A microanalytic study of gaze and expressivity in at risk dyads: Psychotic mothers and their infants at three months of age

Maternal psychosis is an important risk factor for infant’s development, especially when maternal pathology arises before pregnancy during the first three years of infant’s life. Some observational studies of early interaction between psychotic mothers and their infants outlined the quality of maternal interaction, pointing out a lower level of maternal stimulation toward social stimuli, and slower and inadequate responding to infant’s signals, (Seifer & Dickstein, 2000, Lamour, 1989; David, 1987) compared to mothers without psychiatric symptoms. Moreover, psychotic mothers appear more hesitant and rigid during the interaction with their infants, and show tendencies to smile and talk less. Maternal behaviours seem coupled with some defensive behaviour in the infant, shown by gaze aversion or ipervigilant gaze (Fraiberg, 1982; Beebe, 2004). AIMS OF THE STUDY Our study aims to examine the communicative micro-processes of 5 psychotic mothers and their infants at 3 months of life, a period characterized in non-pathological dyads by a high level of exchange and emotional intensity during face to face interaction. In particular: To examine the pattern of associations between infant’s gaze direction and maternal timing in the course of interaction; To examine the co-occurrence of infant and maternal emotional expressions; To examine the sequential structure of the interaction, in order to have a clearer image of the misregulated episodes, for addressing clinical interventions. PARTICIPANTS 5 mothers with a diagnosis of schizophrenic psychosis and their 3 months old infants were recruited among the patients of the Psychiatric Unit of Wiesloch Psychiatric Hospital. The participants were observed under different conditions, but in this study only the face-to-face interaction will be considered PROCEDURE Mothers are requested to play freely for 5 minutes in a standardized setting into a play room in the Hospital, where also some little toys were available. The interaction was videotaped with two cameras and decoded by two trained observers of Bologna University, who were unaware of the psychiatric syntoms of the mothers. An event-based approach with temporal information was adopted to decode the sequences of five minutes interaction. The behavioural dimensions considered in this study were: infant’s gaze direction, facial expressions for both partners, maternal timing . RESULTS These data support the evidences reported in literature (Beebe, 2004; Beebe & Stern, 1977), showing a high level of gaze aversion in infants when associated to inadequate timing of maternal behaviour. Compared to at norm dyads, these results highlight disorganized gaze behaviour and a low level of positive emotions in the mutual exchanges between the mother and the infant; surprisingly, the child shows a more “depressed” emotional pattern, and a intense use of visual cut-off to signal discomfort. Gaze orientation, so, seems to be a very crucial issue to be considered both in research and in clinical intervention.