Teasing play in infancy: Comparing mothers with and without self-reported depressed mood during play with their babies

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1 EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2005, 2(3), Teasing play in infancy: Comparing mothers with and without self-reported depressed mood during play with their babies Nadja Reissland, John Shepherd and Eisquel Herrera University of Aberdeen, UK Research suggests that some forms of maternal play can be interpreted positively leading to healthy development or have negative effects leading to emotional and cognitive vulnerability in children and adolescents. The purpose of this study is to relate maternal mood state to mothers play interactions with their infants and the infants emotional reactions to these play interactions. Fifteen mothers reporting depressed mood (as measured by the Edinburgh Postnatal Depression Scale [EDPS]; mean = 12.6) and their infants (mean age 7.9 months [range 5 11 months], 2 girls, 13 boys) and 15 non-depressed mothers (EPDS mean = 4.4) were video-taped in their homes while playing with their infants (mean age 6.7months [range 6 10 months], 8 girls, 7 boys) using a soft toy. Maternal and infant touch behaviours, as well as gaze and emotional expressions were coded frame by frame. There was an association between psychological well-being and touch behaviour by mothers as well as gaze-direction and emotional expressions by their infants. Non-depressed mothers nestled the toy into the baby significantly more frequently compared with mothers reporting depressed mood. Infants of mothers with depressed mood looked significantly less frequently at their mothers and showed significantly more negative expressions than infants of non-depressed mothers. These differences in maternal play interactions indicate that mothers with depressed mood play with their babies in such a way as to elicit negative emotional reactions as well as gaze avoidance from their baby. The effects of infant gender on maternal behaviour are also discussed. Correspondence should be addressed to N. Reissland, College of Life Sciences and Medicine, William Guild Building, University of Aberdeen, Aberdeen AB24 2UB, UK. n. reissland@abdn.ac.uk We thank the mothers and infants who took part in the study, Sarah Logan, for selecting teasing examples, and Aban Mirza, Jenny Kemp, Lisa Smith and Fiona Smith for coding part of the data. We would like to thank two independent reviewers for their constructive comments, which have been included in the paper. # 2005 Psychology Press Ltd DOI: /

2 272 REISSLAND, SHEPHERD, HERRERA INTRODUCTION Play between a mother and her infant is a leisure activity that is undertaken purely for enjoyment or amusement and has no other objective (e.g., Garvey, 1977; Sutton-Smith, 1980). Some forms of play, such a playing peek-a-boo, create tension between participants by incorporating some form of ambiguity. This tension created by the ambiguity of the interaction may elicit a positive response, such as laughter, from the baby. It can, however, also be negatively perceived by the infant, and hence create an aversive reaction in the target of the action. Creating this tension is related to the concept of teasing, which can be defined as an act that is directed to achieve affective consequences for the target (Keltner, Capps, Kring, Young, & Heerey, 2001; Reddy, 1991). Accordingly, in this paper, teasing is defined as a deliberate act to cause tension. Teasing can elicit a positive bond or communion with the person and hence reflects an intimate bond in a relationship (Eder, 1991; Sharkey, 1992), or it may be hostile (Warm, 1997). The literature on teasing in infancy (e.g., Labrell, 1994) suggests that this provocative play between parent and child may involve a positive overture (e.g., a parent offering a desired object to a child). However, if the tension created in play results in a negative reaction, teasing may become a negative experience. This early experience, if continued, may be perceived by the child to devalue him or her and thus imply interpersonal rejection (Leary, Springer, Negel, Ansell, & Evans, 1998). The effect that playful teasing has on the infant depends on how sensitive the mother is to the emotional reactions of her baby, because the play interactions might be pleasant or unpleasant for the child. In infancy, for example, teasing the baby in a peek-a-boo game or teasing the child by dangling a toy just out of reach has to be finely timed in order to elicit laughter rather than tears of frustration from the target of the tease. Specifically, measures of maternal sensitivity, such as interactional synchrony (Isabella, Belsy, & Von Eye, 1989), harmony (Scholmerich, Fracasso, Lamb, & Broberg, 1995), mind-mindedness (Meins, Fernyhough, Fradley, & Tuckey, 2001) and emotional responsiveness (Tronick, 1989) all indicate that sensitive mothering has an effect on the infant s emotional reactions. One factor influencing the degree of sensitivity of mothering is postnatal depression (e.g., Bettes, 1988; Breznitz & Sherman, 1987; Field, Healy, Goldstein, & Guthertz, 1990; Meins et al., 2001; Sinclair & Murray, 1998; Weinberg & Tronick, 1994). Depressed mothers are less able to mother sensitively, where sensitivity is measured, for example, by maternal responsiveness to infant s gaze direction (e.g., Weinberg & Tronick, 1994) as well as maternal sensitivity to infant s object-directed actions, such as touching and grasping (Meins et al., 2001). Further, depressed mothers are

3 TEASING PLAY IN INFANCY 273 less sensitive to their infants needs (Bettes, 1988; Breznitz & Sherman, 1987; Sinclair & Murray, 1998). The behaviour of depressed mothers, in interacting with their children, is less likely to be contingent on the child s responses (Campbell & Cohn, 1997; Tronick & Weinberg, 1997). In such circumstances the mother s behaviour may become aversive to her child. Postnatal depression is a common disorder. Around 10% of mothers in Britain have been diagnosed with postnatal depression (NHS, Primary Care Trust, 2002). However, higher postnatal depression rates have been reported more recently (30% for an EDPS rating of 9; Teissedre & Chabrol, 2004). It affects a person s interpersonal functioning profoundly (Luoma, Tamminen, Kaukonen, Laippala, Puura, Salmelin, & Almqvist, 2001), and is associated with an increased risk of psychopathology in children of the depressed mothers (Hay, Pawlby, Angold, Harold, & Sharp, 2003; Murray, Cox, Chapman, & Jones,1995). Children s low social competence and low adaptive functioning are associated with concurrent maternal depressive symptoms (Luoma et al., 2001). Maternal current symptomatology, rather than diagnosis, is more important for the quality of mother child interaction, and women with diagnosed depression that is in remission may show normal interactions with their children (Conrad & Hammen, 1989). The severity of maternal depression does not always correlate with negative child-outcome (Rutter, 1990), since mothers with severe depression do not normally care for their young infants and they are more likely to be diagnosed and treated. In contrast, mothers with depressed mood will be accepted as having mood swings and therefore the condition may be given less attention. Hence, depressed mood rather than clinical depression might have a more severe impact on the infant. In the present study, the hypothesis that mothers with depressed mood will play with their infants in a manner that becomes negative for their infants, in contrast to non-depressed mothers who will produce positive outcomes is tested. It is expected that the negativity of play in these circumstances will be conveyed by the type of touch that the mother uses when interacting with her baby, as well as facial emotional expressions and gaze avoidance by the baby. For the purpose of testing this hypothesis, a coding scheme was developed, including three areas of behaviours that have been found to be relevant to maternal sensitivity (e.g., Field et al., 1990; Isabella et al., 1989; Meins et al., 2001; Scholmerich et al., 1995; Tronick, 1989). These include maternal and infant touch behaviour (Meins et al., 2001; Herrera, Reissland, & Shepherd, 2004), facial expression (Cole, Teti, & Zahn-Waxler, 2003) and gaze direction (Reissland & Shepherd, 2002; Tronick, 1989). Mothers offered a soft toy to their child and, during the interaction, touch, emotional expression and gaze behaviour were coded for both mother and child. It is hypothesized that mothers with depressed mood play in such a way that their infants will react negatively in comparison with

4 274 REISSLAND, SHEPHERD, HERRERA non-depressed mothers whose infants will react positively to the play situation. METHOD Participants One hundred and twenty-nine Scottish mothers and their infants, living in the Grampian region, were recruited from the Aberdeen Maternity and Neonatal Databank (ethics approval for this study was obtained from the Grampian Health Board). Mothers were monolingual English speakers and primary caregivers. Mothers and infants were videotaped in their homes. They were asked to play with a soft toy as they normally would. No other instructions were given. Shortly before filming mothers were administered the Edinburgh Postnatal Depression Scale (EPDS; Cox, Holden, & Sagovsky, 1987). Of these mothers 46 mothers were assigned to the depressed mood group (EPDS score 5 9; mean EPDS = 12.21; 29 boys, 17 girls). The remaining 83 mothers were assigned to the non-depressed mood group (mean EPDS = 4.43; 36 boys, 47 girls). An independent observer blind to the hypothesis and mood status of the mother was given a number of definitions of teasing from the literature, and was asked to select all instances of teasing. This resulted in 15 mothers with depressed mood (mean EPDS score = 12.6) out of 46 mothers (32%) and 16 out of 83 mothers who did not show depressed mood who showed teasing behaviour (19%). In order to keep the sample size equal, one mother in the non-depressed mood group showing teasing was excluded leaving 15 mothers (mean EPDS score 4.3). For the depressed mood group this resulted in a group of 2 girls and 13 boys (mean age = 7.9 months; range 5 11 months) and for the non-depressed sample 8 girls and 7 boys (mean age = 6.7 months; range 6 10 months). The two groups were similar with regard to maternal age (mean 28 years for the depressed mood group and mean 28.5 years for the non-depressed group); years of education (mean 12.7 years for the depressed mood group and mean 13.5 years for the nondepressed group) and number of children in the family (mean 1.6 for the depressed mood group and mean 1.4 for the non-depressed group). Coding Mother and infant emotional reactions, behavioural expressions and gaze direction were coded. Mothers, facing their infants, were asked to play with their baby, as they normally would while using the soft toy. The teasing episodes of 30 mothers were coded by two further coders, blind to the hypothesis, from the time the mother started to engage in teasing to the time

5 TEASING PLAY IN INFANCY 275 she stopped. The start of the episode was defined as when the mother moved the soft toy towards the child, and the end of the episode was defined as when the mother ended the episode by moving the toy out of the child s vision, moving her hand back to a passive state or giving the toy to the experimenter. Mother and infant emotional reactions, behaviours and gaze direction were transcribed and analysed. The teasing episodes ranged in length from 3 to 74 seconds (mean 33.9 seconds). Since teasing episodes varied in length, the frequency of occurrences of each of the behaviours observed was divided by the number of seconds in the teasing episode and multiplied by 60 in order to obtain teasing behaviour per minute observed. Maternal and infant touch behaviour The following ten touch behaviours were coded frame by frame: hold toy (lifting toy); grab toy (close hand and pull); reach for toy (making a movement to access the toy); offer toy (the toy is presented to mother/baby on open palm or holding toy in front of mother/baby); defend from toy (hands are up at face level and palm is facing the toy); nestling the infant with the toy (rubbing the infant with the toy); poking with toy (jabbing movement with toy); galloping movement; tug of war (partners pull toy towards each other); and hide toy. Maternal and infant facial expression During play with the soft toy, facial expressions of pleasure, fear, anger, surprise or neutral expression were coded separately from three regions of the face (Hiatt, Campos, & Emde, 1979; Stenberg, Campos, & Emde, 1983), corresponding to appearance change (AC) codes (Izard, 1979, 1995 revised). Mothers and infants are credited with AC 20 (surprise in the eyebrow/ forehead region) if their brows are raised in the normal contour but they are curved and high and the skin below the brow is stretched and/or horizontal wrinkles are visible across the forehead. Mothers and infants are credited with AC 30 (surprise in the eyes/lid region) if the eyelids are open, the upper lid is raised and the lower lid is drawn down. Mothers and infants are credited with AC 50 (surprise in the nose/mouth region) if the jaw drops open so the lips and teeth are parted but there is no tension or stretching of the mouth. Mothers and infants are credited with AC 22 (fear in the eyebrow/forehead region) if the brows are lowered and drawn together and/ or the wrinkles of the forehead are across the centre of the forehead and not the entire forehead or there is thickening in the mid-region of the forehead. Mothers and infants are credited with AC 53 (fear in the nose/mouth region) if the mouth is open and the lips are tensed and drawn back or stretched and drawn back. Mothers and infants are credited with AC 33 and described as a

6 276 REISSLAND, SHEPHERD, HERRERA squint (pleasure in the eyes/lid region) if the upper eyelid corners are raised, and crows feet wrinkles go outward from the corners of the eyes. Mothers and infants are credited with AC 52 (pleasure in the nose/mouth region) if the corners of the lips are drawn back and up and teeth may or may not be visible. Mothers and infants are credited with AC 25 (anger in the eyebrow/ forehead region) if their brows are sharply lowered and drawn together, vertical furrows or a bulge appears between the brows and/or the nasal root is broadened or bulged. Mothers and infants are credited with AC 33 (anger in the eyes/lid region), if the eyes are narrowed or squinted. Mothers and infants are credited with AC 54 (anger in the mouth/lips region) if the mouth is angular, open or tense; and AC 62, if they show compressed lips. Neutral facial expressions were coded for all three regions of the face if there was no visible movement in these regions of the face. Mother and infant were credited with showing surprise, pleasure, fear, or neutral expressions in no region ( = 0) or 1 3 regions of the face. Maternal and infant gaze direction During play with the soft toy, occurrences of maternal and infant gaze at the infant/mother, the toy, or other were coded frame by frame. Reliability For touch, gaze direction and facial expressions, two independent observers coded 10% of the sample. Cohen s Kappa ranged from.82 to.94. RESULTS We retained only those variables for which a minimum of 20% of the sample had data. Because of the small number of girls in the sample of mothers with depressed mood (n = 2) only depressed mood status of mother was entered in the analysis. The data were examined for outliers and all variables had markedly skewed distributions. Consequently, a logarithmic transformation was carried out on all variables. Does play behaviour distinguish between mothers with depressed mood and non-depressed mothers? We selected those variables relating to the use of the toy by the mother (see Table 1). A multivariate analysis of variance (MANOVA) with depressed and non-depressed mood as independent variables, and log mother touching toy, log mother reaching for toy, log mother nestling with the toy, log

7 TEASING PLAY IN INFANCY 277 TABLE 1 Means and standard deviations for scores on maternal play behaviour involving the toy Variables Depressed Non-depressed Mother pokes with toy 8.77 (8.12) 2.97 (10.0) Mother nestles toy 1.30 (2.37) 6.40 (5.86) Mother touching toy 4.98 (4.15) 5.76 (3.27) Mother reaching for toy 1.38 (2.44) 1.80 (2.26) Mother galloping movement with toy 9.45 (6.86) 9.47 (6.71) Mother holds toy 4.65 (4.15) 4.75 (3.77) Note: Means (standard deviations in brackets). Data are for original scores. Analyses were carried out on log transformations. mother poking with toy, log mother galloping movements, and log mother hold toy, as dependent measures. There was a highly significant multivariate effect (Wilks lamda =.459, F = 4.518, p 5.004). Subsequent univariate analyses indicated two significant effects for log mother nestling with toy (F = 13.83, df = 1, 28, p 5.001) and log mother poking with toy (F = 13.82, df = 1, 28, p 5.001). Hence, depending on their mood state, mothers showed different touchbehaviour when interacting with their infants. Mothers with depressed mood jabbed their infants by using the toy as a poking device, whereas mothers who were not depressed used the toy in order to touch the baby in a steadier manner. Are these results due to gender differences? The majority of infants of mothers expressing depressed mood in this sample were boys whereas those of non-depressed mothers were equally divided between the sexes. In an attempt to partially take account of this problem t- tests were carried out on the two significant variables in the univariate analyses using only mothers of male infants. There was a significant difference between the two groups of mothers on both poking (t = 2.085, df =18, p =.05) and nestling (t = 2.78, df = 18, p =.01) Do facial expressions distinguish between mothers with depressed mood and non-depressed mood and their infants? Mothers and their children were coded for each emotion in three areas of their face (see coding). In the analysis we combined the values of the codes for the three areas of the face and divided it by three in order to get one summary result of frequency of facial expressions shown. On inspection of

8 278 REISSLAND, SHEPHERD, HERRERA the data it was found that there were no cases of child anger expressed by the children of non-depressed mothers. A MANOVA with depressed and non-depressed mood as independent variables, and child surprise, child happy, child neutral, mother happy, and mother surprised as dependent measures, was non significant (Wilks lamda =.459, F = 4.518, p = 2.86). Child anger had been excluded from the multivariate analysis because only children of depressed mothers showed it. This variable was therefore recoded as a dichotomous variable and a Fisher exact probability test was run on the two groups of children. This showed a significant association between maternal mood state and child s expression of anger (p 5.01, 2-tailed; Siegel, 1956). More than 53.3% of children of depressed mothers showed anger compared with none of the children of the non-depressed mothers. In order to examine whether child expression of anger was related to mother s poking behaviour, the association between maternal poking and child anger expression was tested using Fisher s exact probabilities test for a two-way contingency table. This resulted in an exact probability of.0056 (1- tail) indicating a significant association: the children of mothers who poked them were more likely to show anger than children of mothers who did not poke. Does gaze behaviour distinguish between mothers with depressed and non-depressed mood and their infants? A MANOVA with depressed and non-depressed mood as independent variables, log of gaze direction shown by infants and their mothers as dependent measures was carried out. There was a highly significant multivariate effect (Wilks lamda =.496, F = 3.889, p 5.008). Subsequent univariate analyses indicated one significant effect for log child gazes at mother (F = , df = 1, 28, p 5.002). Children of non-depressed mothers gazed at their mother significantly more frequently than children of mothers with depressed mood (see Table 2). DISCUSSION The results are discussed in terms of behaviour that is shown by mothers with and without depressed mood while playing with their infants, and the consequences this might have for their infants learning to react to teasing. It was found that both mother and child contributed different elements to the interaction specifically, maternal touch and infant emotional expressions and gaze direction differentiated between the play of mothers reporting depressed mood and non-depressed mothers. Hence, in order to identify

9 TEASING PLAY IN INFANCY 279 TABLE 2 Means and standard deviations for scores on maternal and child gaze behaviour Variables Depressed Non-depressed Child gazes at mother 1.92 (.66) 2.62 (.39) Mother gazes at child 2.42 (.46) 2.43 (.82) Child gazes at other 1.96 (.52) 1.38 (.98) Mother gazes at other 0.46 (.74) 0.19 (.34) Child gazes at toy 3.14 (.40) 2.89 (.53) Mother gazes at toy 1.22 (.98) 1.37 (1.2) Note: Means (standard deviations in brackets). Data are for original scores. Analyses were carried out on log transformations. problems which might occur in the interaction between mother and infant, it is not enough to focus on just one partner, or to focus on just one behavioural domain. Rather, both partners in the context of interaction have to be examined in various behavioural domains, such as touch, gaze and emotional expression. In the present sample, in measures of maternal facial expressions and a number of behaviours, no differences were found. This is consistent with a study by Frankel & Harmon (1996), who used observational measures based on the early relational assessment scales (Clark, Musick, Stott, Klehr, & Cohler, 1983), which measure mostly emotional tone and contingency of interaction on a five-point Likert-type scale. In their study, mothers with self-reported depressed mood and mothers who did not report depressed mood could not be distinguished. In contrast to this more general measure, the present study identified specific measures in different domains that did reveal differences between the groups expressing depressed mood and those who did not. Specifically, when identifying behaviours of touch behaviours and gaze direction, it was maternal touch behaviour and child gaze direction that classified mother and infant pairs according to mood state. Mothers with depressed mood were more likely to poke with the toy than non-depressed mothers and less likely to nestle with the toy. Infants of mothers with depressed mood were less likely to gaze at their mother than infants of non-depressed mothers. Gazing away has been identified in the literature as a coping behaviour (e.g., Adamson & Frick, 2003). Furthermore, infant anger, which was expressed by more than 50% of infants of mothers with depressed mood, differentiated between infants of mothers with and without depressed mood. Both partners contribute different patterns of interaction to the situation, the mother showing differences in her touch behaviour and the baby showing differences in gaze direction and emotional expression.

10 280 REISSLAND, SHEPHERD, HERRERA With regard to the expression of anger in infants of mothers with depressed mood, infants reacted to maternal type of touch according to whether the toy was used as a poking device or used more steadily, by nestling it into the child. Furthermore, infants of mothers with depressed mood avoided looking at her in contrast with infants of non-depressed mothers, who gazed at their mother s face. This finding relates to observations in the so-called still-face procedure, in which infants whose mothers are unresponsive to their infants overtures avoid looking at them, in order to regulate their negative emotions (e.g., Cohn & Tronick, 1983; Moore, Cohn, & Campbell, 2001). Shapiro, Baumeister, and Kessler (1991) suggested that teasing was a mechanism to disguise one s true feelings. Hence, babies might react negatively to their mothers inconsistent behaviour, in which they showed on the one hand positive facial expressions, but on the other hand negative touch in terms of poking their baby with the toy. Mothers of boys appear to be more prone to depressed mood in the postnatal period compared to mothers of girls (e.g., Cutrona & Troutman, 1986; Patel, Rodriguez, & DeSouza, 2002; Radke-Yarrow, McCann, DeMulder, Belmont, Martinez, & Richardson, 1995). In the present sample 63% of the infants of mothers with depressed mood were boys compared with 43% of the infants of non-depressed mothers. There may also be gender differences in vulnerability to maternal depressive symptomatology, given that boys and girls react differently and are affected differently by maternal depressive behaviours (Murray, Hipwell, Hooper, Stein, & Cooper, 1996; Tronick & Weinberg, 1997). In order to identify whether maternal type of touch (nestling versus poking) was due to gender differences or to maternal mood status, we analysed maternal poking and nestling for boys only. We found that there was a significant difference between the two groups of mothers for both nestling and poking in the sample containing only boys. Hence, it was not solely the gender of the baby that dictated maternal touch behaviour, rather it was due to the depression status of the mother. Future research should examine the relationship between mood status of the mother, gender of her child and differences in maternal behaviour, which could not be tested in the present sample of teasing episodes because of the different ratio of boys to girls in the depressed mood versus non-depressed groups. Also, neither infant temperament nor family function were assessed. These might be factors that could influence teasing behaviour and the effect on the baby. CONCLUSION This study has demonstrated that in playful teasing interactions the quality of mothers behaviour and children s responses differ with the affective state

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