The impact of optimality on maternal sensitivity in mothers with substance abuse and psychiatric problems and their infants at 3 months

The main aim of this study was to investigate the predictive validity of four different optimality indexes, as well as infant perinatal status, in relation to maternal sensitivity in interaction at 3 months. The four optimality indexes comprised items related to substance abuse, psychiatric condition, relational experience and socioeconomic status (SES). Maternal sensitivity in mother–infant interaction was assessed in two different groups of mothers. One group consisted of mothers with substance abuse and psychiatric problems who underwent treatment during pregnancy. The other group of mothers had neither substance abuse nor psychiatric problems. The expectant mothers were interviewed in the third trimester of pregnancy. Medical records and meconium were obtained from the infants at birth. Three months after birth, maternal sensitivity in mother–infant interaction was assessed. Altogether 79 mother–infant dyads participated in the study. The mothers’ optimality associated with relational experiences, as well as the infants’ perinatal status were found to predict maternal sensitivity in mother–infant interaction at 3 months. The SES index was also significantly related to maternal sensitivity. The relation between group and maternal sensitivity was mediated by the mothers’ optimality associated with relational experiences. This study points to the importance of addressing the mothers’ own relational experiences and their current representations of motherhood during treatment, in order to support and enhance maternal sensitivity.

► Maternal sensitivity poorer in women with substance abuse and psychiatric problems.
► Significant group differences on four optimality indexes and perinatal status.
► Relational experience and infants’ perinatal status predicted maternal sensitivity.
► Effect of group on maternal sensitivity was mediated by relational experience.
► Treatment should address representations of motherhood to enhance sensitivity.