Screening for sustained social withdrawal behaviors in six-month-old infants during pediatric primary care visits: Results from an at-risk latino immigrant sample with high rates of maternal major depressive disorder

To examine relations between infant social withdrawal behavior and maternal major depression (MDD), 155 mother-infant dyads were evaluated at the 6-month primary care visit. Maternal depression was determined based on a psychiatric interview. Infant social withdrawal behavior was assessed with the Alarm Distress Baby Scale (ADBB; A. Guedeney & J. Fermanian, 2001) based on videotaped mother-infant interactions. Of the sample, 18.7% of mothers were diagnosed with MDD, and 39.4% of infants scored above the clinical ADBB cutoff. Infants of depressed mothers were more likely to score positive on the ADBB (75.8 vs. 31.0%, p < .001) and showed distinct patterns of withdrawal behavior. Within the group of withdrawn infants, however, no differential patterns of behavior could be identified for infants of depressed mothers as compared to infants of mothers with no depression. These findings confirm the validity of the ADBB for detection of infant social withdrawal in the context of MDD. At the same time, they support evidence that the ADBB identifies nonspecific infant distress behaviors. Future studies will need to determine if and how positive ADBB screening results in the absence of maternal MDD might be associated with other maternal psychiatric disorders such as anxiety or borderline personality disorder. These results have important implications for screening guidelines in primary care.