USA:
Irritability in Infants: an intervention study
Jude
Cassidy, Ph.D., Nathan Fox, Ph.D., Gregory Hancock, Ph.D., University
of Maryland
Irritability in infants is more than aversive and
stressful to parents; it is associated with a variety of developmental
problems. Furthermore, although infant irritability does not appear
to be a direct contributor to insecure attachment, infant irritability
does interact with our other maternal stressors such as low social
support and low-SES to contribute to an increased risk of insecure
attachment (Crockenberg, 1981; van den Boom, 1994).
Insecure attachment, in turn, is associated with a
variety of negative outcomes (see Belsky & Cassidy, 1994). Of particular
concern from a mental health perspective is mounting evidence of
links between early insecure attachment and various forms of psychopathology,
including conduct disorder, anxiety, and dissociation (see Greenberg,
in press). Given these negative outcomes, attempts to better understand
infant irritability and to intervene with irritable infants are
crucial.
The proposed study was designed to address the following
four questions:
- Can we successfully intervene with irritable, low-SES infants
to reduce infant irritability and to decrease the risk of insecure
attachment?
- Are the changes in patterns of EEG activity among irritable
infants associated with intervention?
- Is change in maternal sensitivity associated with change in
maternal "state of mind with regard to attachment"?
- How do infant irritability, care giving experiences, and attachment
interact to predict toddler behavioral inhibition and internalizing/externalizing
behavior?
This study will replicate and extend van den Boom's
(1994) intervention study, which revealed striking effects from
a relatively minor intervention. Seventy-five irritable low-SES
infants and mothers will participate in three home-based interventions
between 6 and 9 months, and 75 irritable low-SES infants and mothers
will serve as a control group. Home observations of maternal and
infant behavior will be made at 6m (pre-intervention) and 9m (immediate
post-intervention). Longer-term intervention effectiveness will
be examined with assessments of attachment (12 and 18m), maternal
and child behavior (18 and 24m), child behavioral problems (CBCL
at 24m), and behavioral inhibition (24m).
Two additions in the proposed study will permit examination
of a series of important questions: Infant EEG will be measured
at 6, 12, and 24m, permitting examination of physiological changes
associated with intervention. Maternal Attachment Interviews (at
6 and 12m) will permit examination of several important questions.
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