title: Association between maternal behavior in infancy and adult mental health: a 30-year prospective study.
abstract: BACKGROUND
  Existing theories suggest that the mother-infant relationship has a potentially significant effect on long-term adult mental health, but there are few empirical data to support this view. Even fewer prior studies have examined the specific dynamics of the mother-infant relationship and their association with adult mental health.
  
  
  METHODS
  A total of 1752 inner-city infants born between 1960 and 1965 were followed prospectively as a part of the Collaborative Perinatal Project (CPP) and the Johns Hopkins Pathways to Adulthood Study. Multiple observations of development and an extensive adult interview were performed. Maternal behavior was observed and systematically rated at the infant's 4-month pediatric neurological evaluation and at 8 months by a developmental psychologist. Factor analysis was used to organize the maternal behavior variables into different types of dysfunctional mother-infant relationships. Adult mental health was assessed at the follow-up interview, when the infant had reached the age of 27-33 years, by the General Health Questionnaire (GHQ) and self-perception of current mental health.
  
  
  RESULTS
  There was a significant association between unsupportive maternal behavior at 8 months and subsequent poor adult mental health (Fisher's exact test, p=0.026). There was no association between overly involved maternal behavior and poor mental health as an adult. After adjustment for potential confounding variables, the elevated rates of poor adult mental health in children of mothers who exhibited unsupportive maternal behavior at 8 months persisted (OR=1.41 [95% CI=1.00-1.97], p<0.05).
  
  
  CONCLUSIONS
  Infants who experience unsupportive maternal behavior at 8 months have an increased risk for developing psychological sequelae later in life.
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: fan_angela@hotmail.com.
authors.forename: Angela P
authors.initials: AP
authors.lastname: Fan
authors.affiliation: Department of Epidemiology, Brown University, Providence, RI, USA.
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Buka
authors.affiliation: Santa Clara Valley Medical Center, San Jose, CA, USA.
authors.forename: Russell O
authors.initials: RO
authors.lastname: Kosik
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Ying-Sheue
authors.initials: YS
authors.lastname: Chen
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Shuu-Jiun
authors.initials: SJ
authors.lastname: Wang
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Tung-Ping
authors.initials: TP
authors.lastname: Su
authors.affiliation: Department of Mental Health, School of Public Health, The Johns Hopkins University, Baltimore, MD, USA.
authors.forename: William W
authors.initials: WW
authors.lastname: Eaton
mesh_terms: D000328:Adult; D005260:Female; D006304:Health Status; D006801:Humans; D007223:Infant; D008297:Male; D008425:Maternal Behavior / Q000523:psychology*; D001523:Mental Disorders / Q000523:psychology*; D009034:Mother-Child Relations / Q000523:psychology*; D011446:Prospective Studies; D057566:Self Report; D013997:Time Factors; D014505:Urban Population
keywords: CPP; Collaborative Perinatal Project; GHQ; General Health Questionnaire; JHCPS; Johns Hopkins Collaborative Perinatal Study; NCPP; National Collaborative Perinatal Project; OR; PAS; PTSD; The Pathways to Adulthood Study; odds ratio; posttraumatic stress disorder