Improving antenatal risk assessment in women exposed to high risks.
Abstract
Antenatal substance use and related psychosocial risk factors are known to increase the likelihood of child protection involvement; less is known about the predictive nature of maternal reflective functioning (RF) in this population. This preliminary study assessed psychosocial and psychological risk factors for a group of substance dependent women exposed to high risks in pregnancy, and their impact on child protection involvement. Pregnant women on opiate substitution treatment (n = 11) and a comparison group (n = 15) were recruited during their third trimester to complete measures of RF (Pregnancy Interview), childhood trauma, mental health and psychosocial assessments. At postnatal follow-up, RF was reassessed (Parent Development Interview - Revised Short Version) and mother-infant dyads were videotaped to assess emotional availability (EA). Child protection services were contacted to determine if any concerns had been raised for infant safety. Significant between-group differences were observed for demographics, psychosocial factors, trauma and mental health symptoms. Unexpectedly, no significant differences were found for RF or EA between groups. Eight women in the 'exposed to high risks' group became involved with child protection services. Reflective functioning was not significantly associated with psychosocial risk factors, and therefore did not mediate the outcome of child protection involvement. Women 'exposed to high risks' were equally able to generate a model of their own and their infants' mental states and should not be seen within a deficit perspective. Further research is required to better understand the range of risk factors that predict child protection involvement in high risk groups.
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Perry et al. (2015) did not find any significant relationship between PI-RF, PDI-RF and maternal emotional availability.
“Only Perry et al. (2015) did not find any significant relationship between PI-RF, PDI-RF and maternal emotional availability in a study that, however, had some methodological flaws concerning, above all, sample size and significant delay in follow-up regarding some mother-child dyads.”
From Mentalizing makes parenting work: a review about parental reflective functioning and clinical interventions to improve it (2017) · cites this paper as Perry et al., 2015
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Drury, G., Elezi, J., Kondor, L., Beeghly, M., Trentacosta, C. J., Thomason, M. E., & Stacks, A. M. (2025) · Infant Mental Health Journal · doi:10.1002/imhj.70025 · Cited by 1 · see citing works
Steinmassl, K., Eilts, J., & Paulus, M. (2026) · Developmental Review · doi:10.1016/j.dr.2026.101270 · Cited by 1 · see citing works
Thinking about parents and infants – finding a home for perinatal and infant psychiatry
Newman, L. K. (2020) · Australasian Psychiatry · doi:10.1177/1039856220953717 · Cited by 1 · see citing works
Self-citationSalo, S., Mykkänen, E., Peltonen, S., & Vänskä, M. (2024) · SSRN Electronic Journal · doi:10.2139/ssrn.4999528
Murray, N., Belmar, C. S., Sharma, S., & Subramanian, N. (2026) · Irish Journal of Psychological Medicine · doi:10.1017/ipm.2026.10229
- Authors
- Perry, N., Newman, L. K., Hunter, M., & Dunlop, A.
- Affiliations
- Hunter New England Local Health District (AU)
- Centre for Developmental Psychiatry & Psychology, Melbourne, Victoria, Australia
- University of Newcastle Australia (AU)
- Venue
- Clinical Child Psychology and Psychiatry
- Publisher
- SAGE Publications
- Published
- 2013-08-27
- Volume
- 20
- Issue
- 1
- Pages
- 84-105
- ISSN
- 1359-1045 (ISSN-L)
- 1461-7021
- OpenAlex
- W2132617457
- Cited by
- 28
- References
- 95
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 3 · 2022: 3 · 2021: 2 · 2020: 4 · 2019: 2 · 2018: 1 · 2017: 4 · 2016: 1 · 2015: 3
- FWCI
- 1.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Child Psychology and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- NOVA (University of Newcastle Australia) (submittedVersion)
- Funders
- World Health Organization
- Johns Hopkins University
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Safety Research › Child Welfare and Adoption
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- maternal reflective functioning, prenatal drug exposure, opioid substitution therapy, psychosocial risk factors, childhood trauma, maternal mental health, emotional availability, mother-infant interaction, high-risk pregnancy, deficit perspectives
- MeSH terms
- Adult, Child, Child Welfare, Female, Humans, Infant, Mother-Child Relations, Opioid-Related Disorders, Pregnancy, Pregnancy Complications, Prenatal Care, Surveys and Questionnaires, Stress, Psychological, Case-Control Studies, Risk Assessment, Young Adult, Theory of Mind, Opiate Substitution Treatment
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