still-face paper 1996

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Depressed Motliers' Touching IncreasesInfants' Positive Affect and Attention inStill-Face Interactions

Martha Pelaez Nogueras

Florida International University

Tiffany M. FieldUniversity of Miami

Ziarat Hossain

Fort Lewis College

Jeffrey PlekensJames Mad ison University

PELAEZ-NOGUERAS, MAHTHA. FIELD, TIFFANY M., HOSSAIN, ZL^RAT, and PICKENS, JEFFREY De-pressed Mothers Touching Increases Infants Positive Affect a nd Attention in Still-Face Interac-tions. CHILD DEVELOP^^i:NT, 1996, 67, 1T80-1792. The effects of depressed mothers' touchingon their mfants' behavior were investigated during the still-fece situation. 48 depressed andnondepressed mothers and their 3-mo nth-old infants w ere random ly assigned to control andexperimental conditions. 4 successive 90-sec periods were implemented: (A) normal play, (B)still-face-no-touch, (C) still-face-with-touch, and (A) normal play. D epress ed and nondepressedmotliers were instructed and shown how to provide touch for their infants dur ing the still-face-with-touch period. Different affective and attentive responses of the infants of depres sed versustie infants of nondepressed mothers were observed. Infants of depressed mothers showed morepositive affect (sniiles and v ocalizations) and gazed more at their m others' hands during thestill-face-with-touch perio d than the infants of Bo nde piesse d m others, who grimaced, cried, andgazed away from their mothers' faces more often. The results suggest that by pro\'iding touchstimulation for the ir infants, the depressed mothers can increase infant positive affect and atten-tion and, in this way, comp ensate for negative effects often resulting from their t>'pical lack ofaffectivity (Hat facial and vocal expressions) du ring interactions

Early interaction disturbances place in- nal depression on early infant interactionsants of depressed mothers at risk for later and development and have identified theaffective and socioemotional disorders behavior patterns of depressed mothers asField, 1992; Gaensbauer, Harmon, Cytryn, unresponsive, insensitive, ineffective, non-

McKnew, 1984; Zahn-Waxler, Cummings, contingent, emotionally flat, negative, disen-McKnew, Radke-Yarrow, 1984). Having a gaged, intrusive, avoidant of confrontation,depressed mother increases by three times a and generally less competent and unin-hild's risk of developing the abnormalities volved with their infants (e.g., Campbell,haracteristic of depressed mothers (Weiss- Cohn, Meyers, 1995; Cohn, Matias, Tron-

man et al., 1984). Numerous studies have ick, Connell, Lyons-Ruth, 1986; Cohn documented the negative impact of mater- Tronick, 1983; Field, 1984, 1986; Lyons-

The authors wishto thank Julie Malphurs Jeanette Gonzalez Claudia Larramand Angie


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Pelaez-Nogueras et al, 1781

Ruth, Zoll, Connell, & Grun ebaum , 1986;Pelaez-Nogueras, Field, Cigales, Gonzalez,& Clasky, 1994).

Infants of depressed mothers, in turn,appear to develop a dep ressed mood style asearly as 3 months. The dep ressed infantstypically exhibit less attentiveness, fewersmiles, more fussiness, more gazing away,and lower activity' levels when interactingwith their depressed mothers than infants ofnondepressed mothers (Cohn, Campbell ,Matias, & Ho pkins, 1990; Gelfand & Teti ,1990; Goodman, 1992). Moreover, maternaldepression has been significantly associatedwith attachment insecurity among infantsand preschoolers (Teti, Gelfand, Messinger,& Isabella, 1995). Infants of de pre ssed moth-ers, however, do not necessarily generalizetheir depressed mood to other adults.WTien the infants of depressed mothers in-teracted with their nondepressed nurseryteachers, the infan ts' behav ior rescovered,and their activity levels and positive affectrates were higher than when interactingwith their depressed mothers (Pelaez-

Nogueras et al., 1994).In general, depressed mothers and their

infants appear to share the ir behavior states,spending more time in negative attentive/affective behavior states than pondepressedmQther-infant dyads (Field, Healy, Gold-stein, & Gu thertz , 1990). Different profilesof behavipr have been identified, includingdisengaged mothers (withdrawn and pas-sive) an d intru sive m othe rs (e.g., angry facialexpressions and intrusive poking of the in-

fant) (Field et aL, 1990; M alph urs, Raag,Field, Pickens, & Pelaez-N ogu eras, 1996).But despite the variability observed in themothers' interaction stj-Ies, the infants ofboth disengaged and intrusive mothers areusually uniformly distressed. Also, whetherexperiencing postpartum or chronic depres-sion (Campbell et al., 1995), the commonfindinia in the literature is that the dep ressedmothers' negative mood states and lack ofaffective responses negatively affect thechild's behavior. In this way, the infants ofdepressed mothers begin to show growthand developmental delays at 1 year if their

h i d d h fi

Researchers have prospectively studieinfants and todd lers of dep ressed mothers analyze the processes and mechanism

whereby depression may affect infant be-havior. Diverse mechanisms have been hpothesized to produce the negative out-comes observed in infants and children ofdepressed mothers (e.g., Reardslee, Bemorad, Keller, & Her m an , 1983 ; Cum mings Cicchetti, 1990; Hammen, 1992). Howeveelucidation of the mechanisms and pro-cesses involved in the transmission of socioemotional behavioral problems from de-pressed mothers to the ir infants is still amajor challenge for develop men tal researcers. This is because early dev elopment ofinfant depression may result from the inteaction of mu ltiple influences including biological factors and psychosocial factors. Seeral models of early development ofdepression have been proposed, includinmutual regulation (Tronick & Gianino1986), multivariate cumulati\'e risk (Fiel1992), and temperament and genetic prediposition (\\Tiiffen & Go ttlib, 1989). Th esmodels have focused on the effects of multple factors that include prenatal influencand postnatal experiences. An infant showin g a depressed-m ood pattern could be(a) biologically predisposed to depressiondue to prenatal exposure to the depressedmother's physiological imbalance and hor-monal status or due to a potentially congental predisposition or (fc) e nv ironm en tally af-fected due to continuing maternal depressebehavior patterns, l ike unresponsiveneand flat affect Thus, multiple factors see

to be affecting bo th m othe rs' depressio n aninfants' behavioral patterns denoting de-pression, and there are mu ltiple interactions between these underlying affectivperceptual, physiological, and biochemicaprocesses.

The objective of the present study wato determine whether depressed mothecan improve their infants' attentive and af-fective responses by providing touch stimlation during still face interactions. Toucas a source of stimu lation, has receiv ed littattention in the mother-infant interaction lierature The studies reported below sugge


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178 2 Child Developm ent

For example, an Inter^Sn

iSnsi(Scafidietal.,19l))

p during Face to Face InteractiomFace-tp-face interactions are a primary

way^behavior disorders seem to be transmit--ted from motlier to infant (Cohn et al. 1986-fq«m' 'T^*'^^ ^*?' ' ^ ' ' ' *^* ' ^ Goldstein:1986). The qualitj- of infant behavior hasbeen,related to the wiresponsiveness andemotional unavailability of their mothers?^ S* '^ê in1:emct ions(Samerbff& S i f ^S^*'^êin1:emctions(Samerbff& Seifer1 3 ; Tronicfc & Gianino, 1986). Only a fewstudies have investigated the, effects of ma-ternal toucji during faee-to-face mteractionswitli th.eir infants or ike use of touch inter-ventions to faGilif^te better interactions be-tween mothers and tlieir infknts (e.g. Field

for example, Pelaez-Nogueras et al (inp s ^ ) found that touch can reinforce andmaintain high rates of infant eye contact re

sponses, vocalizations, and smiles duringface-to-face inteTactions. In that study usinea ^tjiKhronous-reinforcementopem7tn^ce-dure, touch stirmilition (gentle rubbtogofthe infant's arms, legs, and feet fw as nr ovided^ by a care ^v er *hile the nfent w ŝmîng eye conSet with hL Af̂ er s t Sponditioning sessions, the infants showedpreferences for the reinforcing stimukHonh^t included touch, as showf b y ^ h ^ Shat they smiled and vocalised U S and

made more eye contact with the caregiverThos ̂findings suggest that i n f k x t s ' a t S ^nd positive affect can be leinforce^d andmaiatainedby an adult providing ?

to study mother-m Ll

i ip p

^ ^ g with negative affect and other

behaviors. Stock and Muir (19901 ** '^**' mothers were asked to be'^responsive, sifent, and not to

*f» * ̂ during the stfll-face epi-displayed more grimacing and^^^^^ ^ perms o£ normal

, when touch was intro-^ ^ still-face period, infantsand attention was higher. Itbe deteimined, however,*« of depressted mothers are

sensitive to maternal touch than in-o^'Nondepressed mothers. As yet, noinvestigated the effects of touch

d mothers using the still-face

f

^™»« ̂the negative effects elicited by theirt f ̂ providing additional touch for

We thought it important t» ex-i^'°'H^^^~ depressed moth-^^ ̂ '^^^ts, to regulate affectincrease their attention. Theh t ifa n ts of depressed moth-

distressed as the infantsmothers during the stilJ-

,îta^tio« because they were&eir mothers with flatWt/ ^ ^^^^^ in to te , touch(or compensate for) the lack

>^^ the other sources (i.e..^ oth^r hand, the u.

mothers were ex-

ced in a stjU-face-period because dieir mothers'


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positively than infants of nondepressedmothers when optimal touch (mild strokes/movements) was introduced in the still-facesituation. Thus, maternal behavior was ma-nipulated, touch was standardized, and themain grouping (independent) variable wasmaternal depression score. By standardizingtouch we minimized differences in de-pressed and non depressed mo thers ' kinds oftouch and were able to assess whejther ma-ternal depression could account for the dif-ferences in infant behavior.

etho

SubjectsFort>'-eight 3-month-old infants (meanage = 13 5 w eek s, SD = 1.2) and their moth-ers (mean age = 19.1, SD = 2.7) partici-pated in this study. All infants were healthy,born at gestational age (M = 38 weeks),were of normal birthweight, and had no his-tory of med ical com plications. Subjects w ererecruited from a longitudinal study sampleof low socioeconomic status based on thetwo-factor Hollingshead Index. Motherswere primiparous black (33 ), Hispanic(40 ), or Cau casian (7 ), and wer e single(86 ) adolescents, and their infants werenormal full term infants. Three mother-infant dyads needed to be rescheduled be-cause the babies were fussy and sleepy.

Mother-infant dyads were assigned toone of four groups: Depressed Mothers-Experimental N = 16), NondepressedMothers-Experimental {N = 16), and De-pressed Control and Nondepressed Control

(A^ = 16). T h e Beck D ep res sio n Inventorv-(BDI) scores defined the depressed and thenondepressed groups (depression classifica-tion is described in detail in the fiDllowingsection). The groups did not differ on demo-graphic variables, including age, ethnicit\ ' ,maritaf status, and SE S, resu lting in a hom o-geneous sample. To ensure group equiva-lence, infants and their mothers were as-signed to control or experimental groupsthrough a random stratification procedure,stratifying in accordance to maternal depres-sion score.Procedure

Pelaez-Nogueras et al. 17 8

instruments in research on nonclinically dpressed samples. This self-report scale wused rather than a diagnostic interview bcause Cohn and Campbell (1992) have rported that depressed mothers' interactibehaviors are more highly correlated wiself-report depression scores than they awith diagnostic interview measures. Moters with BDI scores of 13 or greater (cutpoinof depression in most research protocolwere assigned to the depressed group anmothers with scores of 9 or less were asigned to the nondepressed group. We aministered the BDI to 61 mothers to yieour sample of 24 depressed mothers. In pre

vious studies withi this population, approxmately 30 ofthe mothers sampled receivescores greater than 16 on the BD I (e.g., Eieet al., 1990). The mean BDI score for all dpressed mothers in our sample was 21 (S= 9.1), ranged fram 13 to 52, and for thnondepressed moAers was 4.1 (SD = 2.7rang ed from 1 to 9, Mothers with BDI scorof zero, 10, 11, and 12 did not participate this study. The BDIs were administered 1min before the interaction in a waiting roonext to th e laborator>' by a research assistan

Apparatus and setting.—Infants werseated, in an infant seat facing their motheat a distance of approximately 15 incheM others we re seated directly facing their ifants at eye level. Two cameras, located oeither side of the mother-infant dyad, weconnected to a video recorder and a specieffects generator to yield a split-screen image. One camera recorded the frontal viewof the infant, and the second camera recorded the mother's face and hands. A timdate generator connected to the monitor waused to time the duration (in minutes, seonds, and milliseconds) of each period fosubsequent coding.

Design.—A repeated-measures between-groups design was implem ented: twgroups (depressed vs. non depre ssed) x tw ocond itions (control vs. expe rimen tal) x fosuccessive periods: (A) 90-sec normal inteaction, followed by B) 90-sec still-face-notouch, (C) 90-sec still-face-with-touch, anfinally (A) 90 sec normal interaction Six


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7 84 Child Developm ent

ounterbalanced becau se the purpo se was toave a still-face-no-touch period precedingstill-face-wiA-touch period specifically to

nduce distress in order to increase thehan ces of gettin g an effect an d thu s to com-are Ae depressed and nondepressed dy-ds' performances.

lnstmctions.~-The total procedure re-quired approximately 8 m m . During A e four30-sec intervals between Ae four period, allmothers were given instructions. Iristruc-ions were standard for all mothers. To ad-

dress Ae question of wheAer infants oi de-pressed and nondepressed mothers responddiffferentially to touch when their motlierspose a still face, it was important to reducevariabili ty in moAers' behavior during Aestill-face 'situation. For Ais reason, we irp-posed still-face instructions to all mothers inAe experimental condition.

Before A e first norm al play periodôf in-teraction^ mothers in the efPenmental con-dition w ere instmc ted to play vviA then m-fan*s as Aey would normally do at home.

For the second period (stiU-face-no-touch),Aese mothers were instructed to look/gazeat A eir' infants w iA a neutral expressionand to refrain frorn speaking, smilmg, andtoucliing th e infant du ring this period t o rAe third period of interaction (still-iace-with-touch) instructions were given to looK/gaze at Ae iniknt wiA a neutral expression,to refi-ain from speaking aad smAng, but totouch Ae in&fltas modeled. In Ae last nor-mal period, mothers received the same m-structiions as in the first normal period.

To ensure Aat moAers maintained astill face Aroixghout A e still-face p e m d scontinuous monitoring was conducted byA e second research assistant observing theinteraction from A e observation room, i h eobser^r constant ly checked that moAerswere complying wlA instructions and werenot making anj-chang e in facial exp ressions,

as instjucted. All mothers in both groups

A an 15 sec, A e session was interrup ted andrescheduled. total of five m other-m fant dy-ads nee ded to be retrained and rescheduledfor a second visit.

Touch procedure —]ust before th e still-t-ace-wiA-touch period, ali moAers m A eexperim ental condition received a ôrietdem onstration of optimal touch Th e opti-mal touch procedure involved a motherstroking and rubbing rhythmically the m-fants' arms, legs, and feet using th e five fin-gers of boA hands for Ae duration of Aestill-face period (90 sec). The experimentermodeled gentle pressure in slow circaiarir'otions at a rate of approximately on e circu-lar rub per sec . Negative touch was avoided.Negative touch inv olves rough tickling, pok-i n A ^ d tugging while interact ing wiA A einfant, inclu ding pok ing A e b aby s face,ar'ms, or stomach, or pinching or sqiieemngA e infant, or pullin g or shaking A e infant.MoAers were instrticted not to tickle orpoke, their infants du ring A is p roced ure, norto pu ll intensively th eir infants' legs or an ^s.The motliers' touch was checked routinelydarin« the interactioBS to make sure Aeywere providing toiieh as instnieted.

Behavior coding,—The onset and offsetof the videotaped behavior were registeredbv pressing numeric codes on a laptop com-DUter All behavior modalities were codedseparately. The behaviors were coded con-til iouslv and featured a second-oy-secondlisting of behaviors and a matrix «f percent-age ttme Ae behaviors occurred iGuAeitefe'Reia. 1989). One view of & e videorecord

w a. used per each modality: (1) m fan tfc m leKpressions (three cod es: sm ile, «eu tral gr^mace ) (2> infan t vocal exp res sions (tlijreeSr ies^ positive vo eafertio ns, BO vocahâ-tiom , a 4 p«>tBst/cryir«), (3) iniaBt gaze be -havior (used three codes: gaze at moAersfece, SBze away fiom moAer's fece, gaze atSoth eVs W nds). Thus, coding of these mea-sures required three separate viewu^s ofeach record. In this way, coding o. the m-SS ' t ehav io r. i - c iudBd th ree pos r t i va be .

sm iling, (2) vocalizing.. (3) gazm gexs' ha3»ds, and Are eja eg ati ve a t

£ c ^ beh avi ors: (4) crying, (5) grimacm g,d (6) g i g f


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Pelaez-Nogueras et al. 17 8

but the mother's face, hands, or body. Posi-tive vocalizations were discrete sounds likethose involved in cooing and babbling (but

the infant cou ld not be fussing or protesting ).For crying, the infant had to be grimacingand emitting nondiscrete/loud sounds.

Given the highly standardized proce-dure of this study, for control purposes themother's behaviors were also coded, that is,mother's touch, facial expressions (smiles,negative/angry, neutral), and mother's vocalsounds were coded. This allowed ns to en-sure that mothers were following the still-face, no voice, and no-touch and touch in-structions. For touch behavior, five(numeric) codes on the laptop computerwere used to code touch behavior: (1)mother's hand resting on baby, (2) mildtouching (stroking, caressing, rubbing), (3)intense touching (tickling, poking), (4) mildmovement (lifting baby's feet or arms inslow, rhythmic cycling), and (5) intensemovement (cinick intense movements ofarms and legs or pullin g arms or legs) (Stack& Muir, 1990). The purpose to measure

touch was to ensure that mothers were pro-viding mild touch and movements (2 and 4)for at least 75% of the time during the still-face touch period and were not making in-tense m ovem ents or pu lling the infant's legsor arms.

Observer ReliabilityObservers were unaware of the hypoth-

eses and of the mothers' depression status.The two independent raters were trained to

90% reliability on each response categorywith an exp erience d rater. Reliabilit\ ' of thebehavior measures was determined on one-third of the sample. Product-moment corre-lation coefficients were obtained on the per-centage scores of primary and secondary'ob ser/e rs on all respo nse measures of infantand mother beha'viors. Observer reliability,calculated separately for each respon se m ea-sure, was at p < .001 for each measure. Thereliability coefficients obtained for infants'behaviors w ere as follows: infant smile, r =.96; infant vocalization, r = .92; infant gazeat ha nd s, r = .90; infant grimacing, r = .97;

f f

ResultsThe first analyses were a 2 (group: d

presse d vs. non dep ressed) X 2 (conditioexperimental vs. control) x 4 (periods of iteraction) MAKOVAs on infants' positive bhaviors (smiling, vocalizations, and gazing mo thers' hands), and on infant's negative bhaviors (grimacing, cr>'ing, and gaze awafrom mo thers). Fo r the first MAKOVA on ifant positive behav iors, the analyses yieldea significant three-way interaction effect group X condition x period s, F(9, 36) 2..56, p < .05. Then, significant main effecwere also observed for group, F(3, 42)

4.28, p < .01, and cond ition, F(3, 42) = 2p .05. For the MANOVA on negative bhaviors, the analyses yielded a significathree-w ay interaction effect of group x codition X periods, F(9, 36) = 2.56, p < .0For the negative infant behaviors significamain effects were also observed for grouF(3, 42) = 3.90, p < .05, and for co nditioF(3. 42) = 2.68, p = .05 .

Sepa rate analyses for th e control and thexperimental conditions revealed: (1) nchanges in the control condition on any bhavior were obse] \'ed over time, across tfour period s; (2) no significant differences the beh avior of the infants of dep ressed anond epressed m others were observed in tcontrol condition across the four period(3) no differences were obserx'ed betwethe control and experimental mother-infadyads in the Hrst normal period . Th ese anyses suggested that tlie control and expemental conditions were similar at the begi

ning (first normal period) of the study athat the infants were Bot fatigued over tim

A significant main effect of group (dpres sed vs. non dep ressed ), F(3 , 28) = 7.4p


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17 86 Child De^^elopment

peated meas ures sho wed significant interac-tion effects (Winer, 1971). Paired f tests w erealso conducted Within subjects to comparethe between still-face-with-tpuch and still-face-no-touch periods (shown by subscriptsin Table 1). The results on each variablefollow.

Infant Positive BeliaviorsSmiling.—ANOVA results for smiling

yielde d a group tren d (dejpressed vs. nond e-pressed), F(l, 30) = 3.68, p < ;06, and a sig-nificant gro up X perio d interaction effect,F(3, 90) = 2.94, p < .05. Th e propoition of

smiling decre ased from th e normal period ofinteraction to the still-face-no-touch periodin both groups (Table 1). How ever, only thedepressed group showed a significant in-crease in sm iling from the still-face-no-touchto the inimediately following still-face-wilh-touch period, til5) = - 2 . 3 3 , p < .05. Simplema in effect tests perform ed on infant smilingrevealed that the depressed and nonde-pressed groups differed in the still-face-with-touch period, F (l , 30) = 11.15, p <,005, and in the last normal period, F(l, .30)= 16M0, p < .005, with th e dep resse d giroupsmiling more.

Voe^alizations.—An ANOVA yielded asignificant g rou p effect (dep res sed x .̂ no n-depre ssed), F (l , 30) = 4.79, p < .05, and asignificant group x period interaction effect,F(3, 90) = 8.74, p < .001. T he proportion oftime spent vocalizing decreased from thefirst normal period of interaction to the still-face-without7touch period for the nonde-

pressed group only (Table 1). Post hoc sim-ple main effects revealed group differencesin vocalizing d urin g the still-face-with-touchperiod, F(l, 30) = 5.52, p < .0.5, and duringthe last normal period, F(l, 30) = 12.50,p < .001 , witii infants of de pre ssed mo thersvocalizing m:ore than infants of nonde-pressed mathers;. The differences noted ininfants' vocalizations in the normal periodswerd not signiftcant.

teasing at mother's hands.—Results re-vea led a main effect for grou p (dep ressed v s.non dep ressed ), F (l , 30) = 10.90, p < .005,and a group x period interaction effect F(3

often than infants of nondepressed mothersduring the first nornial episode, F(l, 30) =5.10, p < .05 , still-face-with-touch per iod ,F ( l , 30) = 4.97, p < .05, and dming the lastnormal period, F(l, 30) = 1.3.30, p < .001.

Infant Negative BehaviorsGrimacing.—An ANOVA on grimacing

yielded a group effect (depressed vs. nonde-press ed), F( l, 30) = 5,50, p < .05, and agrou p X perio d interaction effect, F (3 , 90)= 7:01, p < .001. For the d epressed group,infant grimacing decreased from the still-face-no~touch period tq the stiil-face-with-touch period in the depressed group only,i(15) = 2.58, p < .03. sim pl e m ain effectsanalysis revealed that infants in the de-pressed group grimaced less often than theinfants of nqsndepressed mothers during thestill-faee-with-toiich period, F(l, 30) =11.15, p < .005. Grim acing w as also less fre-que nt, F (l , 30) = 7.62, p < .01, in the de -presseti group compared to the nonde-pressed group du ring the last normal period.

Crying.—For crying, only a group x pe-

riod j'nteraction effect was o btain ed, F (3, 90)= 2\B2, p < .05. For the depressed grouponly, infant c m n g dec reased from th e sMll-face-iiO toueh pe rio d to th e still-face-with-touch period, t(15) = 3.43, p < ,005. Cryingwas lower, F (l , 30) = 4.98, p < ,05, in thedepressed group cOmpaired to the nonde-pressed group during the still-face-with-touch period. Crying continued to be lower,F(l, 30) = 4.39, p < .05, fbr the dep ress edgroup compared to the non depressed groupduriflg th e last norrnal pe riod .

Gazing away from mother.— AnANOVA yielded a group effect (depressedvs. non dep ressed ), F( l, .30) = 5,79, p < ,05,and a group x period interaction effect, F (l ,30) = 7.55, p < .001. Th e proportion of timethe Inlaats gazed away from their motherssignificantly decreased, tfl5) = 5.65, p <.001, ffepi the still-faee-no-fouch to the im-mediatipiy following stili-face-with-touch pe-riod ip the depressed groiip but not in thenondepressed group. Simple main effectsanai|fsi| gieifbrmed oii giaing away from themotfifit revealed that e nondepressed


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17 88 Child Development

or grou p X pe riod in teraction effects (p >.10). Touch was provided almost continu-ously by all mothers (97.7% of the time by

depressed mothers and 93.7% ofth e t ime bynondepressed mothers) during the 90-secstill-face-with-touch period (Table 2). Theinstructions provided to both groups for thestill-face-no-touch and for the still-face-with-touch periods minimized siny potentialdifference in maternal beh avior. Also, touchinstructions seemed to produce a carryovereffect of the mothers' touch behavior fromthe still-face-with-touch period to the lastnornial period of interaction, during whichbotla depressed and nondepressed motherstouched their infants more than during tliefirst normal play period. The higher amountof touch during the last normal period com-pared to the first normal period could haveaccounted for the significant differences ob-served in infant behawors between thesetwo periods.

Overall MANOVA for mothers' vocalsoun ds, smiles, and stillface rev ealed no sig-nificant m ain effects of grou ps (dep resse d vs.

nondepressed) or group X period interac-tion effects (p > .10), This result was alsoexpected given that the maternal behaviorin both groups was highly standardized andurlder experimental control during the still-face-no-touch and still-face-with-touch pe-riods.

is ussion

As pred icted, infants of dep ressed moth-ers responded more positively to the rein-

statement of touch following a still-face-no-touch episode than did infants of nonde-pressed motliers. Infants of depressed moth-ers showed more positive affect (moresmiles and vocalizations) and gazed more attheir mothers' hands during the still-face-with-touch period than the infants of nonde-pressed mothers, who grimaced, cried, andgazed away from their mothers' face moreoften during this period.

We should note that, by specifically in-

troducing a still-face-with-touch period im-mediatelv- after a still-face-no-touch period,we w ere able to m easure th e soothing effects

however, the effects were more soothing forthe infants of depressed mothers and gazeaversion significantly decreased, but only

dec rease d for the infants of dep resse d m oth-ers. In this way, the distress caused by ma-ternal lack of facial expressions and voicewas reduced by instructing mothers to ac-tively touch their infants. These findingssuggest that the effects caused by the stillface (lack of emotional expressions) can bepartially eliminated (or reduced) by mothersactively touching their infants while still fa-cially and verbally unresponsive.

In general, both groups of infants

seem ed to l ike touch, and they showed it bysmiling and vocalizing more when theywe re touched. This study extends the previ-ous findings (Pelaez-Nogueras et al,, 1996;Stacks Muir, 1990,1992) by examining dif-ferences between depressed and nonde-pressed groups. In addition to finding thatinfants of depressed mothers smiled and vo-calized more, oriented more to their de-pressed mothers, and cried and grimacedless than infants of nondepressed mothers

during the still-face-with-touch period, wefound that during tlie final return to normalplay period infents of nondepressed mothersdid not app ear to reco ver from the dis-tressing still-faee p eriod s, and they beg an tocry, grimace more, gaze away more, and tosmile and vocalize less compared to infantsof non depre ssed motliers. Because w e m ini-mized the potential sociodemographic con-founds by having a homogeneous sample ofdepressed and nondepressed adolescentmofeeis of low SES, our results can be con-sidered representative for ttiis particularlower-income adolescent population. Giventhis iiomogeneitj ' of o v a sample, the resultsmay be limited in generalizability.

The effects observed in infant behaviorwe re not accounted for by imm ediate groupdifferences in maternal behavior. That is,the depressed and nond^epressed mothers'behaviors were not significantly different inthe conditions in which irifant behavior dif-ferences \vere observed. This uniform pat-tern of maternal behavior was expectedgiven the highly standardized procedures ofhi iid i h b di f h B h


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11/14

17 90 Child Development

fant's prior history of interactions with a de-presse d mother. The differences observed inthe infants' behavior may be attributed tomaternal dep ression and its concom itant his-tory of interactions.

Alternatives to learning-bistor>? explana-tions, however, should be considered. It hasbeen argued that infents of depressed moth-ers are at unu sually b igh risk for d evelopin gdepression due to genetic or prenatal. traBS-mission (Zuckerman , Ais, Baacb ner, Parker,& Cab rai, 1990). To pred ict infant de -pres sive behav ioral outcom es from any sin-gle factor, however, is almost impossible,>vhether this factor is geneti c or postn atal b e-bavior experience . To elucidate the etiologyof infant depression was not the objective,rather, our goal was to determine if a shortintervention with touch by depressed m oth-ers would increase 'infants' positive affectand attention during still-face interactions.As preclicted, touch was more effective inenhancing the positive behavior in infantsof depressed mothers. Depressed mothersseemed to lia^'c facilitated more positive af-

fect and attention in their infants by toueh-ing tbem during die iDteraetioiis, and tlie op-timal/no nintrusiv e type of touch used i3i thisstudy appeared to provide comfort duringthe stressful still-faee interactions.

T he findin,gs can be e xplain ed in a num -ber of waj'-s. On e possible explanation is thatthe infants of nondepressed mothers did notshow significantly less giiroaciiig and cryingwhen touch was intioduced during the sti l lface because these infants wetele^s familiar

with maternal unavailabiliig-' (flat face and af-fect) and were thus much more difficult tosootiie when touch was inti-oduced. More-over, infant grimacing and crj'ing continuedto be em itted by the infants of no nde pres sedmothers even during the resinned nornialperiod . The increase in infant grimacing andcr\ ' ing during the mothers ' subsequent re-turn to noniial play following a period of ma-ternal unavailability was also observed byToda and Fogel (1993).

Typically, mo thers fake good and tryhar der to show positive behaviors duringtlie initial moments of videotaping in experi-

who might normally be deprived of contin-gent maternal touch and contact at home.Touch may have quickly become nonsooth-

ing, and perhaps aversive, for the infants ofnon depressed mothers, who m ight normallynot be deprived and were more upset andstressed by the preceding still-face-no-touchperiod.

During the resumed normal play inter-action, then, the infants of depressed moth-ers w ere not as distressed as those of nonde-pressed mothers. Touch was initiallysoo€iing to the infants of depresse d m others,and in the aftermath ofthe still-face periods,

the infants of nondepressed mothers werenidre apset. This phenomenon suggests thatas a result of their history of experiences,the infaDts of depressed mothers were lessdistressed b y the still-fece perturbations andtiie absence of maternal toucli. Conceivably,infents of depressed mothers could havebeen less distressed in our study becausethey received more optimal touch than they\¥ere used to.

The results ofthe present study can be

related to findings from a recent learningexperiment using a synchronized reinforcement procedure (Pelaez-Nogueras et al.,1996). Pelaez-Nogueras and colleaguesfound that contingent tactile stimulation bya caregiver during face-to-face interactionsincreases affect and attention in .3-month-oldinfants. In that study, when touch was usedas part of the caregiver's social stimulationand prov ided contingently, it effectively re-inftirced and maintained higher rates of in-fant eye contact, smiles, and vocalizations.InterestVagly, the infants in the presentstudy also increased eye contact with theirmoliers during the still-^faee-with-touch pe-riod- tJnis may have occurred as a result ofjntermittent contingent touch stimulationon tafant making eye eonteict with theirmothers.

Bodi learning and emotional regulationprocesses prep are the infant to develo p adap-tive and organized behavior strategies (Pel-aez-5^ogueras, 1992; Thompson, 1994). Thedifferences obse rved in the infants' behaviormay lie in the different histories of mterac-i b h d hild d hi i


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ers, we should be cautious when attributingthese differences to the infants' prior interac-tive histories with their mothers in light ofthefact that there were no immediate group dif-

ferences in the mothers' behaviors in the firstnormal play period.

In sum, the effects of maternal touchduring still fece were more powerful for in-fants of depressed mothers than for infantsof nondepressed mothers, even when theamount and type of touch provided by thedepressed and nondepressed mothers werethe same. Touch appears to have strong posi-tive influences on infant behavior, it can in-crease positive affect, increase infants' nega-tive affect, and direct infants' attention, inparticular, the attention of infani5 of de-pressed mothers during face-to-face interac-tions. The type of stimulation that involvestouch during face-to-face interactions needsto be investigated further. Although short-term positive effects were achieved in thepresent study, long-term assessments andimplementations of this type of interventionare needed to determine the more prolongedpositive effects of touch on infant behavior.

Future research should focus on touch inter-vention strategies with infents and their de-pressed mothers.

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Field, T. (1977). Effects of early sep aration, inteactive deficits, and experimental manipulations on infant moth er face-to-face intera

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Gaensbauer, T J., Harmon, R. J., Cytryn, L ,McKnew, D. H. (1984). Social and affectivedevelopment in infant with manic-depressivparent. American Journal of Psychiatry 141223-229.

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Pelaez-Nogueras, M., Field, T., Cigales, M ., Gon-palez. A., & Clasky, S. (1994). Infants of de-pressed mothers show less depres sed be-havior with their nursery teachers. InfantUental HeaUkJournal, 15, 358-367 .

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