Is poor early bonding at 8 months a risk factor for poor adult mental health? Compr Psy.Feb 2014


Bonding between infant and mother (or other regular caretaker) in the early days is believed to be an essential developmental step that lays the foundation for future social and emotional development. Weich et al 2009 meta analysis showed that maternal emotional unavailability significantly increases the risk of suicide in adolescents. Early abusive relationships significantly increase the risk  of adult mental disorders. Relationship between early maternal behaviour and mental health outcome of grown child has been studied in the past using retrospective designs.

Angela P. Fan and team of researchers report the results of  30 year prospective study with 1752 offsprings born in early 1960s ( John Hopkins Collaborative Perinatal Study ). Mothers and children had extensive interviews over the years as part of the study. 82% of mothers were black. The adult offspring (aged 27-33) outcome was measured by self report questionnaire ( self rated mental health) and depression sub scale of GHQ. Maternal behaviour  ( collected at 4 or 8 months) was converted to three factors.

1. “Low Attachment” factor:  Maternal behavior  was unsupportive of the child’s needs at 8 months and included seven items characterized by indifference, rough handling, and criticism towards the child.  2. “Overly Involved” factor:  Maternal behavior that was overprotective at 8 months and included seven items characterized by excessive pride, caution, and affection  3.’ Unhealthy Behavior at Four Months” factor: included six ratings of maternal behavior characterized by either unsupportive or overly involved behavior at 4 months.


20% of children whose mothers exhibited “Low Attachment” developed poor mental health as an adult, but only 15 % of children whose mothers did not exhibit “Low Attachment” developed poor mental health as an adult. This relationship remained after adjusting for race, gender, mother’s education, age, marital status, and household income. Children whose mothers are overly involved when the child is 8 months old do not have an increased risk of developing poor mental health. 


Maternal behavior toward the infant has a significant long-term impact on the child’s risk of developing poor mental health in adulthood. Primary care physicians/ nurses/ health visitors need to be aware of these findings and try to address these at the earliest. Mental health promotion/ illness prevention programmes should address the long-term implications of faulty maternal- child interactions.

Summary of the article:

Association between maternal behavior in infancy and adult mental health: A 30-year prospective study.

Fan AP, Buka SL, Kosik RO, Chen YS, Wang SJ, Su TP, Eaton WW. Compr Psychiatry. 2014 Feb;55(2):283-9.

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