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Maternal Psychopathology and Prediction of Outcome Based on Mother-Infant Interaction Ratings (BMIS)

Published online by Cambridge University Press:  02 January 2018

A. E. Hipwell  and
R. Kumar
A. E. Hipwell
Affiliation:
Winnicott Research Unit, Department of Psychiatry, University of Cambridge, Gresham Road, Cambridge CB1 2ES
R. Kumar*
Affiliation:
Institute of Psychiatry, Camberwell SE5 8AF
*
R. Kumar, Department of Psychiatry, Institute of Psychiatry, University of London, De Crespigny Park, Camberwell SE5 8AF
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Abstract

Background

Very little is known about the adequacy and safety of maternal parenting behaviour in the context of severe postpartum psychiatric illness, about specific difficulties in relation to different types of mental illness, or about the potential for improvement over the course of an episode of illness. The Bethlem Mother–Infant Interaction Scale (BMIS) was thus developed as an aid to assessment on a specialist psychiatric Mother and Baby Unit.

Method

Nurses' ratings of the quality of mother–infant interaction using the BMIS were collected throughout the consecutive admissions of 78 in-patient pairs. The ratings from three points during the admissions were examined according to the mothers' RDC diagnoses and also according to the eventual outcome of the admission.

Results

The nature of the mother's illness was associated with the quality of her infant care-taking using the BMIS ratings. The nurses' ratings during the second week of admission together with maternal psychiatric diagnosis, were strongly predictive of the eventual outcome of the admission. The majority of women who were separated from their infants on discharge or who required formal supervision belonged to the schizophrenic group.

Conclusions

The results suggest that the BMIS can be used in this in-patient setting to aid clinical decisions about the safety of parenting by individual mothers with severe mental illness in the postpartum period.

Type
Papers
Information
The British Journal of Psychiatry , Volume 169 , Issue 5 , November 1996 , pp. 655 - 661
Copyright
Copyright © Royal College of Psychiatrists, 1996 

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References

Campbell, S. B., Cohn, J. F. & Myers, T. (1995) Depression in first-time mothers: mother–infant interactions and depression chronicity. Developmental Psychology, 31, 349–359.Google Scholar
Cohler, B., Gallant, D., Grunebaum, H., et al (1980) Child care attitudes and development of young children of mentally ill and well mothers. Psychological Reports, 46, 31–46.CrossRefGoogle ScholarPubMed
Cohler, B., Grunebaum, H., Weiss, J., et al (1977) Disturbance of attention among schizophrenic, depressed, and well mothers and their young children. Journal of Child Psychology and Psychiatry, 18, 115–135.Google Scholar
DeMulder, E. K. & Radke-Yarrow, M. (1991) Attachment with affectively ill and well mothers: concurrent behavioural correlates. Development and Psychopathology, 3, 227–242.CrossRefGoogle Scholar
Goodman, S. H. & Brumley, H. E. (1990) Schizophrenic and depressed mothers: relational deficits in parenting. Developmental Psychology, 26, 31–39.Google Scholar
Hipwell, A. E., Goossens, F. A., Melhuish, E. C., et al (1996) Severe Maternal Psychopathology, ‘Joint’ Hospitalisation and Infant-Mother Attachment Development and Psychopathology, (in press).Google Scholar
Kumar, R. & Hipwell, A. E. (1994) Implications for the Infant of Maternal Puerperal Psychiatric Disorders. In Child and Adolescent Psychiatry: Modern Approaches (eds Rutter, M., Taylor, E. & Hersov, L.), pp. 759–775. Oxford: Blackwell Scientific.Google Scholar
Kumar, R. & Hipwell, A. E. (1996) Development of a Clinical Rating Scale to Assess Mother–infant Interaction in a Psychiatric Mother and Baby Unit British Journal of Psychiatry, 169, 18–26.CrossRefGoogle Scholar
Kumar, R., Marks, M., Platz, C., et al (1995) Clinical survey of a psychiatric mother and baby unit: characteristics of 100 consecutive admissions. Journal of Affective Disorders, 33, 11–22.Google Scholar
Murray, L. (1992) The impact of postnatal depression on infant development Journal of Child Psychology and Psychiatry, 33, 543–561.CrossRefGoogle ScholarPubMed
Radke-Yarrow, M., Richters, J. & Wilson, W. E. (1988) Child development in a network of relationships. In Individuals in a Network of Relationships (eds Hinde, R. & Stevenson-Hinde, J.). Cambridge: Cambridge University Press.Google Scholar
Ramsey, R. & Kumar, R. (1996) Ethical dilemmas in perinatal psychiatry. Psychiatric Bulletin, 20, 90–92.Google Scholar
Sameroff, A. J. & Seifer, R. (1987) Rochester Longitudinal Study: Progress Report. Paper presented at the Schizophrenia Consortium Conference on Risk in Infancy, Newport, R.I. Google Scholar
Sharp, D., Hay, D. F., Pawlby, S., et al (1995) The impact of postnatal depression on boys' intellectual development Journal of Child Psychology and Psychiatry, 36, 1315–1336.CrossRefGoogle ScholarPubMed
Stein, A., Gath, D. H., Bucher, J., et al (1991) The relationship between post-natal depression and mother–child interaction. British Journal of Psychiatry, 158, 46–52.Google Scholar
Thiels, C. & Kumar, R. (1987) Severe puerperal mental illness and disturbances of maternal behaviour. Journal of Psychosomatic Obstetrics and Gynaecology, 7, 27–38.Google Scholar
Winnicott, D. W. (1956) Primary Maternal Preoccupation. Through Paediatrics to Psychoanalysis. London: Hogarth Press.Google Scholar
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