Caregiving representations in war conditions: Associations with maternal trauma, mental health, and mother-infant interaction

Infant Ment Health J. 2020 Mar;41(2):246-263. doi: 10.1002/imhj.21841. Epub 2020 Feb 14.

Abstract

Risk features in mothers' caregiving representations remain understudied in dangerous environments where infants most urgently need protective parenting. This pilot study examines the feasibility of a novel coding system for the Parent Development Interview (PDI) interview (ARR, Assessment of Representational Risk) in assessing 50 war-exposed Palestinian mothers' caregiving representations. First, we explored the content and structure of risks in the representations. Second, we examined associations between the high-risk representations, mothers' pre- and postnatal exposure to traumatic war events (TWE), depressive and post-traumatic stress disorder (PTSD) symptoms, and self-rated emotional availability (EA) with their 1-year-old infants. Following three dimensions of high-risk caregiving representations were identified: self/dyadic dysregulation, unavailable, and fearful. Mothers' prenatal depressive symptoms were associated with dysregulating and fearful representations, and their postnatal PTSD with fearful representations. TWE were not associated with the high-risk representations. Moreover, mothers of boys reported more fearful representations, and mothers with financial difficulties reported more unavailable representations. TWE and high-risk representations were not associated with EA. However, qualitative analysis of the representations indicated risks in the mother-infant relationship. Further, older mothers and mothers with postnatal PTSD reported lower EA. Cultural variance in caregiving representations and the use of self-report measures among traumatized mothers are discussed.

Keywords: caregiving representations; emotional availability; mental health; pre- and postnatal; war trauma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Arabs / psychology
  • Armed Conflicts / psychology*
  • Caregivers / psychology*
  • Depression / epidemiology
  • Emotions
  • Feasibility Studies
  • Female
  • Humans
  • Infant
  • Male
  • Mental Health / statistics & numerical data
  • Middle Aged
  • Middle East / epidemiology
  • Mother-Child Relations / psychology
  • Mothers / psychology*
  • Parenting / psychology
  • Peripartum Period / psychology
  • Pilot Projects
  • Postpartum Period / psychology
  • Pregnancy
  • Risk Factors
  • Stress Disorders, Post-Traumatic / epidemiology*
  • Young Adult