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Theory of mind as a predictor of maternal sensitivity in women with severe mental illness

Published online by Cambridge University Press:  16 March 2016

J. Rigby ,
S. Conroy ,
M. Miele-Norton ,
S. Pawlby  and
F. Happé
J. Rigby*
Affiliation:
South London and Maudsley NHS Foundation Trust, London, UK
S. Conroy
Affiliation:
King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
M. Miele-Norton
Affiliation:
Imperial College Medical School, London, UK
S. Pawlby
Affiliation:
King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
F. Happé
Affiliation:
King's College London, Institute of Psychiatry, Psychology and Neuroscience, MRC Social, Genetic and Developmental Psychiatry Centre, London, UK
*
*Address for correspondence: J. Rigby, D.Psych., South London and Maudsley NHS Foundation Trust, London, UK. (Email: [email protected])
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Abstract

Background

Research has shown that maternal mental illness can affect mother–infant interactions with implications for infant outcomes. Severe and chronic mental illness (SMI), particularly schizophrenia, is associated with the greatest risk. Schizophrenia is also associated with impairments in attribution of mental states, ‘theory of mind’ (ToM). Recent attachment research has suggested that maternal mentalizing skills are strongly associated with attachment outcome in infants. To date, no research has explored the relationship between ToM and maternal sensitivity in mothers with SMI using standard tests of ToM. The present study was designed as an exploratory study in order to investigate this.

Method

A total of 40 women with SMI in the postpartum period were administered a battery of ToM tasks and general neuropsychological tasks. The women were also filmed in an unstructured play session with their infants, which was coded for maternal sensitivity using the Crittenden CARE-Index.

Results

One ToM task, the Frith–Happé Animations, predicted maternal sensitivity across all diagnoses. There was also an effect of diagnosis, with lower sensitivity observed in women with schizophrenia. ToM impairments did not fully explain the effect of diagnosis on sensitivity. Mothers of girls were rated as being more sensitive than mothers of boys.

Conclusions

The results suggest that ToM is a significant predictor of maternal sensitivity across all mental health diagnoses, extending the results of studies focusing on healthy populations. Clinical interventions emphasizing the importance of understanding the perspective of the infant may enhance maternal sensitivity.

Keywords

Maternal mental healthmother-infant interactionssevere mental illnesstheory of mind
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 9 , July 2016 , pp. 1853 - 1863
Copyright
Copyright © Cambridge University Press 2016 

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