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Early Reactions to Frustration: Developmental Trends

in Anger, Individual Response Styles, and Caregiving


Risk Implications in Infancy
Joan A. Kearney, PhD(c), APRN, BC

PROBLEM. In an effort to examine early negative Joan A. Kearney, PhD(c), APRN, BC, is Director, Child and
Adolescent Psychiatric Services, The Hospital of St. Raphael,
emotional response patterns, infant responses to New Haven, and Assistant Clinical Professor, Yale School of
Nursing, New Haven, CT.
frustration were studied with specific regard to
anger.
V^ertain early temperament features and regulatory di-
METHODS. Forty infants, 7-9 months (n = 20) mensions of negative affect have been linked with diffi-
culty in sodal compliance and general sodal competencies
and 12-14 months (n = 20) old, were observed in in the preschool years (Houck, 1999; Stifter, Spinrad, &
Braungart-Rieker, 1999). Dysregulated negative emotion
laboratory play situations. Infant affective and behavior also have been associated wdth atypical neu-
response as well as maternal behavior were roendocrine reactivity in infants and young children (Gun-
nar. Tout, deHaan, Pierce, & Stansbuxy, 1997; Stansbury &
observed. Maternal interviews assessed maternal Gunnar, 1994). This risk extends to later psychopathology
as well (Batesdodge & Bayles, 1988; Bates, Bayles, Bennett,
impressions of infant behavior and affect. Ridge, & Brown, 1991; Bates, Maslin, & Frankel, 1985),
when anger is seen as the predominant emotion in con-
FINDINGS. Findings revealed increased displays duct-disordered children, and socially deviant children
tend to perceive the world through a hostile affective orga-
of anger in older infants, evidence of cognitive-
nization (Dodge, Murphy, & Buchsbaum, 1984).
affective linkages in response, and individual Recent clinical studies provide support for the continu-
ity of aggression and affectively mediated externalizing
differences in emotional response style and behavior difficulties beginning in early childhood
(Keenan, Shaw, Delliquadri, Giovanelli, & Walsh, 1998).
maternal-infant processes. Additionally, many methodologies link early patterns of
CONCLUSIONS. Findings relate to the emergence anger, aggression, and difficult temperament, contributing
to those recent temperament formulations that address as-
and interplay of negative emotional response, sociations between negative affective-motivational-behav-
ioral systems to temperament and personality psychology
maternal-infant patterns, and socioemotional constructs in general (Rothbart, Ahadi, & Evans, 2000).
High-risk reactive styles such as type A behavior pat-
risk. terns also may be related to early individual differences in
Search terms: High-risk maternal-infant emotional response along the negative pole. Research on
type A behavior in young children is scant, however, with
patterns, infant anger, socioemotional only a few studies examining downward extensions to the
age of 31/2 years (Brown & Tanner, 1990). That research re-
development, socioemotional risk veals similar behavioral and physiological reactivity pat-
terns between younger and older type A individuals. Pre-
sumably, the study of negative emotion patterns in infants
journal of Child and Adolescent Psychiatric Nursing, Volume 17, and toddlers might yield earlier information on risk status,
Number 3, pp. 105-112. albeit with caution regarding the maintenance of construct

JCAPN Volume 17, Number 3, July-September, 2004 105


Early Reactions to Frustration: Developmental Trends in Anger, Individual Response Styles,
and Caregiving Risk Implications in Infancy

validity when examining qualitatively different develop- groups: 7 to 9 months (mean age 8V2 months) and 14 to 16
mental periods and methodologies. months (mean age I5V2 months). Since the cognitive prereq-
uisites mentioned earlier are consolidated during tiie last
Research Problem and Hypotheses quarter of the first year of Ufe, the age ranges directly preced-
ing and following fhis period were delineated in this study
The research presented here investigated the emergence
of anger as a normal affective response to frustration as Procedure
well as early characteristic tendencies toward intense, dys-
regulated anger in a challenging situation. Although previ- All infants were seen in an infant lab/university set-
ous studies (Kramer & Rosenblum, 1970) have examined ting. To provide some measure of control for state vari-
infant behavior in similar frustrating situations, systematic ables, mothers were asked to schedule their visits at the
delineation of discrete affective response has not been rig- time of day their infant was generally at his or her "best."
orously undertaken. Additionally, it has been noted that The procedure was analogous to a developmental testing
the more general construct of early global distress does not session in which there were a variety of developmentally
sufficiently discriminate among orthogonal affect phenom- appropriate toys available for the infant to play with.
ena such as fear, anger, and sadness, prompting recent in- The session included two "frustration" episodes, pre-
vestigators to call for more sp)edfidty in the assessments of ceded and separated by brief, nonfrustration play peri-
emotional expression (Buss & Goldsmith, 1998). ods. The primary function of these intervening play pe-
The present study was concerned with clinical issues riods initially was to provide baseline information on
such as dysregulated patterns and contextually based rela- affective state, and throughout the session to provide in-
tional patterns, and was based on the developmental as- tervals that contrasted in nature with the frustration
sumption that cognitive and affective domains are inter- episodes. This promoted a naturalistic frustration expe-
dependent with certain cognitive achievements necessary rience as well as an avenue to assess modulation or reg-
in order for the infant to experience anger as we know it. ulation of negative affect. Mothers were asked to allow
These achievements include intentionality, goal orienta- their infants to attempt to solve the problems presented
tion, an understanding of causality and means-ends rela- to them before offering help, if and when they felt it was
tionships, and an ability to anticipate and expect events necessary. The frustration episodes were of two types:
(Piaget, 1981; Sroufe, 1979; Stenberg, Campos, & Emde,
1983). Consequently, the hypotheses for this study were: • T]/pe A: blocking access to a previously accessible and
desired toy, and
• Older infants will display higher levels of clear, dis- • Type B: blocking access coupled with a contradiction
crete anger responses in contrast to the more imdiffer- of expectancy for the child.
entiated distress reactions in younger infants.
• Qualitative analysis will differentiate infants and in- Each episode was a problem-solving situation that
fant-mother dyads based on individual characteristics. consisted of cognitive, emotional, and physical chal-
lenges. The duration of the frustration episodes was
Methods variable, lasting up to 3 minutes, and could be inter-
rupted at any time by mother, baby, or examiner. To con-
Sample trol for task effects, the order of the frustration episodes
was reversed for half the infants in each age group.
The sample consisted of 40 healthy infants divided In addition to observation of maternal behavior through-
evenly on gender There were 20 infants in each of two age out the lab session, mothers took part in a semistructured

106 JCAPN Volume 17, Number 3, July-September, 2004


interview that assessed such issues as infants' laboratory age time spent in anger, as well as intensity, latency, and
emotional responses in comparison with their emotional recovery scores for any given segment. In order to assess
behaviors in naturalistic settings, the mother's emotional re- group differences in percentage of time, anger was dis-
sponses to the infant's frustration, and the mother's general played throughout fhe total play session, and a two-way
working model of the infant's emotional style. ANOVA was conducted for sex and age. A significant
main effect for age was found, with the older group dis-
Measures playing anger a greater percentage of the time (f = 6.03,

Three primary types of measures were used in this Results from the ANOVA conducted for all frustration
study: (a) specific behavioral/affectivity rating scales de- segments combined revealed a significant main effect for
signed to assess a number of behavioral characteristics age as well (F = 4.49, p<.05). This effect was due primar-
presumed toreflectemotional responses, (b) a global as- ily to the males, where analysis revealed a significant in-
sessment of emofional response based on the holistic teraction effect between age and sex (F = 7.83, p<.01).
judgments, and (c) clinical impressions of infant behav- Continued analysis revealed a significant main effect
ior and maternal assessments of affective patterns. The for age in the first task (F = 10.11, p<.01), where com-
rating scale measure consisted of 15 subscales measuring pared to younger infants, the older infants displayed
activity level; behavioral approach-withdrawal on the anger a greater percentage of the time. This may provide
visual, postural, and physical manipulation dimen- support for the cognitive-affective linkage assumption in
sions; object and person orientation; facial affectivity; that the older children were presumably displaying
vocal affectivity; clarity of emotional expression; and achievements in expectancy with some measure of antic-
aggression. ipatory reaction earlier in the play session compared to
The global assessment of emotion was a record of the younger infants, who functioned primarily at the level of
infant's fadal expressions of discreet affects as measured concrete sensory-based experiences.
by holistic judgment of the rater. The holistic judgment In addition, a significant main effect for age (F = 5.35,
consisted of a macroanalytic fadal coding sysfem loosely p<.05) was found for the type A situation, with no signif-
based on the AFFEX system of measuring infant facial icant findings for the type B situation. While no interac-
affect (Izard & Dougherty 1980). tion effects were found between sex and age in these sit-
Interraterreliabilityfell between .83 and .99 on the be- uations, review of the mean percentage times revealed a
havioral/affectivity rating scales, .84 and .99 on the tendency for the older boys to display a consistently
global assessment of emotion. higher percentage of anger "dme" during both tasks. In
The dinical assessment consisted of qualitative exami- short, the age difference revealing higher general anger
nation of sodal, cognitive, and emotional characteristics scores was dear for both boys and girls in the less com-
displayed by the infant as well as parental behavior, im- plex task, but only for boys in the contradiction of ex-
pressions, and parent-child interactions displayed pectancy task. In light of this finding, further study
fhroughout the session. would be necessary to clarify the association between
cognitive complexity, intensity of stimuli, and sex-medi-
Findings ated response differences in infants presumed to have
achieved an understanding of the task at hand.
Quantitative Findings Pearson product-moment correlations between sub-
scales of the behavioral affectivity rating scales and anger
Age-group differences on global facial displays of revealed a small but significant correlation between
anger were calculated using a measure of mean percent- anger and postural approach (r = .35, p<.01). Additional

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Early Reactions to Frustration: Developmental Trends in Anger, Individual Response Styles,
and Caregiving Risk Implications in Infancy

trends on older and younger group curves revealed a tration episodes, virtually none of it could be described
pattern of decreased visual attention to the object, in- as helpless distress. Rather, it was characterized by these
creased visual attention to the mother, and increased infants' angry, aggressive, and somewhat unrelenting ef-
negative facial and vocal affect displays during frustra- forts at meeting their goals. Positive affect was often dis-
tion episodes. This type of multimodal facial/behavior played during nonfrustration episodes. For the most
configuration has been observed elsewhere and concep- part, these were emotionally expressive infants. The re-
tualized as a basic unit of infant experience in affective gressive characteristics of these infants tended to center
constellations (Weinberg & Tronick, 1994). on aggressive reactions, with a recovery period of mod-
Aggressive behavior was differentially displayed erate to long duration following negative affect displays.
across age groups. Younger infants, as part of a more Maternal behavior in this group was distinguishable
global distress picture, displayed diffuse, nonpurposeful from the majority group in that these mothers did not
aggression more often than older infants, who tended to- appear to be concerned about their infants' negative
ward dear, purposeful, and goal-directed aggressive re- emotional experiences during frustration, often telling
sponses a much greater percentage of dme. the investigator that this behavior was expected. In gen-
Age differences on all these variables revealed greater eral, these infants appeared quickly reactive to their envi-
variability or differentiation of response in the older ronment, with moderate latencies to recovery. They
group. Among the clearest patterns were those related to maintained a more aggressive "approach stance" during
hedonic characteristics. The range of scores for each vari- frustration that was characteristic of their general emo-
able was fairly wide, suggesting the im^portance of consid- tional and temperamental style both in the lab setting
ering individual differences when interpreting the results. and at home. In only one case was a frustration sequence
terminated due to a mixed distress/anger response,
Qualitative/Clinical Findings while purely angry responses were associated with
lower levels of distractibiUty and higher levels of deter-
Through the use of these clinical impressions as a sup- mination toward completing the task.
plement to the information gained from the quantitative The second and largest group consisted of 12 infants (6
ratings, three distinct groups or "types" of irifant emo- boys, 6 girls). This group was characterized by more
tional response styles emerged along with general differ- moderate levels of reaction along the arousal, directional-
ences in mother-infant interaction styles. The infant re- ity, and hedonic spheres than either of the other two
sponse styles differentiated along approach-withdrawal groups. They showed a wide variety of emotional re-
and affective characteristics, while the associated mother- sponses including interest, joy, and distress, with lower
infant interaction styles differentiated along the maternal anger scores than the first group. These infants also dis-
regulatory function. Descriptive findings are reported played a greater mix of directional responses and greater
here only for the older infants, in which dear variations modulation of affect than the other groups. Half these in-
were more easily observable, although possible precur- fants did not complete one or another of the frustration
sors to these types were noted in the younger group, segments due to mild or moderate distress or loss of in-
providing questions for further study. terest. Regressive characteristics of this group centered on
The first older subgroup consisted of 5 infants (3 boys, mild anger and/or moderate distress reactions coupled
2 girls) and was characterized by high levels of anger, ag- with a movement toward the mother for help and physi-
gression, and postural "approach" behaviors in the frus- cal comfort when frustrated. Latency to recovery was
tration episodes. These infants were generally described shorter in these infants than in either of the other groups.
by their mothers as "knowing what he/she wants and The mothers in this group tended to show reactions
getting it." While they showed negative affect in the frus- ranging from "I wanted to help her understand how to

108 JCAPN Volume 17, Number 3, July-September, 2004


do it" to "I was getting a little tense when she got upset." the situation. Compared to the other maternal groups,
On the whole, they were characterized by an empathetic they displayed a pattern of "intrusive readiness" to inter-
stance toward their child, but were willing to let the in- vene across segments.
fants try to solve the problem by themselves. For the General patterns in individual response revealed the
most part, they were responsive to their infants' affect majority group displayed more moderate, regulated re-
and behavioral cues, and displayed a posttire of "nonin- actions with good recovery potentials. The Angry-
trusiveness readiness" to help regulate the situation if Approach and Distress-Avoidance groups tended to
necessary. show more extreme reactions and singularly defined
themselves on certain dimensions. This is congruent with
emotion theory models, which note the primacy of fear
and anger on the density dimension. Angry infants main-
Findings support questions regarding the tained consistently higher scores on posttiral and manip-
ulative approach, aggression, and clarity or intensity of
assignment of "distress" as an adequately affect signal. Distress-Avoidance infants maintained con-
sistently higher scores on avoidance of the task, discreet
discriminant label for negative affect affect, and clarity of signal. Both groups scored higher on
visual and postural approach to modier during frustra-
during infant stressor experience. tion, indicating the importance of caregiver protective,
helping, and regulatory ftinctions in infant distress.

Discussion
The third and smallest group of infants (1 boy, 2 girls)
was striking in the infants' consistently avoidant behav- Findings from this study were in keeping with previ-
ior in the frustration episodes. This avoidance was often ous theoretical propositions regarding the appearance
accompanied by clear expressions of fear/wariness. and display of anger as a cognitively and temperamen-
They showed lower levels of positive affect in general tally mediated response to frusfration. They also support
than infants in the other groups and significantly less questions regarding the assignment of "distress" as an
anger. These infants often exhibited highly distressed, adequately discriminant label for negative affect during
helpless posttires toward the tasks. The regressive char- infant stressor experience. Clearly, the high-negativity
acteristics of these infants tended to be more extreme groups in this investigation were differentiated along the
than those of the other two groups, and the infants dis- anger and fear dimensions, emphasizing the need for re-
played a high degree of "flight" behavior combined v^dth fined assessments with reference to ptirported cognitive,
an inability to be soothed by the mother's or examiner's sodal, and biobehavioral dimensions of discreet affective
words. None of these infants was able to complete the response. This specificity allows us to map orthogonal
frustration episodes due to this avoidance and distress. emotional phenomena with implications for long-term
The mothers in this group tended to be quite direc- emotional/behavioral risk patterns. Additionally, it is
tive, often intervening immediately to solve the problem clear from the results regarding age differences presented
by giving the infant directions or motioning as to the cor- here that as infants mature, their socioemotional signal-
rect course of action. It is of note that two of them dis- ing capacity becomes more differentiated and easier to
played this behavior throughout the session, regardless read by those arotmd them.
of segment or activity. On the whole, each of the mothers The sex differences found in this study are interesting
openly expressed various amotmts of anxiety regarding in their support of commonly fotmd tendencies for boys

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Early Reactions to Frustration: Developmental Trends in Anger, Individual Response Styles,
and Caregiving Risk Implications in Infancy

to display aggression and anger more often during goal chosocial disorder, and their sociopsychiatric status was
impediments than females. This finding should be re- not considered high risk. Further, their nonengaged or
garded with caution, however, given the small numbers intrusive behaviors could not be characterized as "pur-
studied here and the fact that in the angriest subgroup of poseful insensitivity," but rather as attempts to regulate
infants, boys and girls were equally represented. The in those ways they were accustomed to or thought help-
regulatory aspects of these infants' emotional behaviors ful to the infant. It is this corrective function in which
is also of interest. In problem-solving situations, it has these mothers appear to differentiate themselves most
been shown that those infants who are capable of effort- clearly compared to mothers in the majority group,
ful control of negative emotion show greater ability for showing either a lack of intervention when appropriate
task focus (Kochanska, Coy, Tjebkes, & Husarek, 1998). or displaying an intrusive pattern. This is significant in
Infants and children who do not regulate or modulate view of the fact that infants in both higher negativity
their emotion well are at a disadvantage when fadng sit- groups displayed consistent approach signals to their
uations that require them to solve situational dilemmas mothers, yet the maternal-infant interaction patterns
and maintain adequate, reasonably nonconflicted cogni- were quite different.
tive functioning in order to successfully negotiate the This finding regarding difterences in maternal correc-
problem at hand. This includes using putative regulatory tive functioning operations, in a normative context, is
strategies to decrease negative stimuli, such as discontin- significant in that our successful intervention in aU high-
uing futile efforts or enlisting help after a reasonable pe- risk caregiver-child relationships is based on our ability
riod of aftempdng to master the situation on their own. to analyze paftems of interaction and strategically inter-
In many cases, infants in the angry and avoidant vene at nodal points of dysfunction. Interventions are
groups displayed signs of emotion dysregulation in their then centered on supporting empathetic, contingent, and
coping and recovery characteristics. In addition, these in- reciprocal paftems, which contribute to coping hardiness
fants and their mothers operated differently within the and correcting those that render predisposed infants and
sodoemotional Held than did infants and mothers in the children vulnerable to sodoemotional difficulties. Addi-
majority group. The findings reveal that not only do in- tionally, it underscores our current understanding that
fants in these groups display what may be higher risk although temperament and reactive style may in large
emotional behaviors and characteristics, but their moth- part have biological substrates, regulation of reactivity
ers also present with behaviors that may prevent these depends on caregiver behavior and socialization pro-
infants from "righting" themselves in emotionally cesses, which allow the child to depend on the caregiver
charged situations. to regulate stressful situations (Fox, 1998).
The mothers of the angriest infants did not make ac-
tive eftorts to "downregulate" their infants' behaviors by Clinical Implications
intervening before or during the infants' peak escalation
period. In contrast, although the mothers of the dis- Specific clinical issues raised in this work center on af-
tressed/avoidant infants tried to regulate the situation, fect and reactivity characteristics in infants as well as
they were ineffective in doing so and in some cases dis- those adaptive and maladaptive processes that reside
played escalation behaviors through their anxious within the relationship itself as caregiver and infant co-
overdirectiveness. This pattern bears similarity to the construct their reality. The mother-infant "meaning-
parental sensitivity/insensitivity patterns observed in making" aspects of these observations were revealed in
studies on socioemotional risk. However, major differ- the clinical interviews with these mothers. Maternal style
ences exist in that all but one of the mothers in this study appeared related to attributional processes and internal-
did not present with clinical signs of affective or psy- ized models of parenting. Clinical impressions reveal a

no JCAPN Volume 17, Number 3, July-September, 2004


tendency for mothers to operate on infant pattern recog- teracdonal characterisdcs, coupled with an understand-
nition and attributions of infant temperament and ing of caregiver needs, resources, internal working mod-
emotional style as well as their internalized models of a els of the child, atdibudonal patterns, and reacdve style,
"parenting self" determined by their own emotional re- provide the nurse with the strategic tools necessary to
acdvity, current family situation, maternal experiences guide new "ways of being" for the primary members of
v^th other children, and reladonal processes. the caregiver-child system. Dysregulated patterns can
This meaning-making aspect differendated mothers in then be addressed direcdy through teaching, redirecting,
the high-negativity groups, revealing a tendency for feedback, and role modeling, and indirectly through a
mothers in the angry group to minimize the distress and suppordve reladonal process. Previous clinical work (Os-
help-seeking behaviors of their infants, thus missing op- ofsky & Eberhart-Wright, 1988) has shown that this inter-
portunities to redirect and regulate aggressive responses. play between internal and external forces guides the
This is significant in light of recent findings that address process and ultimately determines outcomes.
the cridcal mediadon of caregiver-shaping behavior on The prototypical nature of the early caregiver-infant
early and subsequent aggression (Bates, Petdt, Dodge, & reladonship provides continuous informadon on pracd-
Ridge, 1998; Belsky, Hsieh, & Crnic, 1998). Conversely, cal appUcadons in the clinical setting with children who
mothers in the distress-avoidant group tended to over- are experiencing dysregulated emodonal and behavioral
regulate by immediately intervening to prevent the in- styles. In child psychiatric pracdce the majority of the
fant from tackling a task that the mothers felt was too children and families we see have a number of distur-
difficult for the child. These mother-infant pairs appear bances in these areas. Characterisdcs that are first mani-
to be engaged in early, mutually transmitted, and mater- fested in the early months and years of life often con-
nally reinforced schemas of "challenge as threat" and in- tinue into the child and adolescent years and are
fant helplessness. perpetuated by interacdonal substrates such as those dis-
In addition to temperament features and mood- played in this research. Adapdve caregiving processes
related heritability factors operating in mother-infant including redprodty, contingency of response, and gen-
processes, specific elements of early parenting behavior eral sensidvity to infant and child cues are central in this
are seen here as cridcal to the architecture of infant/child regard, and their absence is evident in many of the diffi-
behavior. For example, early parenting pracdces may culdes we encounter in child psychiatric populadons.
strongly deter the development of adapdve, prosocial, AddidonaUy, we see in this type of research the develop-
and self-affirming mastery strategies while shaping neg- mental foundadons of those intervendons we commonly
adve, contradictory, or socially compromising expect- employ in clinical settings that form the bedrock of the
andes in the child. As supported in this research, andd- correcdve experience. For example, the use of emodons-
padon and expectadon are important elements in emo- management protocols and sodal problem-solving skills
donal outcomes. Thus, we can look to the early shaping are based on the interplay of cognidve-affecdve opera-
of expectandes as a cridcal funcdon in the development dons and caregiver-fadlitadng behaviors that are cridcal
of emodonaUy mediated behavior. components of early socioemotional development,
The problem-solving paradigm used in the research is which often are defident or dysfuncdonal in our clinical
a useful vehicle to allow us to incorporate such modaU- populadons. Spedfic components of such intervendons
des as role modeling, cognidve behavioral techniques, include cognidve clarificadon and reframing, emodon-
and reladonal intervendons to help parents and young ally modulated exploradon of opdons, regulated external
children balance specific perturbadons and move toward aid and modeling, appropriate limit setting, support for
normalized patterns. Clinical acumen in assessing so- adaptive behaviors and extinction or management of
cioemodonal development, regulatory abilides, and in- maladapdve reacdons, soofhing of physiological distress.

JCAPN Volume 17, Number 3, July-September, 2004 111


Early Reactions to Frustration: Developmental Trends in Anger, Individual Response Styles,
and Caregiving Risk Implications in Infancy

and the transmission of empathy, positive regard, and Buss, K,A,, & GoldsmitK H,H, (1998), Fear and anger regulation in in-
fancy: Effects on the temporal dynamics of affective expression.
caring support for the achievement of self-efficacy, es- Child Development, 69,359-374,
teem, and general mastery. As in the developmental pro-
Dodge, K,A,, Murphy, R,R,, & Budisbaum, K, (1984), The assessment of
totype, the relational context of these clinical interven- intention-cue detection skills in children: Implications for develop-
tions is central to their success. mental psychopathology. Child Development, 55,163-173,
Finally, the detection of variations within nonclinical Fox, N,A, (1998), Temperament and regulation of emotion in the first
populations allows us to achieve greater specificity in years of life. Pediatrics, 102,1230-1235,
our prediction of risk and assessment of disorder and Gurmar, M,R,, Tout, K,, deHaan, M,, Pierce, S,, & Stansbury, K, (1997),
underscores the significance of normative studies for un- Temperament, social competence and adrenocortical activity in
derstanding atypical patterns. Moreover, the multiply preschoolers. Developmental Psychobiology, 32(1), 65-85,
determined generation of early risk patterns in the care- Houck, G,M, (1999), The measurement of child characteristics from in-
fancy to toddlerhood: Temperament, developmental competence,
giver-child system provides us with opportunities to self concept, and social competence. Issues in Comprehensive Pediatric
prevent or guide in remodeling such patterns as they Nursing, 22,101-127,
undergird the genesis and progression of pathogenic Izard, C , & Dougherty, L, (1980), A system for identifying affect expressions
pathways. As we move forward in our understanding of by holistic judgements. Newark, DE: University of Delaware,
such pathways, developmentally based inquiry such as Keenan, K,, Shaw, D,, Delliquadri, E,, Giovanelli, J,, & Walsh, B, (1998),
this can significantly inform clinical models. Evidence for the continuity of early problem behaviors: Application
of a developmental model. Journal of Abnormal Child Psychology, 26,
441^52,
Author contact: JK3500@aol,com, with a copy to the Editor:
Poster@uta,edu Kochanska, D, (1998), Mother-child relationship, child fearfukiess, and
emerging attachment: A short term longitudinal study. Developmen-
tal Psychology, 34,480-490,
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