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Patricia Crittenden

Patricia Crittenden
Family Relations Institute

PhD

About

102
Publications
97,102
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Introduction
Patricia Crittenden currently works at Family Relations Institute. Patricia does research in Attachment, Forensic Psychology, Developmental Psychology and Clinical Psychology. Her most recent publication, 'Can attachment inform decision-making in child protection and forensic settings? Infant Mental Health Journal, 39, shows that the DMM has more power & precision than ABC+D attachment.

Publications

Publications (102)
Article
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Two methods for classifying Adult Attachment Interviews (AAI) for family court decision-making, Berkeley and DMM, differ in their usefulness for family court. Both expand Ainsworth's three ABC infant categories. The Berkeley method adds a fourth Disorganised/Unresolved category in adulthood, but has low specificity and validity for risk parents. Th...
Article
Parental attachment refers to the protective and comforting role of parents toward their children. This role has been violated in cases of maltreatment. Understanding the attachment of parents who endanger their children can illuminate the psychological processes behind the harmful behaviour of parents. This paper proposes assessing parental attach...
Chapter
Attachment may have reached a turning point in which two sometimes incompatible approaches to individual differences in attachment are being compared. The outcome could influence future work in attachment. This article focuses on individual differences because applications of attachment are predicated on the consequences of individual differences f...
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Mental health treatment, child protection and forensic services for criminality need major reorganisation in conceptualisation and service provision. This need results from the failure of current diagnostic methods, administrative organisations and treatment approaches to reduce the prevalence of mental illness, child maltreatment or criminal behav...
Article
There is concern for the mental health of healthcare providers during the COVID-19 pandemic. In this article, we focus on the protective strategies that all people, but in this case healthcare providers, use when facing danger and how specific preventive responses could reduce the mental health burden to nurses, doctors, and emergency medical perso...
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Over a decade, CCPP published many articles, a special issue and two special sections that enabled the DMM to become established as an alternative to both attachment disorganization and psychiatric diagnoses. New clinical authors from many countries contributed to an empirical set of assessment validity studies and findings regarding troubled and h...
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This paper proposes that clinical practice based on psychiatric diagnoses and categories of harmful behavior may be inadequate at best and harmful at worst. An alternative model of functional family formulations is proposed based on exposure to danger, developmental processes around danger, information processing regarding danger, and strategies fo...
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The original version of this article unfortunately contained errors in the “Abstract”, “Introduction”, “Formulation” and “References.”
Chapter
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Attachment often contributes to decision-making in child care proceedings. 1 Attachment refers to the protection and comfort that caregivers provide and these are precisely the attributes threatened in child care proceedings. Assessment of attachment can reveal family mem-bers' protective strategies, the historical experiences that have shaped the...
Article
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The historic publication of the ‘consensus statement’ on not using the ‘D/disorganized’ category in the infant Strange Situation for case-specific child protection work (Granqvist, et al., 2017) opens the door for a broader discussion of different branches of attachment theory and different attachment classificatory systems applied to infants, youn...
Article
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In this brief response, we commend the commentary authors for joining a dialogue about the future of individual differences in attachment both around person-specific forensic and clinical issues and also around working together to develop theory and coding practices. We point to several areas of explicit and implicit agreement and discuss several m...
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This prospective case study illustrates the ideas on the developmental origins of some cases of autism that were described in Part 1 of this article. We explored and found support for several systemic hypotheses regarding the experience of ‘Graeme’ and his mother. Graeme’s story is told prospectively from the age of 3 until 15. Three independent so...
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Autism is a psychiatric disorder of unknown aetiology. In this article, the literature on genetic, neurological, psychological, relational and cultural causes of autism is reviewed, beginning with the 2014 review of Crittenden, Dallos, Landini et al. (pp. 64–70) up to and including recent publications in 2017. Some of the findings were unexpected;...
Article
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Attachment theory has developed over many decades - and continues to develop. Its roots lie in several seminal publications of John Bowlby (the basis of attachment theory) and Mary D. S. Ainsworth (the notion of individual differences in attachment). This paper identifies the prescient contributions of these early publications and two processes (a...
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Aims: We explored the relation between mothers' protective attachment strategies and those of their school-age children. Methods: In total, 49 child-mother dyads participated in a short longitudinal study when the children were 5.5 and 6.0 years old. Their strategies were first assessed with the Preschool Assessment of Attachment (PAA) and then...
Chapter
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Attachment often contributes to decision-making in child care proceedings. Assessment of attachment can reveal family members' protective strategies, the historical experiences that have shaped the strategies, and the underlying information processing that generates self-, partner- and child-protective behaviour. This chapter offers an approach to...
Article
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Background: Although childhood endangerment often precedes adult posttraumatic stress disorder (PTSD), the mechanism from danger to disorder is unclear. We proposed a developmental process in which unprotected and uncomforted danger in childhood would be associated with "shortcuts" in information processing that, in adulthood, could result in PTSD...
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We hypothesized that parents of child psychiatric patients would themselves show distorted psychological functioning. We tested this hypothesis by comparing the Adult Attachment Interviews (AAI) of 237 Italian parents (128 normative parents with no psychiatric involvement, 30 with a child in psychiatric care, and 79 in psychiatric care themselves)....
Article
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We hypothesized that parents of child psychiatric patients would themselves show distorted psychological functioning. We tested this hypothesis by comparing the Adult Attachment Interviews (AAI) of 237 Italian parents (128 normative parents with no psychiatric involvement, 30 with a child in psychiatric care, and 79 in psychiatric care themselves)....
Article
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This paper describes the semiotic process by which parents, as attachment figures, enable infants to learn to make meaning. It also applies these ideas to psychotherapy, with the therapist functioning as transitional attachment figures to patients where therapy attempts to change semiotic processes that have led to maladaptive behavior. Three types...
Article
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School-aged children who present for psychotherapy are often very perplexing. Their symptoms are clear and concerning, but the reasons for the symptoms are obscure. The parents describe the progress of the symptoms, but usually have little understanding of the process that resulted in problems. The children are even less informative and, when the s...
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This study tested the validity of the School-aged Assessment of Attachment (SAA) in terms of matches from the well-validated Preschool Assessment of Attachment (PAA) to the SAA 6 months later. It also addressed validity in terms of mental health services and measures of stress, depression and anxiety. Children's SAA classifications were predicted t...
Article
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This study tested the validity of the School-aged Assessment of Attachment (SAA) in terms of matches from the well-validated Preschool Assessment of Attachment (PAA) to the SAA 6 months later. It also addressed validity in terms of mental health services and measures of stress, depression and anxiety. Hypotheses: Children's SAA classifications were...
Article
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Purpose ‐ Attachment has long been considered relevant to child care proceedings. However, compared to other forms of evidence, it has been limited by the lack of consistent methods of assessment, training of experts, and empirical evidence. To reduce these limitations, The International Association for the Study of Attachment (IASA) has developed...
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Although it has been proposed that attachment is a key factor in psychopathy and violence, conceptualization of its potential role remains limited. This article uses the dynamic-maturational model of attachment and adaptation (DMM; Crittenden, 2008 ) and a case study to illustrate an etiological model of psychopathy and violence. The Adult Attachme...
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Discusses limitations in both theory of maternal sensitivity and the measures that operationalize theory. Specifically, the exact definition of sensitivity is not clear; what exactly are good attachment figures sensitive to, and methodologically, how does one know if they are sensitive? The authors discuss sensitivity as a multistep communicative p...
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Maternal cognitions regarding parenting have been studied as a means of understanding maternal parenting behavior. This article discusses memory systems and representation in relation to parenting in maltreating families. 107 maltreating and adequate mother–child dyads (mothers aged 15–38 yrs, children aged 11–48 mo) were observed 3 times at home a...
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IntroductionPTSD in childhood and adolescence: Implications for treatment of different theoretical approachesGeneral conclusionsConclusion References
Chapter
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Le ricerche sulla trasmissione dell’attaccamento tra genitori e figli sono state svolte quasi totalmente confrontando i risultati delle Strange Situation (Ainsworth, Wittig, 1969; Ainsworth, Bell, Stayton, 1971) con quelli della Adult Attachment Interview somministrate e codificate secondo il protocollo (George, Kaplan, Main, 1984–1996) e i criteri...
Chapter
Come si impara a essere genitori? In passato c’erano famiglie molto ampie, molto numerose e con molte persone di varia età al loro interno: se si era il primogenito, si imparava a occuparsi dei fratelli nati dopo, se si era nati per ultimi ci si prendeva cura dei nipoti, figli dei fratelli più grandi. Tutto intorno c’era un’atmosfera protettiva: i...
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This study compared aspects of the functioning of mothers with borderline personality disorder (BPD) to those of mothers without psychiatric disorder using two different conceptualizations of attachment theory. The Adult Attachment Interviews (AAIs) of 32 mothers were classified using both the Main and Goldwyn method (M&G) and the Dynamic-Maturatio...
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The development of autonomy is a major goal for individuals with a disabling condition This is particularly true in the transition from adolescence to adulthood The emphasis, in the past, has been upon independence from the assistance especially physical assistance, of others More recent developments in the fields of special education, adolescent d...
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The School-age Assessment of Attachment (SAA) is a newly developed clinical tool to identify pattern of attachment using the Dynamic-Maturational Model of attachment and adaptation (DMM). Seven picture cards were used to elicit fantasy stories and recalled episodes. The transcribed discourse was analyzed to yield one of 13 DMM attachment classifica...
Article
Il mio intervento ha l’obiettivo di dare una breve visione di insieme sul perché ho scelto di «rompere» con la teoria dell’attaccamento, ricordando che anche Bowlby ha «rotto» con la teoria psicoanalitica. Vi presenterò una visione della teoria dell’attaccamento che rispetto a quella comunemente accettata è diversa, per molti versi addirittura oppo...
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Nelle Unità operative di terapia intensiva neonatale (UOTIN) e nei reparti di neonatologia sono sempre più diffuse le collaborazioni tra pediatri, neonatologi e psicologi al fine di affrontare la complessità della nascita prematura non solo dal punto di vista fisico, ma anche da quello psicologico e relazionale. La nascita pretermine, infatti, è un...
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This study compared two methods for classifying preschool-age children's behavior in the Strange Situation procedure, the MacArthur (MAC) and the Preschool Assessment of Attachment (PAA), to determine whether they operationalized converging or diverging approaches to attachment theory. Strange Situations of 306 randomly selected 3-year-old children...
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This article brings together ideas from attachment and systemic family therapy. There is both growing interest among systemic practitioners in the conceptual and empirical base of attachment theory and also the need for attachment theory to expand dyadic patterning to include its context in family functioning. We propose the Dynamic-Maturational Mo...
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In order to study the impact of premature birth and low income on mother–infant interaction, four Portuguese samples were gathered: full-term, middle-class (n = 99); premature, middle-class (n = 63); full-term, low income (n = 22); and premature, low income (n = 21). Infants were filmed in a free play situation with their mothers, and the results w...
Article
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This article addresses the clinical issue of selecting assessments of attachment that are relevant to decision making for families. The validity of three commonly used methods of assessing attachment in preschool-aged children was compared using a sample of 51 low- income mother-child dyads. Thirty-eight of the children had been abused or neglected...
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This study examined pattern of attachment in cohort of women with an eating disorder to determine what types of self-protective strategies they used, and further whether there was a specific relationship between strategy and diagnosis. The participants were 62 young women with an eating disorder (19 with anorexia nervosa, 26 with bulimia nervosa an...
Article
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This article provides an overview of an attachment-based approach to formulation of behavioural and psychiatric disorder. The dynamic-maturational model (DMM) of attachment places many such problems within a context of family-attachment relationships. In the DMM, neurological maturation interacting with experience is central to the self-protective...
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Children are put at risk of emotional and physical harm when parents seek unnecessary medical care. Understanding why parents seek medical interventions that create risk for their children requires us to consider how past experiences, and the mental representations of these experiences influence current behaviour. Past experiences of danger affect...
Article
Understanding why threatened parents behave in ways that seem, from the perspective of less threatened people, to exacerbate the risk to their children requires consideration of the process of generating and selecting among dispositional representational (DR) models. This chapter addresses six forms of DRs from a memory systems perspective (Schacte...
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That was almost 30 years ago, back in the 1970's when I worked with abusing and neglecting mothers. Becky had been to my group meetings with the mothers and their children and she had seen me studying the videotapes of their interactions carefully, viewing them again and again, trying to understand the nuances of communication - or miscommunication...
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Adolescence is a period of dramatic change in attachment relationships. These changes enable attached children to become attachment figures for their spouses and children and to live safely in a world characterized by both safety and danger. Furthermore, adolescence culminates a developmental process in which interaction with parents has shaped chi...
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Los psicoterapeutas cognitivos se interesan por las implicaciones del self y el proceso de construcción del self durante la psicoterapia. Este artículo considera qué tipo de teorías de apego, con su énfasis en los procesos de desarrollo y en la función protectora de las figuras de apego, junto con la información actual de las neurociencias cognitiv...
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An extreme case of a six victim, 38-year-old recidivist sex offender was selected for examining the isomorphic relationships between child sexual abuse trauma and adult sex offenses. This sex offender had victimized children of both sexes and an adult woman. Life history, letter, file, and the Adult Attachment Interview information were analyzed to...
Article
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describe [the author's] thinking about the relations between quality of attachment and aspects of psychopathology from the perspective of mental processing of information / retell the well-known story of attachment in infancy (M. Ainsworth, 1985) in terms of the process of learning to regulate mental and interpersonal functioning / consider the eff...
Article
In this article the author begins to integrate different theoretical perspectives in order to develop a more comprehensive model of normative and disordered pathways of development, in which genetic heritage, maturation, and individual differences in experience all play a role in the development of individual differences in adaptation. Specifically...
Article
focuses on research regarding families experiencing 6 types of [child] maltreatment: physical abuse, physical neglect, abuse and neglect, sexual abuse, psychological maltreatment, and marginal maltreatment / the perspective is that the breadth and certainty of our knowledge are tied to the sophistication of methods and theories / for families with...
Article
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Although maltreatment is known to have detrimental effects on socioemotional development, the relation of those effects to type of maltreatment and child age is not clear. Most studies either focus solely on physical abuse or do not differentiate among types of maltreatment. Furthermore, most concentrate on young children. Studies of psychological...
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This article examines research on neglectful parents to develop theory on how and why neglectful behavior occurs. Using cognitive theory on information processing, four stages at which parents could fail to respond to signals of children's needs are identified. Specifically, parents could fail to respond to stimuli indicative of children's need for...
Article
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This paper integrates the work of Stern on affect regulation, Ainsworth on quality of attachment, Piaget on cognitive development, Tulving on memory systems, and Bowlby on internal representational models around the issue of promoting secure attachment. It is proposed that procedural models of the self and attachment figures develop in infancy, are...
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This is a theoretical paper about differences in quality of attachment in preschool-aged children with emphasis on the development of the goal-corrected partnership. Inferences are made about the processes underlying preschoolers' attachment behavior. Specifically, the notion of quality of attachment is expanded to explicitly include strategy, regu...
Article
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The coping strategies of four groups of maltreated children were compared with those of adequately reared children. The children were videotaped in a brief play session with their mothers, then in the Strange Situation, and finally during free play while the parent(s) were being interviewed. The coded videotapes of mother-child interaction yielded...
Article
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Difficulties in improving services for maltreated children can be attributed in part to misunderstanding of how the forces determining service availability and procedures operate. A case study of an attempt to modify one service delivery system is presented and analyzed in terms of social ecological theory. Recommendations are made for improving se...
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The relation among family relationships was explored for (a) couple pairings and (b) parent-child dyads. In S3 maltreating and adequate families, mothers' and male partners' quality of attachment (drawn from interviews) was compared with each other and with child quality of attachment (drawn from the Strange Situation). The notion of internal repre...
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Maltreatment has serious consequences for the development of children. The reason for the negative outcomes is not, however, fully understood. This study investigated the hypotheses that psychological maltreatment would be present in almost all cases of physical maltreatment and that it would be more related to detrimental outcomes for children tha...
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This study identified dimensions of home behavior of maltreating parents and their children through exploratory factor analysis. Five child factors were identified: self-directed behavior, affiliative behavior, negativity, positive social interaction, and questioning. Five parent factors were identified: positive social interaction, caretaking, dis...
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Bowlby's notion of internal representational models is explored with the purpose of clarifying the nature of such models. Distinctions are made among the concepts of (a) focus, (b) memory systems, (c) content, (d) cognitive function, (e) meta-structure, (f) quality of attachment, (g) behavioral strategies, and (h) attitude toward attachment. New te...
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Maltreating families are commonly believed to neglect or abuse a single child as a scapegoat. A family systems perspective, however, would suggest that dysfunction in one part of the family would be reflected in other parts. This study finds that reported abused children and their siblings are similar in stressful life experiences, quality of the h...
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Child homicide is a frequent cause of death in children under 6 years of age. However, compared to other, less prevalent causes of death, it is poorly understood. There is a need to identify a coherent pattern or set of patterns among cases of child homicide. Child age may be a useful explanatory variable. This study differentiated among neonatal,...
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This article applies the findings of previous research by the author and others to the management of preschool-aged maltreated children in the classroom. Such children are common in both regular and special education classrooms. Depending upon the type of maltreating home environment that they have experienced, they may be expected to display one o...
Article
This study examined the language input of mothers to their infants in three groups of mother-infant dyads: abuse, neglect, and adequate. The speech of the 10 mothers in each group was coded for well-formedness, complexity, sentence type, and accepting and rejecting content. In comparison with the neglect group mothers, the adequate group mothers sp...
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This study explored the development of young children's behavioral strategies for coping with child abuse. It was hypothesized that infants exposed to the controllingness and harshness of interaction with an abusive mother would first learn to inhibit behavior disagreeable to the mother and later learn to comply with maternal demands. It was expect...
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Attachment theory postulates that a person's internal representational model of relationships (derived from past experiences with relationships) influences the relationships which he or she later forms. If such models exist and function as described, they could explain the infrafamilial and intragenerational dysfunction found in maltreating familie...
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present the results of a series of studies, the purpose of which was to explore the nature of the individual, dyadic and family functioning in low-income maltreating and adequate families five patterns of family functioning will be described / knowledge of these patterns is relevant to the prediction and treatment of at-risk and maltreating famil...
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Infants diagnosed non-organic failure-to-thrive (NOFT) show arrested physical development. The cause of the growth delay and of the accompanying behavioral anomalies is not known, but generally is attributed to maternal deprivation. This study investigated the hypothesis that family hostility was also a contributing factor. NOFT families were compa...
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The relation between social support and child development was tested in 121 maltreating and adequate mother-child dyads. 3 patterns of social support were identified: (a) stable, open, and cooperative; (b) stable, closed, and withdrawn; and (c) unstable, open, and hostile. The maternal patterns of social support were related to the child's security...
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This study of maltreated infants offers evidence supporting a model of bidirectional effects in which the mother initiates the maltreatment but both mother and infant behave so as to maintain the situation. Maltreated infants were found not to differ from control infants in congenital characteristics. They did, however, display deviance in learned...
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The relationship between parental risk condition and parents' sensitivity to infants' cues was measured in one father-infant and 59 mother-infant dyads. Parents were videotaped at home, playing with their infants. Systematic differences in interactional patterns were found across six parental risk groups–neglectful, abusing, mentally retarded, low-...
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Theorists have long assumed that an individual's style of child-rearing was based, in large part, on his or her parents' style of parenting. The strongest evidence of such a generational effect comes from retrospective studies of disturbed adults. The present study is an attempt to provide some prospective evidence. Infants, aged 6 to 11 months, we...
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Thirty-three infants at risk for developmental delay were videotaped interacting with their mothers. Maternal position during interaction (facing, beside, or behind the infant) was strongly related to the frequency of maternal interactional behavior and to indices of infant communication and cognitive development. Intervention to teach mothers to u...