Mind-mindedness: an examination of relational, attentional and psychological correlates, and response to intervention

The studies reported in this thesis examined several questions in relation to mind-mindedness and maternal mental health, intervention, emotion processing, and generalization across relationships. Study 1 compared levels of mind-mindedness in mothers with severe mental illness (SMI) to those of psychologically health controls, and evaluated a newly-designed video feedback intervention to facilitate mind-mindedness in a sample of mothers hospitalised for treatment of SMI. Results showed that, on admission to hospital, mothers showed two patterns of mind-related comments with their infants: in high levels of non-attuned mind-related comments relative to a group of psychologically well mothers, and few appropriate mind-related comments compared with psychologically well mothers. The findings suggest that SMI may impact mothers in one of two ways: they may fail to comment on their infants’ internal states, or they may make frequent misattributions about their infants’ internal states. Results from Study 2 also suggested that the mind-mindedness intervention was successful in reducing high levels of non-attuned comments at admission to levels no different from those of psychologically well mothers at discharge. Study 2 investigated whether participation in the mind-mindedness intervention in hospital had an impact on attachment quality in the second year of life. This study also sought to add to the limited data on attachment security in the context of maternal mental illness, and to attempt to delineate factors that may influence attachment security in this context, such as nature, chronicity, and duration of illness. Results showed that mothers who participated in the mind-mindedness video feedback intervention were significantly more likely to have infants classified as secure and as organised than mothers who received the standard care video feedback intervention. Results also showed a high rate of disorganised attachment and a low rate of secure attachment relative to previously published research with both normative and clinical samples. Attachment security and organisation were unrelated to the nature, chronicity, or duration of mothers’ illnesses, or to the majority of demographic variables for which data were available. Study 3 investigated relations between adults’ mind-minded descriptions of friends and partners and performance on (a) a new task to assess internal state interpretations of the behaviour of unknown mothers and infants (Unknown Mother–Infant Interaction Task; UMIIT), and (b) an attentional emotion processing task. Mind-minded descriptions were unrelated to performance on both tasks. Mind-minded descriptions of partners and friends were also unrelated to internal state interpretations on the UMIIT. Parents and non-parents did not differ in their internal state interpretations during the UMIIT. Parents showed more attentional bias to infant faces than to adult faces, but only before controlling for age. Attentional bias to all faces was negatively related to internal state interpretations during the UMIIT. These results are discussed in relation to the proposal that mind-mindedness is a quality of close relationships, rather than a trait-like construct. Findings are discussed in terms of limitations, and theoretical and clinical implications, and directions for future research are suggested