The current paper expands on Ainsworth’s seminal construct of maternal sensitivity by exploring the developmental pathways associated with one particular form of insensitivity, maternal withdrawal. Drawing on longitudinal data from infancy to age 20 in a high-risk cohort, we highlight how maternal withdrawal over the first eight years of life is associated with child caregiving behavior and with maternal role confusion, as well as with features of borderline and antisocial personality disorders. We also present evidence for the specificity of this pathway in relation to other aspects of maternal insensitivity and other aspects of child adaptation. To illuminate these pathways we both review recent published work and report new findings on the middle childhood and adolescent components of these trajectories. Finally, we consider the implications for assessment of maternal behavior in high-risk samples and indicate directions for productive future work.

Posttraumatic reactions are common among mothers of preterm infants and can have a negative influence on their quality of life and lead to interactional difficulties with their baby. Given the possible trajectories of posttraumatic reactions, we hypothesized that prevalences of postpartum posttraumatic reactions at given times underestimate the real amount of mothers experiencing these symptoms within 18 months following delivery. Additionally, we examined whether sociodemographic and clinical characteristics of dyads influence the expression of posttraumatic symptoms among these mothers. A sample of 100 dyads was included in this longitudinal study led by 3 french university hospitals. Preterm infants born before 32 weeks of gestation and their mothers were followed-up over 18 months and attended 5 visits assessing the infants’ health conditions and the mothers’ psychological state with validated scales. Fifty dyads were retained through the 18 months of the study. The period prevalence of posttraumatic reactions was calculated and a group comparison was conducted to determine their predictive factors. Thirty-six percent of the mothers currently suffered from posttraumatic symptoms 18 months after their preterm delivery. The 18 months period prevalence was 60.4% among all the mothers who participated until the end of the follow-up. There was a statistical link between posttraumatic symptoms and a shorter gestational age at delivery, C-section, and the mother’s psychological state of mind at every assessment time. Only a small proportion of mothers were receiving psychological support at 18 months. Preterm mothers are a population at risk of developing a long-lasting postpartum posttraumatic disorder, therefore immediate and delayed systematic screenings for posttraumatic symptoms are strongly recommended to guide at-risk mothers towards appropriate psychological support.

Oxytocin (OT), often called the 'hormone of love' or 'hormone of attachment,' plays a fundamental role in the establishment and quality of parent-infant bonding. However, emerging evidence indicates that OT can also produce antisocial behavior. To clarify these effects, we review studies examining the role of endogenous and exogenous OT on several determinants of attachment: parental sensitivity, and bonding or synchrony in parent-child dyads. Contextual and individual factors moderating the effect of intranasal OT and its peripheral levels are also reviewed. Finally, potential therapeutic applications for OT and current limitations in human OT research are examined. This systematic literature review was based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, with two electronic databases and other bibliographic sources. We identified a total of 47 relevant studies for inclusion in our review. Most of the findings are in accordance with recent ideas that OT administration may increase parent-child prosocial interaction, showing that OT exerts beneficial effects on processes thought to promote bonding, sensitivity, and synchrony. However, we found that OT can induce antisocial behavior (e.g., anxiety) or adverse effects (modulation of maternal care recollections) that are moderated by different contextual (e.g., maltreatment level, presence of unfamiliar people) and individual (attachment style) factors. This review reinforces the importance of context- and individual-dependent factors, which must be taken into account when analyzing the psychophysiological effects of OT.