Prenatal Reflective Functioning as a Predictor of Substance-Using Mothers' Treatment Outcome: Comparing Results From...

Area of Science:

• Psychology
• Perinatal Mental Health
• Addiction Research

Background:

• Mothers with prenatal substance use disorder (SUD) often exhibit deficits in reflective functioning (RF), posing risks to infant relationships.
• Two key types of maternal RF include adult attachment-focused RF (AAI-RF) and parenting-focused RF (PRF), with unclear interrelations and distinct roles in interventions.
• Understanding these RF types is crucial for developing effective perinatal interventions for mothers with SUD.

Purpose of the Study:

• To examine associations between mothers' prenatal AAI-RF and pre/post-natal PRF.
• To investigate the role of AAI-RF and PRF in mother-infant interaction and substance use treatment outcomes.
• To differentiate the unique contributions of AAI-RF and PRF in perinatal interventions.

Main Methods:

• Study included 57 pregnant mothers with SUD and 50 low-risk comparison mothers.
• AAI-RF assessed using the Adult Attachment Interview.
• PRF measured pre- and post-intervention using the Pregnancy Interview and Parent Development Interview.
• Mother-infant interaction assessed via Emotional Availability Scales; substance use via relapse rates.

Main Results:

• Prenatal AAI-RF and PRF were highly correlated.
• Higher prenatal PRF predicted better mother-infant interaction and reduced substance use.
• Prenatal PRF and AAI-RF predicted opposing changes in mother-infant interaction quality.
• AAI-RF specifically related to changes in maternal intrusiveness and hostility.

Conclusions:

• AAI-RF and PRF are partially distinct constructs with unique implications for parenting.
• Higher prenatal PRF is linked to better immediate parenting outcomes.
• Targeting both AAI-RF and PRF uniquely may enhance perinatal interventions for mothers with SUD.