptoms (DASS-21) and relationship satisfaction (RQI). Three standard multiple regression analyses were conducted.Results The combined effects of experiential avoidance, relationship satisfaction, prenatal expectations (compared to postnatal experience) and postpartum support accounted for a significant 21% of variance in maternal attachment, Fch (4,121)=8.01, p<.001, a significant 38% of variance in maternal psychological symptoms Fch (4,121)=18.38, p<.001, and a significant 11% of variance in maternal responsiveness, Fch (4,121)=3.78, p=.013 after controlling for birth weight.Conclusion The four predictor variables predicted maternal attachment, psychological symptoms and responsiveness after controlling for birth weight, with experiential avoidance being the most important predictor, followed by prenatal expectations (compared to postnatal experience), relationship satisfaction, then postpartum support. This has implications for designing interventions to optimise attachment and responsiveness, and minimise psychological symptoms, in mothers of infants born preterm.
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Higher maternal psychological flexibility is associated with greater maternal responsiveness.
“whereas higher maternal psychological flexibility is associated with greater maternal responsiveness (Evans et al., 2012).”
From Randomized controlled trial of a brief online self-compassion intervention for mothers of infants: Effects on mental health outcomes (2021) · cites this paper as Evans et al., 2012
Experiential avoidance has been linked to psychological symptoms, parenting burden and stress for low-income families, and for parents of preterm infants and children with various disabilities.
“EA has been linked to psychological symptoms, parenting burden and stress for low-income families, and for parents of preterm infants and children with various disabilities [10–13].”
From Psychological inflexibility explains distress in parents whose children have chronic conditions (2018) · cites this paper as [11]
ACT promotes acceptance as a key mechanism of change to undermine unworkable levels of experiential avoidance, making it conceptually applicable for parents in the NICU.
“ACT differs from current mental health interventions for parents as it promotes acceptance as a key mechanism of change to undermine unworkable levels of experiential avoidance (9,10), making it conceptually applicable for parents in the NICU.”
From Exploring Acceptance and Commitment Therapy for parents of preterm infants. (2021) · cites this paper as [10]
Avoidance of thoughts and emotions surrounding the preterm birth experience may decrease a mother's sensitivity to infant cues, decrease maternal responsiveness, and impact her ability to form a secure bond with her infant.
“Avoidance of thoughts and emotions surrounding the preterm birth experience may decrease a mother's sensitivity to infant cues, and subsequently decrease maternal responsiveness, impacting her ability to form a secure bond with her infant (10).”
From Exploring Acceptance and Commitment Therapy for parents of preterm infants. (2021) · cites this paper as [10]
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- Authors
- Evans, T., Whittingham, K., & Boyd, R.
- Affiliations
- The University of Queensland (AU)
- Corresponding author
- Evans, Tracey
- Venue
- Infant Behavior and Development
- Publisher
- Elsevier BV
- Published
- 2012-02
- Volume
- 35
- Issue
- 1
- Pages
- 1-11
- ISSN
- 0163-6383 (ISSN-L)
- OpenAlex
- W2077263641
- Cited by
- 91
- References
- 67
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 9 · 2022: 9 · 2021: 10 · 2020: 6 · 2019: 8 · 2018: 6 · 2017: 6 · 2016: 10 · 2015: 8 · 2014: 7 · 2013: 6
- FWCI
- 3.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Infant Behavior and Development (publishedVersion)
- PubMed (publishedVersion)
- eSpace (Curtin University) (submittedVersion)
- Funders
- Bonnie Babes Foundation
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
- Keywords
- preterm infants, maternal attachment, maternal responsiveness, experiential avoidance, relationship satisfaction, prenatal expectations, postpartum support, birth weight, parent-infant attachment
- MeSH terms
- Adult, Female, Helping Behavior, Humans, Infant, Newborn, Infant, Premature, Maternal Behavior, Mother-Child Relations, Object Attachment, Surveys and Questionnaires, Postpartum Period, Young Adult
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