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Prenatal Perception of Infant Personality: A Preliminary Investigation
Prenatal Perception of Infant Personality: A Preliminary Investigation CHARLES H. ZEANAH, M.D., MARCIA A. KEENER, PH.D., LINDA STEWART, M.A., THOMAS F. ANDERS, M.D.
AND
Thirty-five couples were recruited from childbirth classes for a study of their impressions of their firstborn infant's personality. Both mothers and fathers were found to have stable perceptions of their infant's temperament in late pregnancy and in early infancy. Additionally, the prenatal perceptions predicted the postnatal perceptions in severa) dimensions of temperament. Mothers whose perceptions of the infant's temperament changed substantially pre- to postnatally were found to have experienced labor as very different from what they had expected prenatally. Journal of the American Academy of Child Psychiatry, 24, 2:204-210, 1985.
report, either by interview or by questionnaire. As a result, controversy abounds in both theoretical and methodological constructs of temperament (Bates, 1980; Hubert et aI., 1982; Kagan, 1982; Plomin, 1982; Rothbart, 1982; and Thomas et aI., 1982). The interview technique of Thomas et al. (1968) has been criticized for uncertain reliability in scoring (Carey, 1970). The most widely used questionnaire, the Infant Temperament Questionnaire (Carey, 1970), has been criticized for measuring maternal rather than infant characteristics. A variety of maternal characteristics, including prenatal anxiety, race, and socioeconomic status (SES), all have been found to be better predictors of infant temperament designations than objectively rated infant behaviors (Sameroff et aI., 1982; Vaughn et aI., 1980, 1981). Clearly much of what is measured as infant temperament is more precisely parental perception. On the other hand, the objective measures of infant behavior may have been inadequate to sample temperamentally mediated behaviors. A 2- or 3-hour home or laboratory observation of an infant would not be expected to assess adequately the infant's regularity of bodily functioning or adaptability to a variety of environments, for instance. Additionally, twin studies indicate more similarity in temperament characteristics of monozygotic compared to dizygotic twins, even when parents are apparently blind to zygosity (Torgenson and Kringlen, 1978; Torgenson, 1981). At present, the validity of parental assessments of temperament is an important and as yet unresolved question (Bates, 1980; Bates et aI., 1979; Carey, 1982; Carey and McDevitt, 1980; Caron and Templeton, 1982; Chess et aI., 1966; Rutter, 1982; Sameroff et aI., 1982; Vaughn et aI., 1980, 1981). Nevertheless, for clinical purposes, parental preceptions of temperament are vital developmental considerations. Our interest in this area has been in exploring how
Investigations of early personality development have increasingly focused on temperamental characteristics of the infant. Individual differences in the behavior of neonates are presumed to reflect constitutional propensities which are relatively unaffected by socialization and may be important contributors to personality development. The relationship of temperament and personality is controversial (Berger, 1982; Rutter, 1982), and the nature of tempe'rament itself is widely debated (see Goldsmith and Campos (1982) and Hubert et al. (1982) for review). The most influential view, proposed by Thomas, Chess, and colleagues in the New York Longitudinal Study (NYLS), has equated temperament with the child's behavioral style (Thomas et aI., 1963, 1968). Although the investigators in that project were originally interested in organismic characteristics of the child which influence behavior and interactions, they have carefully pointed out that temperament, in their view, is not immutable. Rather, like other characteristics of the organism, such as height or weight, temperament may be significantly influenced by environmental circumstances (Thomas et aI., 1968). Because of the lack of objective measures of behavior which presumably reflect temperamental characteristics, infant temperament is assessed by parental
Received Nov. 18, 1983; revised Feb. 3, 1984; accepted March 23, 1984. From the Division of Child Psychiatry and Child Development, Department of Psychiatry and the Behavioral Sciences, Stanford University School of Medicine. Dr. Zeanah is Research Fellow, Dr. Keener is Research Associate, Ms. Stewart is Research Assistant, and Dr. Anders is Professor of Psychiatry and Pediatrics. This work was supported in part by NIMH MH 16744, by the David and Lucile Packard Foundation, and by the Henry J. Kaiser Family Foundation. Address for reprints: Charles H. Zeanah, M.D., Bradley Hospital, lOll Veterans Memorial Parkway, Riverside, RI02915. 0002-7138/85/2402-6204 $02.00/0 © 1985 by the American Academy of Child Psychiatry. 204
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parents begin to conceptualize their developing infant as a person. Newborns evoke immediate interest in adults who attempt to ascertain whom they look like and whom they are like. Caregivers in a newborn nursery not only speak to infants from the first day of life as if they understand (Rheingold and Adams, 1980), they also endow infants with distinctive personalities (Bennett, 1971). Similarly, parents not only talk to their newborns (Parke and O'Leary, 1976), they also speak to their developing fetus (Jessner et aI., 1970). Frequently, they nickname the fetus and speculate about its sex, with contradictory predictions drawn from folklore. Our clinical experiences suggested that parents may begin to consider the distinctive characteristics of their infant even prior to birth. From the time of quickening, "the other" is actively interacting with the mother, and sometimes indirectly with the father as well. Psychoanalysts have described the wish for the perfect baby and the fear of the damaged baby in expectant parents (Solnit and Stark, 1961), but it is not clear whether these prenatal fantasies coalesce to form a stable image of the baby's personality, or whether there is continual flux in the form and content of these parental impressions. Despite considerable research with expectant couples on their parental attitudes, emotional states, and developmental expectations, there are no previous systematic investigations of parental perceptions of infant personality prenatally. This preliminary investigation is designed to answer two questions: (1) Do parents have a stable impression of their infant's personality in late pregnancy? (2) Does their prenatal impression of the infant's personality predict their postnatal impression of the infant's personality?
Method
Subjects Thirty-eight couples were recruited from childbirth classes for a study of their impressions of their developing babies. Criteria for inclusion were: (1) first pregnancy beyond the first trimester for mothers, (2) singleton birth, (3) sex of the infant unknown, and (4) no children living in the home. During the course of the investigation, two couples were told the sex of their baby after sonography, and they were excluded from all data analysis. One other couple had an infant with significant perinatal medical problems, and they were excluded from postnatal analyses. Data are reported for the 35 remaining couples. These first-time parents were predominantly white (94%), middle-class, and older. Mother's mean age was 28 (range: 22-35) and father's was 30 (range: 2338). The couples were also well educated: 71% of
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fathers and 63% of mothers had college, graduate, or professional degrees. Only 9% of fathers and 14% of mothers had had no formal education after graduating from high school. All of the couples were either working or attending school at the time of recruitment into the study.
Temperament Assessment The Revised Infant Temperament Questionnaire (RITQ) is a 95-item instrument which parents use to rate the occurrence of behaviors in their infants from 1-"almost never" to 6-"almost always" (Carey and McDevitt, 1978). Parents are asked to rate specific everyday infant behaviors, and these ratings are weighted and averaged to determine scores on nine dimensions of temperament: (1) activity level-the amount of motor activity during sleep, feeding, play, dressing; (2) rhythmicity-regularity of bodily functioning; (3) adaptability-adjustment to changes in routine; (4) approach/withdrawal-initial response to new situations; (5) intensity-energy content of responses; (6) mood-predominant affect; (7) persistence-attention span in maintaining specific activities; (8) distractibility-soothability; and (9) threshold-responses to changes in external stimulation. The RITQ is generally administered to parents whose infants are between 4 and 8 months old. Pilot testing suggested that expectant couples tended to imagine a very young infant when they completed their ratings prenatally. Therefore, we modified the RITQ for use in the present investigation. We retained 58 items which could be completed for infants at birth. This procedure eliminated approach/withdrawal, persistence, and threshold dimensions because of inadequate numbers of items from which to derive a score. The six remaining temperament dimensions are shown as headings in Table 1. The modified RITQ (MRITQ) was administered to each parent at 37 weeks of gestation and 1 month postnatally. While one parent was being interviewed, the other completed the MRITQ in another room. To assess stability of parental perceptions in the last trimester, a randomly selected subgroup of 22 couples completed the MRITQ twice, at 33 and 37 weeks of gestation. A second subgroup of 18 couples also completed the MRITQ twice postnatally, at 4 and 7 weeks of age. Interviews Each parent was interviewed individually in a semistructured format at 37 weeks of gestation and at 1 month postnatally. The prenatal interview explored experiences during the pregnancy, impressions about the developing baby, expectations of labor and delivery, and expected changes in the couple's life after the
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birth of their child. Postnatally, the interview concerned labor and delivery, experiences during the first month, and impressions about the baby. Responses to these open-ended questions were coded independently by raters who were unaware of the temperament ratings of the couples.
Results Temperament Rating Stability Our assessment of prenatal stability of parental perceptions of temperament is shown in Table 1. There were moderate to substantial correlations for both mothers and fathers in five of the six dimensions of temperament. The overall stability for mothers was slightly higher than for fathers (0.55 compared to 0.52, respectively). The degree of postnatal stability of the MRITQ is shown in Table 2. Stability in parental perceptions was slightly higher postnatally than it was prenatally, and there were again five moderate to substantial correlations for mothers and four for fathers. Overall, mothers' mean correlation was 0.61 and fathers' was 0.57. To investigate whether or not parents' prenatal impressions of their babies predicted their postnatal impressions, we compared the 37 week gestation MRITQ scores with the I-month postnatal MRITQ scores. As Table 3 indicates, both mothers and fathers
demonstrated moderate stability for several dimensions of temperament, though the strength of the association is slightly higher for mothers. The mean coefficient for mothers is 0.34 and for fathers is 0.30. Mothers' prenatal perceptions of the baby's activity, rhythmicity, and adaptability predicted their postnatal perceptions. Fathers' prenatal perceptions, on the other hand, predicted their postnatal perceptions of rhythmicity, mood, and distractibility.
Temperament Rating Changes Correlation coefficients reflect relative changes within a group. We were also curious about absolute changes in the temperament ratings. We compared mean scores of the temperament dimensions at two points in time. Though the mean scores of each temperament dimension tended to decrease slightly from 33 weeks to 37 weeks prenatally for both mothers and fathers, there were no significant differences in the scores on any temperament dimension. Postnatally, the mean scores of dimensions of babies' temperament declined slightly from 1 month to 7 weeks, but there were no significant differences for mothers' or fathers' scores on any of the six dimensions of temperament. There were several differences in the 37-week prenatal scores and the I-month postnatal scores, however. Mothers perceived their babies as significantly more adaptable (Mann-Whitney V, Z = -3.21, p < 0.001)
TABLE 1 Prenatal stability of infant temperament Spearman Rank Correlation Coefficient Subjects Activity
Rhythmicity
Mothers (N = 22) Fathers (N = 22) 1
P S 0.05.
2
P S 0.01.
3
P sO.OOl.
4
Adaptability
Intensity
0.582 0.84 4
0.57 2 0.17
Mood
Distractibility 0.32 0.47 1
P < 0.0001.
TABLE 2 Postnatal Stability of Infant Temperament Spearman Rank Correlation Coefficient Subjects Activity
1P
s 0.05.
2P
s 0.01.
Rhythmicity
0.783 0.64 2
Mothers (N = 18) Fathers (N = 18) 3
P S 0.001.
4
Adaptability
Intensity
Mood
Distractibility
0.804 0.501
0.51' 0.28
0.682 0.91 4
0.25 0.42
P < 0.0001.
TABLE 3 Prediction of Infant Temperament: Prenatal to Postnatal Spearman Rank Correlation Coefficient Subjects Mothers (N = 35) Fathers (N = 35) 1P
s 0.05.
2P
s 0.01.
3
Activity
Rhythmicity
Adaptability
Intensity
Mood
Distractibility
0.74 3 0.25
0.43 2 0.37 1
0.47 2 0.26
-0.01 0.06
0.16 0.37'
0.21 0.462
P s 0.0001.
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and more easily distracted (Mann-Whitney V, Z = -2.09, P < 0.05) at 4 weeks postnatally compared to 37 weeks prenatally. Otherwise, there were no significant differences in their postnatal and prenatal perceptions of temperament. Fathers perceived the babies as significantly less active (Mann-Whitney V, Z = -3.70, p < 0.001), less rhythmic (Mann-Whitney V, Z = 2.31, P < 0.05), more adaptable (Mann-Whitney V, Z = -3.07, p < 0.001), and less intense (MannWhitney V, Z = -3.58, p < 0.001) postnatally compared to prenatally. Mother-Father Comparisons of Temperament Rating We also wondered whether each couple perceived their own baby similarly. Table 4 indicates that in late pregnancy and in the first 6 weeks of life parents did not perceive their own baby's temperament similarly, as only 1 of 12 prenatal intercorrelations and 1 of 12 postnatal intercorrelations were significant. On the other hand, there were few systematic differences between the perceptions of temperament of mothers as a group compared to the perceptions of fathers as a group. Mothers perceived the babies as significantly more active (Mann-Whitney V, Z = 2.06, p < 0.05) than fathers perceived them at 7 weeks postnatally. They also perceived the babies as more rhythmic than did fathers at 33 weeks of gestation (Mann-Whitney V, Z = -2.83, p < 0.01) and at 1 month postnatally (Mann-Whitney V, Z = -2.33, p < 0.05). There were no other significant differences in perception of infant temperament. Changes in Clinical Designations of Temperament We determined clinical designations of easy, intermediate, and difficult based on a modification of the method used by Carey and McDevitt (1978) with the RITQ. Means and standard deviations for each dimension of temperament were determined separately for mothers and fathers. Easy, intermedaite low, intermediate high, and difficult infants were determined by parental ratings of rhythmicity, adaptability, intensity, and mood. Easy infants were defined as rhythmic,
adaptable, mildly intense, and predominantly positive in mood. Difficult infants were arrhythmic, slow to adapt, intense and predominantly negative in mood. Intermediate low infants were almost easy, and intermediate high infants were almost difficult. We found 43% of mothers and 60% of fathers did not change clinical designations of temperament preto postnatally. These parents were labeled "nonchangers." Parents whose pre- to postnatal clinical designations changed one category or more were labeled as "changers" (57% of mothers and 40% of fathers). We examined a number of variables from prenatal and postnatal interviews to attempt to differentiate these groups of parents. In the prenatal and postnatal interviews, parents were asked independently to describe labor and delivery. The prenatal expectation of the degree of difficulty anticipated was compared to the postnatal description of the degree of difficulty experienced. Mothers who were "changers" were significantly more likely to have described their experience of labor as very different from their prenatal expectations (Mann-Whitney V, Z = 2.83, p s 0.005). Three of the mothers in the "changers" and three of the mothers in the "nonchangers" had Cesarean sections so that the differences were not accounted for by that experience. The discrepancy in expectations and experience, however, did not distinguish "changers" and "nonchangers" among the fathers. Though mothers' and fathers' prenatal expectations of how difficult labor would be were not related (Spearman Rank Correlation Coefficient, 0.04, NS), postnatally, they perceived the experience quite similarly (Spearman rank correlation coefficient, 0.76, p s 0.0001). Several other interview variables did not distinguish the "changers" from "nonchangers" among mothers or fathers. Neither age nor education of the mother or father were significantly different for the two groups. We also examined other discrepancies between what had been expected prenatally and what had been perceived postnatally: neither discrepancies between expected or preferred and actual sex of the child, nor
TABLE 4 Agreement between Perceptions of Mothers and Fathers Spearman Rank Correlation Coefficient
Time of Rating Prenatal: 33 wk (N = 22) 37 wk (N = 36) Postnatal: 1 mo (N= 35) 7 wk (N = 18) 1P
:s 0.05.
2P
:s om.
Activity
Rhythmicity
0.14 0.17
-0.21 0.03
0.24 0.24
0.27 0.572
Adaptability 0.30 0.11 0.05 -0.14
Intensity
Mood
Distractibility
0.46 1 0.20
0.24 -0.05
-0.02 0.04
0.05 0.28
0.25 0.18
0.19 0.24
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the expected and perceived change in the individuals' or the couple's life distinguished the two groups. Parents' Descriptions of Personalities We assessed, from the interview data, whether parents had a general impression of their infant's personality prenatally and at 1 month postnatally. During the pre- and postnatal interviews, parents were asked to describe their baby's personality. Prenatally, three mothers and five fathers said that babies did not have personalities yet, or that they did not know what it was. At 1 month postnatally, one mother and one father said that their babies did not yet have a personality. We were impressed by the remarkably vivid and abstract descriptions of the babies' personalities. Examples of two couples' descriptions of their babies' personalities are given below. Mother A-prenatal: I feel this is a very, very emotional and intense child-very active. Very verbal and very intense. I'll know when it's upset and when it's happy. I cried when something beautiful happened at work. I was sure the baby cried, too. The baby kicked and kicked. It felt what I was feeling. Mother A-postnatal: Definitely not quiet. He's got a mind of his own. He's very alert. If he had his way, he wouldn't sleep all day. He likes to stay up and observe things. Likes human contact, likes a lot of love. Father A-prenatal: A great personality! Both of us are positive people. Will have a positive outlook on life. Will be outgoing, a lot of energy, full of spunk. A challenge to keep up with at times. I don't see a shy, retiring baby. Father A-postnatal. Very, very active. He was in his mother's womb. We felt he'd be active. Seems to be very strong and very active. My wife and I are very active and we thought our baby would be and he is! A lot of energy. A great sleeper-he looks like a millionnaire when he wakes up! He ' turned out to be a good feeder though he was clutzy, at first, while breastfeeding. Mother B-prenatal. More of a quiet kind of temperament. His activity period is eight to nine o'clock at night. He loves food. He gets excited and wakes up when we eat. Not terribly startled by noises. Mellow, I think, thoughtful. Mother B-postnatal, He's really a good-natured boy. A bright little personality. I've been reading cards to him since he was 3 days old; he likes to look at the colors. At times he likes to be with himself. Cuddly-likes to feel close to people. Kind of sensitive. He smiles a lot. Father B-prenatal, Quiet. Genuinely warm. Sensitive. Given to deep, emotional feelings. More of a quiet kind of child. Reflective. Father B-postnatal. Alert-he observes things. Not high strung. Sensitive. Kind of an observing baby. A happy baby. Dependent.
Parents' descriptions were rated for vividness and for positive and negative statements about the baby. We had hypothesized that more vivid impressions of the baby prenatally would be associated with less likelihood of changing perceptions of the baby after birth. There was, however, no relationship between
the vividness of personality descriptions in the "changers" and "nonchangers" for mothers or fathers. Positive and negative statements about the baby were not related to "changers" or "nonchangers," or to the clinical designations. Descriptions ofthe babies' personalities were overwhelmingly positive. Prenatally, 63% of mothers and 46% of fathers made exclusively positive statements about the baby. Another 26% of mothers and 40% of fathers made both positive and negative statements, but positive statements were clearly predominant. Only one mother described her baby's personality negatively prenatally. At 1 month postnatally, 57% of mothers and 57% of fathers described their baby's personality exclusively positively. Another 37% of mothers and 34% offathers made positive and negative statements about the baby. Only one mother and one father described their babies negatively postnatally.
Discussion Our findings suggest that both mothers and fathers develop stable perceptions of their infant's personality in late pregnancy. These prenatal perceptions are nearly as stable as early postnatal perceptions. Further, the birth of the infant does not radically alter these perceptions, as there is modest but significant stability between several prenatal and early postnatal dimensions of temperament. Mothers' direct experience with the developing fetus may account for their more stable perceptions of the infant's activity and rhythmicity. Adaptability, on the other hand, seems less clearly related to experiences with the fetus. Similarly, fathers' prenatal perceptions of rhythmicity, mood, and distractibility, all of which predict postnatal perceptions, are obviously unrelated to direct experiences with the developing fetus. Because we do not have objective measures of infant behavior, we were unable to evaluate directly the relation between infant behavior and parental perceptions. Interestingly, however, at no point in time do both parents rate their own infant similarly, though there are few systematic differences in the ratings of mothers compared to those of fathers. In addition to stable ratings of specific infant behaviors in specific situations, parents also vividly and abstractly describe personality characteristics of their infants. These descriptions reflect more global impressions of the infant's personality than the more specific perceptions measured by the MRITQ. The global impressions, which were overwhelmingly positive, did not relate to the clinical designations of easy, difficult, etc. Carey and McDevitt (1978) found parents' global impressions of their infants were more positive (easy) than their specific ratings. Only 4 % of the mothers in
PRENATAL PERCEPTION OF INFANT PERSONALITY
their sample indicated by general impression that their infant was more difficult than average. Parents may be reluctant to report their infants as difficult because of the implications of a pejorative label. This may also account for the overwhelmingly positive descriptions of personality by our parents. Another important finding in this investigation is that parents were characterized as "changers" and "nonchangers" according to their clinical designations pre- and postnatally. We reemphasize that these are relative terms, as there is evidence that the perceptions of mothers and fathers change to some degree after the infant's birth. What is striking, however, is the amount of agreement between pre- and postnatal perceptions of temperament. Mother-changers were characterized by experiencing labor differently from what they had expected prenatally. This finding might be accounted for by some characteristic of the mother such as flexibilityrigidity. If this were the case, we would expect other discrepancy scores of prenatal expectation and postnatal perception to reflect this rigidity characteristic and distinguish the changers and non-changers. On the contrary, only discrepancy in the perception ofthe difficulty of labor and delivery discriminated the two groups. This suggests that there is something about the mother's view of the labor experience itself which is an important influence on her early perceptions of her infant. Colman (1969) hypothesized that a close fit between a woman's expectations of herself and her actual performance during labor and delivery is an important source of self-esteem for the woman at the threshold of motherhood. Our findings suggest that these feelings may affect a mother's early perceptions of her infant, as well. Several words of caution seem in order. Our findings need replication in a larger sample. We cannot readily extrapolate from findings about the advantaged population in this investigation to more clinical or "atrisk" populations of expectant parents. Because the easy, intermediate, and difficult clinical designations were derived from deviations from the mean, these designations might not apply in a more heterogeneous population. Further, we do not know what the implications of these early perceptions are for later parental perceptions or for infant development. These important questions remain to be explored. At first glance, the idea of preconceived notions of infant personality may seem alarming. The ubiquity of the finding in a relatively low-risk group of parents, however, suggests that this phenomenon is not likely in and of itself pathological. Rather, our data suggest that personification of the developing fetus and infant
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by both parents is a frequent psychological accompaniment to the physical interactions between mother and fetus. Parental perceptions of their child's personality in late pregnancy and early infancy seem to derive in part from interactions between infant and parent and in part from parental projections which are probably unrelated to the infant's behavior. We speculate that parents not only conceptualize and interact with the infant as he or she is, but also with the infant as he or she will be (at least in the parents' view). Our findings do not by any means settle the question of the degree to which temperament and difficult temperament are within-the-infant characteristics, but they do add further complexity to considerations of early personality development. We suggest that the psychobiological interaction between parents and fetus deserves attention in future investigations of personality development. References BATES, J. E. (1980), The concept of difficult temperament. MerrillPalmer Quart., 26:299-319. --FREELAND, C. A. B. & LOUNSBURY, M. L. (1979) Measuremf'nt of infant difficultness. Child Deuelpm., 50:794-803. BENNETT, S. (1971), Infant-caretaker interaction. This Journal, 10:321-335. BERGER, M. (1982), Personality development and temperament. In: Temperamental Differences in Infants and Young Children (Ciba Foundation Symposium 89). London: Pitman Books, pp. 176190. CAREY, W. B. (1970), A simplified method for measuring infant temperament. J. Pediat., 77:188-194. - - (1982), Validity of parental assessments of development and behavior. Amer. J. Dis. Child., 136:97-99. - - & McDEVITT, S. C. (1978), Revision of the infant temperament questionnaire. Pediatrics, 61:735-739. - - - - (1980), Measuring infant temperament. J. Pediat., 96:423-424. CARON, J. W. & TEMPLETON, S. J. (1982), Maternal reports of infant temperament: infant behavior or maternal characteristics? Paper presented to the International Conference on Infant Studies, Austin, Texas. CHESS, S., THOMAS, A. & BIRCH, H. G. (1966), Distortions in developmental reporting made by parents of behaviorally disturbed children. This Journal, 5:226-234. COLMAN, A. D. (1969), Psychological state during first pregnancy. Amer. J. Orthopsychiat. 39:788-797. GOLDSMITH, H. H. & CAMPOS, J. J. (1982), Toward a theory of infant temperament. In: The Deuelopment of Attachment and Affiliatiue Systems, ed. R. Emde & R. Harmon. New York: Plenum Press, pp. 161-193. HUBERT, N. C., WACHS, T. D., PETERS-MARTIN, P. & GANDOUR, M. J. (1982), The study of early temperament: measurement and conceptual issues. Child Deuelopm., 53:571-600. JESSNER, L., WEIGERT E. & Foy, J. L. (1970), The development of parental attitudes during pregnancy. In: Parenthood: Its Psychology and Psychopathology, ed. E. J. Anthony & T. Benedek. Boston: Little, Brown, pp. 209-244. KAGAN, J. (1982), The construct of difficult temperament. MerrillPalmer Quart., 28:21-24. PARKE, R. D. & O'LEARY, S. E. (1976), Family interaction in the newborn period: some findings, some observations and some unresolved issues. In: The Deueloping Indiuidual in a Changing World (Vol. 2): Social and EnuironmentalIssues, ed. K. F. Riegel & J. A. Meacham. The Hague, Netherlands: Mouton.
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PLOMIN, R. (1982), The difficult concept of temperament. MerrillPalmer Quart., 28:25-33. RHEINGOLD, H. L. & ADAMS, J. L. (1980) The significance of speech pf newborns. Develpm. Psycfwl., 16:397-403. ROTHBART, M. K. (1982), The concept of difficult temperament. Merrill·Palmer Quart., 28:35-40. RUTTER, M. (1982), Temperament: concepts, issues, and problems. In: Temperamental Differences In Infants and Young Children (Ciba Foundation Symposium 89). London: Pitman Books, pp. 1-16. SAMEROFF, A. J., SEIFER, R. & ELIAS, P. K. (1982), Sociocultural variability in infant temperament ratings. Child Develpm., 53:164-173. SOLNIT, A. J. & STARK, M. H. (1961), Mourning and the birth of a defective child. The Psycfwanalytic Study of the Child, 16:523537.
THOMAS, A., CHESS, S., BIRCH, H. G., HERTZIG, M. E. & KORN, S. (1963), Behavioral Individuality in Early Childhood. New York: New York University Press. - - - - - - (1968), Temperament and Behavior Disorders in Children. New York: New York University Press. - - - - & KORN, S. (1982), The reality of difficult temperament. Merrill-Palmer Quart., 28:1-20. TORGENSEN, A. M. (1981), Genetic factors in temperamental individuality. This Journal, 20:702-711. - - & KRINGLEN, E. (1978), Genetic aspects of temperamental differences in infants. This Journal, 17:433-444. VAUGHN, B., DEINARD, A. & EGELAND, B. (1980), Measuring temperament in pediatric practice. J. Pediat., 96:510-518. - - TARALDSON, B., CRICHTON, L. & EGELAND, B. (1981), The assessment of infant temperament: a critique of the carey infant temperament questionnaire. Infant Behav. Develpm., 4:1-17.
AND
Thirty-five couples were recruited from childbirth classes for a study of their impressions of their firstborn infant's personality. Both mothers and fathers were found to have stable perceptions of their infant's temperament in late pregnancy and in early infancy. Additionally, the prenatal perceptions predicted the postnatal perceptions in severa) dimensions of temperament. Mothers whose perceptions of the infant's temperament changed substantially pre- to postnatally were found to have experienced labor as very different from what they had expected prenatally. Journal of the American Academy of Child Psychiatry, 24, 2:204-210, 1985.
report, either by interview or by questionnaire. As a result, controversy abounds in both theoretical and methodological constructs of temperament (Bates, 1980; Hubert et aI., 1982; Kagan, 1982; Plomin, 1982; Rothbart, 1982; and Thomas et aI., 1982). The interview technique of Thomas et al. (1968) has been criticized for uncertain reliability in scoring (Carey, 1970). The most widely used questionnaire, the Infant Temperament Questionnaire (Carey, 1970), has been criticized for measuring maternal rather than infant characteristics. A variety of maternal characteristics, including prenatal anxiety, race, and socioeconomic status (SES), all have been found to be better predictors of infant temperament designations than objectively rated infant behaviors (Sameroff et aI., 1982; Vaughn et aI., 1980, 1981). Clearly much of what is measured as infant temperament is more precisely parental perception. On the other hand, the objective measures of infant behavior may have been inadequate to sample temperamentally mediated behaviors. A 2- or 3-hour home or laboratory observation of an infant would not be expected to assess adequately the infant's regularity of bodily functioning or adaptability to a variety of environments, for instance. Additionally, twin studies indicate more similarity in temperament characteristics of monozygotic compared to dizygotic twins, even when parents are apparently blind to zygosity (Torgenson and Kringlen, 1978; Torgenson, 1981). At present, the validity of parental assessments of temperament is an important and as yet unresolved question (Bates, 1980; Bates et aI., 1979; Carey, 1982; Carey and McDevitt, 1980; Caron and Templeton, 1982; Chess et aI., 1966; Rutter, 1982; Sameroff et aI., 1982; Vaughn et aI., 1980, 1981). Nevertheless, for clinical purposes, parental preceptions of temperament are vital developmental considerations. Our interest in this area has been in exploring how
Investigations of early personality development have increasingly focused on temperamental characteristics of the infant. Individual differences in the behavior of neonates are presumed to reflect constitutional propensities which are relatively unaffected by socialization and may be important contributors to personality development. The relationship of temperament and personality is controversial (Berger, 1982; Rutter, 1982), and the nature of tempe'rament itself is widely debated (see Goldsmith and Campos (1982) and Hubert et al. (1982) for review). The most influential view, proposed by Thomas, Chess, and colleagues in the New York Longitudinal Study (NYLS), has equated temperament with the child's behavioral style (Thomas et aI., 1963, 1968). Although the investigators in that project were originally interested in organismic characteristics of the child which influence behavior and interactions, they have carefully pointed out that temperament, in their view, is not immutable. Rather, like other characteristics of the organism, such as height or weight, temperament may be significantly influenced by environmental circumstances (Thomas et aI., 1968). Because of the lack of objective measures of behavior which presumably reflect temperamental characteristics, infant temperament is assessed by parental
Received Nov. 18, 1983; revised Feb. 3, 1984; accepted March 23, 1984. From the Division of Child Psychiatry and Child Development, Department of Psychiatry and the Behavioral Sciences, Stanford University School of Medicine. Dr. Zeanah is Research Fellow, Dr. Keener is Research Associate, Ms. Stewart is Research Assistant, and Dr. Anders is Professor of Psychiatry and Pediatrics. This work was supported in part by NIMH MH 16744, by the David and Lucile Packard Foundation, and by the Henry J. Kaiser Family Foundation. Address for reprints: Charles H. Zeanah, M.D., Bradley Hospital, lOll Veterans Memorial Parkway, Riverside, RI02915. 0002-7138/85/2402-6204 $02.00/0 © 1985 by the American Academy of Child Psychiatry. 204
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parents begin to conceptualize their developing infant as a person. Newborns evoke immediate interest in adults who attempt to ascertain whom they look like and whom they are like. Caregivers in a newborn nursery not only speak to infants from the first day of life as if they understand (Rheingold and Adams, 1980), they also endow infants with distinctive personalities (Bennett, 1971). Similarly, parents not only talk to their newborns (Parke and O'Leary, 1976), they also speak to their developing fetus (Jessner et aI., 1970). Frequently, they nickname the fetus and speculate about its sex, with contradictory predictions drawn from folklore. Our clinical experiences suggested that parents may begin to consider the distinctive characteristics of their infant even prior to birth. From the time of quickening, "the other" is actively interacting with the mother, and sometimes indirectly with the father as well. Psychoanalysts have described the wish for the perfect baby and the fear of the damaged baby in expectant parents (Solnit and Stark, 1961), but it is not clear whether these prenatal fantasies coalesce to form a stable image of the baby's personality, or whether there is continual flux in the form and content of these parental impressions. Despite considerable research with expectant couples on their parental attitudes, emotional states, and developmental expectations, there are no previous systematic investigations of parental perceptions of infant personality prenatally. This preliminary investigation is designed to answer two questions: (1) Do parents have a stable impression of their infant's personality in late pregnancy? (2) Does their prenatal impression of the infant's personality predict their postnatal impression of the infant's personality?
Method
Subjects Thirty-eight couples were recruited from childbirth classes for a study of their impressions of their developing babies. Criteria for inclusion were: (1) first pregnancy beyond the first trimester for mothers, (2) singleton birth, (3) sex of the infant unknown, and (4) no children living in the home. During the course of the investigation, two couples were told the sex of their baby after sonography, and they were excluded from all data analysis. One other couple had an infant with significant perinatal medical problems, and they were excluded from postnatal analyses. Data are reported for the 35 remaining couples. These first-time parents were predominantly white (94%), middle-class, and older. Mother's mean age was 28 (range: 22-35) and father's was 30 (range: 2338). The couples were also well educated: 71% of
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fathers and 63% of mothers had college, graduate, or professional degrees. Only 9% of fathers and 14% of mothers had had no formal education after graduating from high school. All of the couples were either working or attending school at the time of recruitment into the study.
Temperament Assessment The Revised Infant Temperament Questionnaire (RITQ) is a 95-item instrument which parents use to rate the occurrence of behaviors in their infants from 1-"almost never" to 6-"almost always" (Carey and McDevitt, 1978). Parents are asked to rate specific everyday infant behaviors, and these ratings are weighted and averaged to determine scores on nine dimensions of temperament: (1) activity level-the amount of motor activity during sleep, feeding, play, dressing; (2) rhythmicity-regularity of bodily functioning; (3) adaptability-adjustment to changes in routine; (4) approach/withdrawal-initial response to new situations; (5) intensity-energy content of responses; (6) mood-predominant affect; (7) persistence-attention span in maintaining specific activities; (8) distractibility-soothability; and (9) threshold-responses to changes in external stimulation. The RITQ is generally administered to parents whose infants are between 4 and 8 months old. Pilot testing suggested that expectant couples tended to imagine a very young infant when they completed their ratings prenatally. Therefore, we modified the RITQ for use in the present investigation. We retained 58 items which could be completed for infants at birth. This procedure eliminated approach/withdrawal, persistence, and threshold dimensions because of inadequate numbers of items from which to derive a score. The six remaining temperament dimensions are shown as headings in Table 1. The modified RITQ (MRITQ) was administered to each parent at 37 weeks of gestation and 1 month postnatally. While one parent was being interviewed, the other completed the MRITQ in another room. To assess stability of parental perceptions in the last trimester, a randomly selected subgroup of 22 couples completed the MRITQ twice, at 33 and 37 weeks of gestation. A second subgroup of 18 couples also completed the MRITQ twice postnatally, at 4 and 7 weeks of age. Interviews Each parent was interviewed individually in a semistructured format at 37 weeks of gestation and at 1 month postnatally. The prenatal interview explored experiences during the pregnancy, impressions about the developing baby, expectations of labor and delivery, and expected changes in the couple's life after the
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birth of their child. Postnatally, the interview concerned labor and delivery, experiences during the first month, and impressions about the baby. Responses to these open-ended questions were coded independently by raters who were unaware of the temperament ratings of the couples.
Results Temperament Rating Stability Our assessment of prenatal stability of parental perceptions of temperament is shown in Table 1. There were moderate to substantial correlations for both mothers and fathers in five of the six dimensions of temperament. The overall stability for mothers was slightly higher than for fathers (0.55 compared to 0.52, respectively). The degree of postnatal stability of the MRITQ is shown in Table 2. Stability in parental perceptions was slightly higher postnatally than it was prenatally, and there were again five moderate to substantial correlations for mothers and four for fathers. Overall, mothers' mean correlation was 0.61 and fathers' was 0.57. To investigate whether or not parents' prenatal impressions of their babies predicted their postnatal impressions, we compared the 37 week gestation MRITQ scores with the I-month postnatal MRITQ scores. As Table 3 indicates, both mothers and fathers
demonstrated moderate stability for several dimensions of temperament, though the strength of the association is slightly higher for mothers. The mean coefficient for mothers is 0.34 and for fathers is 0.30. Mothers' prenatal perceptions of the baby's activity, rhythmicity, and adaptability predicted their postnatal perceptions. Fathers' prenatal perceptions, on the other hand, predicted their postnatal perceptions of rhythmicity, mood, and distractibility.
Temperament Rating Changes Correlation coefficients reflect relative changes within a group. We were also curious about absolute changes in the temperament ratings. We compared mean scores of the temperament dimensions at two points in time. Though the mean scores of each temperament dimension tended to decrease slightly from 33 weeks to 37 weeks prenatally for both mothers and fathers, there were no significant differences in the scores on any temperament dimension. Postnatally, the mean scores of dimensions of babies' temperament declined slightly from 1 month to 7 weeks, but there were no significant differences for mothers' or fathers' scores on any of the six dimensions of temperament. There were several differences in the 37-week prenatal scores and the I-month postnatal scores, however. Mothers perceived their babies as significantly more adaptable (Mann-Whitney V, Z = -3.21, p < 0.001)
TABLE 1 Prenatal stability of infant temperament Spearman Rank Correlation Coefficient Subjects Activity
Rhythmicity
Mothers (N = 22) Fathers (N = 22) 1
P S 0.05.
2
P S 0.01.
3
P sO.OOl.
4
Adaptability
Intensity
0.582 0.84 4
0.57 2 0.17
Mood
Distractibility 0.32 0.47 1
P < 0.0001.
TABLE 2 Postnatal Stability of Infant Temperament Spearman Rank Correlation Coefficient Subjects Activity
1P
s 0.05.
2P
s 0.01.
Rhythmicity
0.783 0.64 2
Mothers (N = 18) Fathers (N = 18) 3
P S 0.001.
4
Adaptability
Intensity
Mood
Distractibility
0.804 0.501
0.51' 0.28
0.682 0.91 4
0.25 0.42
P < 0.0001.
TABLE 3 Prediction of Infant Temperament: Prenatal to Postnatal Spearman Rank Correlation Coefficient Subjects Mothers (N = 35) Fathers (N = 35) 1P
s 0.05.
2P
s 0.01.
3
Activity
Rhythmicity
Adaptability
Intensity
Mood
Distractibility
0.74 3 0.25
0.43 2 0.37 1
0.47 2 0.26
-0.01 0.06
0.16 0.37'
0.21 0.462
P s 0.0001.
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PRENATAL PERCEPTION OF INFANT PERSONALITY
and more easily distracted (Mann-Whitney V, Z = -2.09, P < 0.05) at 4 weeks postnatally compared to 37 weeks prenatally. Otherwise, there were no significant differences in their postnatal and prenatal perceptions of temperament. Fathers perceived the babies as significantly less active (Mann-Whitney V, Z = -3.70, p < 0.001), less rhythmic (Mann-Whitney V, Z = 2.31, P < 0.05), more adaptable (Mann-Whitney V, Z = -3.07, p < 0.001), and less intense (MannWhitney V, Z = -3.58, p < 0.001) postnatally compared to prenatally. Mother-Father Comparisons of Temperament Rating We also wondered whether each couple perceived their own baby similarly. Table 4 indicates that in late pregnancy and in the first 6 weeks of life parents did not perceive their own baby's temperament similarly, as only 1 of 12 prenatal intercorrelations and 1 of 12 postnatal intercorrelations were significant. On the other hand, there were few systematic differences between the perceptions of temperament of mothers as a group compared to the perceptions of fathers as a group. Mothers perceived the babies as significantly more active (Mann-Whitney V, Z = 2.06, p < 0.05) than fathers perceived them at 7 weeks postnatally. They also perceived the babies as more rhythmic than did fathers at 33 weeks of gestation (Mann-Whitney V, Z = -2.83, p < 0.01) and at 1 month postnatally (Mann-Whitney V, Z = -2.33, p < 0.05). There were no other significant differences in perception of infant temperament. Changes in Clinical Designations of Temperament We determined clinical designations of easy, intermediate, and difficult based on a modification of the method used by Carey and McDevitt (1978) with the RITQ. Means and standard deviations for each dimension of temperament were determined separately for mothers and fathers. Easy, intermedaite low, intermediate high, and difficult infants were determined by parental ratings of rhythmicity, adaptability, intensity, and mood. Easy infants were defined as rhythmic,
adaptable, mildly intense, and predominantly positive in mood. Difficult infants were arrhythmic, slow to adapt, intense and predominantly negative in mood. Intermediate low infants were almost easy, and intermediate high infants were almost difficult. We found 43% of mothers and 60% of fathers did not change clinical designations of temperament preto postnatally. These parents were labeled "nonchangers." Parents whose pre- to postnatal clinical designations changed one category or more were labeled as "changers" (57% of mothers and 40% of fathers). We examined a number of variables from prenatal and postnatal interviews to attempt to differentiate these groups of parents. In the prenatal and postnatal interviews, parents were asked independently to describe labor and delivery. The prenatal expectation of the degree of difficulty anticipated was compared to the postnatal description of the degree of difficulty experienced. Mothers who were "changers" were significantly more likely to have described their experience of labor as very different from their prenatal expectations (Mann-Whitney V, Z = 2.83, p s 0.005). Three of the mothers in the "changers" and three of the mothers in the "nonchangers" had Cesarean sections so that the differences were not accounted for by that experience. The discrepancy in expectations and experience, however, did not distinguish "changers" and "nonchangers" among the fathers. Though mothers' and fathers' prenatal expectations of how difficult labor would be were not related (Spearman Rank Correlation Coefficient, 0.04, NS), postnatally, they perceived the experience quite similarly (Spearman rank correlation coefficient, 0.76, p s 0.0001). Several other interview variables did not distinguish the "changers" from "nonchangers" among mothers or fathers. Neither age nor education of the mother or father were significantly different for the two groups. We also examined other discrepancies between what had been expected prenatally and what had been perceived postnatally: neither discrepancies between expected or preferred and actual sex of the child, nor
TABLE 4 Agreement between Perceptions of Mothers and Fathers Spearman Rank Correlation Coefficient
Time of Rating Prenatal: 33 wk (N = 22) 37 wk (N = 36) Postnatal: 1 mo (N= 35) 7 wk (N = 18) 1P
:s 0.05.
2P
:s om.
Activity
Rhythmicity
0.14 0.17
-0.21 0.03
0.24 0.24
0.27 0.572
Adaptability 0.30 0.11 0.05 -0.14
Intensity
Mood
Distractibility
0.46 1 0.20
0.24 -0.05
-0.02 0.04
0.05 0.28
0.25 0.18
0.19 0.24
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the expected and perceived change in the individuals' or the couple's life distinguished the two groups. Parents' Descriptions of Personalities We assessed, from the interview data, whether parents had a general impression of their infant's personality prenatally and at 1 month postnatally. During the pre- and postnatal interviews, parents were asked to describe their baby's personality. Prenatally, three mothers and five fathers said that babies did not have personalities yet, or that they did not know what it was. At 1 month postnatally, one mother and one father said that their babies did not yet have a personality. We were impressed by the remarkably vivid and abstract descriptions of the babies' personalities. Examples of two couples' descriptions of their babies' personalities are given below. Mother A-prenatal: I feel this is a very, very emotional and intense child-very active. Very verbal and very intense. I'll know when it's upset and when it's happy. I cried when something beautiful happened at work. I was sure the baby cried, too. The baby kicked and kicked. It felt what I was feeling. Mother A-postnatal: Definitely not quiet. He's got a mind of his own. He's very alert. If he had his way, he wouldn't sleep all day. He likes to stay up and observe things. Likes human contact, likes a lot of love. Father A-prenatal: A great personality! Both of us are positive people. Will have a positive outlook on life. Will be outgoing, a lot of energy, full of spunk. A challenge to keep up with at times. I don't see a shy, retiring baby. Father A-postnatal. Very, very active. He was in his mother's womb. We felt he'd be active. Seems to be very strong and very active. My wife and I are very active and we thought our baby would be and he is! A lot of energy. A great sleeper-he looks like a millionnaire when he wakes up! He ' turned out to be a good feeder though he was clutzy, at first, while breastfeeding. Mother B-prenatal. More of a quiet kind of temperament. His activity period is eight to nine o'clock at night. He loves food. He gets excited and wakes up when we eat. Not terribly startled by noises. Mellow, I think, thoughtful. Mother B-postnatal, He's really a good-natured boy. A bright little personality. I've been reading cards to him since he was 3 days old; he likes to look at the colors. At times he likes to be with himself. Cuddly-likes to feel close to people. Kind of sensitive. He smiles a lot. Father B-prenatal, Quiet. Genuinely warm. Sensitive. Given to deep, emotional feelings. More of a quiet kind of child. Reflective. Father B-postnatal. Alert-he observes things. Not high strung. Sensitive. Kind of an observing baby. A happy baby. Dependent.
Parents' descriptions were rated for vividness and for positive and negative statements about the baby. We had hypothesized that more vivid impressions of the baby prenatally would be associated with less likelihood of changing perceptions of the baby after birth. There was, however, no relationship between
the vividness of personality descriptions in the "changers" and "nonchangers" for mothers or fathers. Positive and negative statements about the baby were not related to "changers" or "nonchangers," or to the clinical designations. Descriptions ofthe babies' personalities were overwhelmingly positive. Prenatally, 63% of mothers and 46% of fathers made exclusively positive statements about the baby. Another 26% of mothers and 40% of fathers made both positive and negative statements, but positive statements were clearly predominant. Only one mother described her baby's personality negatively prenatally. At 1 month postnatally, 57% of mothers and 57% of fathers described their baby's personality exclusively positively. Another 37% of mothers and 34% offathers made positive and negative statements about the baby. Only one mother and one father described their babies negatively postnatally.
Discussion Our findings suggest that both mothers and fathers develop stable perceptions of their infant's personality in late pregnancy. These prenatal perceptions are nearly as stable as early postnatal perceptions. Further, the birth of the infant does not radically alter these perceptions, as there is modest but significant stability between several prenatal and early postnatal dimensions of temperament. Mothers' direct experience with the developing fetus may account for their more stable perceptions of the infant's activity and rhythmicity. Adaptability, on the other hand, seems less clearly related to experiences with the fetus. Similarly, fathers' prenatal perceptions of rhythmicity, mood, and distractibility, all of which predict postnatal perceptions, are obviously unrelated to direct experiences with the developing fetus. Because we do not have objective measures of infant behavior, we were unable to evaluate directly the relation between infant behavior and parental perceptions. Interestingly, however, at no point in time do both parents rate their own infant similarly, though there are few systematic differences in the ratings of mothers compared to those of fathers. In addition to stable ratings of specific infant behaviors in specific situations, parents also vividly and abstractly describe personality characteristics of their infants. These descriptions reflect more global impressions of the infant's personality than the more specific perceptions measured by the MRITQ. The global impressions, which were overwhelmingly positive, did not relate to the clinical designations of easy, difficult, etc. Carey and McDevitt (1978) found parents' global impressions of their infants were more positive (easy) than their specific ratings. Only 4 % of the mothers in
PRENATAL PERCEPTION OF INFANT PERSONALITY
their sample indicated by general impression that their infant was more difficult than average. Parents may be reluctant to report their infants as difficult because of the implications of a pejorative label. This may also account for the overwhelmingly positive descriptions of personality by our parents. Another important finding in this investigation is that parents were characterized as "changers" and "nonchangers" according to their clinical designations pre- and postnatally. We reemphasize that these are relative terms, as there is evidence that the perceptions of mothers and fathers change to some degree after the infant's birth. What is striking, however, is the amount of agreement between pre- and postnatal perceptions of temperament. Mother-changers were characterized by experiencing labor differently from what they had expected prenatally. This finding might be accounted for by some characteristic of the mother such as flexibilityrigidity. If this were the case, we would expect other discrepancy scores of prenatal expectation and postnatal perception to reflect this rigidity characteristic and distinguish the changers and non-changers. On the contrary, only discrepancy in the perception ofthe difficulty of labor and delivery discriminated the two groups. This suggests that there is something about the mother's view of the labor experience itself which is an important influence on her early perceptions of her infant. Colman (1969) hypothesized that a close fit between a woman's expectations of herself and her actual performance during labor and delivery is an important source of self-esteem for the woman at the threshold of motherhood. Our findings suggest that these feelings may affect a mother's early perceptions of her infant, as well. Several words of caution seem in order. Our findings need replication in a larger sample. We cannot readily extrapolate from findings about the advantaged population in this investigation to more clinical or "atrisk" populations of expectant parents. Because the easy, intermediate, and difficult clinical designations were derived from deviations from the mean, these designations might not apply in a more heterogeneous population. Further, we do not know what the implications of these early perceptions are for later parental perceptions or for infant development. These important questions remain to be explored. At first glance, the idea of preconceived notions of infant personality may seem alarming. The ubiquity of the finding in a relatively low-risk group of parents, however, suggests that this phenomenon is not likely in and of itself pathological. Rather, our data suggest that personification of the developing fetus and infant
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by both parents is a frequent psychological accompaniment to the physical interactions between mother and fetus. Parental perceptions of their child's personality in late pregnancy and early infancy seem to derive in part from interactions between infant and parent and in part from parental projections which are probably unrelated to the infant's behavior. We speculate that parents not only conceptualize and interact with the infant as he or she is, but also with the infant as he or she will be (at least in the parents' view). Our findings do not by any means settle the question of the degree to which temperament and difficult temperament are within-the-infant characteristics, but they do add further complexity to considerations of early personality development. We suggest that the psychobiological interaction between parents and fetus deserves attention in future investigations of personality development. References BATES, J. E. (1980), The concept of difficult temperament. MerrillPalmer Quart., 26:299-319. --FREELAND, C. A. B. & LOUNSBURY, M. L. (1979) Measuremf'nt of infant difficultness. Child Deuelpm., 50:794-803. BENNETT, S. (1971), Infant-caretaker interaction. This Journal, 10:321-335. BERGER, M. (1982), Personality development and temperament. In: Temperamental Differences in Infants and Young Children (Ciba Foundation Symposium 89). London: Pitman Books, pp. 176190. CAREY, W. B. (1970), A simplified method for measuring infant temperament. J. Pediat., 77:188-194. - - (1982), Validity of parental assessments of development and behavior. Amer. J. Dis. Child., 136:97-99. - - & McDEVITT, S. C. (1978), Revision of the infant temperament questionnaire. Pediatrics, 61:735-739. - - - - (1980), Measuring infant temperament. J. Pediat., 96:423-424. CARON, J. W. & TEMPLETON, S. J. (1982), Maternal reports of infant temperament: infant behavior or maternal characteristics? Paper presented to the International Conference on Infant Studies, Austin, Texas. CHESS, S., THOMAS, A. & BIRCH, H. G. (1966), Distortions in developmental reporting made by parents of behaviorally disturbed children. This Journal, 5:226-234. COLMAN, A. D. (1969), Psychological state during first pregnancy. Amer. J. Orthopsychiat. 39:788-797. GOLDSMITH, H. H. & CAMPOS, J. J. (1982), Toward a theory of infant temperament. In: The Deuelopment of Attachment and Affiliatiue Systems, ed. R. Emde & R. Harmon. New York: Plenum Press, pp. 161-193. HUBERT, N. C., WACHS, T. D., PETERS-MARTIN, P. & GANDOUR, M. J. (1982), The study of early temperament: measurement and conceptual issues. Child Deuelopm., 53:571-600. JESSNER, L., WEIGERT E. & Foy, J. L. (1970), The development of parental attitudes during pregnancy. In: Parenthood: Its Psychology and Psychopathology, ed. E. J. Anthony & T. Benedek. Boston: Little, Brown, pp. 209-244. KAGAN, J. (1982), The construct of difficult temperament. MerrillPalmer Quart., 28:21-24. PARKE, R. D. & O'LEARY, S. E. (1976), Family interaction in the newborn period: some findings, some observations and some unresolved issues. In: The Deueloping Indiuidual in a Changing World (Vol. 2): Social and EnuironmentalIssues, ed. K. F. Riegel & J. A. Meacham. The Hague, Netherlands: Mouton.
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PLOMIN, R. (1982), The difficult concept of temperament. MerrillPalmer Quart., 28:25-33. RHEINGOLD, H. L. & ADAMS, J. L. (1980) The significance of speech pf newborns. Develpm. Psycfwl., 16:397-403. ROTHBART, M. K. (1982), The concept of difficult temperament. Merrill·Palmer Quart., 28:35-40. RUTTER, M. (1982), Temperament: concepts, issues, and problems. In: Temperamental Differences In Infants and Young Children (Ciba Foundation Symposium 89). London: Pitman Books, pp. 1-16. SAMEROFF, A. J., SEIFER, R. & ELIAS, P. K. (1982), Sociocultural variability in infant temperament ratings. Child Develpm., 53:164-173. SOLNIT, A. J. & STARK, M. H. (1961), Mourning and the birth of a defective child. The Psycfwanalytic Study of the Child, 16:523537.
THOMAS, A., CHESS, S., BIRCH, H. G., HERTZIG, M. E. & KORN, S. (1963), Behavioral Individuality in Early Childhood. New York: New York University Press. - - - - - - (1968), Temperament and Behavior Disorders in Children. New York: New York University Press. - - - - & KORN, S. (1982), The reality of difficult temperament. Merrill-Palmer Quart., 28:1-20. TORGENSEN, A. M. (1981), Genetic factors in temperamental individuality. This Journal, 20:702-711. - - & KRINGLEN, E. (1978), Genetic aspects of temperamental differences in infants. This Journal, 17:433-444. VAUGHN, B., DEINARD, A. & EGELAND, B. (1980), Measuring temperament in pediatric practice. J. Pediat., 96:510-518. - - TARALDSON, B., CRICHTON, L. & EGELAND, B. (1981), The assessment of infant temperament: a critique of the carey infant temperament questionnaire. Infant Behav. Develpm., 4:1-17.