Mother-infant and father infant interactions during feeding. A study on paternal involvement

1. A R T I C L E
MOTHER–CHILD AND FATHER–CHILD INTERACTION WITH THEIR 24-MONTH-OLD
CHILDREN DURING FEEDING, CONSIDERING PATERNAL INVOLVEMENT AND THE
CHILD’S TEMPERAMENT IN A COMMUNITY SAMPLE
LUCA CERNIGLIA
International Telematic University Uninettuno
SILVIA CIMINO AND GIULIA BALLAROTTO
University of Rome, Sapienza
ABSTRACT: The article aims to study mother–child and father–child interactions with 24-month-old children during feeding, considering the possible
influence of time spent by the parent with the child, the infantile temperament, and the parental psychological profile. The families were recruited
from 12 preschools in Italy (N = 77 families). Through an observation of the feeding [Scala di Valutazione dell’Interazione Alimentare (SVIA –
Feeding Scale; I. Chatoor et al., 1997; L. Lucarelli et al., 2002)], self-reporting [Symptom Checklist-90-Revised (SCL-90-R; L.R. Derogatis, 1994),
and report-form questionnaires [Italian Questionnaires on Temperament (QUIT; G. Axia, 2002)], and information provided by the parents about
the amount of time spent with their children, results showed that the overall quality of father–child interactions during feeding is lower than that
of mother–child interactions. Fathers showed higher psychological symptoms than did mothers. No associations were found between the fathers’
psychopathological risk and the quality of interactions with their children during feeding. Mothers’ psychopathological risks predicted less contingent
exchanges interactions with their children during feeding. Children’s temperaments significantly influence mother–child interactions, but no association
exists between maternal involvement and the quality of interactions with their children. Paternal involvement predicts a better quality of father–infant
interactions when associated with a child’s higher scores on Social Orientation. The quality of parents’ interactions with their children during feeding
are impacted by different issues originating from the parent’s psychological profile, the degree of involvement, and from the child’s temperament.
RESUMEN: El art´ıculo se propone estudiar las interacciones pap´a-hijo y mam´a-hijo con ni˜nos de 24 meses de edad durante el momento de alimentarse,
considerando la posible influencia del tiempo que el progenitor pasa con el ni˜no, el temperamento infantil y el perfil sicol´ogico de los padres. Las
familias fueron reclutadas en doce centros prescolares en Italia (N = 77 familias). Por medio de una observaci´on del momento de alimentaci´on
(SVIA), el auto-reportaje (SCL-90-R) y cuestionarios en formularios de reporte (QUIT), e informaci´on ofrecida por los padres acerca de la cantidad
de tiempo pasada con sus ni˜nos, los resultados mostraron que la calidad general de las interacciones pap´a-hijo durante el momento de alimentarse es
m´as baja que las de mam´a-hijo. Los pap´as mostraron m´as altos s´ıntomas sicol´ogicos que las mam´as. No se encontr´o ninguna asociaci´on entre el riesgo
sicopatol´ogico de los pap´as y la calidad de las interacciones con sus ni˜nos durante la alimentaci´on. Los riesgos sicopatol´ogicos de las madres predijeron
menos interacciones de intercambios eventuales con sus ni˜nos durante la alimentaci´on. El temperamento de los ni˜nos significativamente influye en las
interacciones mam´a-hijo, pero no existe asociaci´on entre el involucramiento materno y la calidad de las interacciones con sus ni˜nos. El involucramiento
paterno predice una mejor calidad de interacciones pap´a-infante cuando est´a asociado con los m´as altos puntajes del ni˜no en la Orientaci´on Social.
Diferentes asuntos impactan la calidad de las interacciones de los padres con sus ni˜nos durante la alimentaci´on, partiendo del perfil sicol´ogico de los
padres, el grado de involucramiento y el temperamento del ni˜no.
RE´ SUME´ : Cet article a pour but d’e´tudier les interactions pe`re-enfant et me`re-enfant avec leurs enfants de 24 mois durant l’alimentation, en conside´rant
l’influence potentielle du temps pass´e par le parent avec l’enfant, le temp´erament de l’enfant et le profil psychologique parental. Les familles ont
´et´e recrut´ees dans dix cr`eches italiennes (N = 77 familles). Au travers d’une observation de l’alimentation (SVIA), du questionnaire SCL-90-R, des
questionnaires sous forme de rapport (QUIT), et les renseignements donn´es par les parents sur la quantit´e de temps pass´e avec leurs enfants, les r´esultats
ont montr´e que la qualit´e g´en´erale des interactions p`ere-enfant durant l’alimentation est moins ´elev´ee que celle des interactions m`ere-enfant. Les p`eres
ont fait preuve de plus de symptˆomes psychologiques que les m`eres. Aucun lien n’a ´et´e trouv´e entre le risque psychopathologique des p`eres et la
qualit´e des interactions avec leurs enfants durant l’alimentation. Les risques psychopathologiques des m`eres ont pr´edit des ´echanges interactifs moins
I, Luca Cerniglia, declare that no author has any conflict of interest.
Direct correspondence to: Luca Cerniglia, Corso Vittorio Emanuele II, 39–00100–Rome, Italy; e-mail: l.cerniglia@uninettunouniversity.net.
INFANT MENTAL HEALTH JOURNAL, Vol. 35(5), 473–481 (2014)
C
2014 Michigan Association for Infant Mental Health
View this article online at wileyonlinelibrary.com.
DOI: 10.1002/imhj.21466
473

2. 474 • L. Cerniglia, S. Cimino, and G. Ballarotto
contingents avec leurs enfants durant l’alimentation. Le temp´erament des enfants influencent fortement les interactions m`ere-enfant mais aucun lien
n’existe entre l’engagement maternel et la qualit´e des interactions avec leurs enfants. L’engagement paternel pr´edit un meilleure qualit´e des interactions
p`ere-b´eb´e lorsque li´ees `a des scores plus ´elev´es de l’enfant sur l’Orientation Sociale. Diff´erents probl`emes issus du profil psychologique du parent, du
degr´e d’engagement et du temp´erament de l’enfant ont un impact sur la qualit´e des interactions des parents avec leurs enfants durant l’alimentation.
ZUSAMMENFASSUNG: Der Artikel zielt darauf ab, Vater-Kind-und Mutter-Kind-Interaktionen bei 24 Monate alten Kindern w¨ahrend der F¨utterung,
in Anbetracht des m¨oglichen Einflusses der Zeit, die das Elternteil mit dem Kind verbringt, des kindlichen Temperaments und des psychologischen
Profils der Eltern, zu untersuchen. Die Familien wurden aus zw¨olf Vorschulen in Italien (N = 77 Familien) rekrutiert. Anhand einer Beobachtung der
F¨utterung (SVIA), Selbst-Berichten (SCL-90-R) und anderen Frageb¨ogen (QUIT) sowie Informationen von den Eltern ¨uber die Menge der Zeit, die
sie mit ihren Kindern verbracht haben, zeigten die Ergebnisse, dass die Gesamtqualit¨at der Vater-Kind-Interaktionen w¨ahrend der F¨utterung niedriger
ist als die der Mutter-Kind-Interaktionen. V¨ater zeigten h¨ohere psychische Symptome als M¨utter. Es wurden keine Zusammenh¨ange zwischen dem
psychopathologischen Risiko der V¨ater und der Qualit¨at der Interaktion mit ihren Kindern w¨ahrend der F¨utterung gefunden. Die psychopathologischen
Risiken der M¨utter sagten weniger zuf¨allige Austauschsinteraktionen mit ihren Kindern w¨ahrend der F¨utterung vorher. Die Temperamente der
Kinder beeinflussen die Mutter-Kind-Interaktionen signifikant, es besteht jedoch kein Zusammenhang zwischen m¨utterlichem Engagement und der
Interaktionsqualit¨at mit ihren Kindern. V¨aterliches Engagement sagt eine bessere Qualit¨at der Vater-Kind-Interaktionen vorher, wenn sie mit h¨oheren
Werten f¨ur die soziale Orientierung des Kindes assoziiert wird. Die Interaktionsqualit¨at der Eltern mit ihren Kindern w¨ahrend der F¨utterung wird von
unterschiedlichen Themen beeinflusst: dem psychologischen Profil der Eltern, dem Grad des Engagements und vom Temperament des Kindes.
ABSTRACT: :

3. 24
!#12$%(N = 77 )(SVIA)(SCL-90-R)(QUIT)

4. '()%
*+( )%+,
-.
%*/-.
contingent exchanges interactions*)
%*(
Social Orientation(-0# 1+(
')232*
/4(
* * *
It has been widely recognized that the quality of mother–
infant interaction during a child’s first years of life has a profound
influence on his or her psychological welfare and on the possi-ble
onset of psychopathologies in infants (Ramchandani et al.,
2013). Nevertheless, family and ecological theories (Bronfen-brenner,
1979; Minuchin, 1974) suggest that mother–infant and
father–infant dyads are interconnected. Growing evidence has
suggested that positive father–infant interactions can directly im-pact
children’s cognitive and socioemotional development (Brown,
McBride, Bost, Shin, 2011) (e.g., engaging with their children,
monitoring them, and setting limits and rules), and also indirectly
impact such development (e.g., influencing mother–infant inter-actions,
supporting mothers’ decisions and behaviors concerning
their sons and daughters, and/or providing economic support to the
family, which may contribute to the rearing and emotional health
of the children) (Atzaba-Poria et al., 2010; Carlson, 2006; Cimino,
Cerniglia, Paciello, Sinesi, 2012). Lamb’s (2010) theoretical
framework has conceptualized that fathers are unique kinds of in-teractional
partners for their children, and are rather distinct from
mothers; the paternal fashion of interactions differ from the ma-ternal
fashion, being more characterized by physical contact and
rough-and-tumble play, which seems to have a specific role in pro-moting
a child’s emotional-regulation processes (Feldman, 2003).
Consequently, in more recent years, research has concentrated on
both mothers and fathers, specifically on the role of fathers as
protectors, and on risk factors for the development of children’s
psychological difficulties while considering triadic interactions to
verify whether there are differences in parenting quality and chil-dren’s
interactive behaviors with mothers and fathers in the dyadic
context versus those in the triadic context (Di Folco Zavattini,
2014; Kwon, Jeon, Lewsader, Elicker, 2012; Lamb Lewis,
2007). While it has been proposed that a combination of maternal
and paternal psychopathologies may create a style of coparenting
dominated by negative interactive cycles with children during play
and feeding (Pinquart Teubert, 2010), the specific impact that
psychopathological symptoms in fathers might have on a child’s
mental health has been only recently addressed, mostly investigat-ing
the construct of involvement in community samples (Lamb,
2010). Highly involved fathers (in terms of time spent with their
children) seem likely to have more empathic sons and daughters
who show a more internal locus of control (Cerniglia, Cimino, Bal-larotto,
Monniello, 2014; Pleck, 2010). With specific regard to
the context of feeding, international research has mainly focused
on mother–infant interactions because mothers are traditionally
thought to take primary responsibility for feeding their children
(Blissett, Meyer, Haycraft, 2006) and are usually considered
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5. Parent–Child Interaction During Feeding • 475
their primary caregiver (Campbell et al., 2010; Patrick, Nicklas,
Hughes, Morales, 2005). However, parents’ gender roles and re-sponsibilities
have changed in the last few decades, above all as a
result of increasing employment outside the home for mothers with
young children. Research has been considering these changes, and
recently has focused on fathers’ psychological characteristics and
practices during feeding interactions with their children (Khand-pur,
Blaine, Fisher, Davison, 2014). Although Blissett and Hay-craft
(2011) found no significant differences in feeding practices
between mothers and fathers, in the same study fathers reported
feeling personally responsible for organising meals at least half of
the time, and deciding what kinds of foods their children should
eat (Mallan et al., 2013). Hendy, Williams, Camise, Eckman, and
Hedemann (2009) found that fathers were less likely to limit their
children in consuming snacks and were less focused on letting
them eat a variety of foods such as fruits and vegetables. Some
studies have shown that fathers are more likely than are mothers
to encourage children to eat using prompts (verbal or physical),
reasoning, pressure, and incentives during feeding (Haycraft
Blissett, 2008; Orrell-Valente et al., 2007). Nevertheless, threats to
withdraw play privileges or access to food were not usually used
by fathers, with no psychopathological risk (Haycraft Blissett,
2012; Tschann et al., 2013). Regarding the context of feeding,
the ages of children have been linked to diverse father–child in-teractions.
Fathers of older children reported lower use of food
for emotional regulation than did fathers of younger children, and
more restriction of food for older children if they were concerned
about the child’s weight (Musher-Eizenman, de Lauzon-Guillain,
Holub, Leporc, Charles, 2009). Furthermore, parent–child inter-actions
during feeding seem to be less problematic with toddlers
than with infants, although this result seems to have been con-firmed
only in low-risk samples whereas high-risk samples show a
different trend. Psychopathological risk in mothers and in fathers
as well as in low-income parents seems to be related to maladaptive
parent–child interactions more frequently during toddlerhood than
during childhood (Horodynski Arndt, 2005).
In fact, nonresponsive parenting characterizes families with
psychopathological parents who frequently fail to respond to new
skills and signals shown by toddlers, such as self-feeding, the use
of utensils, and the use of language to request food and help (Birch,
Fisher, Davison, 2003).
In clinical samples, paternal pressure to eat has been corre-lated
with bulimia and restriction symptoms in fathers (Blissett
et al., 2006) whereas eating disorders and depression in mothers
proved to be the most significant psychopathology correlated with
maladaptive patterns of interaction between mothers and infants
(Cimino, Cerniglia, Paciello 2014; Watkins, Cooper, Lask,
2012). Depressed mothers seem to display less positive engage-ment
with their infants during feeding interactions and to show
anxiety, anger, and intrusivity, having difficulties with empathi-cally
recognizing and regulating the child’s affective states during
mealtimes. Ammaniti, Lucarelli, Cimino, D’Olimpio, and Chatoor
(2010) showed that these parental symptoms may foster feeding
disorders in children.
While earlier studies have aimed to consider the amount of
time spent by fathers with their children as an indicator of in-volvement,
more recent studies seem to have underlined the im-portance
of the actual quality of interactions to specifically un-derstand
why and how paternal involvement should be expected
to have a positive effect on child development (Stueve Pleck,
2001). Lamb (2013) stressed the role of engagement accessibil-ity
and sensitivity as well as the significance of paternal warmth
and support during interactions. Attachment theory proposes that
fathers’ involvement promotes child development because it fos-ters
secure attachment, which is linked to positive child outcomes
(Brown, McBride, Shin, Bost, 2007). Nevertheless, little at-tention
has been given in attachment literature to the quality of
father–child interactions during feeding and to their links with
adaptive or maladaptive outcomes in the emotional and behavioral
development of children, which in turn may be bidirectionally
linked to security or insecurity of attachment in infants and in their
parents.
Some research has suggested that temperamentally easy chil-dren
are more likely to be involved in good-quality interactions
with their fathers (Mehall, Spinrad, Eisenberg, Gaertner, 2009).
Children who show high levels of irritability, negative moods, and
irregular behavioral and biological patterns seem to be involved
in lower quality interactions with their mothers and fathers. On
the other hand, Frodi et al. (1982) found that fathers were more
involved with difficult sons (but not with difficult daughters), as
recently confirmed by Leaper (2002) and Cabrera, Fagan, Wight,
and Schadler (2011).
To capture the bidirectional effect of child–father interaction,
several studies have chosen to use observational methods, which
take into consideration verbal and nonverbal contexts of behavioral
dynamics (Hughes et al., 2010).Many of these studies have focused
on play routines (both involving mothers and fathers) while only
some of them have observed feeding interactions (Blissett, 2011).
Yet, several studies have suggested that feeding interactions be-tween
parents and their children constitute an important context in
which infants and toddlers may learn to recognize and make sense
of verbal and nonverbal communications and signals, thus build-ing
a basis for emotional bonds and attachment quality that in turn
forms essential roots for healthy emotional/behavioral functioning
(Black Aboud, 2011).
Based on these theoretical and empirical premises, which
include Lamb’s (2010) conceptual framework, and that no other
study to our knowledge has addressed father–toddler interactions
during feeding in nonclinical samples, we chose to study father–
infant and mother–infant interactions during feeding at 24 months
of age, considering the possible influence of time spent by the
parent with the child, the infantile temperament, and the parental
psychological profile.
In particular, this study has the following objectives:
• to verify whether the quality of mother–child and father–
child interactions during feeding differ from each other;
• to assess parental psychopathological risks; and
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6. 476 • L. Cerniglia, S. Cimino, and G. Ballarotto
• to verify whether parental psychopathological risks affect
the quality of parent–child interactions during feeding while
considering child temperament and parental involvement.
METHOD
Participants
Seventy-seven families were recruited from 12 preschools in Italy
(N = 77). The children (45 girls, 32 boys) ranged from 23 to 26
months of age (SD = 0.8), and their parents’ mean ages were 34.5
(SD = 1.2) years for the fathers and 32.3 (SD = 0.9) years for
the mothers. Eighty-nine per cent of the children were firstborn,
and 73% of them had been breast-fed in their first year of life.
Ninety-one per cent of the couples were married, and all parents
were of middle-class socioeconomic status (SES; Hollingshead,
1975). Ninety-four percent of the parents cohabited, three percent
of the parents who cohabited were not married, and 82% of the
families had double income. All partners of the mothers recruited
for the present study were biological fathers of the children, and
all parents were Caucasian. All parents included in the study, both
mothers and fathers, were involved in caregiving practices with
their children on a daily basis [average time spent weekly by the
mothers with their children: 76.1 hr (SD = 2.3); average time spent
weekly by the fathers with their children: 38.6 hr (SD = 4.1)].
Procedure
Sample selection criteria were: (a) age of the children ranging
between 23 and 26 months, (b) no reported mental or physical
problems or disorders in either the parents or the children, and
(c) both parents reporting frequently feeding the child without the
presence of the other parent. A group of trained psychologists con-tacted
12 preschools in Central Italy and presented the research
rationale and objective. Families who agreed to be recruited for the
study filled out an informed consent form. The order of the admin-istration
of the measures (described later) was randomly selected.
All parent–child pairs in the sample were observed at their homes
in 20-min video-recordings during lunch at midday; the feeding
interactions were part of one regular meal observed separately (on
2 different days) for mother–child and father–child interactions.
The videos were recorded by psychologists who were specifically
trained in the use of this observational tool, and were coded by
two trained independent raters who watched the videos and scored
them on the basis of the manual (Lucarelli et al., 2002) using both
a paper–pencil system and a coding software program designed for
the computation of scores on each subscale. The whole observation
was scheduled on the basis of a validated procedure for the Ital-ian
population [Scala di Valutazione dell’Interazione Alimentare
(SVIA) – Observational Scale for Mother-Infant Interaction dur-ing
Feeding; Chatoor et al., 1997; Lucarelli et al., 2002; described
later] and in connection with several previous studies (Ammaniti
et al., 2010). This tool was chosen over others because it is the
only procedure that specifically assesses parent–child interactions
during feeding that are validated for the Italian population. Two
instruments were given to each parent to be completed at their
home and independently: a self-report measure for the assessment
of their psychological symptom status, the Symptom Checklist-
90-Revised (SCL-90-R; Derogatis, 1994), which was filled out
independently by each parent, and a report-form questionnaire to
evaluate their child’s temperament: the Italian Questionnaires on
Temperament (QUIT; Axia, 2002). Mothers and fathers indepen-dently
filled out this questionnaire, but they obtained an interrater
agreement of 89%. Consequently, we used a mean score. More-over,
each parent filled out a form asking him or her to report the
average number of hours spent with the child during the week.
Measures
Assessment of parents’ psychological symptom statuses. The
SCL-90-R is a 90-item self-report symptom inventory designed
to measure psychological symptoms and psychological distress
(Derogatis, 1994). It is scored and interpreted in terms of
nine primary subscales (Somatisation, Obsessive-Compulsivity,
Interpersonal Sensitivity, Depression, Anxiety, Hostility, Phobic
Anxiety, Paranoid Ideation, and Psychoticism) and three Global
Indices of Distress (Global Severity Index, Positive Symptom
Distress Index, and Positive Symptom Total). The SCL-90-R
is rated on a Likert scale of 0 (not at all) to 4 (extremely) and
asks participants to report if they have suffered in the past week
from: Headaches (Somatisation scale), Trouble remembering
things (Obsessive-Compulsivity scale), Feeling critical of others
(Interpersonal Sensitivity scale), Blaming oneself for things (De-pression
scale), Feeling fearful (Anxiety scale), Feeling watched
or talked about by others (Paranoid Ideation scale), and The idea
that something is wrong with one’s mind (Psychoticism scale).
The SCL-90-R has been shown to have good internal coher-ence
(α = 0.70–0.96) in adolescents and adults (Italian validated
version: Prunas, Sarno, Preti, Madeddu, Perugini, 2012).
Assessment of child temperament. Participants’ answers on the
QUIT (Axia, 2002) are rated on a Likert scale of 1 (almost never)
to 6 (almost always). This questionnairewas validated for an Italian
sample to measure child temperament from the first month after
birth to 11 years of age, within four age groups: 1 to 12 months,
13 to 36 months, 3 to 6 years, and 7 to 11 years. It is given to the
parents and investigates six dimensions: the level of motor activity
(e.g., The child grasps objects with rapid movements), attentional
capacity (e.g., The child immediately turns his/her gaze towards
the person by whom he or she is called), inhibition to novelty and
availability to socialization (e.g., the child observes strangers for a
long time), positive emotionality (e.g., the child maintains a smiling
face when playing), and negative emotionality (e.g., the child cries
for a long time when contradicted). The questionnaire for the age
group 1 to 12 months showed good internal consistency (Cronbach
αs = .59–.71), and the values of the Pearson correlations between
the scales of the questionnaire completed separately by the mother
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7. Parent–Child Interaction During Feeding • 477
and father, ranging between .32 and .62, show that both give a very
similar assessment of the child (Axia, 2002).
Assessment of parent–child feeding interactions. The Italian ver-sion
(SVIA – Feeding Scale; Chatoor et al., 1997; Lucarelli et al.,
2002) of the observational scale has 41 items rated on a Likert
scale of 0 (confirm, none) to 3 (confirm, many) and four subscales
coding dyadic mother–child and father–child interactions sepa-rately:
Affective State of the Parent (e.g., the parent appears sad
during feeding), Interactional Conflict (e.g., the parent forces food
into the child’s mouth), Food Refusal Behaviors of the Child (e.g.,
the child refuses to open his/her mouth), and Affective State of
the Dyad (e.g., the parent and the child show joy during feeding).
Higher scores on the Affective State of the Parent refer to greater
difficulties of the caregiver in showing positive affects and to a
higher frequency of negative affects such as sadness or distress.
The subscale Interactional Conflict evaluates both the presence
and the intensity of conflictual exchanges within the dyad (e.g.,
the parent directs the meal according to his or her own emotions
and intentions rather than following the signals from the child).
The subscale Food Refusal Behaviors of the Child explores the
behavioral and emotional characteristics of the feeding patterns
of the child (e.g., being easily distracted, or showing opposition
or negativity). Higher scores on the Affective State of the Dyad
refer to the difficulties of the caregiver in supporting autonomous
initiatives of the child (by means of requests, insistent orders, and
criticism) while the child demonstrates distress and is generally
oppositional. In the Italian version that was validated for mother–
infant interactions (Lucarelli et al., 2002), the discriminant analysis
showed correct group classification ranging from 82 to 92%, and
construct validity for the tool has been proven. Interrater reliability
ranged between 0.82 and 0.92 (intraclass correlation coefficients).
DATA ANALYSES
A preliminary screening of the data showed few data missing for
each instrument (4% for each instrument). Missing data were cor-rected
using multiple imputation in SPSS software (Version 18.0).
To examine the quality of the interactional patterns between fa-thers
and children and mothers and children during feeding, we
carried out multivariate analyses of variances (MANOVAs) on the
SVIA dimensions (to respond to Objective a). In all MANOVAs,
univariate analyses were then conducted on significant effects, and
the Duncan test (Bonferroni correction) was used for contrasts. To
respond to Objective b, we investigated the maternal and paternal
psychological status through a series of MANOVAs that were car-ried
out on the scores (transformed in their square root whenever
the distribution deviated from normality) obtained from the SCL-
90-R (the Global Severity Index and, subsequently, the subscales).
In MANOVAs regarding the SVIA procedure and the SCL-90-R
questionnaires, we considered the group of mothers and the group
of fathers as criterion variables while mothers’ and fathers’ scores
on the measures constituted dependent variables. As a final step
(to respond to Objective c), two hierarchical regression analyses
were conducted to investigate the influence of specific SCL-90-R
subscales, temperament subscales, and parental involvement on
the relational dimensions of the Feeding Scale in mother–infant
and father–infant interactions. In all the analyses we conducted,
the child’s gender showed no significant effect on the variables.
All analyses were performed with SPSS software (Version
18.0).
RESULTS
Quality of Mother–Child and Father–Child Interactions During
Feeding
MANOVA analyses of the observational scale during feeding
showed that fathers’ scores were significantly higher than were
mothers’ scores in all four subscales, p .01 (see Table 1). No
participant exceeded the cutoffs for the clinical population of the
Italian version of the SVIA (Lucarelli et al., 2002).
Parental Psychopathological Risk Assessment
With respect to the assessment of mothers’ and fathers’ psycho-logical
symptoms, the analyses showed that fathers scored higher
than did mothers on the Global Severity Index and in all SCL-90-
R subscales, p .01 (see Table 2). Furthermore, 3 mothers and 4
fathers obtained scores higher than the cutoffs of the clinical range
(Prunas et al., 2012).
Quality of Parent–Child Interactions During Feeding Considering
Parental Psychopathological Risk, Child Temperament, and
Parental Involvement
Two regression analyses were conducted separately for mothers
and fathers to investigate the influence of all nine SCL-90-R sub-scales,
all five temperament subscales, and parental involvement
(in terms of hours spent by the parent with the child) on all four
of the relational dimensions of the SVIA in mother–infant and
father–infant interactions, which showed higher maternal scores
on Phobic Anxiety predicting mothers’ Affective State of the Par-ent,
p .05, in the direction of more negative affects. Higher
children’s Negative Emotionality scores in the QUIT, p .001,
predicted the Affective State of the Dyad in the direction of more
maladaptive mother–infant interactions during feeding. Maternal
psychological symptoms and involvement of the mother (in terms
of time spent with the child weekly) did not predict the quality of
mother–infant interactions during feeding.
Regarding fathers, the regression analyses showed the only
significant results: Higher paternal involvement (in terms of the
number of hours spent with the child) predicts lower scores (i.e., a
better quality of father–child interactions) on three of the sub-scales
of the SVIA only when considered in association with
higher children’s scores on Social Orientation (in particular, In-teractional
Conflict, p .05; Food Refusal of the Child, p
.05; and Affective State of the Dyad, p .05). No association or
prediction was found between fathers’ psychopathological risks
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8. 478 • L. Cerniglia, S. Cimino, and G. Ballarotto
TABLE 1. Means (SDs), F, and P Values of Mothers’ and Fathers’ Scores on SVIA Subscales
Mothers Fathers Fisher F Test p
Affective State of the Parent 5.27 (3.33) 12.46 (5.35) F(1, 153) = 100,29 .001
Interactional Conflict 4.64 (3.85) 11.29 (6.2) F(1, 153) = 63,91 .001
Food Refusal of the Child 2.52 (1.94) 6.42 (3.36) F(1, 153) = 77,86 .001
Affective State of the Dyad 2.79 (2.25) 6.55 (4.27) F(1, 153) = 46,61 .001
SVIA = Scala di Valutazione dell’Interazione Alimentare.
TABLE 2. Means (SDs) F, and P Values of Mothers’ and Fathers’ Scores on SCL-90-R Subscales
Mothers Fathers Fisher F Test p
Somatization 0.15 (0.11) 0.41 (0.44) F(1, 153) = 24,93 .001
Obsessive-Compulsive 0.11 (0.11) 0.71 (1.08) F(1, 153) = 23,7 .001
Interpersonal Sensitivity 0.1 (0.1) 0.49 (0.61) F(1, 153) = 30,45 .001
Depression 0.12 (0.11) 0.41 (0.42) F(1, 153) = 34,49 .001
Anxiety 0.1 (0.12) 0.75 (1.02) F(1, 153) = 30,02 .001
Hostility 0.1 (0.14) 0.41 (0.40) F(1, 153) = 41,98 .001
Phobic Anxiety 0.12 (0.13) 0.48 (0.5) F(1, 153) = 36,98 .001
Paranoid Ideation 0.07 (0.11) 0.41 (0.46) F(1, 153) = 39,67 .001
Psycoticism 0.14 (0.12) 0.44 (0.4) F(1, 153) = 39,49 .001
Global Severity Index 0.11 (0.05) 0.5 (0.54) F(1, 153) = 39,14 .001
SCL-90-R = Symptom Checklist-90-Revised.
TABLE 3. Results and Values of the Regression Analyses
SVIA QUIT Negative Emotionality SCL-90-R Phobic Anxiety
Mother R2 β t p R2 β t p
Affective State n.s. n.s. n.s. n.s. .239 .365 2.232 .029∗
Affective State of the Dyad .001 .342 2.749 .001∗∗ n.s. n.s. n.s. n.s.
Involvement
Father R2 β t p
Interactional Conflict • Social Orientation .121 .348 3.214 .002∗
Food Refusal of the Child • Social Orientation .062 .249 2.227 .029∗
Affective State of the Dyad • Social Orientation .112 .334 3.073 .003∗
Note. The subscales that are not shown in this table are not statistically significant. n.s. = not significant; SVIA = Scala di Valutazione dell’Interazione Alimentare;
QUIT = [Italian Questionnaires on Temperament Questionnaire; SCL-90-R = Symptom Checklist-90-Revised; • = Association with.
∗p .05. ∗∗p .01.
and the quality of interactions with their children during feeding.
The results and values of the regression analyses are shown in
Table 3.
DISCUSSION
This study aimed to examine specific characteristics of mother–
infant and father–infant interactions during feeding, taking into
account the possible influence of parental psychological profiles,
children’s temperaments, and parental involvement.
To assess the quality of parent–child interactions during feed-ing,
we chose to use an observational procedure (SVIA). Our re-sults
indicated that mothers’ and fathers’ interactions with their
children differ significantly. In particular, father–child interactions
are significantly more maladaptive. Despite this, no participant
(mothers or fathers) exceeded the clinical cutoffs in the Italian pop-ulation.
To verify the possible weight of parental psychopathologi-cal
risk, child temperament, and parental involvement on the qual-ity
of parent–child interactions during feeding (assessed through
the SVIA), we chose to use a self-report questionnaire (for parental
psychopathological risk; SCL-90-R), a report-form measure (for
child’s temperament; QUIT), and information provided by parents
about the time spent with their children during the week (parental
involvement). We found that mothers’ psychopathological risks
(viz., phobic anxiety) predict the general quality of their interac-tions
with their children during feeding in the direction of less
Infant Mental Health Journal DOI 10.1002/imhj. Published on behalf of the Michigan Association for Infant Mental Health.

9. Parent–Child Interaction During Feeding • 479
contingent and less sensitive exchanges. Nevertheless, no predic-tion
was found between mothers’ psychological profiles or risks
and conflictual interactions (in terms of mothers’ controlling prac-tices
and/or nonemphatic behaviors). Children’s temperaments ap-pear
to significantly influence mother–infant interactions. Nega-tive
emotionality in the child predicts difficulties for the mother in
supporting the autonomous initiatives of the child (by means of re-quests,
insistent orders, and criticism) while the child demonstrates
distress and is generally oppositional during feeding. Mothers’ in-volvement
seems to be unrelated to the quality of interactions with
their children. No association or prediction was found between
fathers’ psychological profiles or psychopathological risks and the
quality of interactions with their children during feeding. More-over,
in agreement with Kim and Kochanska (2012), our results
show that the quantity of paternal involvement is related to better
quality of interactions with their children only in cases where the
children had higher scores on Social Orientation (a subdimension
of children’s temperament).
Although Braungart-Rieker, Courtney, and Garwood (1999)
suggested that mothers and fathers do not differ in their level of
sensitiveness and contingency toward their children, nor do they
show differences in recognizing emotional and behavioral signals
from children and adjusting to them (Notaro Volling, 1999), our
results are in line with those of Shoppe-Sullivan, Brown, Cannon,
Mangelsdorf, and Sokolowski (2008) and Lamb (2010). According
to these authors, fathers displayed a poorer ability to recognize
distress cues shown by their childrenwhen compared with mothers.
They also found that fathers were less sensitive and attuned to
their children in the first years of life. It also has been suggested
that mothers tend to stimulate children with more rhythmical and
containing gestures and speeches whereas fathers are more prone
to sudden and unpredictable stimuli and rough-and-tumble play
(Lamb, 2010).
Our results show that mothers’ psychopathological risks have
an influence on the quality of dyadic exchanges with their children
during feeding, which has not proven true in the case of fathers.
This result needs further investigation; however, Borke,
Lamm, Eickhorst, and Keller (2007) stated that fathers are more
likely to engage in “distal” interactions whereas mothers show
more “proximal” ones, evenwhen the overall quality of interactions
was good for both parents. Thus, the difference in the observed
interactions could be related to a different style of reciprocal com-munication
between fathers and children, and not to an impaired
or compromised pattern of behavioral and emotional exchanges.
Lamb and Lewis (2010) emphasized that these hypotheses must
be reconsidered once the involvement of the father is controlled,
as lower attunement could derive from a smaller amount of time
spent by fathers with their children when compared to mothers,
who generally interact more with infants in their first years of life
due to maternity leave.
We tried to respond to this suggestion, and our findings
state that father–child interactions during feeding are not im-proved
by paternal involvement, except in the case of the child’s
temperamental-specific characteristics (high scores on Social Ori-entation).
This indicates that fathers are more strictly influenced
by children’s behaviors rather than the emotional content in the
context of feeding, so that even when psychopathologically at risk,
fathers succeed in having moments of good quality with their sons
and daughters if the moment of feeding is not compromised by
the oppositional behaviors of the children. It must be stressed that
this article presents a community sample in which no participants
had a referred diagnosis that could substantially impair parent–
infant interactions. The present study, thus, supports previous re-sults
(Sarkadi, Kristiansson, Oberklaid, Bremberg, 2008) that
have stated that father–child interactions are more simply related
to the child’s behaviors while maternal dyadic exchanges may be
related to a wide-ranging spectrum of factors related to both the
child’s and the mother’s characteristics.
Limitations
This study has limitations. First, we did not control or investi-gate
the emotional/adaptive profiles of the children, except regard-ing
their temperaments. Second, no attachment security/insecurity
measure was used to assess the quality of attachment between the
children and their parents. Furthermore, we used report-form tools
to assess the parents’ psychological profiles and the children’s
temperaments, although it could have been informative to have an
objective assessment administered by a professional psychologist.
The homogeneity of the sample, in terms of cultural, geographi-cal,
and SES, limits replication of the study in other countries or
cultures.
Conclusion and Future Directions
Nevertheless, we think this article has several strengths. To our
knowledge, no other study has addressed father–child interac-tions
during feeding in nonclinical samples. We used widely used
and validated tools regarding the infants’ temperaments and the
parents’ psychological profiles. In addition, we chose to use an
observational and naturalistic method to investigate parent–infant
interactions during feeding whereas most studies have used report-form
questionnaires filled out by parents. We intend to further
our research with a larger sample and to fix the aforementioned
limitations within a longitudinal study, which should consider sta-bility
and changes in the specific patterns of interaction between
mothers, fathers, and their infants over time.
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