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This study examined associations between mother–infant nighttime interactions and mother–infant attachment when infants were 12 months old. Forty-four mother–infant pairs participated in this study. For three consecutive nights at home, babies were observed in their cribs using a digital video system. Mothers reported on their nighttime interactions with their babies using a self-report diary and completed a questionnaire regarding child temperament. Attachment was assessed in the Strange Situation (Ainsworth, Blehar, Waters, & Wall, 19783. Ainsworth , M. D.S. , Blehar , M. C. , Waters , E. and Wall , S. 1978. Patterns of attachment: A psychological study of the strange situation, Hillsdale, NJ: Lawrence Erlbaum Associates. View all references). Mothers of securely attached infants had nighttime interactions that were generally more consistent, sensitive and responsive than those of insecurely attached infants. Specifically, in secure dyads, mothers generally picked up and soothed infants when they fussed or cried after an awakening.
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Nighttime maternal responsiveness and infant attachment at one year
Elizabeth Higley and Mary Dozier*
Department of Psychology, University of Delaware, Newark, DE, USA
(Received 5 November 2008; final version received 10 January 2009)
This study examined associations between mother–infant nighttime interactions
and mother–infant attachment when infants were 12 months old. Forty-four
mother–infant pairs participated in this study. For three consecutive nights at
home, babies were observed in their cribs using a digital video system. Mothers
reported on their nighttime interactions with their babies using a self-report diary
and completed a questionnaire regarding child temperament. Attachment was
assessed in the Strange Situation (Ainsworth, Blehar, Waters, & Wall, 1978).
Mothers of securely attached infants had nighttime interactions that were
generally more consistent, sensitive and responsive than those of insecurely
attached infants. Specifically, in secure dyads, mothers generally picked up and
soothed infants when they fussed or cried after an awakening.
Keywords: maternal responsiveness; attachment; infants; nighttime; sleep
Introduction
Popular parenting literature (e.g., Ferber, 1985/2006), as well as many pediatricians
and psychologists (e.g., Meltzer & Mindell, 2004), suggest that parents should teach
babies to soothe themselves to sleep by not responding to their cries for attention.
These recommendations are based on evidence that parental nighttime interactions
(e.g., rocking, feeding, parental presence) initiate and maintain sleep problems
(Adair, Bauchner, Philipp, Levenson, & Zuckerman, 1991; Morrell & Cortina-Borja,
2002; Van Tassel, 1985). Attachment theory, however, suggests that parents respond
quickly and sensitively to infants’ signals (e.g., Ainsworth, Bell, & Stayton, 1974),
thus appearing at odds with this contemporary advice regarding handling sleep
issues. With several exceptions (Scher, 2001; Scher & Asher, 2004), attachment
researchers have not addressed this issue of nighttime responsiveness directly, even
though daytime responsiveness has been researched extensively. From an
evolutionary perspective, nighttime is associated with a greater likelihood of
threatening conditions than daytime (Bowlby, 1969/1982; Norluchi, Kikucki, &
Senoo, 2007), thus making the study of the attachment system during nighttime
interactions especially important. Given the emphasis in the popular literature on
teaching infants to soothe themselves to sleep, even when it involves crying for
progressively longer periods of time (Adair et al., 1991; Ferber, 1985/2006), this issue
is critical. This study examined the association between mother–infant nighttime
interactions and infant attachment security.
*Corresponding author. Email: mdozier@udel.edu
Attachment & Human Development
Vol. 11, No. 4, July 2009, 347–363
ISSN 1461-6734 print/ISSN 1469-2988 online
!2009 Taylor & Francis
DOI: 10.1080/14616730903016979
http://www.informaworld.com
The most common sleep problems in early childhood are the inability to fall asleep
alone (sleep onset problems) and problems resuming sleep alone after an awakening
(night waking problems) (Gaylor, Goodlin-Jones, & Anders, 2001). However, there are
no standard criteria or clear definitions for infant sleep problems (Goodlin-Jones,
Burnham, & Anders, 2000; Tikotzky & Sadeh, 2001). The main criterion for
determining a sleep problem is parental distress regarding infants who do not fall
asleep without their parents’ help (Ferber, 1985/2006; Gaylor et al., 2001). Further,
sleep experts have found that night waking is normal in young children (Goodlin-Jones
et al., 2000; Sadeh, 2002; Scher & Asher, 2004) and that ‘‘all children wake periodically
during the night between sleep cycles’’ (Ferber, 1985/2006, p. 62). Thus, the real issue is
in understanding why some infants cry when they wake at night and how to respond to
their cries. Ferber asserted that infants cry when they wake because they are frustrated
to find that the conditions they have learned to associate with falling asleep (e.g., being
rocked, held or patted) are no longer present and, therefore, they need to reestablish
those conditions to fall back to sleep. He cautioned that repeatedly going in to comfort
a child is ‘‘often not the best thing to do’’ and ‘‘may only be strengthening a habit, not
responding to a real need’’ (Ferber, 1985/2006, p. 99). He advised that infants learn
sleep associations that do not involve parental support or intervention, although he
also conceded more recently that parents can do whatever they feel is best ‘‘as long as it
works’’ (Ferber, 1985/2006, p. 41).
Attachment theory provides another possible explanation for the problem of
infants who cry for their parents at night. Bowlby contends that children are
biologically programmed to respond with fear to certain situations. Conditions such
as being alone and in darkness elicit fear because they signal potential danger,
regardless of the real danger. Fear-inducing situations activate the attachment
system and children display attachment behaviors (e.g., crying, protesting separa-
tion, clinging when frightened) to gain proximity to caregivers (Bowlby, 1973). These
are innate behaviors, not learned habits. Ainsworth et al. (1974) described infant
behaviors (e.g., crying, demands for contact, and intolerance of separation) that
serve a biological function but are inconvenient to caregivers. Nighttime waking,
particularly when it involves crying and demands for contact, is an example of an
aspect of early development that may be inconvenient to parents in developed
cultures. Infants, even those who have grown accustomed to the parental expectation
of transitioning to sleep alone, may be biologically predisposed to signal their
distress to these separations.
Attachment and sleep
Several studies have examined associations between attachment and sleep problems
or sleep–wake behavior. In a study of toddlers whose mothers received treatment for
their children’s sleep problem, Benoit et al. (1992) found that 100% of the mothers of
toddlers with sleep problems had non-autonomous states of mind with regard to
attachment, compared to 57% of the control group. Morrell and Steele (2003), in a
study of 14–16-month-olds with sleep problems, found that ambivalent attachment
was associated with concurrent and persistent sleep problems. Seifer, Samero,
Dickstein, Hayden, and Schiller (1996) found, in a sample of adults with emerging
psychiatric disorders, insecurely attached 12-month-olds had more parent-reported
night wakings than securely attached infants. Thus, clinical studies of infants and
toddlers suggest that sleep problems are associated with insecure attachment.
348 E. Higley and M. Dozier
By contrast, in studies with community samples of normal Israeli infants,
attachment has not been associated with sleep problems or with objective night
waking and sleep eciency. In a study of 94 1-year-old infants, Scher (2001) found
that attachment security, assessed with the Strange Situation, was not associated
with parent-reported sleep problems or actigraphic measures of sleep eciency and
night waking. Similarly, Scher and Asher (2004) found that attachment security,
assessed by the Attachment Q-Sort (Waters & Deane, 1985), was not associated with
parent-reported sleep problems, bedtime settling strategies, or actigraphic measures
of sleep eciency and night waking in 12-month-olds. Thus, these studies failed to
find support for the link between attachment and infant sleep. With the exception of
Scher (2001) and Scher and Asher (2004), these studies relied on parent report rather
than observational measures of sleep problems. Given that parents of children
diering in attachment quality may dierentially report child problems, it is critical
that observational studies be conducted.
The present study
The purpose of this study was to investigate the associations between mother–infant
nighttime interactions and mother–infant attachment security when infants were 12
months old. Unlike prior studies of attachment and sleep, this study used video
observation of nighttime interaction rather thanmaternal report or actigraphic measures
of infant sleep behavior. This methodology provides the opportunity to observe the
quality of mother–infant interactions rather than relying upon frequency counts or
durations of infant sleep behaviors, such as the number and length of awakenings.
Secure mother–infant dyads were expected to be characterized by more
consistent, sensitive, and responsive maternal behavior during nighttime interactions
than insecure dyads. According to attachment theory, the development of secure
attachment results from experiences with an available, reliable and comforting
caregiver (Ainsworth et al., 1978; Bowlby, 1969/1982). Infants in securely attached
relationships were expected to signal clearly when they woke during the night. This
hypothesis rests on the assumption that a history of responsive caregiving leads
secure infants to expect that their needs will be met quickly and sensitively.
Method
Participants
Fifty-two 12-month-old infants were recruited into the study. Digital video
observations were collected for 46 of the 52 infants. (The video recordings of two
infants were lost due to technical errors and six infants were not videotaped at all
because they either slept in the living room or in their parents’ room.) Analyses were
conducted with the 44 infants (29 male) for whom video observations were available.
Of this group, 36 were White (non-Hispanic), 4 were Asian-American, 3 were
African-American, and 1 was Biracial. Twenty-seven were first born, 15 were second
born, and 2 were fourth born. Thirty-nine infants were born full-term (37–41 weeks
gestation), 3 were post-term (over 41 weeks gestation), and 2 were premature (less
than 37 weeks gestation). Mean infant age at the time of the study was 12.8 months
(Range 11–14 months; SD ¼.77).
Mothers’ age at the time of the study ranged from 24–44 years of age
(Median ¼32). Annual family income ranged from $40,000 (US$) to $200,000
Attachment & Human Development 349
(US$) (Median ¼$92,000). Fifteen mothers described themselves as homemakers, 14
were working full-time, 14 were working part-time, and 1 was a part-time student.
Six mothers had a high school diploma, 3 had an associate’s degree, 19 had a college
degree, 11 had a master’s degree, and 5 had a professional degree or a doctoral
degree (see Table 1).
Most (57%) of the infants and their mothers were recruited by word of mouth,
14% were recruited from a university childcare center, 18% from mothers’ groups,
9% from a pediatric practice, and 2% from the workplace. Healthy, singleton infants
and their married, English-speaking mothers were included. Mothers were required
to be the primary caregivers at night, defined as providing at least 75% of the
nighttime caregiving. Exclusion criteria included any evidence of abnormal
pregnancy or delivery and chronic health problems in the mother or infant. Families
were compensated $100 (US$) for their participation. Consent was obtained from all
participating mothers.
Procedure
Data were collected in the home and in the laboratory when infants were between 11
and 14 months of age. For three consecutive nights, a video camera was placed next
to the infant’s crib to record the infant’s night of sleep, including bedtime and night
waking interactions. The video recordings were limited to events that took place
while infants were in their cribs. The total number of hours of video observation
collected for all the participants combined was 1273 with a minimum of 5 and a
maximum of 38.5 hours per participant (Median ¼28.9). Mothers were asked to fill
out a nighttime diary each morning and to complete a demographic and
temperament questionnaire in the home. After completing the nighttime observa-
tions and questionnaires at home, mothers and babies participated in the Strange
Situation Procedure (Ainsworth et al., 1978) in the laboratory.
Measures
Description of digital video system
Objective data on nighttime interactions were obtained using a digital video system.
Video/audio observations were recorded directly to a computer hard disk as digital
Table 1. Maternal and infant characteristics.
Characteristics Min. Max. M SD %
Attachment classification (% secure) 61
Infants’ gender (% male) 66
Infants’ age at time of study (months) 11.4 14.4 12.78 .77
Ethnicity of infants (% Caucasian) 82
Ethnicity of mothers (% Caucasian) 82
Mothers’ age at time of study (years) 24 44 32.61 4.60
Family income (US$) 40,000 200,000 98,629 36,209
First born (%) 61
Full-term (%) 89
Mother as main weekday
caregiver since birth (%)
64
350 E. Higley and M. Dozier
media. The base of the system is a multi port video capture card which captured
a separate audio track for each video track and gave the capture frame rate and level
of video compression desired. The computer was a standard Dell desktop with 1
megabyte of ram and a 3 gigahertz processor. A desktop computer was used because
the video capture card was not available for a laptop.
Using standard video coax cabling, two Sony color cameras designed for security
and surveillance were connected to the capture card. These fixed focus, auto iris
cameras are small, durable, cost eective, and have night vision capabilities with
built-in infrared illuminators. Typically, one camera was mounted to a microphone
stand next to the crib and the other was clamped onto a nearby shelf or piece of
furniture. The single boundary microphone was connected to a small pre-amplifier
allowing level control. The computer, microphone and amplifier were usually stored
under the crib.
There are several advantages of this system. First, it allows for capturing an
entire night without the use of time-lapse equipment and the video files can be
watched in real-time. Second, no additional eort is required of the mothers because
the system is activated each night by a pre-set timer to turn on each evening and turn
oeach morning. Third, the system is minimally disruptive to the baby’s sleep
because it is quiet and adds no visible light to the room due to the infrared
illuminators. Finally, the digital files (as opposed to videotape) provide a convenient
way to view, code and archive the data.
Overview of coding system for mother–infant nighttime interactions
The first author, blind to infant attachment status, coded each of the video files by
increasing the speed of the video/audio to 16 times normal speed during the times
that the infant appeared to be asleep and watching the events of interest (i.e.,
bedtime and night wakings) at normal speed. The following information was
recorded at bedtime: time in crib, whether put in crib awake or asleep, and whether
infant cried in crib before falling asleep. The following information was recorded for
each awakening: time awake, confidence that infant is awake, whether and how
infant vocalizes, who responds to the awakening, latency to respond to crying, and
how the infant is put back to sleep. A distinction was made between infants who
vocalized and those who signaled distress during an awakening. A vocalization was
defined as any sound emitted by the infant (i.e., coos, grunts, whimpers, babbles, or
brief cry noises) that was not sucient enough to be considered a signal of distress
(i.e., fussing or crying).
Infants diered in whether and how they signaled an awakening. Some infants
(‘‘clear signalers’’) signaled their awakenings clearly by standing at the crib railing
and crying or fussing or sitting up and crying. Their signals seemed directed at their
caregivers as though they were calling for them. Others (‘‘not clear signalers’’)
signaled more passively and with less intensity, merely vocalized, or never seemed to
wake. Thus, infants were coded as either ‘‘clear signalers’’ or ‘‘not clear signalers’’
based on their predominant method of signaling.
In terms of patterns of nighttime interaction, there were dierences in whether
and how mothers and infants interacted during the night. Some dyads had no
interaction during the night and others had multiple interactions. Some of those
interactions were smooth, in tune and responsive. Infants were responded to quickly,
picked up and later either returned to their crib to resume sleeping or taken into the
Attachment & Human Development 351
parents’ bed. Other interactions consisted of multiple attempts at soothing,
ineective soothing attempts (i.e., rubbing the baby’s back in the crib while the
baby continued to cry) or showed little consistency in the type of soothing method
used from one waking to another. Thus, each infant–mother dyad was assigned a
global code to describe its overall pattern of nighttime interaction. This was arrived
at through a two-step process.
Each signaled awakening observed during the three nights was coded according
to the following methods of responding: (1) no response/let cry, (2) let cry (at least 5
minutes) and then soothe, (3) soothe in crib (including lay back down, give pacifier,
cover with blanket, pat back), (4) pick up, (5) increase physical contact (first soothe
in crib and then pick up), (6) multiple attempts/no clear pattern (four or more
attempts at soothing or fewer than four attempts which could not be described using
one of the previous methods of responding). See Appendix A for additional details.
Second, a global code to characterize the overall pattern of nighttime interaction
per dyad was determined according to the most commonly used method of
responding per awakening across the three nights of observation. Infants who either
did not wake or did not signal distress during the three nights were coded ‘‘no wake/
no signal.’’ Infants who woke and signaled, but were usually not responded to were
coded ‘‘no response.’’ Infants who signaled distress and were usually picked up or
soothed in their cribs were coded ‘‘pick up/soothe.’’ Infants who were usually
soothed with four or more attempts at one awakening or an array of attempts across
all the awakenings were coded ‘‘multiple attempts/inconsistent.’’
To determine inter-rater reliability, 20% of the videotapes were coded by a
second rater. Observers showed agreement by coding each awakening with the same
method of responding and by coding each dyad with the same overall classification
for mother–infant pattern of nighttime interaction. There was 71% agreement
(kappa ¼.58) between coders on the method of responding assigned to each
awakening. There was 89% agreement (kappa ¼.85) between coders on the
assignment to category for child signaling and to pattern of nighttime interaction,
which served as the primary data for analyses.
Maternal self-report of nighttime interactions
A nighttime self-report diary allowed mothers to report bedtime and night waking
interactions. This was used as an adjunct to the video observations. Mothers
reported on how infants were put to sleep at bedtime and what transpired if infants
woke during the night, such as whether a parent responded to the awakening and
how the infant fell back to sleep. The measure was based on Anders’ sleep–wake
diary (Goodlin-Jones, Burnham, Gaylor, & Anders, 2001) and Sadeh’s Brief Infant
Sleep Questionnaire (Sadeh, 2005).
Mother–infant attachment relationship
Attachment was assessed using the Strange Situation Procedure (Ainsworth et al.,
1978). This 24-minute laboratory task is designed to increasingly stress the infant to
assess his or her reliance on the mother for comfort during distress. The infant and
mother are separated and reunited twice and the infant’s attachment behaviors
during the reunion episodes are coded in terms of proximity-seeking, contact
maintenance, resistance, and avoidance (Ainsworth et al., 1978). Infant–mother
352 E. Higley and M. Dozier
dyads are assigned to one of four classifications: secure, avoidant, resistant, or
disorganized. Upon reunion, infants classified as secure (B) seek out whatever
contact is needed and calm easily in the presence of their mothers. Infants classified
as avoidant (A) turn away from their mothers when distressed. Infants classified as
resistant (C) show angry resistance to attempts by their mothers to calm them.
Infants classified as disorganized (D) appear to lack a strategy for dealing with
distress in the mother’s presence or show a breakdown in their strategies for dealing
with distress. For the purposes of this study, infant–mother dyads were grouped as
either secure (B) or insecure (A, C, or D) because of the small sample size.
Four trained coders (not including the coders of nighttime interaction) were
used to classify the infant–mother attachment relationship. Each attended a 2-week
training course on coding organized patterns of attachment (ABC) oered by Alan
Sroufe and disorganized patterns of attachment (D) oered by Elizabeth Carlson or
Mary Main, all experts in the assessment of attachment. All coders had passed
reliability tests for classifying organized attachment, achieving at least 80% agreement
with the expert coders. Two of the four coders had also passed reliability tests for
classifying disorganized attachment, achieving at least 80% agreement with the expert
coders. All Strange Situations were double-coded. Each pair of raters included one
rater reliable on coding disorganized attachment. When there were disagreements
between raters, the procedure was coded by a third reliable coder (i.e., the other coder
who was reliable on organized and disorganized attachment), with final classifications
determined by conferencing of the three coders. In this sample, the agreement between
raters was 75% agreement (kappa ¼.47) for secure versus insecure classifications used
in analyses here. (Agreement was 77% for three-category distinctions, and 68% for
four-category distinctions, with kappas of .54 and .49, respectively.) Although this
level of agreement is somewhat lower than often obtained, this is compensated for by
the use of two raters on every Strange Situation, rather than only for a subset. Thus,
all Strange Situation classifications were concordant at the level of the 4-way
classification, or involved a third coder who independently coded and conferenced
with the first two coders to determine classification.
Maternal perceived temperament
Temperament has been associated with attachment status and maternal sensitivity
(Seifer, Schiller, Samero, Resnick, & Riordan, 1996); therefore, infant temperament
data were collected from mothers. Perceived temperament was assessed using five
subscales from the Revised Infant Behavior Questionnaire (IBQ-R; Gartstein &
Rothbart, 2003). The five subscales are Distress to Limitations, Fear, Soothability,
Cuddliness, and Smiling and Laughter. The IBQ-R is a 184-item instrument that
assesses 14 dimensions of temperament in infants between the ages of 3 and 12
months. Parents indicate on a 7-point scale (never to always) how frequently their
infants responded to events (e.g., visiting a new place) in specific ways during the
past week. An initial evaluation of the IBQ-R supports the reliability and validity of
the instrument (Gartstein & Rothbart, 2003).
Results
Results are presented in the following order. First, the sample is described in terms of
attachment classification. Second, preliminary analyses conducted to examine any
Attachment & Human Development 353
confounding variables are presented. Third, the sample is described in terms of
infant and mother nighttime behaviors. Finally, the central study hypotheses
regarding the dierences in the ways secure and insecure mother–infant dyads
interact at night are presented.
Attachment classifications
Sixty-one percent (N¼27) of the infants were classified secure in the Strange
Situation, 27% (N¼12) were classified disorganized, 7% (N¼3) were classified
resistant, and 5% (N¼2) were classified avoidant. Of the infants classified
disorganized, 5 had secondary secure classifications, 6 had secondary resistant
classifications, and 1 had a secondary avoidant classification. To allow sucient
power to detect dierences, attachment was considered as a dichotomous variable.
Thus, 61% (N¼27) were classified secure and 39% percent (N¼17) were classified
insecure (avoidant, resistant, or disorganized).
Preliminary analyses
Preliminary analyses were conducted to examine associations between attachment
and temperament. T-tests of maternal perceived temperament (five subscales) and
attachment at 12 months showed no significant dierences for secure and insecure
dyads (see Table 2). In addition, temperament was not correlated with either the
infants’ rate of signaling their distress after an awakening or the overall pattern of
nighttime interaction. Clear signaling was correlated with two temperament
subscales (Distress to Limitations .339 and Fear .341). Compared with insecure
infants, more secure infants had mothers who were their main caregivers during the
weekday, w
2
(1, N¼44) ¼6.04, p¼.01. No other associations between demo-
graphic variables and attachment were significant.
Infant and mother behaviors at night
Infant and mother nighttime behaviors are described in five areas: how infants are
put to sleep at bedtime, how often infants wake in their cribs during the night, how
often infants signal their awakenings by fussing or crying, how often mothers
respond to the infants’ signaled awakenings, and whether infants are taken into the
parents’ bed after an awakening (see Table 3). First, mothers reported on whether or
not they stayed with their babies until the infants had fallen asleep at bedtime for
each of the three nights of observation. Thirty-five percent reported staying all three
Table 2. Preliminary analyses of associations between attachment and temperament.
Temperament subscales Secure (N¼27) Insecure (N¼17)
1. Distress to limitations M ¼3.66 M ¼3.26
2. Fear M ¼3.11 M ¼2.89
3. Soothability M ¼5.22 M ¼5.33
4. Cuddliness M ¼5.59 M ¼5.60
5. Smiling and laughing M ¼5.36 M ¼5.46
Note: *p5.05.
354 E. Higley and M. Dozier
nights, 9% stayed two nights, 4% stayed one night, and 48% never stayed. Second,
the number of awakenings observed across the three nights while babies slept in their
cribs ranged from 0 to 11 (N¼44, M¼3.77, SD ¼2.78). Third, the number of
times babies were observed across the three nights to signal that they were awake by
fussing or crying ranged from 0 to10 (N¼41, M¼3.12, SD ¼2.69). Fourth, the
number of times mothers were observed across the three nights to respond to babies
who signaled their awakening with fussing or crying ranged from 0 to 9 (N¼34,
M¼2.8, SD ¼2.56). Finally, 75% of mothers (N¼33) reported that they never
brought their babies into their beds after an awakening and 25% (N¼11) reported
taking their babies into their beds at least one of the three nights. There were no
dierences between secure and insecure dyads in any of these behaviors.
Mother–infant nighttime interactions
Clear signaling of awakenings
It was hypothesized that secure infants would be more likely than insecure infants to
signal their awakenings clearly. There were no significant dierences in the
percentage of infants who signaled clearly as a function of attachment, w
2
(1,
N¼44) ¼3.20, p¼.07, although the percentage of infants who signaled clearly
tended to be higher for securely attached than insecurely attached infants. For the
securely attached infants, 63% were ‘‘clear signalers’’ and 37% were ‘‘not clear
signalers.’’ For the insecurely attached infants, 35% were ‘‘clear signalers’’ and 65%
were ‘‘not clear signalers’’ (see Table 4).
Patterns of mother–infant nighttime interaction
To investigate the hypothesis that secure infants are more likely to have consistent,
sensitive, responsive maternal behavior during nighttime interactions than insecure
infants, a 2 (attachment classification: secure vs. insecure) x 4 (pattern of nighttime
interaction: no wake/no signal vs. no response vs. pick up/soothe vs. multiple
Table 3. Ranges, means, standard deviations and percentages for infant and mother
behaviors during night wakings.
Variable (observed across the three nights) Min. Max. M SD %
1. Percent of mothers who put babies to bed awake 48
2. Number of infant awakenings in crib 0 11 3.77 2.78
3. Number of signaled awakenings in crib 0 10 3.12 2.69
4. Number of caregiver responses to signaled awakenings 0 9 2.8 2.56
5. Percent of mothers who took babies into
their beds after an awakening at least one night
25
Table 4. Clear signaling of awakenings in securely and insecurely attached infants.
Clear signaling of awakenings Secure dyads (N¼27) Insecure dyads (N¼17)
Infants who signal clearly 17 (14.1) 6 (8.9)
Infants who do not signal clearly 10 (12.9) 11 (8.1)
Attachment & Human Development 355
attempts/inconsistent) Pearson chi-square analysis was performed. The patterns of
nighttime interaction diered by attachment security, w
2
(3, N¼44) ¼11.04,
p5.01. The results are shown in Table 5 and Figure 1.
Secondary analyses were performed to identify which patterns of nighttime
interaction dierentiated secure and insecure dyads. A series of chi-square goodness
of fit tests were performed. The results indicated that securely and insecurely
attached dyads diered significantly for the ‘‘pick up/soothe’’ pattern of nighttime
interaction, w
2
(1, N¼14) ¼7.14, p5.01, with the mothers of secure infants more
likely to pick up and soothe infants who woke and signaled. For the ‘‘no wake/no
signal,’’ ‘‘no response,’’ ‘‘multiple attempts/inconsistent’’ patterns, the results were as
follows: w
2
(1, N¼10) ¼.40, p¼.53, w
2
(1, N¼10) ¼3.6, p¼.06, w
2
(1,
N¼10) ¼1.6, p¼.21, respectively.
Discussion
The purpose of this study was to investigate the dierences between secure and
insecure mother–infant dyads in the way they interact at night when infants are 12
Table 5. Patterns of nighttime interactions in secure and insecure dyads.
Patterns of nighttime interactions
Secure dyads
(N¼27)
Insecure dyads
(N¼17)
Number of infants who do not wake or signal 4 (6.1) 6 (3.9)
Number of infants who signal and no one responds 8 (6.1) 2 (3.9)
Number of infants who signal and are
picked up or soothed in crib
12 (8.6) 2 (5.4)
Number of infants who signal and caregiver
responds with multiple attempts or inconsistently
3 (6.1) 7 (3.9)
Figure 1. Patterns of mother–infant nighttime interactions for secure and insecure dyads.
356 E. Higley and M. Dozier
months old. Patterns of nighttime interaction were significantly dierent for secure
and insecure dyads. The interactions most characteristic of secure dyads involved
infants signaling their awakenings with fussing or crying and mothers responding
quickly by picking up and soothing the baby. These interactions were usually
smooth, the responses were generally in tune with the baby’s signals, and the
methods of responding were similar from one awakening to the next.
To further explore dierences in nighttime interactions between secure and
insecure dyads, each pattern of interaction was examined independently. First,
comparisons were made between securely and insecurely attached infants who never
woke or never signaled distress. There were no significant dierences. In other words,
‘‘good sleepers’’ (i.e., infants who do not disturb their parents during the night either
because they never wake or they never make their awakenings known to their
parents by fussing or crying) are not significantly more likely to be securely attached
than insecurely attached. Second, comparisons were made between mothers in secure
and insecure dyads who generally did not respond to their infants’ signaled
awakenings. There were no significant dierences, although mothers in secure dyads
were more likely to use the ‘‘no response’’ pattern of interaction than mothers in
insecure dyads. Third, comparisons were made between mothers in secure and
insecure dyads who generally picked up and soothed their infants when they woke
and fussed or cried. As expected, mothers of secure infants were significantly more
likely to be characterized by the ‘‘pick up/soothe’’ pattern of interaction than
mothers of insecurely attached infants. Finally, comparisons were made between
mothers in secure and insecure dyads who generally made multiple soothing
attempts or were inconsistent in terms of the ways they responded across all
awakenings. There were no significant dierences between mothers in secure and
insecure dyads. Thus, the overall finding that the patterns of nighttime interaction
vary by attachment classification is due to mothers in secure dyads being more likely
to pick up and soothe their infants when the infants wake and fuss or cry during the
night as compared to mothers in insecure dyads.
In terms of how infants signaled their awakenings, dierences were in the
direction of securely attached infants signaling their awakenings more clearly than
insecurely attached infants, but the dierence was not significant. The power to
detect dierences was weak in this study. It is plausible that dierences would have
reached significance with a larger sample size. However, it is also possible that the
expected association between attachment and clear signaling does not exist.
Viewed in light of attachment theory and research, the results of the present
study can be interpreted as showing that consistent, sensitive responses to infant
signals of distress relate to attachment security, even at night. In other words,
mothers of securely and insecurely attached infants are not dierent in terms of how
frequently they respond to their infants’ signaled awakenings; they are dierent in
that, when they respond, mothers of securely attached infants are more likely to
respond sensitively and consistently. In a meta-analysis on parental antecedents of
infant attachment, De Woland van IJzendoorn (1997) found that sensitivity (i.e.,
the ability to perceive the infant’s signals accurately and respond promptly and
appropriately) is a better predictor of attachment than contiguity of response (i.e.,
the promptness or frequency of the mother’s responses, not taking into account
appropriateness). This may explain why this present study found associations
between attachment and the quality of mothers’ responses to awakenings, but not
their frequency of responding.
Attachment & Human Development 357
van IJzendoorn and Hubbard (2000) found that mothers of avoidant infants
actually picked up their crying infants more quickly than other mothers. Although
the number of avoidant infants in our study was too small (n¼2) to allow specific
comparisons, the van IJzendoorn and Hubbard finding is interesting to consider as
related to our findings more generally. van IJzendoorn and Hubbard interpreted
their findings to suggest that mothers whose infants are avoidantly attached to them
may pick them up ‘‘too quickly’’ because of discomfort in hearing the cry. A lack of
power did not allow a full test of this possibility.
It is interesting to compare this data set with the findings from prior studies of
attachment and sleep. In terms of bedtime settling practices, about half (52%) of the
mothers reported staying with their babies until babies fell asleep at bedtime. Thus,
putting 12-month-old babies to bed asleep is common despite cautions against such
practices. Furthermore, whether mothers helped their infants transition to sleep was
not related to attachment, which is consistent with the findings of prior studies
(Scher & Asher, 2004). In terms of night waking, the majority of infants (93%) had
at least one night waking during the three nights of observation. Scher (2001)
reported that more than 50% of the 12-month-olds were classified as nightwakers. In
the present study, the rate of waking did not relate to attachment security. Although
some prior studies reported that insecure 12-month-olds were more likely to awaken
(Seifer et al., 1996), that finding was based on maternal report from a sample of
mothers with mental illness. In studies that used community samples (Scher, 2001;
Scher & Asher, 2004), security of attachment was not related to frequency of
nightwaking. Thus, it seems that there is not evidence that how often infants wake at
night is related to attachment, at least in a low-risk sample.
Limitations and future directions
This study has several limitations that limit generalization of the results. First, the
sample was small, self-selected and consisted mostly of upper-middle class non-
Hispanic white mothers. Second, the cross-sectional design does not allow for an
examination of whether and how mother–infant interactions changed over time.
Third, the digital video recordings captured only those interactions that occurred
while infants were in their cribs. Thus, how mothers and infants interacted when
babies were out of their cribs or whether mothers responded dierently ocamera or
during nights other than the three that were recorded is not known. Finally, the rate
of disorganized attachment (27%) was high for this low-risk sample. In typical,
middle class families, about 15% of infants develop disorganized attachments (van
IJzendoorn, Schuengel, & Bakersmans-Kranenburg, 1999). Mothers were recruited
largely by word of mouth and told that the purpose of the study was to learn more
about what mothers do at night, how their babies sleep, and how it relates to
mother–infant interactions during the day. It is not clear why the majority of the
infants classified as insecure were disorganized, but it may be that the findings only
relate to disorganized attachment.
Nonetheless, this study provides important new information about the
dierences in the patterns of interactions between secure and insecure mother–
infant dyads. A prospective, longitudinal study needs to be conducted with larger
samples to verify and expand on these patterns and to help in understanding how
these patterns develop over time. A larger sample would also provide the power to
evaluate how dierent attachment classifications relate to patterns of nighttime
358 E. Higley and M. Dozier
interaction. Future research should include measures that allow for an examination
of the consistency between daytime and nighttime interactions in terms of sensitivity
and attachment. To do so, it may be necessary to observe mothers and infants during
the day in somewhat stressful contexts that trigger the attachment system (Smith &
Pederson, 1988).
Summary
In conclusion, this study examined the association between attachment quality and
mother–infant interaction at night. It combined the well-established assessment of
attachment (i.e., Ainsworth’s Strange Situation) with new digital video technology
that captured naturalistic mother and infant interactions during the night in real-
time with minimal disruption. The focus was on observing the interactions of a low-
risk community sample as opposed to those seeking treatment for a perceived sleep
problem in their infants.
The primary finding was that mothers of securely attached infants had nighttime
interactions that were generally more consistent, sensitive and responsive than those
of insecurely attached infants. Specifically, in secure dyads, mothers generally picked
up and soothed infants when they woke and fussed or cried. In insecure dyads,
mothers generally made multiple soothing attempts and tended to be inconsistent in
terms of the methods of responding they used across all awakenings. Secure and
insecure dyads did not dier significantly in terms of whether there was generally no
contact between mothers and infants during the night or whether mothers generally
soothed infants during the night. This study suggests that, at least in terms of
attachment security, it is not simply whether the infant wakes or whether the mother
responds to the infant’s fussing or crying during awakenings, but rather, for those
mothers who generally do respond, whether the response is sensitive, consistent and
in tune with the baby’s needs.
Acknowledgements
This research was supported in part by National Institutes of Mental Health grants 52135 and
74374 to the second author. We thank Elizabeth Peloso for her help developing the
methodology and the families who participated in the study.
References
Adair, R., Bauchner, H., Philipp, B., Levenson, S., & Zuckerman, B. (1991). Night waking
during infancy: Role of parental presence at bedtime. Pediatrics,87, 500–504.
Ainsworth, M.D.S., Bell, S., & Stayton, D. (1974). Infant–mother attachment and social
development: Socialization as a product of reciprocal responsiveness to signals. In M.
Richards (Ed.), The integration of the child into the social world (pp. 99–135). Cambridge:
Cambridge University Press.
Ainsworth, M.D.S., Blehar, M.C., Waters, E., & Wall, S. (1978). Patterns of attachment: A
psychological study of the strange situation. Hillsdale, NJ: Lawrence Erlbaum Associates.
Benoit, D., Zeanah, C.H., Boucher, C., & Minde, K.K. (1992). Sleep disorders in early
childhood: Associations with insecure maternal attachment. Journal of American Academy
of Child and Adolescent Psychiatry,31, 86–93.
Bowlby, J. (1973). Attachment and loss. Vol. 2: Separation: Anxiety and anger. New York:
Basic Books.
Bowlby, J. (1982). Attachment and loss. Vol. 1: Attachment (2nd ed.). New York: Basic Books.
(Original work published 1969).
De Wol, M.S., & van IJzendoorn, M.H. (1997). Sensitivity and attachment: A meta-analysis
on parental antecedents of infant attachment. Child Development,68, 571–591.
Attachment & Human Development 359
Ferber, R. (2006). Solve your child’s sleep problems. New York: Simon and Schuster. (Original
work published 1985).
Gartstein, M.A., & Rothbart, M.K. (2003). Studying infant temperament via the revised
infant behavior questionnaire. Infant Behavior and Development,26(1), 64–86.
Gaylor, E.E., Goodlin-Jones, B.L., & Anders, T.F. (2001). Classification of young children’s
sleep problems: A pilot study. Journal of the American Academy of Child and Adolescent
Psychiatry,40, 61–67.
Goodlin-Jones, B.L., Burnham, M.M., & Anders, T.F. (2000). Sleep and sleep disturbances:
Regulatory processes in infancy. In A.J. Samero, M. Lewis, & S.M. Miller (Eds.),
Handbook of developmental psychopathology (2nd ed., pp. 309–325). New York: Kluwer
Academic/Plenum Publishers.
Goodlin-Jones, B.L., Burnham, M.M., Gaylor, E.E., & Anders, T.F. (2001). Night waking,
sleep–wake organization, and self-soothing in the first year of life. Developmental and
Behavioral Pediatrics,22, 226–233.
Hayes, M.J. (2002). Methodological issues in the study of arousals and awakenings during
sleep in the human infant. In P. Salzarulo & G. Ficca (Eds.), Awakening and Sleep-wake
Cycle Across Development (pp. 23–46). Amsterdam: John Benjamins Publishing.
Meltzer, L.J., & Mindell, J.A. (2004). Nonpharmacologic treatments for pediatric sleepless-
ness. Pediatric Clinics of North America,51, 135–151.
Morrell, J., & Cortina-Borja, M. (2002). The developmental change in strategies parents
employ to settle young children to sleep, and their relationship to infant sleeping problems,
as assessed by a new questionnaire: The parental interactive bedtime behaviour scale.
Infant and Child Development,11, 17–41.
Morrell, J., & Steele, H. (2003). The role of attachment security, temperament, maternal
perception, and care-giving behavior in persistent infant sleeping problems. Infant Mental
Health Journal,24, 447–468.
Norluchi, M., Kikuchi, Y., & Senoo, A. (2007). The functional neuroanatomy of maternal
love: Mother’s response to infant’s attachment behaviors. Biological Psychiatry,63, 415–
423.
Sadeh, A. (2002). Sleep fragmentation and awakening during development: Insights from
actigraphic studies. In P. Salzarulo & G. Ficca (Eds.), Awakenings and sleep–wake cycles
across development (pp. 199–211). Amsterdam: John Benjamin Publishing.
Sadeh, A. (2005). A brief screening questionnaire for infant sleep problems: Validation and
findings for an internet sample. Pediatrics,114, 570–577.
Scher, A. (2001). Attachment and sleep: A study of night waking in 12-month-old infants.
Developmental Psychobiology,38, 274–285.
Scher, A., & Asher, R. (2004). Is attachment security related to sleep–wake regulation?
Mothers’ reports and objective sleep recordings. Infant Behavior and Development,27,
288–302.
Seifer, R., Samero, A.J., Dickstein, S., Hayden, L.C., & Schiller, M. (1996). Parental
psychopathology and sleep variation in children. Child and Adolescent Psychiatric Clinics
of North America,5(3), 715–727.
Seifer, R., Schiller, M., Samero, A.J., Resnick, S., & Riordan, K. (1996). Attachment,
maternal sensitivity, and infant temperament during the first year of life. Developmental
Psychology,32(1), 12–25.
Smith, P.B., & Pederson, D.R. (1988). Maternal sensitivity and patterns of infant–mother
attachment. Child Development,59(4), 1097–1101.
Tikotzky, L., & Sadeh, A. (2001). Sleep patterns and sleep disruptions in kindergarten
children. Journal of Clinical Child Psychology,30, 581–591.
van IJzendoorn, M.H., & Hubbard, R.O.A. (2000). Are infant crying and maternal
responsiveness during the first year related to infant–mother attachment at 15 months?
Attachment and Human Development,2, 371–391.
van IJzendoorn, M.H., Schuengel, C., & Bakermans-Kranenburg, M. (1999). Disorganized
attachment in early childhood: Meta-analysis of precursors, concomitants, and sequelae.
Development and Psychopathology,11, 225–250.
Van Tassel, E.B. (1985). The relative influence of child and environmental characteristics on
sleep disturbances in the first and second years of life. Journal of Developmental and
Behavioral Pediatrics,6, 81–86.
360 E. Higley and M. Dozier
Waters, E., & Deane, K.E. (1985). Defining and assessing individual dierences in attachment
relationships: Q-methodology and the organization of behavior in infancy and early childhood.
In I. Bretherton & E. Waters (Eds.), Growing points of attachment theory and research.
Monographs of the Society of Research in Child Development (50, pp. 41–65).
Appendix A
Code Catalog for Nighttime Interaction
This is a description of the steps involved in coding the nighttime videos used to calculate
agreement between observers. Observers need to show agreement in two ways:
(1) Observers need to code each awakening with the same method of responding.
(2) Observers need to code each dyad with the same overall classification for mother–
infant pattern of nighttime interaction.
Step 1: Nighttime Video Coding
Watch the video and complete one ‘‘Nighttime Video Coding’’ sheet for each of the three
nights of video. Refer to the accompanying ‘‘Nighttime Diary’’ that mothers completed.
Record:
(1) Dates (e.g., 8/16 – 8/17) (night of the 16
th
into morning of the 17
th
)
(2) Night (i.e., 1, 2, or 3)
(3) ID # (i.e., child’s subject code)
Bedtime
(1) Time in crib (hr:min) (time baby is put in the crib)
(2) Who put baby to bed (Mom, Dad, Other) (may need to refer to mother’s diary)
(3) Stays until asleep (Yes/No) (whether the mom reports staying until the baby fell asleep
at bedtime)
(4) Baby cried before falling asleep (Yes/No/N/A) (If mom does not stay until asleep,
indicate whether the baby cries in their crib before falling asleep)
(5) Brief description of bedtime interaction
Awakenings
An awakening is defined as a transition from sleep to waking. According to Hayes (2002),
‘‘an awakening is behaviourally defined when the individual engages in conscious behaviors
that reflect awareness of their surroundings such as eyes open, talking, or positional and motor
movements incompatible with sleep (sitting up, walking, etc) . . .’’ (p. 25). Awakenings last at
least 1–2 minutes.
(1) Confidence (how confident you are that the baby is awake)
(a) not sure awake
(b) probably awake
(c) definitely awake
(2) Time awake (hr:min:sec)
(3) Vocalization (any sound emitted by baby)
(a) No vocalization
(b) Mild vocalization (whines/whimpers/grunts/coos/babbles/brief cry noise)
(c) Signals distress (Fusses/Cries)
(4) Responder (Mom, Dad, Other, No one) and time (time response occurred)
(5) Latency to respond to cry (how many minutes the baby fussed/cried before the
caregiver responded. Round to the nearest half minute.)
(6) Stays until asleep (Yes, No, N/A) (whether the mother reports staying until baby falls
back to sleep)
Attachment & Human Development 361
(7) If no, does baby cry (Yes, No, N/A) (If caregiver does not stay until back to sleep,
indicate whether the baby cries)
(8) Describe awakening (write a brief description of the awakening. Include times where
appropriate)
General
(1) Total # of awakenings (only those awakenings coded ‘‘probably’’ or ‘‘definitely’’
awake)
(2) Time woke up in the morning
(3) Time out of crib for that night
Step 2: Code Each Soothing Attempt per Awakening
For each awakening (that is considered probably or definitely awake), record the following
information on a spreadsheet:
(1) Subject code
(2) Night (1,2,3) – which night the awakening occurred
(3) Time (hr:min) – time of the awakening
(4) Signals distress (Yes, No) – whether the baby signaled distress (fussed/cried)
(5) Responder (Mom, Dad, No one) – who responded to the awakening (exclude
awakenings when someone other than parent responded)
(6) Return (#) – the number of times caregiver had to return to perform more soothing
attempts for that awakening
(7) Latency (min) – how many minutes the baby fussed/cried before the caregiver
responded. (Round to the nearest half minute)
(8) R1 – R6 (or more if needed) – assign one of the following 5 codes for each soothing
attempt performed during that awakening:
(1) no response/let cry
(2) stands by crib (no touch)
(3) resettles (repositions baby, lays baby back down, give pacifier/cuddly, cover with
blanket)
(4) pats/rubs back, belly or head
(5) picks up
Step 3: Assign One Method of Responding per Signaled Awakening
Describe the method of responding (based on R1 – R5 from Step 2) using the following codes:
(1) no response/let cry (when no one responds to baby’s signal of distress during an
awakening)
(2) let cry/soothe (1 to 2,3,4,5) (for caregivers who let infants cry at least 5 min and then
respond with either picking up or soothing in crib)
(3) soothe in crib (2,3,4) (when standing by crib, resettling, and/or rubbing back are the
first and only response)
(4) pick up (5) (when picking up is the first and only response)
(5) increasing physical contact (2,3,4 to 5) (to begin with soothing in crib and then to pick up)
(6) multiple soothing strategies/no clear pattern (for caregivers who make 4 or more
attempts at soothing or those who make fewer soothing attempts that do not fit within
the above methods)
Step 4: Assign a Summary Code for the Pattern of Nighttime Interaction
Assign each dyad one of the following overall pattern of nighttime interaction codes according
to the caregiver’s most frequently used method of response (from Step 3) across the three nights.
(1) no wake/no signal (babies who never wake and/or never signal distress during
awakenings across the three nights of observation)
362 E. Higley and M. Dozier
(2) no response (the most frequent response to signaling distress during awakenings is no
response)
(3) pick up/soothe (the most frequent response to signaling distress during awakenings is
either 3, 4, or 5 from step 3)
(4) multiple attempts/inconsistent (either 6 is the most frequent response or a mixture of
1–6 is used such that no one method predominates)
Attachment & Human Development 363
... Nighttime sleep typically involves a situation in which infants are alone in a dark room while having no interactive contact with a caregiver, which can be highly stressful for the infant (Higley & Dozier, 2009;Sadeh, Tikotzky, & Scher, 2010;Scher, 2001). Hence, infants may activate attachment behaviors (e.g., crying, protesting against separation) to seek proximity to an attachment figure (Higley & Dozier, 2009;Sadeh et al., 2010;Scher, 2001). ...
... Nighttime sleep typically involves a situation in which infants are alone in a dark room while having no interactive contact with a caregiver, which can be highly stressful for the infant (Higley & Dozier, 2009;Sadeh, Tikotzky, & Scher, 2010;Scher, 2001). Hence, infants may activate attachment behaviors (e.g., crying, protesting against separation) to seek proximity to an attachment figure (Higley & Dozier, 2009;Sadeh et al., 2010;Scher, 2001). Several studies have examined associations between infant sleep problems and attachment security, but results have been inconsistent (Bilgin & Wolke, 2019;McNamara, Belsky, & Fearon, 2003;Morrell & Steele, 2003;Scher, 2001;Scher & Asher, 2004;Simard, Chevalier, & Bedard, 2017;Weinraub et al., 2012). ...
... Empirical evidence for associations between infant sleep problems and attachment security has been limited and inconsistent (Bilgin & Wolke, 2019;McNamara et al., 2003;Morrell & Steele, 2003;Scher, 2001;Scher & Asher, 2004;Simard et al., 2017). For example, research showed that 12-month-old infants with a secure versus insecure infant-mother attachment relationship did not differ in video recorded number of nighttime awakenings or in signaling their awakening to their parents (Higley & Dozier, 2009). A meta-analysis including 16 studies (2783 children between the age of 6 and 38 months) showed only small to moderate associations between sleeping behaviors and infant-mother attachment security. ...
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... Training to administer and rate the SSP requires a two-week (usually US-based) course, then rigorous reliability training to reach at least 80% agreement with expert raters. Thereafter, high quality research labs achieve four-way attachment classifications of variable reliability (Cohen's Kappas 0.49 to 0.93) [11,12]. Therefore, despite the recommendation for these attachment measures (e.g. by the UK National Institute for Health and Care Excellence [13]), their use is rarely feasible in clinical practice. ...
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Preprint
Full-text available
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Infants evolved in the context of close contact (including co-sleeping). Evolutionary context is rarely considered in psychological infant sleep research, and Western sleep researchers make assumptions about what optimal “normal” infant sleep is and how to achieve early, deep, infant sleep consolidation and avoid infant sleep problems. However, an evolutionary and anthropological view of infant sleep as species-typical recognizes that human evolution likely prepared the infant brain for optimal development within its evolutionary context – co-sleeping. Thus, “normal” infant sleep, sleep consolidation, and sleep problems should all be understood within the framework of co-sleeping infants, not the historically new-phenomenon of solitary-sleeping infants. Much work needs to be done in order to understand “normal” infant sleep as species-typical and how adaptive infants are to environments that stray from their evolutionary norm.
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Objective To investigate the association between night waking frequency in 3‐ to 4‐month‐old infants and mothers' response to them. Design Cross‐sectional survey. Sample We examined 663 mothers of infants aged 3–5 months who attended regular health checks for 4 months at 7 public health centres in Japan between September 2006 and March 2007. Measurements Mother‐reported questionnaires were used, measuring the frequency of infants' night waking and four types of responses by mothers. Using multiple regression, the association between number of wakings and each response was evaluated adjusting for covariates, that is mother's (e.g. feelings of worry and bed‐sharing) and infant's (e.g. age and sex) demographic variables. Results The number of wakings was related to “immediately feeding and/or checking diapers” (β = 0.16, p = .002).This response to infants' night waking may be associated with night waking frequency. Conclusion Modifying caregiver responses to infants' night waking by reducing immediate feeding or diaper checks could improve infants' night waking frequency.
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The parent-infant dynamic has a foundational role in emotion regulation development. Electroencephalography (EEG) hyperscanning from mother-infant dyads can provide an unprecedented window into inter-brain dynamics during the parent-infant exchange. This potential depends on the feasibility of hyperscanning with dyads in emotionally taxing contexts. We sought to demonstrate feasibility of hyperscanning from 10 mother-infant dyads during the Still Face Procedure (SFP). We measured frontal alpha asymmetry (FAA) to elucidate ongoing regulatory dynamics and considered maternal caregiving quality as a window into dyads’ history. Results showed dyads exhibited a rightward shift in FAA over the course of SFP, indicating growing negative emotionality and desire to withdraw. Results also showed growing variability in FAA for infants over the course of SFP, indicating less active emotional control as stress ensued. Variability was especially low for mothers during periods when asked to be emotionally unavailable, suggesting active control to match the task demands. Dyads with a more responsive mother exhibited higher (more left) FAA relative to dyads with a less responsive mother, which might reflect a more positive emotional experience overall. We raise important methodological and theoretical questions that hyperscanning during SFP can address, such as the developmental origins of trait-like self-regulatory dispositions.
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Research guided by attachment theory as formulated by Bowlby and Ainsworth is branching out in exciting new directions. The 12 chapters collected together in this Monograph present theoretical and methodological tools that will facilitate further research on attachment across the life span, across generations, and across cultures. The Monograph is divided into 4 parts. Part 1 provides the theoretical framework, emphasizing the ethological and the psychoanalytic roots of attachment theory. Part 2 is concerned with translating theory into measurement (presenting the Attachment Q-sort and the Adult Attachment Interview that raised attachment research to the level of representation). Part 3 chapters examine short-term and long-term adaptations to nonmaternal care. Part 4 is devoted to cross-national research on attachment in infancy (Germany, Japan, and Israel).
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Families were examined at 6, 9, and 12 months in an intensive longitudinal study that included Home Behavior Attachment Q-sorts, laboratory Strange Situation assessment, home observations of infant temperament behavior on 24 occasions, observations of maternal parenting sensitivity on 12 occasions, and maternal reports of infant temperament. Maternal sensitivity was modestly related to Q-sort security and unrelated to Strange Situation classification. In contrast, observed infant temperament was more strongly related to both maternal sensitivity and Q-sort security. The relation between home and laboratory assessment of attachment security, which was at the level found in prior work (e.g., B. E. Vaughn & E. Waters, 1990), remained after the effects of observed and mother-reported infant temperament were partialed. Our data highlight the need to consider other factors besides maternal sensitivity in the explanation of variability in the attachment status of 1-year-olds.
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Ethological attachment theory is a landmark of 20th century social and behavioral sciences theory and research. This new paradigm for understanding primary relationships across the lifespan evolved from John Bowlby's critique of psychoanalytic drive theory and his own clinical observations, supplemented by his knowledge of fields as diverse as primate ethology, control systems theory, and cognitive psychology. By the time he had written the first volume of his classic Attachment and Loss trilogy, Mary D. Salter Ainsworth's naturalistic observations in Uganda and Baltimore, and her theoretical and descriptive insights about maternal care and the secure base phenomenon had become integral to attachment theory. Patterns of Attachment reports the methods and key results of Ainsworth's landmark Baltimore Longitudinal Study. Following upon her naturalistic home observations in Uganda, the Baltimore project yielded a wealth of enduring, benchmark results on the nature of the child's tie to its primary caregiver and the importance of early experience. It also addressed a wide range of conceptual and methodological issues common to many developmental and longitudinal projects, especially issues of age appropriate assessment, quantifying behavior, and comprehending individual differences. In addition, Ainsworth and her students broke new ground, clarifying and defining new concepts, demonstrating the value of the ethological methods and insights about behavior. Today, as we enter the fourth generation of attachment study, we have a rich and growing catalogue of behavioral and narrative approaches to measuring attachment from infancy to adulthood. Each of them has roots in the Strange Situation and the secure base concept presented in Patterns of Attachment. It inclusion in the Psychology Press Classic Editions series reflects Patterns of Attachment's continuing significance and insures its availability to new generations of students, researchers, and clinicians.
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Describes preliminary empiric data on sleep habits collected in the Providence Family Study, which is a longitudinal examination of infants and young children and their families in which parents have mental disorders. Overall, 182 families have participated. Parent report of sleep habits in toddlers at risk for psychopathology was examined using the newly developed Sleep Habits Questionnaire. Total sleep time, bedtime struggles, sleep behavior, night waking, morning waking, and daytime sleepiness were assessed. Specific maternal diagnostic classification was not associated with the child's sleep, but general indices of mental illness were. Also, more competent child behavior was associated with better organized sleep. Poorly functioning families had children whose sleep habits were less optimal. The interpretation of sleep organization within the larger developmental psychopathology framework is discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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for some years we have been concerned with research into the development of the attachment relationship between an infant and his mother in the first year of life / in the course of this, research findings have emerged that seem relevant to issues that are commonly conceived to pertain to 'socialisation' two of these issues are considered in some detail in this chapter / under what conditions does an infant learn to cry less than he did in the beginning and thus become less demanding and less of a nuisance / under what conditions does an infant come to comply readily with his mother's commands and prohibitions before presenting research findings pertinent to these issues, it is first desirable to discuss the theoretical context of the research itself gives a condensed account of our attachment theory (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Families were examined at 6, 9, and 12 months in an intensive longitudinal study that included Home Behavior Attachment Q-sorts, laboratory Strange Situation assessment, home observations of infant temperament behavior on 24 occasions, observations of maternal parenting sensitivity on 12 occasions, and maternal reports of infant temperament. Maternal sensitivity was modestly related to Q-sort security and unrelated to Strange Situation classification. In contrast, observed infant temperament was more strongly related to both maternal sensitivity and Q-sort security. The relation between home and laboratory assessment of attachment security, which was at the level found in prior work ( e.g., B. E. Vaughn & E. Waters, 1990 ), remained after the effects of observed and mother reported infant temperament were partialed. Our data highlight the need to consider other factors besides maternal sensitivity in the explanation of variability in the attachment status of l-year-olds. (PsycINFO Database Record (c) 2012 APA, all rights reserved)