J Child Fam Stud (2007) 16:483–497 DOI 10.1007/s10826-006-9099-9 ORIGINAL PAPER
Mothers’ Empathic Understanding of their Toddlers: Associations with Maternal Depression and Sensitivity Lisa W. Coyne · Christine M. Low · Alison L. Miller · Ronald Seifer · Susan Dickstein
Published online: 23 December 2006 C Springer Science+Business Media LLC 2006
Abstract Mothers’ empathic understanding of their children’s motives, thoughts, and feelings is thought to guide parenting behaviors and shape the mother-child relationship. However, little is known about the relation between empathic understanding and parenting behaviors during developmental shifts that may be emotionally challenging for mothers, such as the transition from infancy to the toddler years, or how it may relate to maternal depressive symptoms. We assessed relations between maternal empathic understanding, depression, and sensitivity. We developed a coding system, the Empathic Understanding Assessment (EUA), to measure this construct in the mothers of 30-month old children. One hundred twenty eight mother-child pairs participated in a series of lab-based tasks designed to be challenging for the children. Mothers then watched these videotaped interactions and responded to questions regarding their children’s experiences. Interview content was coded using the EUA. Results indicated that mothers higher in empathic understanding and more intensely emotional were rated as more sensitive. Maternal depression was negatively related to empathic understanding. The importance of considering the role of maternal empathic understanding in parenting behavior is discussed, as are potential implications for child outcomes. Keywords Mothers . Empathic understanding . Sensitivity . Depression . Experiential avoidance Mothers’ ability to take into account their children’s perspectives, motives, and goals, or maternal representational ability, is thought to be important in the development of parenting behaviors and early relationship formation (Bretherton, Biringen, Ridgeway, Maslin, & Sherman, 1989; Slade, Belsky, Aber, & Phelps, 1999). Maternal representations consist of knowledge, beliefs, expectations, and attributions about one’s child that continually develop L. W. Coyne () Psychology Department, Suffolk University, 41 Temple Street, Boston, MA 02114 e-mail:
[email protected] C. M. Low · A. L. Miller · R. Seifer · S. Dickstein Early Childhood Clinical Research Center, Brown Medical School/E. P. Bradley Hospital ,East Providence, RI Springer
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and deepen over time. Recently, investigators have targeted a more specific aspect of maternal representation. Empathic understanding, or insightfulness, typically defined as the ability to take one’s child’s perspective, includes 1) understanding of and reflection on the child’s motives, 2) the ability to hold a rich and detailed view of the child, and 3) willingness to accept and integrate new information into existing conceptualizations about one’s child (Oppenheim, Koren-Karie, & Sagi, 2001). Mothers’ capacity for empathic understanding may vary in different contexts, for example, when mothers experience negative emotions during challenging interactions with their children. Mothers’ experiences of negative emotion or depressive symptoms may further compromise this capacity. Empathic understanding is best conceptualized as an evolving process that develops within the context of the parent-child relationship. As such, it extends to a variety of different situations, and the need for empathic understanding is ubiquitous in daily caregiving tasks. For example, when dressing and feeding one’s toddler, bringing that child to the grocery store, helping the child engage in peer interactions, or teaching toilet training, a mother’s attunement to the child’s abilities assists the child in completing such daily tasks in a fluid way. Mothers’ attention to their children’s likes/dislikes, physical well-being and present mood, and their potential reactions to maternal behaviors and emotional states allows mothers to respond in nuanced and sensitive ways. This in turn may assist children in regulating their own behavior and mood. Empathic understanding is thought to influence the parent-child relationship in more global ways than in influencing mothers’ merely engaging in individual empathic acts. For example, rather than simply affecting whether or not mothers set limits in a particular situation, maternal empathic understanding may influence how flexibly those limits are set. It may also influence how mothers structure daily routines to facilitate and maintain their children’s self-esteem, sense of safety, and general well-being, based on their children’s unique needs in a given moment (Oppenheim et al., 2001). Consider the case of a sick toddler. An empathic mother might set particular limits around certain child behaviors such as whining or oppositionality when the child is feeling well, but relax these limits briefly in response to the child’s perhaps compromised ability to adhere to them when sick. At times such as these when children may be feeling vulnerable, it is important for mothers to have an understanding of when and how best to modify their behavior guided by clear, comprehensive, and accepting views of their children. Oppenheim and Koren-Karie (2002) have used a video-review methodology to assess maternal empathic understanding (i.e., Insightfulness Assessment). This procedure involves videotaping interactions between mothers and their children, followed by mothers watching tape segments and responding to interview queries regarding their own, and their children’s, thoughts and emotions about the activities in the video segments. Interviews are transcribed and coded with respect to mothers’ openness, complexity, and insightfulness. Codes deemphasize the content of mothers’ descriptions (i.e., what mothers say about their children) in favor of more global process variables (i.e., how mothers communicate about their children). For example, “openness” describes mothers’ capacity to acknowledge their children’s familiar behaviors, as well as integrating unexpected responses into their view of their children. Additional codes include maintenance of focus on child, richness of description of child, coherence of thought, acceptance, anger, worry, and separateness of child. Ratings form the basis for classification of mothers into high-empathic understanding and low-empathic understanding groups. Using this assessment in an initial study of 4 1/2-year-olds, Oppenheim et al. (2001) sought to investigate whether mothers of securely attached children were better able to take their children’s perspectives than mothers of insecurely attached children, and whether Springer
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these mothers’ perceptions of their children’s motives, emotions, and behaviors were more accurate as compared to those of mothers who had insecurely attached children. Children of less-empathically understanding mothers were more frequently insecurely attached relative to those of empathic mothers. In a study of maternal empathic understanding, caregiving, and child attachment in mothers of 12 month-old infants, mothers rated as more empathically aware demonstrated more sensitive caregiving and were more likely to have infants who were securely attached. Moreover, empathic understanding accounted for additional unique variance in infant attachment above and beyond sensitivity (Koren-Karie, Oppenheim, Dolev, Sher, & Etzion-Carrasso, 2002). More recent work has built upon these findings and has assessed the impact of enhancing maternal empathic understanding on parenting skills and child behavior problems (Oppenheim, Goldsmith, & Koren-Karie, 2004). Parents with behaviorally disordered 4and 5-year-old children participated in an intervention aimed at fostering maternal empathic understanding. Investigators found that the children of mothers who moved from a categorization of less to more empathically understanding post-treatment had decreased behavior problems. Mothers failing to develop empathic understanding had children whose behavior problems increased, regardless of the acquisition of parenting skills (Oppenheim et al., 2004). Taken together, these data suggest that more accurate and detailed empathic understanding sets the stage for sensitive and contingent caregiving behavior, whereas a lack of such understanding may preclude the development and/or implementation of optimal caregiving. Although there is a growing body of literature elucidating empirical associations between maternal empathic understanding and parenting behaviors, little is known about the relation of empathic understanding to maternal emotion, and in particular, negative emotional states (e.g., sadness, anger, fear, anxiety). Mothers may have more difficulty being empathic when they are vulnerable to experiencing negative emotions (Adam, Gunnar, & Tanaka, 2004; Dix, Gershoff, Meunier, & Miller, 2004). Some research from a cognitive-behavioral perspective suggests that individuals who engage in experiential avoidance, or deliberate attempts to suppress or minimize unpleasant thoughts, emotions, or bodily sensations (Hayes, Strohsahl, & Wilson, 1999) may be less sensitive to, and thus less responsive to, their environment as a whole. Mothers’ attempts to limit/minimize their own negative emotions may prohibit the development of a sophisticated empathic understanding of their children, and thus may compromise their ability to respond in sensitive, contingent ways to their children’s needs. When mothers allocate their attention to the deliberate regulation of their own negative emotional states, their capacity to attend to their children’s needs may be attenuated. Thus, when mothers experience difficult interactions with their children characterized by their own frustration, anger, or other negative emotional states, they may be less capable of empathic understanding. The impact of experiential avoidance on empathic understanding may be even more pronounced in mothers who experience symptoms of depression (which often include anger, irritability, and comorbid anxiety), given that they may experience more frequent and intense negative emotion states. Data have suggested that even among parents who do not experience clinical levels of depression, negative emotional states have been linked with irritable and aversive parent-child interactions (Crnic & Acevedo, 1995; Crnic & Greenberg, 1990). Cognitive models would predict that mothers experiencing dysphoric mood would be more likely to view both themselves and their children negatively, and to experience difficult situations with their children as uncontrollable (Blaney, 1986; Eich, 1995; Gottlieb & McLeod, 1997; Lau, Segal, & Williams, 2004; Teasdale, 1983). Springer
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Mothers’ experiences of interactions with their children are important for three reasons. Most obviously, measures of empathic understanding in the context of negative mood or emotion should be diminished. Specifically, mothers may attend exclusively to more negative or undesirable child behaviors or emotions, which in turn could affect two additional processes. Next, if mothers perceive and or attend to only negative child behaviors through reduced empathic understanding, the parenting repertoires associated with such perceptions may lack objectivity, may be extremely limited in scope, and as such, may not be appropriate to or effective in particular situations with one’s child, especially those that are stressful or difficult. Thus, mothers may be insensitive to, or incapable of taking in, new or inconsistent information about their children and responding to it in a sensitive manner. Finally, mothers may be less likely to modify their own behaviors, including their cognitive appraisals, in the ongoing context of a situation, since such responses may be viewed as “hopeless,” or the child’s behaviors viewed as stable and uncontrollable. In this way, limited empathic understanding may translate to rigid and inflexible (i.e., non-sensitive) parenting, with selfperpetuating characteristics. This in turn could play a role in child attachment or behavior problems. In this study, we investigated relations among maternal empathic understanding, maternal sensitivity, and depressive symptoms. We defined empathic understanding as a mother’s capacity to describe her child’s thoughts, feelings, and behaviors in a rich, nuanced, and accepting way (Oppenheim et al., 2002). To this end, we constructed a coding system to analyze mothers’ reactions during the video review task designed by Oppenheim et al. (2002). The current study expanded upon their methodology in unique ways. Whereas their coding system attempted to capture empathic understanding more globally by rating how mothers communicated about their children, we took a more content-oriented approach. Because we conceptualized maternal emotion, as well as maternal awareness of child emotion, as central to the construct of empathic understanding, we also coded specific maternal descriptors of both child and mother emotions. Because mothers’ emotional experience may have an impact on empathic understanding, we rated these descriptors with regard to intensity and valence using established lexicons (see below). In addition, we coded mothers’ awareness of the impact of their own emotions on their children and their engagement in providing descriptions of their children. Finally, we examined the relationships between maternal depressive symptoms and the intensity and valence of mothers’ descriptions of their children. In addition to developing the above coding system, our study advances the literature in that we investigate empathic understanding 1) in difficult or situations designed to elicit negative emotion in children (i.e., anxiety, frustration and disappointment), and 2) during toddlerhood (age 30 months), which is characterized by emotional challenge for mothers due to their children’s growing autonomy. Previous work has utilized more neutral parent-child interactions in video vignette procedures, for example, structured play situations, diapering, or distraction conditions (e.g., Koren-Karie et al., 2002). We assessed mothers’ empathic understanding as they watched their children experience challenging situations, namely, a separation procedure, a frustration task, and a disappointment task. Additionally, most other studies examine empathic understanding in infants or in children between 4 and 5 years old. We assessed the construct in mothers of 30-month old children, a developmental period during which mothers may experience more frequent and intense negative emotion in interactions with their children. Critical developmental shifts occurring during this time include burgeoning autonomy and independence (Klimes-Dougan & Kopp, 1999; Kopp, 1989), increasing sophistication in emotion recognition and expression, and growing behavioral regulation and perspective-taking abilities. All of these are critical foundational experiences for attaining Springer
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other developmental milestones, such as theory of mind. Thus, empathic understanding and sensitive parenting, in particular, the adaptation of existing parenting skills to new behavioral challenges is crucial during this developmental stage. We expected that mothers who showed greater empathic understanding would demonstrate more sensitive parenting than other mothers. We also expected that as levels of depressive symptoms increased, overall empathic understanding would decrease. Finally, we expected that as levels of maternal depressive symptoms increased, mothers would display more negatively valenced views of their children.
Method Participants Families of 128 infants who participated in the Goodness of Fit (GOF) study are considered in this report. These 128 families participated in the 5th wave of a longitudinal study when their children were 30 months of age. The original cohort included 160 families at the time of the child’s birth (80% retention through 30 months of age). There was no evidence of differential attrition on any of the demographic variables described below. We report the characteristics of the sample for the 128 families participating at 30 months of age. Families were recruited during the prenatal period at the main obstetrics hospital that accounts for about 90% of the 12,000 births each year in the state of Rhode Island, encompassing a metropolitan area of about 1.2 million people. Parents were approached during prenatal birthing classes at the hospital (and satellite sites) and given a brief presentation about the study. This presentation included a description of procedures as well as the statement that we were looking for mothers with a history of emotional problems (especially depression). Interested parents provided their contact information and were subsequently contacted by project staff for a more thorough discussion of the study. If interested, the parents were scheduled for a prenatal assessment to begin study participation. For the 128 families remaining at 30 months of age, their children included 69 boys and 59 girls. Twenty of the children (16%) were of minority racial status: 6 Black, 8 Latino, 1 Asian, and 5 mixed race. The remaining 108 children were White. One hundred five of the mothers were married and living with their spouse, an additional 15 were single, divorced, or separated and living with a partner, and 8 mothers were divorced or single and not living with a partner. The large majority of the sample was middle or upper SES (120 with Hollingshead [1975] SES of 1-3; 8 families had SES of 4 or 5). In line with this SES breakdown, 3 mothers had less than high school education, 12 were high school graduates, 40 had some college, and 73 had a 4-year college degree (with an almost identical breakdown for spouses and partners). Study design The GOF study had assessments during the prenatal period and at 4 months, 8 months, 15 months, and 30 months of age. In the current report, we use data from the prenatal and 30-month assessments only. The prenatal assessment focused on psychiatric diagnostic status of the mothers. At 30 months of age a series of 8 home observations was conducted over a 4-week period to assess parenting behaviors, child temperament, and attachment. In Springer
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addition, a laboratory assessment was conducted at 30 months that included the Empathic Understanding Assessment (EUA) procedure that is the focus of this report. Procedure and measures Empathic understanding assessment (EUA) We developed a coding system for use with a video review procedure (the Empathic Understanding Assessment; EUA) similar to that developed by Oppenheim and colleagues (Oppenheim & Koren-Karie, 2002) to measure maternal empathic understanding. At 30 months, mother-toddler dyads participated in a series of laboratory-based, videotaped interactions, including the Strange Situation, a frustration task, and a disappointment task. Immediately after participating in these interaction tasks, mothers completed the Empathic Understanding Assessment (EUA) portion of the procedures. Mothers were videotaped while they watched these 3 lab segments and were interviewed about their experience. They were asked to reflect on their perceptions about their child’s and their own experiences (specifically, emotions, thoughts and behaviors). Mothers were asked specific questions after viewing each of the three challenging tasks, prompted to offer specific adjectives about their child’s and their own experiences, and then to provide a global assessment of their experience. Raters coded these videotaped interviews using the EUA coding system (described below). In addition to being blind to broader subject characteristics (e.g., maternal mental health functioning), these raters viewed only the mothers’ EUA interviews, and therefore never watched any segments that included child behavior. EUA: Global empathic understanding ratings We used the video review and interview procedure to measure three components of empathic understanding, including: (1) maternal representational ability; (2) mothers’ views of their children’s emotional experience during the challenging situations; and (3) mothers’ views of their own emotion as they observed interactions with their children. The EUA coding system thus yielded the following globally-rated variables on a scale of 1 (low) to 7 (high): Representational Attunement (global rating of the extent to which mother considers child’s perspective, discusses motivations for the child’s behaviors, thoughts and emotions, ICC = .75); Engagement (global rating of the extent to which mother engages in responding to the video of their child, and appears invested and interested in communicating about all aspects of their child’s functioning, ICC = .94); Awareness of Emotional Impact (global rating of the extent of maternal awareness that own emotions may impact child behaviors, thoughts, emotions, ICC = .80); Mother’s Descriptions of Child Emotion (Global rating of maternal description of child emotion; 1 = negative to 7 = positive, ICC = .76); and Mother’s Descriptions of Own Emotion (Global rating of mothers’ description of their own emotion; 1 = negative to 7 = positive, ICC = .86). EUA coders achieved intraclass reliability of .80 or greater for all codes on a subset of 20% of the videotapes. After initial reliability was established, continued double-coding was conducted at regular intervals to minimize the potential for coder drift. EUA: Lexicon ratings The EUA also involved coding the specific adjectives mothers used to describe themselves and their children. We coded these adjectives with regard to valence and intensity using Springer
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established lexicons of personality and emotion descriptors (I-FEEL; Emde, Osofsky, & Butterfield, 1993; Havill & Halverson, 1994) . Both emotion and personality words were included so that the range of adjectives typically produced in such tasks would be captured. The emotion lexicon, which was developed for use with the I-FEEL task, included hundreds of emotion descriptors that had consensus ratings by experienced emotion researchers on Intensity and Valence (Emde et al., 1993). The personality lexicon was derived from free descriptions of children’s personality provided by mothers in five cultures (Havill & Halverson, 1994). Seven raters (all researchers experienced in assessing parents’ narratives about themselves and others) rated the words in the existing personality lexicon, which included 94 words that overlapped with words in the I-FEEL emotion lexicon. The average intraclass correlation among raters for intensity and valence of personality words was .88. Furthermore, the average intraclass correlation (for the 94 overlapping items) between local raters and the established emotions lexicon exceeded .90. The final Intensity and Valence ratings for the non-overlapping personality descriptors were the means of the seven raters’ scores. For the overlapping personality/emotion descriptors, the original I-FEEL ratings were retained. Note that the result of this process was that the personality and emotion ratings were well calibrated, since the personality raters had very high correspondence with the original emotion ratings, and the intraclass correlation implicitly accounts for both ordering of item ratings and absolute level of ratings. The specific descriptors (i.e., adjectives) mothers used to describe their child’s and their own emotion, behavior, or thoughts were recorded. These adjectives were then matched with the combined lexicon and the consensus ratings for Intensity and Valence were recorded as the data for that adjective. For words or phrases that did not have a specific match in the lexicon, the research team met on a periodic basis to reach consensus on which existing item best matched the data provided. When a match was found, the Intensity and Valence ratings from the match were used, and the new word or phrase was added to the lexicon with those values attached. For words or phrases where no match was found, missing values were assigned to the adjective (typically, these were responses that were not, in fact, personality or emotion descriptors, (e.g., “He’s thirsty”). Only 7 mothers (6%) used such descriptors.
Depressive symptoms Maternal depressive symptoms were measured using the Beck Depression Inventory (BDI; Beck, 1967; Beck, Steer, & Garbin, 1988). Mothers completed the BDI when children were 30 months of age. The BDI is a 21-item scale that measures the presence and degree of severity of depressive symptoms in both normative and clinical populations (e.g., sadness, hopelessness, loss of interest in activities, diminished concentration). Mothers indicated the degree of severity for each of 21 self-evaluative statements, on a scale ranging from 0 to 3. The scale results in a single score ranging from 0–63, with higher scores indicating more depressive symptoms. The BDI is a widely used instrument and has demonstrated psychometric properties.
Maternal sensitivity During the eight 1-hour home visits, independent raters completed observations of free play, which included dyadic interaction, to assess maternal sensitivity. Following the home visits the raters completed the Parenting Sensitivity Q-sort (Pederson & Moran, 1995). The 90-item Springer
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Q-sort yields scores for Sensitivity (lower scores = less sensitivity) and Security (lower scores = less security). Maternal verbal ability Upon enrollment in the broader prospective study mothers were administered selected subtests from the Wechsler Adult Intelligence Scale (WAIS-R; 1981). Scores ranged from 76–139 (M = 104; SD = 14). This assessment served as our measure of verbal ability. Potential covariates maternal verbal ability and SES were moderately related to the variables of interest (zero-order correlations ranged from .03 to .25). Thus, to provide a stringent test of associations between empathic understanding and maternal outcome variables, mothers’ verbal ability and SES were covaried in all analyses.
Results Descriptives for empathic understanding variables We first examined descriptive statistics to determine the mean ratings of empathic understanding variables and to ascertain whether this procedure and coding system elicited adequate variability (see Table 1). An inspection of the means and standard deviations indicate that on average, mothers were coded as showing moderate representational attunement (i.e., could offer some accounts of the child’s feelings/thoughts and related them somewhat to situational determinants) and engagement (i.e., showed interest in discussing experiences). Mothers also showed some awareness of their emotional impact on their child’s behavior, on average (i.e., noted that child may be aware of her emotions, but did not acknowledge that her feelings affected child’s behavior/emotions). The entire available scale range was Table 1
Descriptives for study variables (n = 128) Range
M (SD)
Min
Max
Maternal representation Representational attunement (MOAR) 1–7 Engagement (MED) 1–7 Awareness of Emotional Impact (MAEI) 1–7
4.71 (1.33) 4.77 (1.67) 3.75 (2.07)
1 1 1
7 7 7
Mother’s view of child emotion Described child emotion (MOCE) Described child valence (MVAL) Described child intensity (MINT) # Adjectives Used (NADJ)
1–7 1–9 1–9 0–30
3.84 (0.85) 5.24 (1.34) 6.13 (0.91) 7.64 (2.83)
1.6 2.10 3.90 3
5.9 8.40 7.80 18
Mother’s view of own emotion Mother emotion (MFEM) Mother emotion valence (MFVAL) Mother emotion intensity (MFINT)
1–7 1–9 1–9
4.37 (1.37) 5.80 (2.19) 6.67 (1.27)
1 1.7 2.1
7 8.4 8.5
Covariates and maternal characteristics IQ (WAIS subscales) SES (Hollingshead) Sensitivity (Q-sort) Depression (BDI)
0–140 1–5 − 1.0–1.0 0–63
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104 (14) 76 2.06 (0.85) 1 0.64 (0.35) − 0.78 6.13 (6.79) 0
139 5 0.91 36
J Child Fam Stud (2007) 16:483–497 Table 2
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Correlations among empathic understanding variables (covarying IQ and SES; n = 114) 1
Maternal representation 1. Representational Attunement (MOAR) 2. Engagement (MFED) 3. Awareness of emotional impact (MFAEI) Mother’s View of Child Emotion 4. Described child emotion (MOCE) 5. Described child valence (MFVAL) 6. Described child intensity (MFINT) 7. # adjectives used (NADJ) Mother’s view of own emotion 8. Mother emotion (MFEM) 9. Mother emotion valence (MFVAL) 10. Mother emotion Intensity (MFINT)
2
3
4
5
6
7
8
9
10
1.0 .82∗ .49∗
1.0 .54∗ 1.0
.19∗
.20∗
.25∗ 1.0
.02
.02
.04
.83∗ 1.0
−.04
−.08
.12
.12
.02
1.0 −.11
.36∗
.35∗
.36∗
.06
.07
.41∗ .09
.42∗ .07
.40∗ .11
.49∗ .21∗
.30∗ .20∗
.07 .08
.12 .12
.12
.14
.08
.07
.08
.09
.08
1.0 1.0 .51∗ 1.0 .23∗
.39∗ 1.0
Note. ∗ p < .05.
used for the maternal representation variables, and all variables had substantial individual variation about the mean. With regard to describing emotions, mothers tended to describe their children’s and their own emotions as fairly neutral in valence and moderate in intensity. Almost the entire available range of these scales was used for both the globally coded and lexicon-rated variables (see Table 1). Interrelations among empathic understanding variables Partial correlations (covarying IQ and SES) were used to examine relations among the empathic understanding variables (see Table 2). Maternal representation variables were correlated with one another (the strongest association was between representational attunement and engagement). In addition, maternal representation variables were associated with mothers’ descriptions of child emotion, the number of adjectives mothers used to describe their child, and mothers’ descriptions of their own emotions. Mothers who showed greater representational abilities described their children as showing more positive emotion, used more adjectives to describe their child, and reported feeling more positive themselves. Empathic understanding, maternal sensitivity and depressive symptoms Partial correlations (covarying IQ and SES) were also used to examine relations among empathic understanding variables, maternal sensitivity, and maternal depression (see Table 3). Maternal empathic understanding variables were related to sensitivity. Mothers who demonstrated greater representational attunement and engagement were rated as more sensitive. Springer
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J Child Fam Stud (2007) 16:483–497 Table 3 Partial correlations: empathic understanding variables and maternal characteristics (covarying IQ and SES; n = 114) Sensitivity (Q-sort) Maternal representation 1. Representational attunement (MOAR) 2. Engagement (MFED) 3. Awareness of emotional impact (MFAEI) Mother’s View of child Emotion 4. Described child emotion (MOCE) 5. Described child valence (MFVAL) 6. Described child intensity (MFINT) 7. # Adjectives Used (NADJ) Mother’s view of own emotion 8. Mother emotion (MFEM) 9. Mother emotion valence (MFVAL) 10. Mother emotion intensity (MFINT)
.35∗ .26∗ .03 .05 .08 −.09 .08 .13 .11 .23∗
Depression Depression (BDI) −.29∗ −.26∗ −.20∗ −.27∗ −.23∗ .02 −.01 −.27∗ −.17† −.11
Note. ∗ p < .05. † p < .10.
Mothers who described their emotional experience as more intense during the EUA were also rated as more sensitive. With regard to depressive symptoms, mothers who reported higher depression scores demonstrated less representational attunement, were less engaged, and were less aware of the emotional impact they had on their child. Mothers with higher depression scores also described their own, and their children’s, emotional experiences during the laboratory interaction sequences as more negative and less intense than mothers with lower depression scores (see Table 3). As maternal depressive symptoms increased, sensitivity declined (r = − .23).
Discussion Although empathic understanding is a complex construct, we developed a coding system to assess it in a meaningful and reliable way. As assessed via this coding system, maternal empathic understanding was related to mothers’ descriptions of their own and their children’s emotions. In particular, mothers who demonstrated greater representational abilities perceived their children as showing more positive emotion, gave more rich, detailed descriptions of their children, and experienced more positive emotion themselves while viewing videotapes of their children. Furthermore, as expected, empathic understanding related to independently assessed and rated maternal sensitivity and maternal depression, even when controlling for mothers’ verbal ability and socioeconomic status. Specifically, mothers who demonstrated greater representational attunement, greater engagement, and who described their emotional experience as more intense were rated as more sensitive. Mothers who reported higher depression scores demonstrated less representational attunement, were less engaged, and were less aware of the emotional impact they had on their child. Mothers with higher depression scores also experienced their own, and their children’s, emotional experiences during the laboratory interaction sequences more negatively and less intensely than mothers with lower depression scores. Maternal depressive symptoms were inversely related to sensitivity. Springer
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An important aspect of empathic understanding, as defined by our coding system, involved maternal emotional experience and mothers’ descriptions of their children’s emotions. Mothers’ unidimensional emotional descriptions of their children were associated with less nuanced representations. In particular, the more negative mothers’ descriptions of their children’s emotional state, the more constrained their empathic understanding. One interpretation of this finding is that mothers who tend to engage in experiential avoidance (i.e., attempts to minimize negative feelings) may be less sensitive to other child behaviors and the richness and detail of exchanges between mother and child. Data from broader adult samples has shown that such a focus may actually inadvertently intensify a given psychological experience despite attempts to diminish it (e.g., Greco, Blackledge, Coyne, & Ehrenreich, 2005; Hayes, Wilson, & Strohsahl, 1999). Mothers who try to avoid experiencing negative emotions that arise during frustrating or difficult interactions with their children may therefore perceive these experiences with their children as more intensely aversive. In such circumstances, mothers’ attention may more likely rest on their children’s negative emotion so that they might be better able to control it, and in so doing, their own negative emotional reactions. Thus, mothers may pay relatively less attention to their children’s more varied emotional states, maintaining their negative perceptions of children, and constraining the development of more detailed and diverse representations. This may have implications for children’s attachment and socioemotional development. Mothers who are either unwilling or unable to experience the full range of their emotions as they occur may model such propensities to their children. For example, mothers who have difficulty tolerating the stress incurred by reaching particular developmental milestones, such as learning to read, may assist children in an intrusive way rather than allowing them to struggle with their negative emotions and reach mastery on their own. Conversely, mothers who described their own emotions as more intense were more likely to communicate rich, detailed accounts of their children’s motives. They were also more aware of the impact of their own emotions on their children. More emotionally intense mothers may be more attuned and reactive to the full range of their own, as well as their children’s, feelings. Similarly, they may be more likely to respond to their children’s emotions and may regulate their own expression of emotion to meet the needs of their children in a particular context or situation (Dix, 1991; Dix et al., 2004). Additionally, more emotionally intense mothers may engage in more targeted attempts both to foster communication about emotions and in so doing, model more sophisticated emotion expression and regulation skills for their children. This conceptualization appears apropos to theoretical work of Gottman (1999), which differentiates between parents’ emotion-coaching vs. emotion-dismissing strategies of addressing their children’s emotions. Parents who emotion-coach are attuned both to their own and their children’s emotions. They value their children’s emotional expressions, have open discussions about feelings, and are responsive to negative emotional displays. In contrast, parents who are dismissive of emotions are unaware and disapproving of their children’s feelings, and may seek to control or brush off these emotions. Recent work has suggested that these approaches are related to the quality of the parent-child relationship and children’s emotion regulation (Katz, Wilson, & Gottman, 1999). Given that the valence of mothers’ emotion was positively associated with their description of their children’s emotion, mothers may have been interpreting their children’s emotions in the context of their own emotions. This suggests that mothers’ perceptions of child emotions may in part be a function of maternal mood, a point particularly important to consider with regard to maternal depression. Although we investigated levels of depressive symptomatology, it is notable that even at low levels of current symptoms, maternal depression was an important correlate of empathic Springer
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understanding. As maternal depressive symptoms increased, mothers’ empathic understanding of and sensitivity to their children decreased. More depressed mothers also described their children’s emotions as more negatively valenced. In addition, the more negative the mothers’ descriptions of child emotion, the less engaged mothers were in task participation, and the less aware they were of the impact of their own emotions on their children. Maternal depression, even at low levels, may limit the development of empathic understanding – negative mood affects information processing, including selective attention, memory and recall (Gottlieb & McLeod, 1997). A recent study suggests that depressed mothers are more likely to focus on their own emotions rather than those of their children, even when attending to the latter may assist children to acquire desired goals (Dix et. al, 2004), consistent with the inferences drawn from Katz et al. work (Katz, Wilson, & Gottman, 1999). Additionally, depressed mothers were more likely to report experiencing negative emotions about their children. Depressed mothers may also focus selectively on negative child emotions and behaviors rather than attending to or recalling more positive or rewarding interactions. Just as negative interpretations of events may exacerbate depressed mood, perceptions of a child’s behavior as “beyond one’s control” may contribute to continued negative evaluations of not just one’s child, but also a mother’s ability to be a sensitive caregiver. For example, a mother who experiences her child as “bad” may be hypersensitive to or hypervigilant for behaviors that fit that description, whereas appropriate behaviors may either be ignored or misinterpreted (Coyne & Wilson, 2004). Moreover, a mother’s responses may be limited to behavior management strategies rather than attempts to support socioemotional expression, or even simply to enjoy interactions with one’s child. Thus, underdeveloped maternal empathic understanding of children’s thoughts, emotions, and motives may limit mothers’ experience of, as well as behavior towards, their children. As such, mothers may demonstrate a narrowed repertoire of parenting behaviors that are insensitive to a given child’s needs in a particular moment. Mothers who demonstrated poorer empathic understanding in the lab-based EUA were judged by independent raters conducting home-based behavioral observations as less sensitive to their children. This may have implications for child outcomes that compound over the course of development. Given that less empathic mothers are less attuned to and hold less sophisticated representations of their children, their abilities to make accurate guesses or relevant predictions about their children’s behavior may be compromised. Recent work with infants has suggested that mothers’ mind-minded comments (their capacity to make appropriate comments about their children’s thoughts and feelings) contributes to secure attachment (Meins, Fernyhough, Fradley, & Tuckey, 2001). Over time, lack of attunement to infants and toddlers may constrain mothers’ understanding of their children’s emotions, abilities, and vulnerabilities. Thus, in the novel or challenging situations often characteristic of parent-child interactions with toddlers, mothers may be less able to respond in a nurturing and contingent manner. They may be inflexible either in how they elicit or react to their children’s moment-to-moment emotions or mood. Moreover, mothers may be less aware of developmental changes as they occur, and less willing or able to integrate and learn from their children’s novel responses to their environment. In short, less empathic mothers may be less aware of or able to conceptualize their children as whole, unique individuals independent from themselves. This may have implications for children’s ability to regulate their behaviors and emotions, as well as their developing theory of mind (Meins et al., 2002; Meins et al., 2003). Extending to clinical situations, at least one recent study has also suggested that improving maternal empathic understanding positively affected child behavioral outcomes Oppenheim et al., 2004). Springer
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We expected that the global ratings of mothers’ interview responses would correspond to the lexicon ratings of the intensity and valence of their adjectives. Although some expected correlations were found, their magnitude was small to modest. This relative lack of correspondence may result from the fact that the maternal representation ratings were derived from rich interview materials, and that the adjective scores derived from a few isolated pieces of data, a speculation consistent with the stronger association of the maternal representation variables with depression and sensitivity compared with the adjective scores. Still, the lexicon ratings may be useful in studies where few resources are available to assess empathic understanding. Correlations within certain components of the overall study (e.g., correlations among maternal representation variables) come from the same informant (mother) scored by the same rater. Thus, these should be treated with some caution, particularly when considering the magnitude of the association. Other correlations, however, were among variables derived from different informants using different raters (e.g., associations between empathic understanding and maternal sensitivity). These findings are particularly compelling given the multimethod/multi-informant strategy for addressing those questions. Our study also has a number of methodological strengths. We used independent measures of maternal sensitivity (i.e., behavioral observations, Q-sort ratings). Because our coding system assessed mothers’ verbal descriptions of their children, we covaried verbal ability and socioeconomic status in all analyses. Although several studies have used maternal education (typically operationalized as years of education) as a covariate (Oppenheim, Goldsmith, & Koren-Karie, 2004; Oppenheim, et al., 2001), only one similar study to date has taken verbal ability, or more specifically, maternal vocabulary into account (Koren-Karie et al., 2002). None have addressed SES in measures of maternal empathic understanding. Our study expands the previous literature in several important ways. First, using work of Oppenheim and colleagues (Koren-Karie et al., 2002; Oppenheim, Goldsmith, & Koren-Karie, 2004; Oppenhein et al., 2001) as a starting point, we developed a reliable coding system to assess maternal empathic understanding. As assessed by our coding system, empathic understanding was meaningfully related to maternal sensitivity and maternal depression. Second, much of the literature on maternal representations and empathic understanding to date involves infants and toddlers, whereas we explored this construct in the mothers of 30 month-old children. This developmental period is often characterized by challenging behavior that may test mothers’ empathic understanding of and sensitive behavior towards their children. Further data analyses will investigate the relationship of maternal empathic understanding to attachment and child behavior. Understanding the role of depression is limited based on the results of this study due to the relatively low levels of maternal depression, and future work should explore these variables in samples where mothers are currently symptomatic. However, given that meaningful associations were found between empathic understanding and these rather low levels of depression hint at potentially greater impact of clinically significant depressed mood. Future research should explore empathic understanding as a mediator of maternal depression and maternal behaviors, child attachment and other child behavioral outcomes, and perhaps child theory of mind. Results from such work could have important clinical implications. For example, given that depressed mothers are less attuned to their children and tend to view their children’s emotion as more negative, interventions assessing and treatments targeting maternal empathic understanding may have a positive impact on behavioral sensitivity. Acknowledgments This research was supported by NIHM grants R01- MH51301 to Ronald Seifer, a K01MH-066139–04 to Alison L. Miller, and an Institutional Research Fellowship (T32-MH19927–11) to Lisa W. Springer
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Coyne. The first author would like to thank Amy R. Murrell and Jane A. Bybee for their thoughtful comments on this manuscript.
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