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Mind-mindedness and maternal responsiveness in infant–mother interactions in mothers with severe mental illness

  • S. Pawlby (a1), C. Fernyhough (a2), E. Meins (a2), C. M. Pariante (a1), G. Seneviratne (a1) and R. P. Bentall (a3)
  • DOI:
  • Published online: 27 January 2010

Previous cross-diagnosis studies of interaction between mothers with severe mental illness and their babies have concluded that mothers with schizophrenia have deficits in interaction, but these studies have not included healthy controls.


In-patients on a mother and baby unit, with diagnoses of schizophrenia (n=15), depressive mood disorders with or without psychosis (n=23), or mood disorders where mania was the predominant feature, with or without psychosis (n=12), were observed interacting with their infants on admission and discharge. Mothers' mind-mindedness and other measures of the quality of maternal and infant behaviour were coded. Findings from this sample were compared with those from healthy mothers and their infants (n=49).


Compared with healthy controls, on admission depressed mothers were marginally less likely to comment appropriately on their infants' mental states. Both the depressed and mania groups were more likely to touch their babies and engage in attention-seeking behaviours. Interactional behaviours of mothers in the schizophrenia group were not markedly different from healthy controls. On discharge there were fewer differences between the clinical and healthy groups, although the depressed group continued to engage in more attention-seeking and touching behaviour and the mania group continued to touch their infants more. Only mothers in the schizophrenia group showed changes in interactional behaviours between admission and discharge, talking more to their infants.


The findings challenge previous conclusions that mothers with schizophrenia have deficits in their interactions with their babies, and demonstrate that mothers with severe mental illness are able to respond appropriately to their infants' cues.

Corresponding author
*Address for correspondence: Dr S. Pawlby, PO 71, Section of Perinatal Psychiatry and Stress, Psychiatry and Immunology, Institute of Psychiatry, King's College London, De Crespigny Park, LondonSE5 8AF, UK (Email:
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KM Abel , RT Webb , MP Salmon , MW Wan , L Appleby (2005). Prevalence and predictors of parenting outcomes in a cohort of mothers with schizophrenia admitted for joint mother and baby psychiatric care in England. Journal of Clinical Psychiatry 66, 781789.

B Arnott , E Meins (2007). Links between antenatal attachment representations, postnatal mind-mindedness, and infant attachment security: A preliminary study of mothers and fathers. Bulletin of the Menninger Clinic 71, 132149.

M Cannon , A Caspi , TE Moffitt , H-L Harrington , A Taylor , RM Murray , R Poulton (2002). Evidence for early childhood, pan-developmental impairment specific to schizophreniform disorder: results from a longitudinal birth cohort. Archives of General Psychiatry 59, 449457.

J Cohen (1988). Statistical Power Analysis for the Behavioral Sciences. Lawrence Erlbaum Associates: Hillsdale, NJ.

JF Cohn , SB Campbell , R Matias , J Hopkins (1990). Face-to-face interactions of postpartum depressed and non-depressed mother–infant pairs. Developmental Psychology 26, 1523.

R Corcoran , G Mercer , CD Frith (1995). Schizophrenia, symptomatology and social inference: Investigating ‘theory of mind’ in people with schizophrenia. Schizophrenia Research 17, 5–13.

DF Hay , S Pawlby , CS Waters , D Sharp (2008). Antepartum and postpartum exposure to maternal depression: Different effects on different adolescent outcomes. Journal of Child Psychology and Psychiatry 49, 10791088.

LM Howard , G Thornicroft , M Salmon , L Appleby (2004). Predictors of parenting outcome in women with psychotic disorders discharged from mother and baby units. Acta Psychiatrica Scandinavica 110, 347355.

BL Lundy (2003). Father- and mother-infant face to face interactions: Differences in mind-related comments and infant attachment? Infant Behavior and Development 26, 200212.

JJ McGrath , J Hearle , L Jenner , K Plant , A Drummond , JM Barkla (1999). The fertility and fecundity of patients with psychosis. Acta Psychiatrica Scandinavica 99, 441446.

E Meins , C Fernyhough , E Fradley , M Tuckey (2001). Rethinking maternal sensitivity: Mothers' comments on infants' mental processes predict security of attachment at 12 months. Journal of Child Psychology and Psychiatry 42, 637648.

E Meins , C Fernyhough , R Wainwright , D Clark-Carter , M Das Gupta , E Fradley , M Tuckey (2003). Pathways to understanding mind: Construct validity and predictive validity of maternal mind-mindedness. Child Development 74, 11941211.

E Meins , C Fernyhough , R Wainwright , M Das Gupta , E Fradley , M Tuckey (2002). Maternal mind-mindedness and attachment security as predictors of theory of mind understanding. Child Development 73, 17151726.

L Murray , A Fiori-Cowley , R Hooper , P Cooper (1996). The impact of postnatal depression and associated adversity on early mother–infant interactions and later infant outcome. Child Development 67, 25122526.

L Murray , C Kempton , M Woolgar , R Hooper (1993). Depressed mothers' speech to their infants and its relation to infant gender and cognitive development. Journal of Child Psychology and Psychiatry 34, 10831101.

L Murray , D Sinclair , P Cooper , P Ducournau , P Turner (1999). The socioemotional development of 5-year-old children of postnatally depressed mothers. Journal of Child Psychology and Psychiatry 40, 12591271.

TG O'Connor , J Heron , J Golding , M Beveridge , V Glover (2002). Maternal antenatal anxiety and children's behavioural/emotional problems at 4 years. Report from the Avon Longitudinal Study of Parents and Children. British Journal of Psychiatry 180, 502508.

S Pawlby , DF Hay , D Sharp , CS Waters , V O'Keane (2009). Antenatal depression predicts depression in adolescent offspring: prospective longitudinal community based study. Journal of Affective Disorders 113, 236243.

D Riordan , L Appleby , B Faragher (1999). Mother–infant interaction in post-partum women with schizophrenia and affective disorders. Psychological Medicine 29, 991995.

AJ Sameroff , R Seifer , M Zax (1982). Early development of children at risk for emotional disorder. Monographs of the Society for Research in Child Development 47, 182.

M Snellen , K Mack , T Trauer (1999). Schizophrenia, mental state, and mother-infant interaction: examining the relationship. Australian and New Zealand Journal of Psychiatry 33, 902911.

MW Wan , V Penketh , MP Salmon , K Abel (2008 a). Content and style of speech from mothers with schizophrenia towards their infants. Psychiatry Research 159, 109114.

MW Wan , K Warren , MP Salmon , K Abel (2008 b). Patterns of maternal responding in postpartum mothers with schizophrenia. Infant Behaviour and Development, 31, 532538.

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Psychological Medicine
  • ISSN: 0033-2917
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