Link to full paper :
SCREENING FOR SUSTAINED SOCIAL WITHDRAWAL BEHAVIORS IN SIX-MONTH-OLD INFANTS DURING PEDIATRIC PRIMARY CARE VISITS: RESULTS FROM AN AT-RISK LATINO IMMIGRANT SAMPLE WITH HIGH RATES OF MATERNAL MAJOR DEPRESSIVE DISORDER
ABSTRACT:To examine relations between infant social withdrawal behavior and maternal major depression (MDD), 155 mother–infant dyads wereevaluated at the 6-month primary care visit. Maternal depression was determined based on a psychiatric interview. Infant social withdrawal behaviorwas assessed with the Alarm Distress Baby Scale (ADBB; A. Guedeney & J. Fermanian, 2001) based on videotaped mother–infant interactions. Ofthe sample, 18.7% of mothers were diagnosed with MDD, and 39.4% of infants scored above the clinical ADBB cutoff. Infants of depressed motherswere more likely to score positive on the ADBB (75.8 vs. 31.0%,p<.001) and showed distinct patterns of withdrawal behavior. Within the group ofwithdrawn infants, however, no differential patterns of behavior could be identified for infants of depressed mothers as compared to infants of motherswith no depression. These findings confirm the validity of the ADBB for detection of infant social withdrawal in the context of MDD. At the sametime, they support evidence that the ADBB identifies nonspecific infant distress behaviors. Future studies will need to determine if and how positiveADBB screening results in the absence of maternal MDD might be associated with other maternal psychiatric disorders such as anxiety or borderlinepersonality disorder. These results have important implications for screening guidelines in primary care
Expert’s note: This article presents a study that once again confirms the link between relational withdrawal of the infant screened during home visits using the ADBB and the presence of postpartum depression in the mother, but it also suggests that in the absence of postpartum depression but withdrawal in the baby, it is necessary to explore for the presence of other disorders in the parent and/or in the child, since some babies presented with sustained relational withdrawal without their mother presenting depressive symptoms. It may be of interest in practices to also screen the father and other caregivers such as the nanny or the quality of the daycare. It may also be necessary to screen for maternal anxiety, post-traumatic stress disorder, and to check the baby for disorders unique to him or her.