Infantile Anorexia and Co-parenting: A Pilot Study on Mother–Father–Child Triadic Interactions during Feeding and Play

Abstract

Infantile Anorexia (IA), defined by the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood Revised (DC: 0-3R, Zero To Three, 2005), occurs when the child (a) refuses to eat adequate amounts of food for at least 1 month, and shows growth deficiency, (b) does not communicate hunger and lacks interest in food, and (c) the child’s food refusal does not follow a traumatic event and is not due to an underlying medical illness. IA usually emerges during the transition to self-feeding, when the child issues of autonomy are played out daily in the feeding situation. Studies evidence that the feeding interactions between children with IA and their mothers are characterized by low reciprocity, greater interactional conflict and negative affects (Chatoor et al., 2000; Ammaniti et al., 2010, 2012). Moreover, these studies pointed out that maternal depression and eating disorders are frequently associated with IA (Cooper et al., 2004; Ammaniti et al., 2010; Lucarelli et al., 2013). To date, research has focused almost exclusively on the mother–child dyad, while fathers’ involvement, co-parental and family interactions are poorly studied. The current study is a pilot research that investigated mother–father–child triadic interactions, during feeding and play, in families with children diagnosed with IA, in comparison to families with normally developing children. Until now, at the study participated N = 10 families (five with a child with IA diagnosis and five with lack of child’s IA diagnosis, matched for child’s age and gender). The parents–child triadic interactions were assessed in feeding and play contexts using the Lausanne Trilogue Play (Fivaz-Depeursinge and Corboz-Warnery, 1999), adapted to observe father-mother-infant primary triangle in the feeding context, compared to the play context (Lucarelli et al., 2012). Families of the IA-group showed difficulties in expressing and sharing pleasure and positive affects, and in structuring a predictable and flexible context. Children showed little autonomy and difficulty in being actively engaged and tune with parents. Dysfunctional family interactions are a critical issue for IA that affects co-parental and family subsystems, stressing the importance of an articulated diagnostic assessment in order to target effective treatment approaches.

Impact of Parental Binge Eating Disorder: Exploring Children's Emotional/Behavioral Problems and the Quality of Parent–child Feeding Interactions

“…Nevertheless, we used an observational measure to study the quality of dyadic feeding interactions, which guaranteed the objective assessment of emotional/behavioral functioning of the child during exchanges with their parents. Another limitation is that our study did not address some important issues such as family functioning in general (e.g., marital adjustment, alliance, and satisfaction) and reciprocal support in coparenting and childrearing agreement or disagreement (Lucarelli, Ammaniti, Porreca, & Simonelli, ). Instead, as suggested by Feinberg (), it is useful to address all questions to understand the effect of the possible high levels of coparental distress on their offspring's psychological well‐being (Rutter, ).…”

Mother–Infant and Extra-Dyadic Interactions with a New Social Partner: Developmental Trajectories of Early Social Abilities during Play

“…In the course of the uncountable mutual exchanges during feeding and play activities with their mother, infants not only practice a number of social skills like turn-taking and joint attention behaviors, but they also develop self-regulatory abilities and a basic sense of self (Fogel, 1995; Fonagy et al, 2002; Feldman, 2007; Ammaniti and Gallese, 2014; Lucarelli et al, 2017). …”

Development of the Parent‐child Play Scale for Use in Children With Feeding Disorders

“…The importance of the assessment of parent-infant/toddler interactions in multiple settings has been emphasized by several authors in the context of attachment and intersubjectivity theories (Ainsworth, 1969;Feldman, 2007;Feldman, Keren, Gross-Rozval, & Tyano, 2004;Lieberman & Slade, 2000;Lucarelli, Ammaniti, Porreca, & Simonelli, 2017;Murray, Fiori-Cowley, Hooper, & Cooper, 1996;Papoušek, 2007;Stern, 1985Stern, , 2010Trevarthen & Aitken, 2001;Zeanah, Larrieu, Heller, & Valliere, 2000). Particularly, when assessing the quality of the parent-child relationship in children with different disturbances (i.e., infantile feeding disorders), it seems to be crucial not only to observe parent-child interactions in settings where the child and his or her mother are distressed but also in settings where activities can be pleasurable.…”