Diagnoses and interactive patterns of infants referred to a community-based infant mental health clinic

Miri Keren, Ruth Feldman, Samuel Tyano

Research output: Contribution to journalArticlepeer-review

100 Scopus citations

Abstract

Objectives: To describe the distribution of symptoms and diagnoses in a community-based infant mental health clinic and to compare play and feeding interactions of referred and nonreferred infants. Method: The Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC 0-3) was used to diagnose 113 referred infants (60% were boys). Thirty additional dyads were matched with 30 nonreferred dyads. Feeding, play interactions, and home environment were compared. Results: Two peaks of referral were found: 0 to 6 and 12 to 18 months. The main reasons for referral were eating problems, sleep problems, aggressive behavior, irritability, and maternal depression. The most common DC 0-3 diagnosis was a combination of primary infant disorder, parent-child relationship disorder, and parental psychopathology. Mothers of referred children provided lower levels of sensitivity, support, and structuring of the interaction, and less optimal home environment. The dyadic relationship showed a lower degree of mutuality and higher negative exchanges. Feeding interactions elicited more negative interactions than play. Conclusions: Infants referred by community health workers showed less optimal mother-infant interactions and had less optimal environment, compared with nonreferred dyads. Symptoms of emotional distress in infancy are best apprehended when assessed in multisituational contexts and formulated in a multiaxial approach.

Original languageEnglish
Pages (from-to)27-35
Number of pages9
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume40
Issue number1
DOIs
StatePublished - 2001

Bibliographical note

Funding Information:
The authors thank the SACTA Foundation and General Kupat Holim for their joint financial support of the Unit, the Well-Baby Clinics, and the Mother–Child Branch of the Ministry of Health for providing us access to the control sample.

Keywords

  • Clinic and non-clinic infants
  • Diagnoses
  • Mother-infant feeding and play interactions

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