Maternal resolution of grief in infants with varying medical conditions: Infant and dyadic outcomes, and implications for intervention

OBJECTIVE: This symposium explores the construct of maternal resolution of grief in infants with varying medical conditions, and highlights implications for intervention. We will demonstrate how maternal resolution of grief was explored in mothers of infants with prematurity and cerebral palsy, using the Reaction to Diagnosis Interview. Findings will be used to highlight potential opportunities to address maternal resolution of grief in a clinical intervention with dyads at risk. PAPER 1: Maternal Resolution of Grief Regarding Preterm Birth, Implications for Attachment Security: Prachi Shah, Melissa Clements, Julie Poehlmann. This study explored the association between maternal unresolved grief regarding preterm birth, quality of parent-child interactions, and infant-mother attachment security, and assessed 74 preterm infants a larger longitudinal study of high-risk infants. The association of maternal resolution of grief regarding preterm birth, and quality of infant-mother attachment was assessed using a relative risk ratio and multipleregression models. Maternal resolved grief regarding prematurity was associated with attachment security at 16 months after controlling for covariates (adjusted OR 2.94); maternal grief resolution and interaction quality were both independent predictors of attachment security. Results suggest that future research should explore screening for maternal grief resolution following preterm birth in pediatric practice.PAPER 2: Reactions to Diagnosis of Cerebral Palsy: Patterns of Resolution Across Development: Carlo Schuengel, Ingrid C.M. Rentinck, Marjolein Ketelaar, Jules Becher.This study explored the patterns of adaptation of parents to their children’s diagnosis of cerebral palsy (CP). The Reaction to Diagnosis Interview was given to 255 parents of infants, school age children, and teenagers with CP. In a subsample of 38 parents of infants, the interview was repeated after 1 year. A significant shift was observed from more cognition-focused patterns of resolution to strategies focused on addressing the needs related to the disabilities. Disability severity played a minor role. Results suggest that patterns of adaptation to their child’s diagnosis of CP may guide clinical interventions to parents with problematic grief resolution.PAPER 3 : Incorporating Reactions to Diagnosis With Couples with a Prenatal Diagnosis of a Congenital Malformation. Margot Hankel, Mirjam Oosterman, Christine Brouwer-Dudok de Wit, Carlo Schuengel. Individual differences exist in parents’ reactions to a diagnosis of a congenital malformation or disability in theirchild. Increasingly, couples receive such diagnoses prenatally. Prenatal interventions focused on the couple’s selfawareness about their reaction to diagnosis, while providing strategies towards resolution may assist in their adaptation to caring for their infant. This paper describes how the Reaction to Diagnosis Interview may be used as an intervention tool, to highlight representational diversity and change, foster coherence in emerging working models of their relationship with the infant, and to strengthen marital support. Case notes on first participants in an ongoing trial will illustrate the benefits and challenges of this approach.