Dissertations, Theses, and Capstone Projects

Date of Degree


Document Type


Degree Name





Steven Tuber


Arietta Slade

Committee Members

Brent Finger

Diana Punales

Lissa Weinstein

Subject Categories

Clinical Psychology | Developmental Psychology | Maternal and Child Health | Trauma


Disorganized attachment, pregnancy, maltreatment, at-risk, Hostile-Helpless


The present pilot study examined whether there are reliable indices in the narratives of pregnant women that can be used to identify child abuse and neglect potential before the birth of the child. The Hostile/Helpless (HH) Classification system (Lyons-Ruth et al., 1995-2005), which detects mental states associated with trauma, disturbances in early attachment, and severe pathology, was adapted for use with the Pregnancy Interview (PI), a semi-structured clinical interview (Slade, 2003) that assesses a woman's emotional experience of pregnancy, and quality of her developing relationship with her baby. The study sample was drawn from a replication study of the Minding the Baby® (MTB) attachment-supportive home-visiting intervention currently underway in the United Kingdom. The adapted HH system was used to code 13 pregnancy narratives of mothers whose infants were removed from custody due to maltreatment within 2 years of childbirth, and 13 pregnancy narratives of mothers who did not have their infants removed (N=26). Results indicate that mothers whose infants were removed from their custody had significantly higher HH scores than mothers of infants who were not removed from their care. The relation between HH classification and infant removal status was also significant. This is the first study to use the HH system to systematically investigate pregnancy narratives. Study results provide preliminary support for a prenatal approach to maltreatment risk assessment in at- risk populations.