Worst Case Scenario Moms

For most of us, when we make plans we take into consideration a small number of logical problems that might occur. In this case, a little bit of anxiety helps us make logical choices to keep ourselves safe. For example, if you are planning a road trip it is a good idea to use Google maps or your GPS to navigate without getting lost. 

For some individuals who struggle with anxiety that list of possible problems would not only be lengthy, it might also include some very unlikely and illogical problems. For example, if the weather report predicts sunny skies and you are very worried about a million things - including that you will have to drive through massive thunderstorms - this is probably a sign of an anxiety disorder. Even worse, when your friend tells you that you don't need to worry, you are still convinced that your concern is based in reality.

Our meme uses a good key word to help you understand one aspect of anxiety disorders:  catastrophically. Catastrophic thinking is a cognitive bias that is associated with anxiety disorders. It causes people to generate and fear many possible, even if unlikely, worst case scenarios. This might lead a person who fails one exam to believe, "I am going to fail out of school and be homeless;" a person who has a sore throat would think, "I am going to die from throat cancer;" and a person going through a break-up could fear, "I am going to die alone because nobody will ever want me."

In addition to worrying about themselves, people who are very anxious may also worry about catastrophes that could occur in others' lives. Based on this, Lester, Field, & Cartwright-Hatton (2012) wanted to clarify the relationship between anxiety and catastrophic thinking as they relate to mothers. This is very sensible as parents are charged with protecting their children from harm and teaching children how to be careful: all parents are expected to envision what could go wrong for their kids. 
 

 

As well, we know that anxiety disorders are caused by an interplay of genetic and environmental influences. If parents model catastrophic thinking it may be that their children will start to have the same cognitive bias.

In the study, 300 English mothers of elementary school children were tested for their baseline level of anxiety, or trait anxiety. Overall, they were not particularly anxious - only 5% or so were anxious enough to meet the criteria for Generalized Anxiety Disorder - but there were some moms who scored higher than others.

Next, the mothers were interviewed to measure their tendencies toward catastrophic thinking, or catastrophic processing. Almost 200 of the moms were asked to imagine that a person doing something dangerous was their own child; about 100 of the moms were instead asked to imagine themselves as the person doing the dangerous thing. For example (p. 759), the participants were asked to imagine their child or themselves as the man standing atop this high column.

They were then asked to state what worried them about that situation. The interviewer continued with follow-up questions based on these answers to generate a list of possible worst case scenarios. The mothers who came up with more of these had a larger bias toward catastrophic thinking.

All of the mothers participated in another test to see if they were simply biased to see danger in general. They read 20 descriptions of ambiguous situations - situations that could be interpreted as being dangerous or safe. Examples are not given in the Lester at al. article, but I can imagine a situation like, "Walking alone to a friend's house." Half of the situations were described as applying to them (my version: "You are walking alone to a friend's house....") and the other half were described as applying to the participants' children (my version: "Your child is walking alone to a friend's house....").

Bias toward seeing danger was assessed through a test of recognition memory. Recognition memory is what you use to complete multiple choice exams: you simply pick out the choice that matches what you remember. In this case the mothers' memories for the 20 situations were tested: for each one they had to choose between a version that was dangerous and a version that was safe. So if we use my made-up example of "walking alone to a friend's house" the choices might include:

a) ...walking alone to a friend's house and a man jumps out of a car with a knife...

b) ...walking alone to a friend's house and a rabbit jumps out from behind a bush...

Having a bias toward seeing danger would lead participants to choose the memory that depicted a threat as the correct answer.

The results confirmed that mothers who are higher in trait anxiety generated more possible worst case scenarios: anxious mothers were more likely to demonstrate catastrophic thinking. This was equally true regardless if they were asked to envision outcomes for their children or for themselves. This suggests that anxious mothers may generalize their own anxiety to their children's experiences.

Likewise, Lester et al. found that mothers who are higher in trait anxiety were more likely to remember ambiguous situations as including threats: they were biased to see danger. This was especially true when they were asked to imagine themselves in those ambiguous situations; it was true to a lesser extent when they were asked to imagine their children in the situations. Some further analyses led to the suggestion that higher trait anxiety leads to a bias of seeing danger as it might affect you personally; this self-directed bias in turn increases your likelihood to imagine danger for your child.

Lester at al. were careful to point out that their methods do not allow them to state that these biases cause children of anxious parents to become anxious themselves. However they raise the possibility that kids could be at risk of anxiety if they grow up with parents who engage in catastrophic thinking and who are led to envision danger in their children's lives. The authors also offer another possibility based on their results: parents of anxious children may develop these cognitive biases, such as catastrophic thinking, as a result of raising their fearful offspring. Talk about an ambiguous situation!

Further Reading:

The Lester et al. (2012) article can be accessed through your local college library.

For a humorous look at worst case scenarios and parenting, try this book by Piven, Borgenicht, & Jordan (2003). You can find an excerpt from the chapter on "long car journeys" here.

If you are concerned about your anxiety or the anxiety of your mother a loved one, the Anxiety and Depression Association of America offers good information on treatment. This includes a podcast about Cognitive Behavioral Therapy, a common treatment to combat irrational thoughts, including a bias toward catastrophic thinking.

B.F. Skinner and Cry-babies

Because of our parenting practices, long periods of crying are considered a normal part of infancy in Western cultures. When babies cry they are communicating that something feels bad: they may have pain; be frightened or lonely; feel uncomfortable; or be absolutely starving. In addition to the compassion that crying evokes, hearing a baby cry is simply unpleasant - we react to it physiologically and are motivated to do whatever it takes to stop it. We pick up our babies, inspect them, rock them, sing to them, offer them food, or grab a favorite toy to distract them...

In B.F. Skinner's theory of Operant Conditioning the reaction, or reinforcement, after a behavior happens is what encourages or discourages it from happening again. This meme is an example of two kinds of conditioning, or training, that encourage behaviors to continue:  negative and positive reinforcement. Without meaning to, both the child and the mother are training each other to keep doing these things.

The child is using negative reinforcement to to train his mother to continue giving him a teddy bear. In negative reinforcement there is something that is ongoing and unpleasant - in this case crying - and it is removed only when the trainee does what she is supposed to do - give a teddy bear. Negative reinforcement encourages a trained behavior to continue in the future, so the little boy is increasing the likeliness of getting his teddy bear in the future.

The mother is using positive reinforcement, or reward, to train her child to cry. In positive reinforcement once the trainee does what he is supposed to do - in this case crying - he gets something pleasant as a reward - the teddy bear. Positive reinforcement also encourages a trained behavior to continue in the future, so the mother is increasing the likeliness of having her son cry in the future.

Skinner, like the other Behaviorists, was not interested in thoughts or feelings because those are not observable actions. Instead he saw this type of training as reflexive: contrary to our meme, the boy and his mother are not planning these behaviors instead they are reacting to the situation. Even so, their reactions increase the likelihood of the situation occurring again.

Operant Conditioning is a very old theory, but it still can be applied to parenting today. For example, Thompson, Bruzek, and Cotnoir-Bichelman (2011) designed a small experiment to examine how infant cries may negatively reinforce caregivers and train them to perform comforting behaviors. The authors were also interested in what happens when that training has occurred but none of the comforting behaviors works to stop inconsolable crying.

Thompson et al. had a very small sample size: eight female and three male undergraduates were observed as they interacted with a baby doll under directions to, "...do what comes naturally" (p. 297). Eight of the participants were asked if they had prior experience with babies and all of them did; the other three were not asked. Even with this curiously missing information, we know that the majority of participants had real life experience "doing what comes naturally" with an infant.

Tested one at a time, all of the participants experienced several Negative Reinforcement conditions: a recording of an infant crying played until the participant engaged in the desired behavior with the doll. These behaviors ranged from rocking, bottle feeding, and offering a toy. All of the participants showed signs of training: they learned to do the desired behavior to stop the recorded crying.

Eventually the participants were each placed into an Extinction condition: this time no matter what comforting behavior they tried, the recorded crying would not stop. The participants all tried the behavior that had previously worked to stop the crying in the earlier conditions. When it did not work nine of these undergraduates showed extinction of that training: they gave up trying to get the crying to stop. Two of the participants did not show an extinction: they persisted with the trained comforting behavior for 30 minutes as the crying recording played the entire time. Perhaps these participants had real-life experience with their own colicky babies and their behavior in the Extinction condition mirrored what they did for their own children: persisted in giving care.

The results support the notion that negative reinforcement teaches parents which comforting behaviors work to stop their babies' crying and thus encourages these behaviors to continue in the future. The results may also demonstrate how some parents could give up and stop any attempt to comfort their babies when inconsolable crying occurs. In the worst case, these parents might engage in neglect or abuse of these infants. The authors did note that these findings and their implications would be stronger with a larger sample and a more realistic test situation.

In addition, I would caution that we should not interpret this to mean that babies consciously manipulate their caregivers. To manipulate another person is a very advanced cognitive ability. It implies that one person is going to fake a behavior to trick another person into doing something that he or she really does not want to do. Young infants do not possess the ability to do this: instead they simply cry when they feel bad. As well, most parents want to care for their babies and are motivated to reduce their babies' distress - they do not need to be tricked into these behaviors. In the ideal situation babies learn that if they cry a parent will help them feel better, and parents learn how to best calm their babies' distress - or even better, how to avoid that distress in the first place.

Further Reading:

A pdf of the Thompson et al. article, published in the Journal of Applied Behavior Analysis, can be accessed for free online.

Here are some good ideas for comforting a baby who is crying inconsolably from Ask Dr. Sears. Dr. Harvey Karp has a combination of five comforting behaviors that can help even colicky babies stop crying: here is a video of that technique on WebMD.

In addition to learning their babies' early cues of distress, parents can REDUCE crying by carrying their babies MORE often. An article by Hunziker and Barr (1986), published in Pediatrics, supports this idea.

The Walking Dead: New Parents

I went back to work when my daughter was 7 months old.  Even though I had taught psychology for a long time, the lack of sleep made it hard for me to remember even basic things.  Once I was lecturing on Piaget's stages and for a good 10 seconds I had to stall because instead of the names of the stages all I had in my head was this.  Eventually I remembered the stages; but I have never forgotten that moment.

So this week's blog is dedicated to all of the new parents out there...

First, is this plotting baby correct?  Yes - for the near future.  Newborn babies wake to eat every two or three hours - so in a given night the parents might be awakened four or more times!  A study by McDaniel and Teti (2012) found that one-month old babies wake two to three times each night and three month old babies still wake one to two times each night.  Babies this young require attention at night - to feed them, to soothe their gas pains, to change their diapers, to rock them - so if the baby is awake, that means that the parents aren't sleeping either.

So what is the problem?  Many studies including McDaniel and Teti's demonstrate that getting less sleep tends to go hand in hand with more clinical depression in new parents.  Most, but not all, find that this is especially true for new mothers who are more likely than new fathers to lose sleep caring for Baby's nighttime needs.  We can't be sure that it is only the loss of sleep that is causing the depression; but a positive correlation like this means that it's common to see these two things happening at the same time.

McDaniel and Teti also looked at how lack of sleep might relate to parents' perceptions of each other as parents.  This is important because, "...supportive coparenting, such as when partners endorse and support each others' parenting behaviors and cooperate with each other in raising their children, has been linked to increased relationship quality, less depression, and less parenting stress (p. 886)."  So if parents do not feel like they are a team, that also seems to go hand in hand with depression.

To unravel this riddle, the researchers used data from Project SIESTA (Study of Infants' Emergent Sleep TrAjectories) that included how 132 new parent (heterosexual) couples responded to a questionnaire about coparenting.  The parents rated themselves on how much they agree about parenting, how close they feel to each other and if they fight in front of their baby, their feelings of competition as parents, and how fairly they share the tasks of parenting.  This questionnaire, a measure of parents' depressive symptoms, and reports on their babies' nighttime wakings were collected when the infants were one month old and three months old.

Using a statistical method, McDaniel and Teti were able to determine how these things are related.  Put simply: between one month and three months, babies sleeping less predicted parents sleeping less; parents sleeping less predicted more depression symptoms; more depression symptoms predicted feeling worse about how coparenting is going.  This flow remained the same regardless of the family's social class and the baby's level of fussiness - so even well-off, well-educated families with easy-going babies were likely to show this pattern.

If this sounds miserable (and even more miserable for single parents doing it solo), you may be relieved to learn that most babies are able to sleep through the night by about six months.  Until then, there are some things that you can do to help your baby sleep and ways to make this sleep deprivation even a bit funny (see below) when you feel like a zombie parent.

Further Reading:

Get Your Baby to Sleep: Infant sleep suggestions from pediatrician, Dr. William Sears.  I like that he is clear:  each baby is an individual and each family has its own needs - so choose what feels right for you.

Adam Mansbach wrote a darkly humorous book for ADULTS who are suffering from child-induced sleep deprivation.  Its title and text does contain the F-word so don't click this or buy this book if it would be offensive to you.  Although it is meant to be funny, its angry and defeated tone is probably a good demonstration of depressive symptoms!

You can read the entire McDaniel and Teti (2012) paper here and find out more about Project SIESTA on Douglas Teti's homepage.