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The Effects of Prematurity on Development: Process Studies: Summary of Research Literature Findings

By Michelle Bell

In summary, the process literature documented in this thesis highlights the unique experience parent's face when they have given birth to a premature infant. Firstly, the mother's pregnancy is suddenly interrupted which changes the birth from a prepared event to a crisis associated with anxiety for their infant's very survival. In addition, the mother's attachment to her infant proceeds under very different circumstances where interactions take place in a highly technical space, largely separated in time and not necessarily associated with feeding or nurturing her infant.

Still another set of events that appears to affect interactions between mother's and their premature infants is associated with the disruption of some basic psychological parameters linked with the mothers mental life following the birth of her infant. With prolonged separation the mother's psychological state which begins with normal maternal preoccupations reflecting a slight increase in caring anxiety appears to turn into an abnormally high state of anxiety, disengagement and diminished reactivity characteristic of depression (Feldman, Weller, Leckman, Kuint & Eidelman, 1999). Yet, after the premature birth there is little time to adjust to this unforseen event before the demands of the premature infant who is often described as less socially responsive and harder to soothe must be met (Goldberg & DiVitto, 2002; Cox, Hopkins & Hans, 2000; Field, 1979). Not surprisingly, much research documents a higher prevalence of depression among mothers of premature infants in both the hospital environment and some 3 months following discharge (Bidder, Crowe & Gray, 1974; O'Brian, Heron Asay, McCluskey-Fawcett, 1999).

Moreover, studies that document the attachment patterns of premature infants suggest that those very premature infants who are separated from their mothers for prolonged periods do tend to develop insecure attachment patterns (Plunkett, Meisels, Stiefel, Pasick & Roloff, 1986; Willie, 1991; Mangelsdorf, Plunkett, Dedrick, Berlin, Meisels, McHale, & Dichtellmiller, 1996).

In keeping with an Object Relation's perspective, how a child views others as accessible and responsive, and how they view themselves as preferring close relationships, is directly influenced in early infancy by the quality of early object introjects, most importantly the mother. That is, substantial aberrations in early bonding between the mother and infant may have a negative affect on the child's ego maturity which would be expected to impact on later psychosocial functioning. Indeed both theory and empirical evidence from outcome studies support the notion that premature children are more likely to suffer with internalising problems denoting anxiety and depression, and to have social difficulties that persist into early adolescence (e.g. Hack, Breslau, Aram, Weissmen, Klein & Borawski-Clark, 1992; Breslau, Brown, DelDotto, Kumar, Ezhuthachan, Andreski & Hufnagle, 1996; Szatmari, Saigal, Rosenbaum & Campbell, 1993).

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