Frontiers of Infant Psychiatry - Vol. 2

By Justin D. Call; Eleanor Galenson et al. | Go to book overview

32
Improving the Psychological Prognosis for
Offspring of Adolescent Mothers

Peter Barglow, M.D.

Roger Hatcher, Ph.D.

Lyle Joffe, Ph.D.

In 1979 there were over a quarter of a million births to unwed teenage mothers in the United States, an increase of 44 percent from a decade earlier. The child resulting from an adolescent pregnancy is subjected to a high degree of medical and psychological risk, as is the mother herself (Fried, 1980, Peterson et al., 1982). Measurements used to evaluate these infants include birthweight, the Brazelton (1973) neonatal examination, the Bayley (1969) Mental and Motor Scales, and the Graham Behavior Test (1956). Later sequelae of adolescent parenting are measured through rating how the mother talks to and holds the infant. Subsequently, the incidence of child abuse and neglect has been measured, and the child's IQ, reading ability, and educational attachment have been checked. Research conclusions that offspring deficits result from adolescent pregnancy are not unanimous (Sandler, 1977), but there is sufficient recent evidence to warrant caregiver intervention to minimize long-term damage, particularly among poverty populations.

Sameroff's studies (1975) have indicated that, regardless of maternal age, socioeconomic milieu is the single most important variable determining the long-range sequelae of early mother-infant pathology. But poverty is not the only influential factor. Werner's group (1969) has shown that resilience in children of the poor depends on a wide variety of factors —family size, the presence of alternative caregivers, family cohesiveness, and the infant's capacity to stimulate positive parental response. Over the past decade we have had the opportunity to scrutinize and evaluate the positive effects of the interventions described below.


Precision in Diagnosis

Effective intervention always requires skilled and detailed psychological interviewing. The regressive tendencies and fear of the unknown that usually characterize adolescent pregnancy, and age or sociocultural and ethnic gaps between client and interviewer make obtaining emotional data both difficult and time‐ consuming. When the adolescent girl first discovers that she is pregnant, denial and disbelief ("How could this could happen to me?") are common defense mechanisms contributing to a typical withholding of vital psychological information. The pregnant girl often has fantasies that she will be a better mother than her own mother, incorporating intense feelings of bitterness, disappointment, and anger toward

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