Parental embodied mentalizing: Associations with maternal depression, anxiety, verbal mentalizing, and maternal styles of interaction

Background: Maternal depression and anxiety in the perinatal period affect the quality of maternal sensitivity and mentalizing abilities. Few studies analyzed implicit mentalizing in relation to maternal distress. The aims of the study were: to examine the relation between nonverbal mentalizing - parental embodied mentalizing (PEM) - and maternal depression and anxiety, verbal mentalizing, and maternal styles of interaction; and to test PEM as a mediator of the effect of maternal distress on styles of interaction. Method: 81 mother-infant dyads have been recruited. At infant three months, maternal depression was assessed using the Edinburgh Postnatal Depression Scale, anxiety with State Trait Anxiety Inventory, and reflective functioning with Reflective Functioning Scale. Mother–infant interactions were coded with various approaches: PEM for nonverbal mentalizing, Mind-mindedness coding system for Mind-mindedness, and CARE-Index for maternal styles of interaction. Results: Maternal depression and state anxiety were negatively correlated with PEM. PEM was also negatively correlated to maternal controlling style. Mothers with psychopathological problems (vs. mothers with no psychopathological problems) had lower PEM and sensitivity and more controlling style. Moreover, maternal depression and anxiety had direct effects on maternal sensitivity and had indirect effects mediated by PEM on controlling style. Limitations: The study evaluates interactions at three months; longitudinal studies will be able to examine maternal mentalizing and sensitivity in various stages and identify the effect on the child's attachment. Conclusions: PEM is associated to maternal anxiety and depression and mediates the effects of depression and anxiety on mother controlling style. These results emphasize the importance of early prevention programs for mothers focused also on implicit mentalizing.