The role of maternal sensitivity and irritable infant temperament in the development of behavioral problems: Findings from the Bangalore Child Health and Development Study.

Abstract

In spite of extensive evidence from studies in the Western contexts that maternal sensitivity and infant temperament are associated with emotional and behavioural adjustment in early childhood, we do not know whether this is the case in non-western cultural contexts. We investigated whether early maternal sensitivity to infant's distress and irritable infant temperament predict child's externalizing and internalizing problems at age 1, and whether maternal sensitivity to distress moderated the association between irritable temperament and child mental health outcomes in a sample of mother-infant dyads in India. The sample comprised 195 dyads taking part in the Bangalore Child Health and Development Study (BCHADS) in India. Maternal sensitivity to distress was assessed during a video-recorded free-play interaction at age 6 months and coded using the National Institute of Child Health and Human Development (NICHD) coding scheme. Infant irritable temperament (distress to limitations) was assessed at 6 months using a validated 8-item subset of Infant Behavior Questionnaire - Revised (IBQ-R), and child internalizing and externalizing problems at 1 year using the Brief Infant Toddler Social Emotional Assessment (BITSEA) respectively. Data was analyzed using regression and moderation analysis. After accounting for socio-demographic confounders and maternal depressive symptoms at the time of outcome report, maternal sensitivity to distress and infant's irritable temperament at 6 months independently predicted externalizing behaviors at age 1. High infant irritability and low maternal sensitivity functioned as distinct, additive risks; no significant moderation effect was observed. Neither predictor was associated with internalizing problems. These findings provide the first evidence from India linking early sensitivity to distress with externalizing problems, and are not dissimilar to those reported in Western settings. The independent contributions of temperament and maternal sensitivity suggest a two-pronged intervention approach: enhancing maternal sensitivity while simultaneously providing specific support for parents of irritable infants.