Mother infant attachment path analysis of the predictive role of

Andrews University Digital Commons @ Andrews University Dissertations Graduate Research 2020 Mother-Infant Attachment: Path Analysis of the Predictive Role of Trauma Therapy and Select Demographics on Mother's Cognitive Responses Nicole D. Knapp Follow this and additional works at: https://digitalcommons.edu/dissertations Recommended Citation Knapp, Nicole D., "Mother-Infant Attachment: Path Analysis of the Predictive Role of Trauma Therapy and Select Demographics on Mother's Cognitive Responses" (2020).edu/dissertations/1727 This Dissertation is brought to you for free and open access by the Graduate Research at Digital Commons @ Andrews University. It has been accepted for inclusion in Dissertations by an authorized administrator of Digital Commons @ Andrews University. For more information, please contact repository@andrews.

ABSTRACT MOTHER-INFANT ATTACHMENT: PATH ANALYSIS OF THE PREDICTIVE ROLE OF TRAUMA THERAPY AND SELECT DEMOGRAPHICS ON MOTHER’S COGNITIVE RESPONSES by Nicole D. Knapp Chair: Dennis Waite, Ed. ABSTRACT OF GRADUATE STUDENT RESEARCH Dissertation Andrews University College of Education & International Services Title: Mother-infant Attachment: Path Analysis of the Predictive Role of Trauma Therapy and Select Demographics on Mother’s Cognitive Responses Name of researcher: Nicole D. Knapp Name and degree of faculty chair: Dennis Waite, Ed.

Date completed: June 2020 Problem The best outcome for attachment when an infant is born would be a secure attachment, but this is not always the case. Insecure attachments are likely to be formed when the mother has experienced domestic violence given the right environment (Huth- Bocks et al., 2011; Theran et al. A previous study showed that changes to attachment due to postnatal intervention are based on external behaviors rather than internal though processes (Theran et al. Because of this, the purpose of this study is to compare therapy categories and each of the observable attachment factors.

Method Participants completed a survey which measured the tolerance, acceptance, pleasure in proximity, and competence as a parent in regard to the mother’s response to her child(ren) ages zero to six months old, as well demographic information. Data was analyzed using a one-way multivariate analysis of variance (MANOVA), a one-way analysis of variance (ANOVA), post hoc tests, and a path analysis to answer two main research questions and five sub-questions. Results The MANOVA results showed a marginally significant difference among the trauma therapy categories on the dependent variables. Subsequent ANOVA results showed that, individually, trauma therapy had a significant effect on tolerance, pleasure in proximity, and competence as a parent.

Bonferroni post hoc analysis showed that not attending therapy significantly differs from attending group therapy in regard to competence as a parent. The hypothesized model was a good fit for the data. This model indicated a weak statistically significant direct effect of childhood abuse on trauma therapy. Race, childhood abuse, and support system all had weak statistically significant direct effect on ATT and trauma therapy had a weak moderately significant direct effect on ATT.

Conclusion This study was designed to help understand if various types of trauma therapy could be effective in the formation of a more secure attachment between mother and infant when the mother has had a history of domestic violence. This study also looked to understand if various demographic factors have an effect on the attendance of trauma therapy or on ATT, either directly or as mediated through trauma therapy. Results have indicated that when looking at maternal attachment responses, it may be more beneficial to look at the individual types of trauma therapy and areas of attachment rather than at trauma therapy and attachment as wholes. In regard to demographic factors, there were weak significant direct effects found for both trauma therapy and ATT.

This study also offers various implications for future research and professional practice. Andrews University College of Education & International Services MOTHER-INFANT ATTACHMENT: PATH ANALYSIS OF THE PREDICTIVE ROLE OF TRAUMA THERAPY AND SELECT DEMOGRAPHICS ON MOTHER’S COGNITIVE RESPONSES A Dissertation Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy by Nicole D. Knapp June 2020 ©Copyright by Nicole D. Knapp 2020 All Rights Reserved MOTHER-INFANT ATTACHMENT: PATH ANALYSIS OF THE PREDICTIVE ROLE OF TRAUMA THERAPY AND SELECT DEMOGRAPHICS ON MOTHER’S COGNITIVE RESPONSES A dissertation presented in partial fulfillment of the requirements for the degree Doctor of Philosophy by Nicole D.

Knapp APPROVAL BY THE COMMITTEE: __________________________________ ______________________________ Chair: Dennis Waite Dean, College of Education & International Services Alayne Thorpe __________________________________ Member: Nancy Carbonell __________________________________ Member: Tevni Grajales __________________________________ ______________________________ External: Melissa Ponce-Rodas Date approved TABLE OF CONTENTS LIST OF ILLUSTRATIONS. vi LIST OF TABLES. vi LIST OF ABBREVIATIONS. 1 Background of the Problem.

1 Statement of the Problem. 2 Purpose of the Study. 3 Significance of the Study. 5 Definition of Terms.

7 Limitations and Delimitations. 8 Organization of Study. 11 Mother-Child Attachment. 14 Trauma Theory and Hormone Activation.

15 Trauma Theory and the Brain. 16 Types of Domestic Violence. 17 Factors Influencing Domestic Violence. 17 Beliefs and Attitudes Regarding Domestic Violence.

19 Trauma Therapy and Domestic Violence. 20 Mother-Child Attachment and Domestic Violence. 23 Influences on Perceived Maternal Capability. 23 iii Impact of Domestic Violence.

24 Maternal Views of Child. 25 Mother-Infant Attachment. 26 Mother-Child Attachment. 30 Type of Study.

30 Population and Sample. 33 The Maternal Postnatal Attachment Scale. 35 Analysis of the Data. 39 Description of Sample.

39 Observed Variables Description. 40 Zero-Order Correlations. 40 Results by Question. 44 Question 2: Hypothesis Testing.

44 Intercorrelations Among Variables. 46 Summary of Findings. SUMMARY, DISCUSSION, AND IMPLICATIONS. 49 Purpose of Study.

49 Summary of Literature Review. 50 Trauma Theory, Domestic Violence, and Trauma Therapy. 51 Mother-Infant Attachment and Domestic Violence. 53 Findings and Discussion.

58 Recommendations for Future Research. 59 iv Recommendations for Practice. DEMOGRAPHIC QUESTIONNAIRE & MPAS. PATH ANALYSIS TABLES.

90 v LIST OF ILLUSTATIONS 1. 45 LIST OF TABLES 1. Observed Variable Statistics. Zero-Order Correlation.

Means and Standard Deviations for Attachment Factors by Trauma Therapy Categories. Summary of Casual Effects of the Attachment Model. Raw and Standardized Coefficients for the Attachment Model. 47 vi LIST OF ABBREVIATIONS AMOS Analysis of a Moment Structures ANOVA One-way Analysis of Variance APA American Psychological Association CFI Comparative Fit Index CTT-BW Cognitive Trauma Therapy for Battered Women DOJ Department of Justice DV Domestic Violence GFI Goodness of Fit Index IA Insecure Attachment MANOVA One-way Multivariate Analysis of Variance MPAS The Maternal Postnatal Attachment Scale NDVH National Domestic Violence Hotline NFI Normed Fit Index PTSD Post-Traumatic Stress Disorder RMSEA Root Mean Square Error of Approximation SA Secure Attachment SPSS Statistical Package for Social Sciences vii ACKNOWLEDGEMENTS This has been a process and there are some people whom I would not have been able to do this without.

First and foremost, I would like to acknowledge and give endless thanks to my son, Brayden. Without his support, understanding, comedy, and, at times, not so subtle annoyance with my whining, I would have not been able to make it through my courses and especially through the writing of my dissertation. To my mom who has given me her full support every step of the way, even when she didn’t quite understand what she was supporting. To Kati for continually asking me questions and pushing me to think about every detail of this research.

And lastly, to Hadiya who went through this process with me, kept me at a relatively sane level when things weren’t going how I planned, and celebrated all of the little victories with me along the way. Lastly, I would like to thank my committee: Dr. Dennis Waite, Dr. Nancy Carbonell, and Dr.

Without your guidance, encouragement, understanding, and patience, this would not have been possible. viii CHAPTER 1 INTRODUCTION Background of the Problem In an article written for PewResearch, Livingston and Bialik (2018) reported that on average, mothers who were also in the labor force in 2016 were dedicating about 14 hours a week to childcare. This was about six hours more than the fathers during that same year and about four more hours than what was reported by working mothers in 1965. This is in addition to the estimated 27% of all mothers who are stay-at-home moms (Livingston, 2018).

With millions of individuals experiencing domestic violence (DV) each year (Centers for Disease Control and Prevention, 2017), it could be presumed that many of those, whether they be working or stay-at-home mothers, whom are the primary caregivers, are experiencing or have experienced some form of DV. While previous studies have already examined the impact of DV on the mother’s ability to form a secure attachment (SA) with their child, this study looked to ways for improving the attachment that was formed by examining the impact in which trauma therapy conducted before or during pregnancy had on the later development of SA between mother and child. 1 Statement of the Problem Hamilton et al. (2019) reported that provision numbers for live births in the United States was 3,788,235 in 2018.

This is almost four million opportunities for women to bond and create a SA with their infant. However, a SA will not be created out of all the live births. One reason for this is the impact of DV on how the mother views herself as a mother and how she views and reacts to the child (Huth-Bocks et al., 2004; Levendosky, Bogat, & Huth-Bocks, 2011; Lyon-Ruth et al. Levendosky, Bogat, Huth-Bocks, Rosenblum et al.

(2011) among others have found that mothers who experience DV have a higher chance of creating an insecure attachment (IA) with their child. While Theran et al. (2005) found that progress towards the creation of pseudo SA relationship can be made, those who begin with an IA relationship are unable to move towards a true SA relationship. Later in their lives, children who experience an IA with their primary caregiver have grown to be more maladjusted both socially and emotionally when relating to peers and significant others as compared to their peers who experienced a SA throughout childhood (Benoit, 2004).

While some researchers (Huth-Bocks et al., 2011; Levendosky, Bogat, & Huth- Bocks, 2011; Malone et al., 2010) have suggested future exploration of interventions postnatally to aid in the development of a SA between mother and child, Theran et al. (2005) has shown that this may develop an attachment that only looks like SA rather than truly being secure. Because of the impact on both mother and child, it appears to be an issue that should be addressed during the early stages of attachment development, shown to be during pregnancy (Félix Teixeira et al. At the time, there is no research that looks to interventions prior to birth alone to aid in the development of SA.

2 Purpose of the Study One purpose of this study was to compare the therapy categories (individual therapy, group therapy, a combination of group and individual therapy, or no therapy) and the observable attachment factors (tolerance, acceptance, pleasure in proximity, and competence as a parent). Another purpose of this study was to explore potential predictive roles of demographic factors (race, income, support system, marital status, childhood abuse, and trauma therapy) on attachment. This study aimed to further the understanding of which general category of intervention may assist in the formation of SA between mothers and their infants when the mother had a history of DV and which predictive factors may effect this attachment. Research Questions The following research questions were used for this study: 1.

Are there significant mean differences in secure mother-infant attachment (as measured by tolerance, acceptance, pleasure in proximity, and competence as a parent) for the four trauma therapy categories? a. Are there significant mean differences in tolerance for the four trauma therapy categories? b. Are there significant mean differences in acceptance for the four trauma therapy categories? c. Are there significant mean differences in pleasure in proximity for the four trauma therapy categories? 3 d.