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<p>The overall purpose of this longitudinal exploratory study was to describe the interactive behaviors of American Indian mothers and their prematurely born infants. The first study examined behaviors of American Indian mothers and their premature infants when the infants were 3, 6, and 12 months of age corrected for prematurity as well as the effects of infant illness severity (NBRS) and socioeconomic status (maternal education) on these behaviors. Higher infant illness severity was associated with more maternal touch, more infant vocalization, and fewer opportunities for variety in daily stimulation. Higher maternal education was associated with more maternal talk; more infant vocalization; less infant touch; and higher scores on the provision of appropriate play materials, parental involvement with the child, and opportunities for variety in daily stimulation subscales of the HOME. The second study compared the interactions of American Indian and African American mothers with their prematures when the infants were 6 months corrected age. Most of the interactions between American Indian mothers and their premature infants were similar to those of African American mothers and their premature infants. However, American Indian mothers were more often the caregivers, looked more, and gestured more to their infants than African American mothers. Furthermore, American Indian infants expressed more positive affect and gestured more to their mothers than African American infants. The third study explored Lumbee mothers' responses to the birth and hospitalization of their premature infant at 3 months and explored the extent to which these early responses were related to maternal experiences of parenting at 12 months. This study indicated that culture appeared to be important in Lumbee mothers' responses to having a premature infant in the hospital and in caring for their infants. Promoting a strong cultural identity and family involvement may be protective factors for American Indians that enhance child development and health of premature infants who are at high risk for developmental delays and illnesses.</p> / Dissertation

Cette étude constitue un suivi longitudinal prospectif d’une cohorte de dyades de mères présentant un trouble de personnalité borderline avec leur enfant, dans une approche comparative avec unepopulation contrôle de dyades avec des mères sans trouble psychique. Elle a pour but d’éclairer le fonctionnement intrapsychique des mères et des bébés par l’étude des interactions précoces entre les mères borderline et leur bébé de trois mois. La grossesse représente une véritable crise identitaire et narcissique nécessitant un réaménagement des imagos maternels. Celui-ci ébranle l’identité de ces mères borderline déjà fragilisée par un narcissisme défaillant. Le bébé impose une relation de dépendance de laquelle la mère ne peut s’extraire. Les interactions précoces entre ces mères et leur bébé sont décrites comme étant teintées par l’intrusivité et la répétitivité, et reflètent leur incapacité à s’accorder aux rythmes propres et aux mouvements affectifs de leur enfant. Elles seraient en difficulté au sein d’un partage intersubjectif troublé pour aider le bébé à réguler ses émotions. Cette étude a aussi pour but d’éclairer la manière dont les comportements d’attachement de ces enfants, à 13 mois, s’ancrent dans la particularité de ces dysfonctionnements interactifs. L’évaluation des représentations d’attachement chez ces enfants, âgés de 4 à 8 ans, met en lumière différentes évolutions dans la qualité de leur attachement. Enfin, une approche psychodynamique de leurs récits, au test des histoires à compléter, éclaire les particularités de leur fonctionnement psychique. / This study comprises a prospective longitudinal exploration of a cohort of mother-child dyads with mothers with borderline personality disorder, compared with a control group of dyads in which mothers don’t display any psychological disorder. The aim of this study is to elucidate the early intrapsychic functioning of these mothers and infants through the study of the early interactions between these borderline mothers and their three-month-old infants. Pregnancy represents a powerful crisis, both of identity and narcissism, necessitating a reorganization of the maternal imago. It weakens the identity of mothers suffering from borderline personality disorder who are already debilitated by a failing narcissism. The infant imposes a relationship of dependence on its mother, from which she cannot extricate herself. The early mother-infant interactions are described as being imbued with intrusion and repetition, which reflect the mother’s incapacity to attune herself to the distinct rhythms and emotional movements of her child. They show difficulties at the heart of a troubled sharing of intersubjectivity to help the infant to regulate its emotions. This study endeavours to expound the way in which the attachment behaviours of these 13 month-old infants are embedded in the distinctive features of these dysfunctional interactions. The evaluation of the attachment representations of these children, aged from 4 to 8 years, draws light on different evolutions in the quality of their attachment. Ultimately, a psychodynamic approach of their narratives during the Attachment Story Stem Battery reveals the features of their psychological functioning.