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Expanding the concept of unresolved mental states: Hostile/Helpless states of mind on the Adult Attachment Interview are associated with disrupted mother–infant communication and infant disorganization


In a recent meta-analysis, only 53% of disorganized infants were predicted by parental Unresolved states of mind on the Adult Attachment Interview (AAI). The goal of this study was to identify additional predictors of infant disorganization on the AAI by developing and validating an interview-wide coding system for Hostile/Helpless (H/H) parental states of mind with respect to attachment. Maternal AAIs were collected from 45 low-income mothers with high rates of childhood trauma when their children were age 7; Strange Situation assessments had been collected at 18 months of age. AAIs were independently coded using both the Main and Goldwyn coding system and newly developed codes for H/H states of mind. Results indicated that the H/H coding system displayed discriminant validity in that it did not overlap substantially with the Unresolved, Cannot Classify, or Fearfully Preoccupied by Traumatic Events categories in the Main and Goldwyn coding system. Second, H/H states of mind accounted for variance in disorganized infant behavior not associated with the Unresolved classification. Third, H/H states of mind were significantly related to maternal disrupted affective communication as coded by the Atypical Maternal Behavior Instrument for Assessment and Classification coding system, and maternal disrupted communication mediated the relations between H/H states of mind and infant disorganization.

Corresponding author
Address correspondence and reprint requests to: K. Lyons–Ruth, Department of Psychiatry, Harvard Medical School at Cambridge Hospital, 1493 Cambridge Street, Cambridge, MA 02139; E-mail:
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