MOTHER-INFANT TOUCH IN THE CONTEXT OF RISK 

By 

Nicola Bernard 

 

 

 

 

 

 

 

 

A DISSERTATION 

 

Submitted to 

Michigan State University 

in partial fulfillment of the requirements 

for the degree of 

 

Psychology – Doctor of Philosophy 

 

2019  

 

1 

 

 

 

ABSTRACT 

MOTHER-INFANT TOUCH IN THE CONTEXT OF RISK 

By 

Nicola Bernard 

Touch is a primary form of communication for mother-infant dyads in the infant’s first 

year of life. Mothers use touch to soothe their infants, communicate safety, and teach self-

regulatory skills. Infants, in turn, increasingly use touch to communicate their internal states and 

get their needs for care and regulation met. Stressors such as intimate partner violence (IPV) and 

maternal depression experienced during pregnancy and the first year postpartum may interfere 

with mother-infant touch by disrupting the communicative function of touch and affecting 

maternal representations, which guide mothering behavior postpartum. It was hypothesized that 

exposure to IPV or depression during pregnancy or postpartum would be associated with fewer 

positive and more negative maternal and infant touch behaviors, and that the relationship 

between these risk factors and maternal touch would be mediated by maternal representations. 

Mother-infant touch behaviors were coded in 173 mother-infant dyads while they engaged in a 

free play. One half of the mothers had been exposed to IPV during pregnancy and one third 

experienced clinically significant levels of pregnancy depression. The findings indicated that 

pregnancy IPV predicted increased use of positive touch behaviors by mothers with infant sons, 

whereas pregnancy and postpartum IPV predicted more negative touch behavior by infants, 

primarily in males. Pregnancy and postpartum depression were associated with more intrusive 

touch by mothers with male and female infants, and more negative touch behavior in male 

infants. Maternal representations did not mediate the relationship between IPV/depression and 

maternal touch. The results suggest that mothers may attempt to compensate for one type of risk 

 

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– IPV – specifically with their male infants. In addition, male infant touch may be more 

susceptible to alterations in the context of risk than female infant touch.  

 
 
 
 
 
 

3 

 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
 
 

 

 

To my parents – you are instrumental in who I am and where I am today. 

 

iv 

ACKNOWLEDGEMENTS 

 

 

I am very thankful to my mentor and dissertation chair, Dr. Alytia Levendosky, for her 

guidance, feedback, and support throughout graduate school. Alytia, you have been everything I 

could have hoped for in an advisor and I feel incredibly lucky! You have challenged me and 

helped me grow professionally - in research and clinical work - and personally. You inspire me. 

 

Thank you to my committee members, Drs. Anne Bogat, Debby Kashy, and Joe Lonstein. 

You have been a wonderful committee throughout graduate school, providing me with support 

and encouraging me to grow as a researcher and a writer. Thank you, Debby, for the hours upon 

hours of meetings to go over the statistical analyses of this project (and others!)! 

 

Thank you to Victoria Brown, Melody Marzjarani, and Amanda Gareffa for your help 

with coding the videos for my dissertation. This project would not have been possible without 

you and I am so grateful to you! Thank you to Drs. Levendosky, Bogat and von Eye, and the 

numerous hard-working graduate and undergraduate students who created the Mother Infant 

Study and collected the data. Your years of hard work have yielded incredible insights into the 

effect of IPV on the mother-child relationship, from pregnancy through middle childhood. I feel 

fortunate to have had the opportunity to look at this data as well.  

 

Thank you to my parents for encouraging me throughout this process. You have been 

phenomenal! I am also grateful to my partner and friends for the words of encouragement and for 

working beside me in coffee shops, libraries, offices, restaurants – really anywhere with a power 

outlet!  

 

 

 

v 

TABLE OF CONTENTS 

 
 

LIST OF TABLES………………………………………………………………………….….viii 
 
LIST OF FIGURES……………………………………………………………………….……xiv 
 
INTRODUCTION……………………………………………………………………….……….1 
Maternal Caregiving System…………………………………………………………….…...5 
Maternal Representations………………………………………………………….……..5 
Intimate Partner Violence………………………………………………………….…….6 
Maternal Depression………………………………………………………………….….8 
Risk and Infant Outcomes……………………………………………………………….….11 
Touch………………………………………………………………………………………..13 
Maternal Touch…………………………………………………………………………14 
Types of Maternal Touch…………………………………………………………...17 
Coding Maternal Touch…………………………………………………………….18 
Infant Touch…………………………………………………………………………….19 
Coding Infant Touch………………………………………………………………..21 
Mother-Infant Touch……………………………………………………………………22 
Coding Mother-Infant Touch……………………………………………………….23 
IPV, Maternal Depression, and Touch……………………………………………………...27 
Current Project……………………………………………………………………………...30 
Hypotheses………………………………………………………………………………….31 
Aim 1…………………………………………………………………………..……......31 
Hypothesis 1a……………………………………………………………………….31 
Hypothesis 1b……………………………………………………………………….31 
Hypothesis 1c……………………………………………………………………….31 
Hypothesis 1d……………………………………………………………………….32 
Aim 2……………………………………………………………………………………32 
Hypothesis 2a……………………………………………………………………….32 
Hypothesis 2b……………………………………………………………………….32 
Aim 3……………………………………………………………………………………32 
Hypothesis 3a……………………………………………………………………….32 
Hypothesis 3b……………………………………………………………………….33 

 
METHODS………………………………………………………………………………….......34 
Participants………………………………………………………………………………….34 
Procedures…………………………………………………………………………………..35 
Measures…………………………………………………………………………………....36 
Intimate Partner Violence…………………………………………………………........36 
Maternal Depression………………………………………………………………........36 
Maternal Representations…………………………………………………………….....37 
Demographic Risk……………………………………………………………………...38 
Infant Sex…………………………………………………………………………….....38 
Mother-Infant Touch………………………………………………………………...…38 

 

vi 

Coding Plan and Ethogram…………………………………………………………………39 
Coding……………………………………………………………………………………....40 
Missing Data………………………………………………………………………………...41 
Data Analytic Approach…………………………………………………………………….41 

 
RESULTS……………………………………………………………………………………….44 
Aim 1………………………………………………………………………………………..45 
Hypothesis 1a…………………………………………………………………………...45 
Hypothesis 1b…………………………………………………………………………...48 
Hypothesis 1c…………………………………………………………………………...49 
Hypothesis 1d…………………………………………………………………………...52 
Aim Summary…………………………………………………………………………..55 
Aim 2………………………………………………………………………………………..55 
Hypothesis 2a…………………………………………………………………………...55 
Hypothesis 2b…………………………………………………………………………...57 
Aim Summary…………………………………………………………………………..58 
Aim 3……………………………………………………………………………………......58 
Hypothesis 3a……………………………………………………………………….......58 
Hypothesis 3b…………………………………………………………………………...62 
Aim Summary…………………………………………………………………………..66 

 

DISCUSSION…………………………………………………………………………………..67 
Limitations…………………………………………………………………………..……...81 
Implications……..……………………………………………………………………….....81 
Theoretical Implications………………………………………………………………..81 
Clinical Implications………………………………………...……….……………...….82 
Research Implications………………………………………………………………......83 
Conclusion…………………………………………………………………..……………...85 

 

 
APPENDICES……………………………………………………………………………….....87 
APPENDIX A: Coding Manual for Mother-Infant Touch……………………………........88 
APPENDIX B: IPV, Depression, and Maternal Touch………………………………........103 
APPENDIX C: Pregnancy Representations……………………………...………………..107 
APPENDIX D: Specific Touch Predicting Specific Touch Responses……...………..…..108 
APPENDIX E: Tables…………………………………………………………………......110 
APPENDIX F: Figures………………………………………………………………….....206 

 
REFERENCES………………………………………………………………………………...211 
 

 

 

vii 

LIST OF TABLES 

 

Table 1: Correlations and Means for Mother Touch…………………………………………..110 

Table 2: Correlations and Means for Infant Touch…………………………………………....111 

Table 3: Correlations and Means for Maternal Touch Response to Infant Touch………….....112 

Table 4: Correlations and Means for Infant Touch Response to Maternal Touch………..…...113 

Table 5: Correlations between Mother and Infant Touch………………………………..……114 

Table 6: Correlations between IPV, Depression, and WMCI Subscales…………………..….115 

Table 7: Correlations between WMCI Subscales and Maternal Touch…………………..…...116 

Table 8: Percentage of Initiated Touch Behavior that Received a Touch Response…….........117 

Table 9a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
continuous pregnancy IPV and depression on affectionate touch……………………………..118 
 
Table 9b: Estimating separate role effects for mother and infants testing the effects of infant sex 
and continuous pregnancy IPV and depression on affectionate touch……………………...…119 
 
Table 9c: Estimating separate effect estimates for mothers with male versus female infants for 
continuous pregnancy IPV and depression on affectionate touch………………………...…...120 
 
Table 10a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
continuous postpartum IPV and depression on affectionate touch………………………...…..121 
 
Table 11a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
categorical pregnancy IPV and depression on affectionate touch…………………………......122 
 
Table 12a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
categorical postpartum IPV and depression on affectionate touch………………………..…...123 
 
Table 13a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
continuous pregnancy IPV and depression on negative touch……………………………..…..124 
 
Table 14a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
continuous postpartum IPV and depression on negative touch……………………………..….125 
 
Table 15a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
categorical pregnancy IPV and depression on negative touch……………………………..…..126 

 

viii 

Table 15b: Estimated marginal means for the effects of role, infant sex, and categorical 
pregnancy IPV and depression on negative touch………………………………………….….127 
 
Table 16a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
categorical postpartum IPV and depression on negative touch…………………………….….128 
 
Table 16b: Estimated marginal means for the effects of role, infant sex, and categorical 
postpartum IPV and depression on negative touch…………………………………………….129 
 
Table 17a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
continuous pregnancy IPV and depression on intrusive touch……………………………...…131 
 
Table 18a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
continuous postpartum IPV and depression on intrusive touch…………………………..........132 
 
Table 19a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
categorical pregnancy IPV and depression on intrusive touch………………………………...133 
 
Table 20a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
categorical postpartum IPV and depression on intrusive touch…………………………….....134 
 
Table 21a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
continuous pregnancy IPV and depression on no touch……………………………………….135 
 
Table 21b: Estimating separate effects for mothers and infants testing the effects of infant sex 
and continuous pregnancy IPV and depression on no touch………………………………......136 
 
Table 22a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
continuous postpartum IPV and depression on no touch……………………………………...137 
 
Table 23a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
categorical pregnancy IPV and depression on no touch………………………………………138 
 
Table 24a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
categorical postpartum IPV and depression on no touch………………………………….......139 
 
Table 25: Maternal representations mediating the relationship between continuous 
IPV/depression and affectionate touch…………………………………………………….......140 
 
Table 26: Maternal representations mediating the relationship between categorical 
IPV/depression and affectionate touch………………………………………………………...142 
 
Table 27: Maternal representations mediating the relationship between continuous 
IPV/depression and instrumental touch………………………………………………………..144 
 

 

ix 

Table 28: Maternal representations mediating the relationship between categorical 
IPV/depression and instrumental touch………………………………………………………..146 
 
Table 29: Maternal representations mediating the relationship between continuous 
IPV/depression and passive touch……………………………………………………………..148 
 
Table 30: Maternal representations mediating the relationship between categorical 
IPV/depression and passive touch……………………………………………………………..150 
 
Table 31: Maternal representations mediating the relationship between continuous 
IPV/depression and negative touch……………………………………………………………152 
 
Table 32: Maternal representations mediating the relationship between categorical 
IPV/depression and negative touch……………………………………………………………154 
 
Table 33: Maternal representations mediating the relationship between continuous 
IPV/depression and no touch………………………………………………………………….156 
 
Table 34: Maternal representations mediating the relationship between categorical 
IPV/depression and no touch………………………………………………………………….158 
 
Table 35a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
continuous pregnancy IPV and depression on instrumental touch……………………………160 
 
Table 35b: Estimating separate effects for mothers and infants testing the effects of infant sex 
and continuous pregnancy IPV and depression on instrumental touch…………………...…..161 
 
Table 35c: Estimating separate effect estimates for mothers with male versus female infants for 
continuous pregnancy IPV and depression on instrumental touch…………………………....162 
 
Table 36a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
continuous postpartum IPV and depression on instrumental touch………………………...…163 
 
Table 36b: Estimating separate effects for mothers and infants testing the effects of infant sex 
and continuous postpartum IPV and depression on instrumental touch…………………...….164 
 
Table 36c: Estimating separate effect estimates for mothers with male versus female infants for 
continuous postpartum IPV and depression on instrumental touch…………………………...165 
 
Table 37a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
categorical pregnancy IPV and depression on instrumental touch…………………………….166 
 
Table 37b: Estimated marginal means for the effects of role, infant sex, and categorical 
pregnancy IPV and depression on instrumental touch………………………………………...167 
 

 

x 

Table 38a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
categorical postpartum IPV and depression on instrumental touch…………………………....169 
 
Table 38b: Estimated marginal means for the effects of role, infant sex, and categorical 
postpartum IPV and depression on instrumental touch…………………………………….….170 
 
Table 39a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
continuous pregnancy IPV and depression on passive touch……………………………....….171 
 
Table 40a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
continuous postpartum IPV and depression on passive touch………………………………....172 
 
Table 41a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
categorical pregnancy IPV and depression on passive touch………………………………….173 
 
Table 42a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
categorical postpartum IPV and depression on passive touch…………………………………174 
 
Table 43a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
continuous pregnancy IPV and depression on positive/neutral touch response……………….175 
 
Table 43b: Estimating separate effects for mothers and infants testing the effects of infant sex 
and continuous pregnancy IPV and depression on positive/neutral touch response…………..176 
 
Table 43c: Estimating separate effect estimates for mothers with male versus female infants for 
continuous pregnancy IPV and depression on positive/neutral touch response……………….177 
 
Table 44a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
continuous postpartum IPV and depression on positive/neutral touch response………………178 
 
Table 45a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
categorical pregnancy IPV and depression on positive/neutral touch response……………….179 
 
Table 46a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
categorical postpartum IPV and depression on positive/neutral touch response………………180 
 
Table 47a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
continuous pregnancy IPV and depression on negative touch response……………………....181 
 
Table 48a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
continuous postpartum IPV and depression on negative touch response……………………...182 
 
Table 49a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
categorical pregnancy IPV and depression on negative touch response………………………183 
 

 

xi 

Table 49b: Estimated marginal means for the effects of role, infant sex, and categorical 
pregnancy IPV and depression on negative touch response……………………………….…..184 
 
Table 50a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
categorical postpartum IPV and depression on negative touch response……………………...186 
 
Table 50b: Estimated marginal means for the effects of role, infant sex, and categorical 
postpartum IPV and depression on negative touch response………………………………….187 
 
Table 51a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
continuous pregnancy IPV and depression on no touch response…………………………….188 
 
Table 52a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
continuous postpartum IPV and depression on no touch response……………………………189 
 
Table 53a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
categorical pregnancy IPV and depression on no touch response…………………………….190 
 
Table 54a: Multilevel regression coefficients estimating the effects of role, infant sex, and 
categorical postpartum IPV and depression on no touch response……………………………191 
 
Table 55: Pregnancy maternal representations mediating the relationship between continuous 
IPV/depression and affectionate touch………………………………………………………..192 
 
Table 56: Pregnancy maternal representations mediating the relationship between continuous 
IPV/depression and instrumental touch……………………………………………………….193 
 
Table 57: Pregnancy maternal representations mediating the relationship between continuous 
IPV/depression and passive touch…………………………………………………………….194 
 
Table 58: Pregnancy maternal representations mediating the relationship between continuous 
IPV/depression and negative touch…………………………………………………………...195 
 
Table 59: Pregnancy maternal representations mediating the relationship between continuous 
IPV/depression and no touch………………………………………………………………….196 
 
Table 60: Pregnancy maternal representations mediating the relationship between categorical 
IPV/depression and affectionate touch………………………………………………………..197 
 
Table 61: Pregnancy maternal representations mediating the relationship between categorical 
IPV/depression and instrumental touch…………………………………………………….…198 
 
Table 62: Pregnancy maternal representations mediating the relationship between categorical 
IPV/depression and passive touch…………………………………………………………….199 
 

 

xii 

Table 63: Pregnancy maternal representations mediating the relationship between categorical 
IPV/depression and negative touch………………………………………………………....…200 
 
Table 64: Pregnancy maternal representations mediating the relationship between categorical 
IPV/depression and no touch…………………………………………………………………..201 
 
Table 65a: Multilevel regression coefficients estimating the effects of role, touch, and 
IPV/depression touch responses…………………………………………………………….…202 
 
Table 65b: Estimating separate effects for role, different touch types and continuous pregnancy 
IPV on touch responses………………………………………………………………………...203 
 
Table 65c: Estimating separate effects for role, different touch types and continuous pregnancy 
IPV on specific touch responses……………………………………………………………….204 
 
Table 65d: Estimating separate effects for role, different touch types and continuous pregnancy 
IPV on positive touch response………………………………………………………………..205 
 
 

 
 
 
 

 
 

 

 

xiii 

LIST OF FIGURES 

 

Figure 1: Theoretical model……………………………………………………………………206 

Figure 2: Maternal postpartum representations………………………………………………..207 

Figure 3: Maternal representations mediating the effects of IPV and depression on affectionate 
touch……………………………………………………………………………………………208  
 
Figure 4: The interaction between infant sex, and categorical pregnancy depression on negative 
infant touch response…………………………………………………………………..…….…209 
 
Figure 5: Maternal pregnancy representation…………………………………………………..210

 

xiv 

INTRODUCTION 

Within the context of the mother-infant relationship, infants typically learn important 

self-regulatory skills and develop expectations of interactive behavior that guide their 

understanding of present and future relationships (Beebe, Lachmann, & Jaffe, 1997; for review 

see Fonagy, 2010). During infancy, touch is an important form of interactive behavior between 

mother and infant, particularly when the infant is pre-verbal (e.g., Hertenstein, 2002). Mothers 

use touch to communicate safety and teach self-regulatory skills to their infants, and infants 

increasingly use touch to communicate their needs and internal states to their mothers 

(Hertenstein, 2002; Kaye & Fogel, 1980). However, mother-infant interactive touch behavior 

may be disrupted by risk factors that interfere with mother-infant contact, self-regulatory 

behavior, and the psychological or physiological perception of touch, such as maternal mental 

health problems, intimate partner violence (IPV), and infant factors (e.g., preterm birth, infant 

illness) (e.g., D’Andrea, Pole, DePierro, Freed, & Wallace, 2013; Feldman, Keren, Gross-

Rozval, & Tyano, 2004; Herrera, Reissland, & Shepherd, 2004; Mantis, Stack Ng, Serbin, & 

Schwartzman, 2014). 

Maternal depression and IPV (defined here as physical, sexual, or psychological violence 

perpetrated by a male towards his female partner) are prevalent risk factors among young adult 

women of child-bearing age (Tjaden & Thoennes, 2000; Whiteford et al., 2013). Moreover, 

women are at increased risk of experiencing depressive symptoms and IPV during pregnancy 

(e.g., Campbell, Oliver, & Bullock, 1998; Goodman, Rouse, Long, Ji, & Brand, 2011). 

Pregnancy and postpartum IPV exposure have been shown to negatively affect mothers and their 

children, and are associated with more negative maternal parenting behaviors; maternal and child 

affective, behavioral and physiological dysregulation; and insecure attachment (e.g., Boeckel, 

 

1 

Blasco-Ros, Grassi-Oliveira, & Martinez, 2014; Bogat, DeJonghe, Levendosky, Davidson, & 

von Eye, 2006; Kessler, Molnar, Feurer, & Applebaum, 2001; Leung & Slep, 2006). Maternal 

depression is associated with similar problems for mothers and their children (Campbell, Cohn, 

& Meyers, 1995; Korja et al., 2008; Lyons-Ruth, Wolfe, Lyubchik, & Steingard, 2002). 

Despite the detrimental effects of depression and IPV on the mother-infant relationship, 

interactive behavior, and physical and psychological health, research has not yet examined their 

effects on mother-infant touch. Specifically, maternal touch behaviors have been examined in 

relation to maternal mental health problems, but infant touch behaviors have not. Maternal 

parenting more broadly has been studied in the context of IPV, but maternal touch and infant 

touch have not been explicitly examined in IPV-exposed dyads. Research on mother-infant touch 

behaviors in the context of other risk factors (e.g., preterm birth, infant feeding disorders), 

however, suggests that maternal and infant touch behaviors are negatively affected by risk (e.g., 

Herrera et al., 2004; Mantis et al., 2014). 

IPV and maternal mental health problems may affect mother-infant touch behavior by 

informing an important component of the maternal caregiving system – maternal representations. 

Maternal representations are defined as the thoughts/attributions a woman has about her child 

and the maternal role (Ammaniti, 1991; Cohen & Slade, 2000; Zeanah, Zeanah, & Stewart, 

1990). These representations primarily develop during pregnancy, as a woman is physically and 

psychologically preparing for her new maternal role. Research suggests that the representations 

are shaped by a woman’s experiences within her own attachment relationships (childhood and 

adulthood) and by the exogenous and endogenous environment within which the representations 

develop (for review, see George & Solomon, 2008). Thus, factors like maternal mental health 

and the quality of a woman’s adult romantic attachment relationship in pregnancy and the 

 

2 

postpartum period may affect how a woman thinks about her child and her capacity to meet the 

child’s needs. Consequently, once the child is born, the past or concurrent experience of stressors 

likely has implications for maternal parenting behaviors such as touch.  

The goal of the current study was to examine mother and infant touch behaviors within 

the context of IPV and maternal depression. The first aim was to investigate whether the 

experiences of pregnancy and postpartum IPV and maternal depression are associated with 

alterations in maternal touch behaviors. Specifically, types of touch behavior and amount of time 

spent touching were studied. While maternal touch has been examined in the context of other 

types of risk, including maternal depression, the effect of IPV exposure on maternal touch has 

not yet been elucidated. Moreover, possible mechanisms through which risk affects maternal 

touch behaviors, such as maternal representations, have not yet been studied. Research suggests 

that there may be sensitive periods during which risk factors may have a greater effect on 

maternal functioning. In particular, stress during the prenatal period, when maternal 

representations are developing most rapidly, may play a critical role in postpartum maternal 

parenting behaviors (e.g., Flykt, Kanninen, Sinkkonen, & Punamäki, 2010), such as touch. 

Therefore, in addition to the role of severity of risk on touch behaviors, the timing of risk 

exposure (pre- versus postpartum) was also examined.  

The second aim examined the role of IPV and maternal depression in infant touch 

behaviors. Infant touch behaviors are also shaped by the environment within which they develop 

(Mantis et al., 2014; Moszkowski & Stack, 2007). Exposure to stressors like IPV and depression 

during gestation may affect fetal development and postnatal outcomes, and exposure postnatally 

may further contribute to an infant’s understanding and use of touch by either demonstrating how 

touch can be harmful (e.g., if an infant witnesses physical IPV) or creating a context within 

 

3 

which touch may yield either unpredictable, inadequate, or harsh responses (e.g., if an infant 

initiates touch and his mother withdraws or responds in a way that the infant does not expect or 

understand). The types of touch that infants used and the amount of time infants spent touching 

their mothers was examined.  

The third aim investigated maternal and infant touch responses to the other’s touch 

behavior. Mother-infant touch is a process in which mother and infant organize their behavior in 

response to the other within the dynamically-changing interaction and the developing 

relationship. By the time the infant is one year of age, mother and infant can actively approach 

one another to engage in patterns of touch initiation and touch responses, which build on 

experiences and expectations developed in prior interactions (Kaye, 1982; Cohn & Tronick, 

1989; Tronick, Als, Adamson, Wise, Brazelton, 1978).  In this way, both mother and infant 

interact to create touch patterns that develop and adapt in response to the environment and the 

infant’s development. Therefore, the present study examined whether pregnancy and postpartum 

IPV and depression were associated with differences in maternal and infant touch responses to 

one another’s touch behavior.  

In sum, the goal of the current study was to examine mother-infant touch behaviors 

within an interaction and within the broader context of risk factors that may influence maternal 

caregiving. Specifically, this study examined the effects of IPV exposure and maternal 

depression on maternal representations, and the role of these three predictors in maternal and 

infant touch behaviors. The following sections will review the existing literature on maternal 

caregiving, IPV, depression, and mother-infant touch. This will be followed by a description of 

the proposed association between the predictors and mother-infant touch. Where there is limited 

information on touch, parenting behavior more broadly will be discussed.  

 

4 

Maternal Caregiving System 

When parenting her child, a mother must integrate multiple sources of information to 

determine a response that is appropriate to the context, the child’s needs, and the mother’s 

capacity to meet those needs. The sources of information are endogenous (e.g., maternal health) 

and exogenous (e.g., environmental, relational), and they are understood both within the 

immediate context and the broader mother-child relationship. The focus of the caregiving system 

is to protect and care for the child, particularly in the context of potential threat, making it 

complementary to the child’s attachment system (George & Solomon, 2008).  The caregiving 

system helps a mother to provide physical and psychological safety for offspring.  In other 

words, the caregiving system guides what a mother perceives as a threat to her child, what she 

understands the child’s need to be, what she decides is the appropriate and sensitive response, 

and her emotional and physical capacity to respond.  

Maternal Representations. Solomon and George (1996) theorize that the caregiving 

system begins to develop from childhood into adulthood, with puberty and pregnancy being the 

most intense periods of development.  They propose that this system is shaped by experiences 

from early childhood, such as childhood working models (which originated in the context of her 

own early attachment relationships; Bowlby, 1969/1982), through adulthood, such as the present 

caregiving environment.  These working models are templates that guide her perception in and 

expectations of close relationships (Slade & Cohen 1996).  As a woman gets older, new 

experiences are integrated into the models of self and other, and the models become distinct 

complex working models (Solomon & George, 1996).  When a woman becomes pregnant, her 

role transition, and her fantasies and expectations of her child and of herself as a mother are 

integrated into the higher-order working models.  This process is a kind of “mental pregnancy,” 

 

5 

which psychologically prepares her for parenthood. The mental pregnancy involves changes to 

her representations of herself in her romantic relationship, her professional and social life, her 

role as a soon-to-be mother, and her fantasies about her infant’s role in the family (Stern, 1999).  

The newly developed maternal pregnancy representations are considered to be the earliest 

form of parenting (Stern, 1995). Postpartum, maternal representations guide maternal 

perceptions of the infant and the self-as-mother, and maternal behavior. Representations 

typically remain stable from pregnancy to postpartum, although experiences in the postpartum 

period may continue to modify maternal representations to help mothers integrate new 

information and adapt (for review, see George & Solomon, 2008). Ideally, maternal 

representations help a mother to be sensitive to her infant and respond appropriately. However, 

negative experiences with her own primary attachment figure(s) (which can include an adult 

romantic partner), the experience of trauma, or the experience of environmental stressors may 

lead a mother to develop maternal representations that distort how she perceives herself and her 

infant, and how she engages with her infant (e.g., Malone, Levendosky, Dayton, & Bogat, 2010). 

IPV and maternal mental health problems, for example, have been associated with alterations in 

maternal representations (Huth-Bocks, Levendosky, Theran, & Bogat, 2004; Korja et al., 2008).  

Intimate Partner Violence. IPV is a common stressor among young adult women 

(O’Leary, 1999). Consequently, pregnant women, and young mothers and their children are 

disproportionately exposed to IPV, particularly if they are from high-risk populations (e.g., racial 

and ethnic minority women, low socioeconomic status women; Charles & Perreira, 2007; 

Gazmararian et al., 2000; Fantuzzo, Boruch, Beriama, Atkins, & Marcus, 1997; McDonald, 

Jouriles, Ramisetty-Mikler, Caetano, & Green, 2006). Therefore, a number of mothers and their 

infants are exposed to violence prepartum and/or postpartum during periods that are critical for 

 

6 

the developing mother-infant relationship. Exposure to IPV is associated with detrimental effects 

to mothers (e.g., mental health, bonding, parenting behaviors) and infants (e.g., mental health, 

psychosocial development, attachment, self-regulation) (Bogat et al., 2006; Kessler et al., 2001; 

Leung & Slep, 2006; Levendosky, Leahy, Bogat, Davidson, & von Eye, 2006).  

IPV experienced during pregnancy and postpartum may affect the development and 

stability of the maternal caregiving system. In particular, research suggests that a mother may 

integrate her experience of IPV into her maternal representations. Indeed, research suggests that 

women who experience IPV during pregnancy are more likely to perceive their infants in 

disengaged (i.e., emotionally removed, indifferent, and/or superficial) or distorted (i.e., 

confusing, unrealistic, and/or dysregulated) ways, rather than in a balanced (i.e., thoughtful, 

sensitive, and/or accepting) way (Huth-Bocks et al., 2004). Mothers with disengaged or distorted 

maternal representations may interpret fetal movements as violent or experience role confusion 

(Huth-Bocks et al., 2004). Pregnancy representations predict postpartum representations (Theran, 

Levendosky, Bogat, & Huth-Bocks, 2005) and postpartum parenting behavior (Dayton, 

Levendosky, Davidson, & Bogat, 2010), suggesting that IPV experienced during pregnancy may 

continue to affect maternal parenting into the postpartum period via maternal representations 

(Theran et al., 2005). Indeed, maternal IPV exposure may lead to distortion in how fetal and 

child behaviors are perceived (Huth-Bocks et al., 2004; Levendosky, Bogat, & Huth-Bocks, 

2011).  

Research suggests that women who experience IPV postpartum are more likely to engage 

in negative parenting behaviors, including inappropriate discipline, intrusive parenting, and more 

authoritarian parenting (e.g., Boeckel et al., 2014; Holden & Ritchie, 1991; Levendosky et al., 

2006; McElwain & Volling, 1999). However, a smaller subset of research has also suggested that 

 

7 

IPV-exposed mothers may engage in more positive and effective parenting behaviors to 

“compensate” for the IPV exposure (e.g., Letourneau et al., 2013; Levendosky & Graham-

Bermann, 2000; Levendosky, Huth-Bocks, Shapiro, & Semel, 2003). The discrepancy in 

findings suggests that the effect of IPV on maternal parenting may be influenced by additional 

factors, such as maternal representations, other aspects of the maternal caregiving system, or 

characteristics of the child. For example, a mother who experiences postpartum IPV may 

conflate her partner’s behavior with her infant’s, perceiving a fussy baby to be “just like his 

father”. This may cause a mother to parent her child differently in response to her distorted 

perception of the infant’s cues. However, if a mother develops balanced maternal representations 

prepartum, the negative effect of postpartum IPV on parenting may be mitigated by her 

sensitivity to her child’s needs. Still, research also suggests that IPV-exposed mothers worry 

about their sons engaging in violent behavior and their daughters being victims of violent 

behavior in adulthood (Levendosky et al., 2000), which may also result in differences in how 

IPV-exposed mothers parent their sons and daughters.  

Thus, IPV has the potential to influence the caregiving system via the multiple inputs that 

inform the system.  Information that typically guides the caregiving system may be altered or 

distorted.  The effects of IPV on maternal caregiving may be immediate – such as difficulty 

perceiving an infant’s cues due to shifted attentional resources – or long-term.   

Maternal Depression.  Research suggests that maternal mental health problems, such as 

depression, are associated with changes in maternal caregiving. During pregnancy and 

postpartum, women are at greater risk of experiencing depressive symptoms (Beck, 2001; 

Goodman et al., 2011). 10-22% of women develop postpartum depression within a year of giving 

birth (Cox, Murray, & Chapman, 1993; Gress-Smith, Luecken, Lemery-Chalfant, & Howe, 

 

8 

2012). In the postpartum period, mothers with depression have been found to be less sensitive, 

more intrusive, and more rejecting (Campbell et al., 1995; Lovejoy, Graczyk, O’Hare, & 

Neuman, 2000; Murray, Fiori-Cowley, Hooper, & Cooper, 1996). Depressed mothers also 

demonstrate less positive affect when interacting with their infants (Righetti-Veltema, Conne-

Perreard, Bousquet, & Manzano, 2002). Moreover, depressed mothers have also been found to 

use different speech patterns with their infants, such as an increased expression of negative affect 

and a decreased focus on the infant’s internal state and experience, with the effects also differing 

by infant sex (Murray, Kempton, Woolgar, & Hooper, 1993). Postpartum depression is also 

associated with more negative perceptions of infant temperament (Britton, 2011), though 

observational research does not consistently find that infants of depressed mothers actually 

demonstrate more negative emotionality (Feldman et al., 2009; Pauli-Pott, Mertesacker, & 

Beckmann, 2004). Extant research suggests that pregnancy depression also predicts postpartum 

parenting, primarily by reducing maternal sensitivity to infant cues, resulting in lower quality 

interactions (Pearson, Cooper, Penton-Voak, Lightman, & Evans, 2010; Pearson, Lightman & 

Evans, 2011). Indeed, antepartum depressive symptoms are associated with a greater reduction in 

maternal responsiveness to infant cues than postpartum depressive symptoms (Flykt et al., 2010). 

This finding suggests that maternal mental health problems during the pregnancy period, when 

the maternal caregiving system and maternal representations are developing most rapidly, have 

significant implications for postpartum parenting.  

 While the link between maternal depression and increased risk of negative parenting 

behaviors is well-established, the mechanism(s) by which depression affects parenting have only 

more recently been examined (Trapolini, Ungerer, & McMahon, 2008). Research on depression 

and maternal representations has produced mixed findings, suggesting both a greater percentage 

 

9 

of mothers with distorted representations in samples of depressed women (Korja et al., 2008; 

Rosenblum, McDonough, Muzik, Miller, & Sameroff, 2002) and no difference in depressed 

versus nondepressed women (Sokolowski, Hans, Bernstein, & Cox, 2007). However, women in 

the study by Sokolowski et al. were at greater risk of developing nonbalanced representations if 

they reported higher levels of hostility. The authors argued that hostility may be a symptom of 

depression. Trapolini and colleagues (2008) found that cognitive symptoms of depression 

affected maternal sensitivity via the effect of cognitive distortions on maternal representations. 

The findings from these studies provide evidence for a relationship between depressive 

symptoms, maternal representations, and maternal parenting behaviors.  

IPV and depression typically occur over an extended period of time and are associated 

with changes in how mothers perceive and parent their male and female children (e.g., Boeckel 

et al., 2014; Holmes, 2013; Leung & Slep, 2006; Levendosky et al., 2000; Levendosky, Lannert, 

& Yalch, 2012; Murray et al., 1993). Moreover, IPV and depression often co-occur (e.g., Kessler 

et al., 2001; Pico-Alfonso et al., 2006). While the caregiving system ideally is flexible and able 

to withstand unexpected day-to-day stressors, research suggests that the caregiving system may 

be derailed by experiences that interfere with the physical and psychological well-being of the 

mother and child, such as IPV and maternal depression (e.g., Borghini et al., 2006; Solomon & 

George, 1996). Given the associations between these risk factors and maternal parenting, it is 

likely that IPV and maternal depression may specifically influence touch behaviors. Though the 

research is limited, it is possible that the effects of IPV on maternal touch behaviors may differ 

depending on the sex of the infant. 

 

 

 

10 

Risk and Infant Outcomes 

 

Maternal experience of stress, such as IPV and depression, during pregnancy when fetal 

brains are undergoing rapid development, is associated with differences in infant social-

emotional, cognitive, and behavioral outcomes postnatally (Kingston, Tough, & Whitfield, 2012; 

Monk, Spicer, & Champagne, 2012; Zhang et al., 2018). Research suggests that prenatal 

exposure to maternal stress can result in epigenetic and developmental changes to a fetus (for 

review, see Hicks, Swales, Garcia, Driver, & Davis, 2019). These changes may be evident 

postpartum in physiological, behavioral, and emotion regulation differences, particularly in 

response to stress (Hicks et al., 2019). More specifically, research has found that prenatal 

exposure to stress is associated with increased negative affectivity (e.g., Austin, Hadzi-Pavlovic, 

Leader, Saint, & Parker, 2005), HPA axis (the long-acting stress response system) dysregulation 

(e.g., de Bruijn, van Bakel, Wijnen, Pop, & van Baar, 2009), differences in brain development 

(e.g., Sandman, Buss, Head, & Davis, 2015), and increased risk for later psychopathology (e.g., 

Bergh et al., 2017; Essau, Sasagawa, Lewinsohn, & Rohde, 2018). Maternal stress is thought to 

enact these changes via alterations to the maternal HPA axis and changes to the placenta, which 

in turn alter fetal development (Carpenter, Grecian, & Reynolds, 2017). In the postnatal period, 

these early differences may, in turn, influence the child’s developmental trajectory beyond 

infancy (for review, see Bergh et al., 2017). Research suggests that the effects of prenatal stress 

on infant outcomes may differ by infant sex (e.g., Gerardin et al., 2011; Khashan et al., 2011).  

Exposure to IPV postnatally is associated with increased risk of insecure attachment by 

age 1 (Levendosky, Bogat, Huth-Bocks, Rosenblum, & von Eye, 2011). In addition, infants 

exposed to IPV postnatally show greater difficulty with emotion regulation, with increased rates 

of internalizing behavior problems among females and externalizing behavior problems among 

 

11 

males (for reviews, see Evans, Davies, DiLillo, 2008; Tailor & Letourneau, 2012). Indeed, 

research has demonstrated that infants of mothers exposed to IPV show more distress to 

simulated adult conflict (DeJonghe, Levendosky, von Eye, & Davidson, 2005), and in the 

context of severe IPV, will even demonstrate trauma symptoms such as avoidance, hyperarousal, 

and regression in previously achieved developmental skills (Bogat, DeJonghe, Levendosky, 

Davidson, & von Eye, 2006).  

Exposure to maternal depression in the postnatal period is similarly associated with an 

increased risk of insecure attachment (Campbell et al., 2004) and increased affective reactivity, 

particularly among male infants (Beeghly et al., 2017; Carter, Mayes, & Pajer, 1990; Weinberg, 

Tronick, Cohn, & Olson, 1999). However, other research has not found sex differences in the 

effects of postpartum depression on infant interactive behavior with mothers postpartum (e.g., 

Granat, Gadassi, Gilboa-Schechtman, & Feldman, 2017). Chronic maternal depression during 

the first year of life is especially pernicious for infant development, increasing the risk for 

cognitive and psychomotor deficits (Cornish et al., 2005). The effects of postnatal exposure to 

IPV and depression on infants may be due to direct exposure (e.g., witnessing IPV being 

perpetrated, which is thought to result in both a fearfulness for the mother’s well-being and, 

paradoxically, a fear of the mother; Zeanah et al., 1999) and alterations in maternal parenting and 

the postnatal environment as a result of the IPV and maternal depression.  The effects also have 

implications for how an infant interacts with his mother, particularly if the infant feels fearful of 

his mother or has learned that his mother does not respond appropriately to his cues or 

predictably meet his needs for care (e.g., Granat et al., 2017). Notably, the negative effects of 

IPV and depression on infant outcomes may be mitigated by other infant and maternal factors 

that promote resilience, such as infant positive temperament, shorter duration of exposure, and 

 

12 

maternal sensitivity (Bowen, 2015; Feldman et al., 2009; Martinez-Torteya, Bogat, von Eye, & 

Levendosky, 2009; Tomlinson, Cooper, & Murray, 2005).  

Touch 

Mother-infant touch is an important component of the early caregiving relationship. 

Touch communicates intimacy and availability, and promotes security, which increase a person’s 

sense of well-being and interconnectivity (Andersen, 1985; Guerrero & Andersen, 1991; 

Jakubiak & Feeney, 2016).  Although touch is a critical component of interpersonal relationships 

across the lifespan, touch takes on additional importance in the mother-infant relationship 

(Feldman, 2011). During this time, the infant is entirely dependent on the mother for care and 

regulation. However, a mother is more limited in how she can communicate safety and promote 

regulation in her infant due to the infant’s immature cognitive and emotional developmental state 

(Brazelton & Cramer, 1990; Hertenstein, 2002; Stack, 2001). The infant, in turn, can use touch to 

help his mother organize her behavior in a way that is responsive to his needs (Kaye & Fogel, 

1980). 

Mother-infant touch is a dynamic process that involves mutual influence and co-

regulation (Hertenstein, 2002). During an interaction, mother and infant continuously adjust to 

one another (Fogel & Garvey, 2007). How they adjust is informed by maternal and infant states, 

prior behaviors, the immediate context, and expectations developed within the context of the 

mother-infant relationship. For touch specifically, prior mother-infant touch interactions create 

patterns and expectations that continue to be shaped by experience and infant development. 

Despite the dyadic nature of touch, research has typically focused on maternal touch of the 

infant, and the implications of this touch for mothers and infants. Thus, infant touch and the 

significance of infant touch for mother and infant have been understudied. Without the 

 

13 

consideration of infant touch, touch patterns within a mother-infant dyad have rarely been 

examined. Therefore, an essential component of touch between mother and infant – that is, the 

consideration of the role of the other member of the dyad – has been neglected. Consequently, 

although an aim of the present research is to examine mother-infant touch, the examination of 

infant touch will be more exploratory and will be informed by a broader range of literature. As 

touch has typically been examined individually in mothers and infants, the maternal touch and 

infant touch literatures will first be reviewed separately. The integrated mother-infant touch 

literature will follow.  

Maternal Touch. A mother’s first experience of touching her infant skin-to-skin 

frequently occurs during or shortly after birth. This early skin-to-skin contact (SSC) is associated 

with immediate effects, such as increased physiological stability (e.g., breathing, glucose levels, 

temperature, blood pressure, etc.) for the infant, synchrony between mother and infant body 

temperatures (Moore, Anderson, Bergman, & Dowswell, 2012; Phillips, 2013) and increased 

maternal oxytocin, which promotes maternal bonding (e.g., Matthiesen, Ransjö-Arvidson, 

Nissen, & Uvnäs-Moberg, 2001). Physical contact immediately after birth between mothers and 

infants is associated with an increase in maternal touch during breastfeeding for several days 

following (Carlsson et al., 1978). The effect of early maternal touch on mothers and their infants 

is also evident one year later (Bystrova et al., 2009). Bystrova and colleagues (2009) found that 

at 1 year postpartum, mothers who had physical contact directly after birth demonstrated greater 

maternal sensitivity, whereas infants had improved self-regulation and greater dyadic reciprocity 

relative to dyads who were separated for the first 2 hours following birth. These findings provide 

support for the importance of touch in the early mother-infant relationship.  

 

14 

Mothers typically touch their infants most during the first six months of the infant’s life, 

when touch is one of the primary ways in which a mother can communicate with her infant and 

modulate the infant’s arousal (Hertenstein, 2002; Kaye & Fogel, 1980; Stern, 1985; Tronick, 

1995). As a mother perceives changes in her infant’s needs across infancy, she may adjust the 

quality and quantity of her touch in response (e.g., Field, Vega-Lahr, Goldstein, & Scafidi, 1987; 

Jean, Stack, & Fogel, 2009). Jean and colleagues (2009) examined maternal touch longitudinally 

in mother-infant dyads when the infants were 1, 3, and 5 months old. Maternal touch quantity 

decreased over time, and the quality of touch also changed. Mothers used more stroking touch in 

early infancy and more static touch by 5 months. The use of more static touch may be related to 

maternal responsiveness to the infant’s increasingly independent movement, as this kind of touch 

would allow a mother to be in contact with her child without interfering with the infant’s 

exploration and play. In addition, the mother’s increased use of a more passive type of touch may 

be in response to an increase in infant-initiated touch behaviors by 5 months (Ferber, Feldman, & 

Makhoul, 2008; Jean et al., 2009).  

Research suggests that over the second 6 months of life, mothers continue to adjust their 

touch in response to the infant’s increased independence (Crnic, Ragozin, Greenberg, Robinson, 

& Basham, 1983; Ferber et al., 2008; Field et al., 1987). For example, Ferber and colleagues 

(2008) examined maternal touch cross-sectionally across the first year of life and found that 

maternal touch decreased for all types of touch (affectionate, stimulating, and instrumental) in 

mothers of older infants. In particular, affectionate and stimulating touch decreased significantly 

between mothers of infants aged 6 months and 9 months. However, dyadic reciprocity increased 

over the second 6 months of life. Thus, the increasing independence of older infants may have 

 

15 

led mothers to reduce their active touch behavior, thereby allowing older infants to become more 

dominant and touch to become more reciprocal within an interaction.  

Touch between mothers and their infants contributes to maternal and infant physical and 

psychological health (Field, 2002; Montagu, 1986). Maternal touch may reduce maternal anxiety 

and depressive symptoms, and promote the mother-infant relationship (Ferber et al., 2005; 

Moszkowski & Stack, 2007). Research suggests that maternal touch may also stimulate infant 

growth and help with infant physiological, behavioral and emotional regulation (Montagu, 1986; 

Stack, 2010). Moreover, maternal touch plays an important role in infant cognitive development 

(Field, 2010; Hertenstein, 2002; Stack, 2004). Maternal touch also promotes the expression of 

positive emotions in infants (e.g., Stack & Arnold, 1998). The importance of touch for infant 

development is underscored by research on touch deprivation, which further suggests that 

physical contact is critical for emotional and interpersonal development (e.g., Harry Harlow’s 

monkeys; Harlow & Harlow, 1962), and for cognitive and physical development (e.g., infants in 

eastern European orphanages; Kuhn & Schanberg, 1998).  

There are many different ways that a mother may touch her child, and the touch that she 

uses may depend on multiple factors, such as the context, the purpose of the touch (e.g., to get 

the infant’s attention, feed, or soothe), maternal and infant health (e.g., depressed mothers may 

touch their infants differently, or mothers of fragile preterm infants may handle their infants 

differently; Herrera et al., 2004; Harrison & Woods, 1991), and infant sex (e.g., mothers may use 

more stimulating touch with their sons, but more instrumental touch with their daughters; 

Feldman & Eidelman, 2004). In addition to these, maternal touch may also depend on the touch a 

mother experienced from her primary attachment figure when she was a child (Weiss, Wilson, 

Hertenstein, & Campos, 2000), and the touch she is currently receiving in her romantic 

 

16 

relationship from her adult attachment figure (Weiss & Goebel, 2003). Weiss and Goebel (2003) 

examined maternal and paternal touch in parents of preterm infants 3 months postpartum, also 

assessing for each parent’s “felt security regarding tactile experience as a child” (assessing the 

degree to which the need for positive (affectionate and comforting) touch was met when the 

respondent was a child) and “felt security regarding current tactile experience” (assessing the 

degree to which the respondent feels their need for positive (affectionate and comforting) touch 

is satisfied by the current romantic partner) (subscales taken from the Physical Contact 

Assessment Questionnaire; Weiss et al., 2000). While childhood touch did not predict how 

mothers touched their infants, the degree of maternal satisfaction with partner touch predicted 

how mothers touched their infants. Specifically, the more that mothers felt their need for 

affectionate and comforting touch was being met, the more frequently they touched their infants. 

These findings suggest that a mother’s internalization of her own touch experiences in her adult 

attachment relationship may be transmitted to her infant via her touch.   

Types of Maternal Touch. There are multiple qualitative and quantitative features 

through which touch can be described and examined, such as the action, location, intensity, 

frequency, or duration of touch (e.g., Hertenstein, 2002). Hertenstein argued that these 

components of touch combine to communicate distinct and valenced emotions (Hertenstein, 

Holmes, McCullough, & Keltner, 2009). In a study by Stack and LePage (1996), the authors 

found evidence to suggest that mothers communicated distinct emotions to their 5-month-old 

infants using nonverbal touch behaviors. Mothers were instructed to maintain still faces to 

minimize the communicative effect of facial expressions.  Additional studies by Jean and Stack 

(e.g., Jean & Stack, 2009; Stack & Jean, 2011) support Hertenstein’s hypothesis that mothers can 

communicate emotions to their infants using touch, and that mothers may use certain kinds of 

 

17 

touch depending on the infant’s needs (with the ultimate goal of infant emotional and behavioral 

regulation; Jean & Stack, 2012). 

Coding Maternal Touch. Multiple coding schemes have been developed to study 

maternal touch behavior, such as the Touch Scoring Instrument (TSI; Polan & Ward, 1994), 

Caregiver Infant Touch Scale (CITS; Stack, LePage, Hains, & Muir, 1996), and Functions of 

Touch Scale (FTS; Jean & Stack, 2009). The TSI and CITS primarily describe the type of 

maternal touch (e.g., proprioceptive stimulation, stroking/shaking/rocking) whereas the FTS 

describes the purpose of the touch behavior (e.g., nurturing touch, harsh touch). While 

understanding how specific touch types change over time is informative, assessing the purpose of 

the touch is critical to understanding the role of touch in communication because it provides a 

context within which the touch can be understood (Jean & Stack, 2009). 

The FTS was developed by Jean and Stack (2009) to better understand the function or 

purpose of maternal touch during a mother-infant interaction. The authors perceived a gap in the 

maternal touch literature, given that most studies on maternal touch examine the properties of 

touch without understanding the communicative function of touch. During each second of an 

interaction, the function of a touch is coded using 1 of 9 possible functions: passive 

accompaniment (i.e., when touch co-occurs with another form of communication, and touch is 

not the main form); active accompaniment (i.e., when touch co-occurs with another form of 

communication, and touch is a focus); nurturing touch; playful touch; attention-getting touch; 

accidental touch; utilitarian touch; harsh or negative touch, and touch with no obvious purpose. 

Jean and Stack (2009) coded interactions between 40 mother-infant dyads using the FTS. Infants 

were approximately 5.5 months of age. A two minute normal interaction period was coded, 

 

18 

which was followed by a Still Face Task1, and another two minute normal interaction period, 

which was again coded.  Jean and Stack found that the amount of maternal touch did not 

significantly vary between the first normal interaction period and the second. During both 

periods, mothers tended to use playful touch, active accompaniment, and passive accompaniment 

most. However, the results suggested that some of the functions of the touch that mothers 

provided between the two periods differed. During the first normal interaction, mothers used 

more attention-getting touch than during the second normal interaction. When the level of infant 

distress during the still face was taken into account, the results suggested that mothers of more 

distressed infants used significantly more nurturing touch during the second period than did 

mothers of infants with low levels of distress. These results suggest that the function of maternal 

touch changed in response to maternal perception of the infant’s needs. Therefore, if an infant 

becomes distressed, a mother may attune to her infant’s changing needs, and the goal of maternal 

touch may become to provide warmth and nurturance to soothe the infant. These findings are 

also consistent with research that suggests the important role of maternal touch in infant emotion 

regulation (Feldman, Singer, & Zagoory, 2010). 

Infant Touch. Despite the importance of touch in the early caregiving relationship, 

research on infant communication and interactive behavior has primarily examined other 

modalities, such as vocalizations, gaze, body movements, and facial expressions (e.g., Ellsworth, 

Muir, & Hains, 1993; Moszkowski & Stack, 2007; Segal et al., 1995; Weinberg & Tronick, 

1994). Moreover, the research that has been conducted on infant touch has typically been an 

                                                           
1 During the Still Face Experiment (Tronick et al., 1978), a parent and child face one another for three episodes: 
play, still-face, and reunion. The play and reunion episodes are considered “normal interactions”. During the still 
face, the parent maintains a still and unresponsive facial expression. The parent resumes normal behavior for the 
reunion. Studies vary as to whether the parent can or cannot touch the infant during the still-face. The still face has 
been used to study the child’s reactivity and ability to self-regulate, and the quality of the parent-child interaction 
during the reunion episode. 

 

19 

examination of touch outside of an interaction (e.g., touching objects; Rochat, 1997; Stack & 

Tsonis, 1999) or self-touch within an interaction (e.g., Murray & Trevarthen, 1985; Toda & 

Fogel, 1993). Thus, this research has not provided insight into touch as a form of communication 

and as an interactive, dynamic behavior (Moszkowski & Stack, 2007).  

 

Infants are active participants in their environments, and by approximately 2 months of 

age, infants respond with shifts in facial expression and gaze during an interaction to perceived 

changes in others’ behavior (Trevarthen, 1977). By 3-4 months of age, infants can initiate 

interactions with others (Kaye & Fogel, 1980). These early mutual interactions can include 

mutual gaze, facial mirroring, turn-taking with vocalizations, mutual approach and avoidance, 

and touch behavior (Beebe et al., 2012; Feldman, 2007; Jaffe et al., 2001; Malatesta, Culver, 

Tesman, & Shepard, 1989; Messinger, 2002; Stern, 1985; Tronick, 1989). As an infant’s social-

emotional and physical development progresses across time, infant touch becomes more 

complex. By the time the infant is one year of age, the infant can initiate touch, understands 

reciprocity in touch, and has developed expectations about whether and how his needs will be 

met when he touches his mother (Cohn & Tronick, 1989; Feldman, 2010; Kaye, 1982; 

Moszkowski, Stack, & Chiarella, 2009; Tronick et al., 1978). When these expectations are 

violated, infants have been found to react with changes in touch behavior. For example, 

Moszkowski et al. (2009) examined infant touch during a Still Face task and found that infant 

touch of self, object, and mother varied across the Still Face and Normal periods as infants 

attempted to engage their mothers, self-soothe, and distract themselves from their nonresponding 

mothers. 

 

The limited research that has been conducted on infant touch suggests that infant touch 

has implications for both infants and their mothers. Infant touch, including self-touch, is 

 

20 

associated with the development of infant self-regulation (Murray & Trevarthen, 1985; Toda & 

Fogel, 1993). Infant self-touch has typically been examined during the unmodified Still Face 

Task, with research indicating that infants engage in more self-touch during the still-face period 

when they are emotionally dysregulated than during the normal periods (Weinberg & Tronick, 

1996). The goal of self-touch may be two-fold – engaging in self-soothing touch to manage 

distress and eliciting maternal caregiving behaviors by alerting a mother to her infant’s inner 

state (Tronick, 1989; Gianino & Tronick, 1988). Infant touch of the mother may also cue the 

mother in to the infant’s need for attention or regulation. In addition, infant touch may also affect 

maternal biology to promote caretaking behavior. Infant touch during breastfeeding (i.e., hand 

stimulation and sucking behavior) or during an interaction, for example, may increase maternal 

oxytocin production, which is associated with increased maternal bonding (Feldman, Gordon, & 

Zagoory-Sharon, 2011; Matthiesen et al., 2001). Research has not demonstrated sex differences 

with regard to infant touch of the mother (Moszkowski & Stack, 2007).  

 

Coding Infant Touch. Infant touch coding has typically examined self-touch and object-

touch (e.g., Rochat, 1989; Stack & Tsonis, 1999), or coded touch along with other modes of 

communication (e.g., gesturing; Murray & Trevarthen, 1985). However, recent research has 

noted that infant touch behavior has been neglected in studies of “mother-infant touch” 

(Crucianelli et al., 2019; Moszkowski et al., 2009). To address this gap, Moszkowski and Stack 

(2007) created a scale intended solely for coding infant touch. The Infant Touch Scale (ITS; 

Moszkowski & Stack, 2007) was intended to complement the CITS and provides codes for the 

type of touch and the area touched. However, as with the CITS, the communicative function of 

the coded touch behavior is unclear. In addition, the scale is primarily focused on self-touch, 

which may provide insight into infant self-regulation, rather than other-touch, which could 

 

21 

provide insight into the communicative function of the touch. Although the ITS does not assess 

infant touch purpose, a review of the literature suggests that infant touch purpose has been 

examined in mother-infant touch coding schemes (see below), providing support for the 

feasibility and meaningfulness of examining the function of infant touch.   

Mother-Infant Touch. From a dynamic systems theory perspective, a mother-infant 

interaction is a dynamic interplay between mother and infant, in which they are responsive to one 

another and their environment (Fogel & Garvey, 2007). This dynamic responsivity facilitates 

stability within the mother-infant interaction through co-regulation. How a mother responds to 

her infant depends on the maternal caregiving system, which integrates her perception of the 

environment, her maternal role, the needs of her infant, and her ability to respond to those needs 

(George & Solomon, 2008). How her infant responds is shaped by the infant’s perception of 

threat in the environment, his sense of security with his mother, and his needs (for review, see 

Mikulincer, Shaver, & Pereg, 2003). Thus, a mother-infant interaction involves a dynamic 

interplay between maternal and infant perceptions and needs within the current environment, and 

their expectations based on experiences in prior interactions.    

 

Mother-infant touch is a dyadic process that is ideally responsive, flexible, and sensitive. 

While mother-infant touch is a nascent field of study, studies of broader mother-infant interactive 

behavior can provide a model for understanding touch specifically. Within the context of the 

dyad, the infant learns social behavior and develops expectations for relationships and 

reciprocity. The mother, in turn, adapts her childhood models for interactive behavior in response 

to her perception of the infant and her changing role. Within any given interaction, mother and 

infant engage in a continuous process in which their behaviors, intentions, and feelings become 

more detailed as a result of the interactive context (Fogel & Garvey, 2007).  

 

22 

 

During an interaction, mother and infant adapt their behavior and affect in response to 

changes in the other’s behavior and affect (Cohn & Tronick, 1987; 1989; Kaye, 1982). When 

mother and infant are out of sync, the dyad works to correct the interaction and return mother 

and infant to synchrony within the interaction (Gianino & Tronick, 1988; Tronick, 1989; 

Tronick, Als, & Brazelton, 1977). Through this reparative process, infants learn emotion 

regulation and develop expectations of patterns of interactive behavior. When these learned 

expectations are not met, infants will work to alter their behavior to elicit the expected maternal 

reaction. During the Still Face Task, for example, mothers maintain a still and unresponsive 

facial expression while facing their infants. This behavior typically violates infant expectations 

of maternal responsivity, and infants are frequently observed modifying their behavior (e.g., 

reaching towards their mothers, becoming more affectively expressive) to elicit the expected 

behavior (e.g., responsive engagement) from the mother (e.g., Tronick et al., 1978). If mothers 

are able to touch their infants during the Still Face, however, the infant remains better-regulated 

emotionally despite the violation of infant expectation, suggesting that maternal touch helps the 

infant to modulate arousal in spite of the absence of maternal facial cues (Jean & Stack, 2009).  

 

However, in the context of risk, such as when mothers have mental health problems or 

mother and infant experience IPV, mother-infant interactions can also become a context within 

which risk is transferred from mother to infant. If maternal or infant ability to engage in 

responsive co-activity with one another is impaired, the infant may become distressed rather than 

regulated within the mother-infant interactive context (Crockenberg & Leerkes, 2005; Jahromi & 

Stifter, 2007; Shaver & Mikulincer, 2002). 

 

Coding Mother-Infant Touch. A review of the literature suggests that a few studies have 

examined mother-infant touch, with one study focusing solely on touch, while other studies 

 

23 

coded multiple interactive behaviors (Beebe et al., 2012; Crucianelli et al., 2019; Feldman et al., 

2004; Mantis et al., 2014). Mantis and colleagues (2014) coded mother-infant touch in 121 

mothers and their 5.5-month-old infants. One third of the infants were born preterm, one third 

were at psychosocial risk (low SES), and one third were low risk. Using a simple coding scheme 

(Co-Touch Scale; Mantis, Ng, & Stack, 2010) that assessed whether mother and infant were 

engaged in mutual (mother and infant are both touching each other), one-sided (only mother or 

infant is touching the other), or no touch (neither mother nor infant is touching the other), Mantis 

and colleagues found that the mother-infant interactions during normal periods of a modified 

Still Face2 were characterized primarily by mutual or one-sided touch. Risk was differentially 

associated with the amount of mutual touch used, with dyads in which the infant was born 

preterm engaging in significantly less mutual touch than dyads with psychosocial or low risk. 

While this study provides support for the presence of maternal and infant touch in co-regulation 

and the detrimental effect of one form of risk (preterm birth), it does not provide insight into the 

quality of the touch.  

Beebe and colleagues (2012) studied mother-infant interactive behavior in 4-month old 

infants. Mothers were seated across from their infants and instructed to play for 10 minutes 

without the use of toys. Maternal and infant interactive behaviors, such as gaze, facial affect, and 

touch were coded. Maternal touch was coded for affectionate to intrusive touch, and infant touch 

was examined via infant-initiated touch (touch that is initiated and completed by the infant, of 

self, object, or mother). Maternal and infant behaviors were coded second-by-second, and eight 

interactive patterns were identified. At 12 months, infant attachment was examined using the 

Strange Situation Procedure (Ainsworth, Blehar, Waters, & Wall, 1978). In infants who were 

                                                           
2 Maternal touch was permitted during the still-face period. 

24 

 

later classified as secure, more frequent infant-initiated touch was associated with more 

affectionate maternal touch behaviors. Maternal touch overall did not specifically predict infant 

touch initiation. In infants who were later classified as disorganized, infants initiated fewer touch 

behaviors overall (of self, object, and mother). When infants did increase touch initiation with 

their mothers, mothers were less likely to respond with affectionate touch than mothers of future-

secure infants. The results suggest that future disorganized infants were less able to use touch for 

self-soothing (self-touch) and for eliciting maternal interactive behavior (other-touch). Moreover, 

mothers of future disorganized infants engaged in less coordinated touch and were less 

responsive to infant touch. Therefore, long before the infant was classified as disorganized, 

mother and infant engaged in less interactive touch behavior, and the touch that did occur was 

less attuned and more dysregulated. Conversely, in mothers of future secure infants, infant touch 

initiation functioned as a signal for mothers to increase their affectionate touch behaviors. The 

differences may have been due to differences in self- and other-regulation. In dyads with future 

disorganized infants, mother and infant may have experienced more physiological and affective 

dysregulation, which was then reinforced and maintained by mother-infant interactive 

dysregulation (Beebe et al., 2012).  

 

Feldman and colleagues (2004) examined mother-child touch behaviors and interactive 

behaviors in children aged 9 months to approximately 3 years (average age: 25 months). Some of 

the children had a feeding disorder (FD). Mothers were videotaped during a 15-minute free play 

and a 15-minute feeding session. The free play was coded for child proximity to mother, 

maternal and child touch patterns (no touch, affectionate touch, proprioceptive touch, 

instrumental touch, unintentional touch, and negative touch), partner’s response to touch 

(approach, acceptance, practical response, withdrawal, or rejection), and joint gaze patterns. The 

 

25 

feeding session was coded for interactive behaviors (not specific to touch). During the free play, 

mothers of children with FDs used less affectionate, proprioceptive and unintentional touch than 

mothers of children without FDs. Mothers of children with FDs tended to respond to their child’s 

touch with more practical and rejecting responses. Children with FDs used less affectionate 

touch and more negative touch with their mothers. When touched, children with FDs tended to 

withdraw from or reject their mothers. The results indicate a pattern of more negative touch and 

rejecting touch behaviors in mother-child dyads. This suggests that disruptions to basic functions 

(such as feeding) in early infancy may have more global implications for mother-child 

interactive behavior. Mothers may feel ineffective and worry about causing their children harm 

and their children may associate interactions with their mothers with stress and physical 

discomfort.   

 

Crucianelli and colleagues (2019) recently developed the Mother-Infant Touch Scale 

(MITS), which codes maternal and infant touch in terms of valence, functionality, and purpose. 

The coding system also assesses maternal and infant touch in parallel and, for mothers, allows 

for the examination of whether or not the touch is contingent with the infant’s emotional state 

and experience. The researchers noted a gap in the literature, not only of coding systems for 

infant touch behavior, but specifically of coding systems that examine infant touch of the mother. 

Crucianelli et al. applied the MITS to a mother-infant book-reading interaction when infants 

were 1 year of age. They also assessed maternal ability to mentalize the infant (i.e., maternal 

ability to understand the infant’s mental state). Findings suggested that mothers who were less 

able to mentalize their infants used touch behaviors that were less attuned (contingent) to the 

infant. Unattuned maternal touch predicted less affectionate infant touch. However, the reverse 

was not true – mothers who were able to mentalize their infant did not use more attuned touch 

 

26 

behavior, and more attuned maternal touch behavior was not associated with more infant 

affectionate touch. Thus, mothers who have greater difficulty understanding their infants are at 

greater risk of using touch behaviors that are not sensitive to the infant needs, which in turn 

elicits fewer positive touch behaviors from the infant. The authors did not find any interactive or 

main effects of infant sex.  

 

This research suggests that various forms of risk are associated with alterations in 

mother-infant touch. Beebe et al. (2012) and Feldman et al. (2004) capture more specific, 

meaningful effects of risk on interactive behavior by coding mother and infant touch 

individually, and assessing both initiated touch behaviors and responses to touch. Crucianelli et 

al. (2019) capture a broader type of risk (maternal difficulty understanding infant internal states) 

and the resulting lack of attunement in maternal touch and reduction in affectionate infant touch. 

Consequently, the coding scheme in the present study also proposes to examine touch behaviors 

and responses to touch in mothers and their infants to better understand the effect of other forms 

of risk on mother-infant touch.  

IPV, Maternal Depression, and Touch 

As reviewed, maternal and infant touch behaviors are likely to be shaped by factors 

within the immediate context (e.g., the other person’s touch behavior) and broader factors within 

which the relationship developed (e.g., IPV, maternal depression, and maternal representations). 

Some research exists on the relationship between other risk factors and maternal touch, and very 

limited research exists on infant touch. However, maternal and infant touch have not yet been 

examined together within the context of IPV and maternal depression, which are common 

stressors. Maternal and infant touch behaviors may be affected directly by risk, and indirectly via 

 

27 

the effect of risk on the other person’s touch behavior. In addition, risk may affect maternal 

touch behavior by shaping how a mother perceives her child and the maternal role.  

Given the association between IPV and other types of negative parenting behavior, IPV is 

likely associated with the use of more negative touch behavior (e.g., harsh, intrusive touch) as 

well. IPV may also lead to altered physical and psychological touch perception, which in turn 

affect touch behaviors. Mothers may psychologically associate touch with violence and pain, 

and/or experience an altered physiological response (i.e., hyper- or hypo-reactivity) to touch due 

to the trauma of IPV (e.g., physiological reactivity, which is associated with somatosensory 

function, has been found to be altered in individuals with trauma-exposure, leading to hyper- and 

hypo-arousal; D’Andrea et al., 2013; Gupta, Lanius, & van der Kolk, 2005; van der Kolk, 

Greenberg, Orr, & Pittman, 1989). Consequently, mothers may avoid being touched by their 

infants, or respond negatively when touched (e.g., flinch, become upset). Infants may, in turn, 

perceive this negative reaction to touch and therefore reduce touch and touch-seeking behaviors. 

In addition, infants may also experience physiological hyper- or hypo-reactivity as a 

consequence of increased prenatal stress exposure (Glover, O’Connor, & O’Donnell, 2010), 

which could affect infant temperament and touch behaviors (initiation and response) postnatally. 

For example, if the infant experiences hypo- or hyper-responsivity to stressful stimuli 

postpartum, normative infant touch behaviors to seek help with co-regulation may be disrupted. 

Consequently, infants may also reduce or otherwise alter their touch behaviors. 

IPV may also influence maternal touch indirectly via changes to maternal representations. 

For example, if a mother perceives her child to be a victim like her, experiences role reversal and 

perceives her child to be taking care of her, or perceives her child to be violent towards her like 

her perpetrator, this likely has implications for how she engages with and touches her child. That 

 

28 

is, her distorted perception of her maternal role and of the infant may cause her to misinterpret 

the infant’s (tactile or other) cues and alter how she responds with touch to the cues. As a result, 

maternal touch behaviors may be unpredictable for the infant, and mothers may instead become a 

source of dysregulation rather than regulation. 

Maternal mental health problems are associated with changes in maternal touch 

behaviors. Depressed mothers have demonstrated differences in touch behaviors relative to their 

non-depressed counterparts (e.g., more intrusive, over-stimulating, and developmentally 

inappropriate touch; Cohn & Tronick, 1989; Fergus, Pickens, & Schmidt, 1998; Herrera, 

Reissland, & Shepherd, 2004). Maternal depressive symptoms may contribute to distorted 

maternal representations (e.g., Korja et al., 2008), which may in turn lead to mismatched and 

developmentally inappropriate maternal touch behaviors. These kinds of maternal touch 

behaviors have been found to elicit withdrawal, conflict behaviors, frustration, and anxiety in 

infants and young children (e.g., Apter-Levy, Feldman, Vakart, Ebstein, & Feldman, 2013), 

likely leading to less or more aggressive child touch. When maternal touch is taken into account, 

maternal mental health problems have not been found to predict infant touch behaviors (e.g., 

Feldman et al., 2004). Thus, the effect of maternal mental health problems on infant touch may 

be largely through the effect of mental health problems on maternal touch. 

In sum, IPV and maternal depression may significantly undermine mother-infant touch 

by (1) altering touch behaviors; (2) influencing the perception of the other’s touch behaviors; and 

(3) affecting maternal representations, which may influence a mother’s capacity to respond 

appropriately, predictably, and sensitively to her infant’s cues.   

 

 

29 

Current Project 

  

The present study was designed to address several limitations of extant research on 

mother-infant touch. First, this study aimed to examine maternal touch in the context of risk. IPV 

and maternal depression have been shown to affect maternal caregiving, infant outcomes, and the 

mother infant relationship. This study also examined maternal representations as a mechanism by 

which risk affects maternal touch behaviors. That is, a mother’s representations of her infant’s 

needs and her ability to fulfill those needs were posited to be affected by maternal depression and 

IPV, which could in turn interfere with her ability to emotionally engage with and mentalize her 

infant. These representations, in turn, were theorized to shape how she touched her infant. 

Second, this study aimed to understand infant touch in the context of risk. IPV and maternal 

depression are known to affect infant development, and social-emotional outcomes, such as 

interactive behavior. Therefore, it followed that these risk factors could also be associated with 

differences in infant touch behavior. Third, this study aimed to identify common patterns in 

touch interactions in the context of risk, including how mother and infant respond to the other’s 

touch in the moment. Increased understanding of the effect of these risk factors on mother and 

infant touch behavior may help to explain how the detrimental effects of exposure to these risk 

factors persist over time. For all of the hypotheses, the pregnancy and postpartum periods were 

examined separately for IPV and depression to assess the role of timing of exposure in the effect 

of these risk factors on touch outcomes. When examining the role of maternal representations, 

representations from the postpartum period were used to allow for the potential effect of risk 

during the pregnancy or postpartum periods on maternal representations to occur. Given research 

to suggest potential sex differences in the effects of risk on mother-infant interactive behavior, 

 

30 

infant sex was included in the analyses. As research is limited, no specific hypotheses were made 

regarding infant sex.  

 

The current project assessed mother-infant touch with a coding scheme that is informed 

by existing studies of mother and infant touch behaviors. The coding scheme captured the 

function of touch behaviors, intrusiveness, and tactile responses to the other’s touch behaviors. 

These aspects of touch are hypothesized to vary between IPV and maternal depression-exposed 

and non-exposed dyads, based on prior research and the maternal caregiving system theory. 

Please see Figure 1 for a theoretical model of the present study. 

Hypotheses 

Aim 1. The first aim was to determine whether IPV and maternal depression will predict 

maternal touch behaviors.  

Hypothesis 1a. Controlling for maternal depression, mothers with pregnancy or 

postpartum IPV were predicted to use less affectionate and more negative touch compared to 

non-exposed mothers. In addition, mothers with IPV were predicted to use more intrusive touch 

than non-exposed mothers. In addition, mothers with IPV were expected to touch their infants 

less overall.  

Hypothesis 1b. Controlling for IPV, mothers with pregnancy or postpartum depression 

were predicted to use more intrusive touch. In addition, mothers with depression were expected 

to touch their infants more overall. 

Hypothesis 1c. The detrimental effect of IPV on touch behaviors was predicted to be 

partly explained by postpartum maternal representations. Pregnancy and postpartum IPV were 

predicted to affect developing maternal representations, which in turn were predicted to affect 

 

31 

how a mother touches her child. Thus, postpartum maternal representations were expected to 

partially mediate the relationship between IPV and maternal touch behaviors.     

Hypothesis 1d. The detrimental effect of maternal depression on touch behaviors was 

predicted to be partly explained by postpartum maternal representations. Pregnancy and 

postpartum maternal depression were predicted to affect developing maternal representations, 

which in turn were predicted to affect how a mother touches her child. Thus, postpartum 

maternal representations were expected to partially mediate the relationship between maternal 

depression and maternal touch behaviors. 

Aim 2. The second aim was to examine the relationship between IPV-exposure, maternal 

depression, and infant touch. 

Hypothesis 2a. Controlling for maternal depression, infant touch was predicted to differ 

between IPV-exposed and non-exposed infants. Types of touch used, overall amount of touch, 

and proportions of each type of touch were predicted to vary. Given the more exploratory nature 

of the infant touch analyses, the predictions were intentionally broad. 

Hypothesis 2b. Controlling for IPV, infant touch was predicted to differ between infants 

of mothers with depression and infants of mothers without depression. Types of touch used, 

overall amount of touch, and proportions of each type of touch were predicted to vary. 

Aim 3. The third aim was to determine mother and infant tactile responses to touch in 

relation to IPV and maternal depression.  

 

Hypothesis 3a.  During an interaction, touch and attempts to touch may elicit a range of 

tactile responses from the recipient of the touch or touch attempts. It was predicted that maternal 

and infant tactile responses to touch would vary between mother-infant dyads who have 

 

32 

experienced pregnancy or postpartum IPV and mother-infant dyads who have not. Mothers and 

infants with IPV exposure were predicted to respond with more no touch or negative touch (e.g., 

push) than mothers and infants without IPV exposure. 

Hypothesis 3b. It was predicted that maternal and infant tactile responses to touch would 

vary between mother-infant dyads who have experienced pregnancy or postpartum maternal 

depression and mother-infant dyads who have not. Infants with exposure to maternal depression 

were predicted to respond to maternal touch with more no touch or negative touch (e.g., push) 

than infants without exposure to maternal depression. Mothers with depression were predicted to 

more often respond to infant touch with a touch response than mothers without depression.   

 

 

 

 

 

 

 

 

 

33 

 

 

 

METHODS 

Participants 

This study will use existing data collected as part of a larger longitudinal study on the 

effect of IPV on women and their children from pregnancy to age 10. Participants were recruited 

during pregnancy from 4 counties in the mid-Michigan area. They were oversampled for IPV 

exposure, which was defined as exposure to physical, sexual, or psychological violence in the 

past year. IPV-exposed women and non-exposed women were matched on demographic 

characteristics. The larger study involved 10 waves of data collection, and mothers were 

financially compensated for their participation. All procedures were approved by the university 

Institutional Review Board (IRB). The current study uses data from the first 2 waves of data 

collection. 

 

Two hundred and six pregnant women were enrolled in the larger study and interviewed 

during the last trimester of pregnancy. By the next in-person interview at 1 year postpartum, 189 

of the original participants were reached and interviewed. Of the 189 dyads, 16 had missing data 

due to loss of custody, living out of state, or technical problems during the interview. Therefore, 

173 mothers and their 1-year-old infants were included in the final sample of this study. The 

diversity of the participants was reflective of the population in these areas, with 63% of the 

women identifying as White, 25% as African American, 5% as Latina, and 7% as being of other 

ethnic/racial backgrounds. 44% of the women were single, 44% were married, and 12% were 

separated, divorced, or widowed. 38% of the women had a high school education or less, 42% 

had some college, 14% had an AA/BA/BS degree or some graduate school, and 6% had a 

graduate degree. Their monthly incomes ranged from $267 to $10,000, with a median household 

income of $1600 per month.   

 

34 

Procedures  

Women were first screened over the phone for eligibility. In order to be included in the 

study, they needed to be (1) in the last trimester of pregnancy; (2) between 18 and 40 years old; 

(3) English speakers; and (4) in a romantic relationship for at least 6 weeks during the 

pregnancy. To ensure that a number of participants would have experienced IPV during 

pregnancy, additional recruitment and screening procedures were implemented. As noted earlier, 

two waves of data from the larger longitudinal study were used for this research. The first 

interview took place when women were in their third trimester of pregnancy. The second 

interview took place when infants were approximately 12 months old. Interviews were 

conducted by trained graduate and undergraduate students. The pregnancy interview was 

conducted either in the woman’s home or in the research office, depending on the participant’s 

preference, and the follow up interview at 1 year postpartum was conducted in the research 

office.   

At the first interview, the pregnant mothers completed a consent form, demographic 

questionnaire, and mental health questionnaires. Following these, the mothers completed IPV 

questionnaires. At the second interview, mothers again completed a consent form and 

demographic questionnaire. Mothers and infants then participated in the free play episode. At the 

start of the 12 minute free play, mothers were instructed to interact with their infant as they 

normally would at home, including feeding or changing if need be. The room contained two 

chairs, a box of age-appropriate toys, anything mothers brought with them (e.g., toys, food, or 

diapers) and strategically placed mirrors to assist with viewing the interaction. The free play was 

taped with a video camera. Research assistants operated the video camera and observed from 

behind a 2-way mirror. After the free play, mother and infant were separated to complete the 

 

35 

remaining assessments, including the Working Model of the Child Interview (WMCI) and 

questionnaires pertaining to IPV. 

Measures 

 

Intimate Partner Violence. To assess IPV, women completed the Severity of Violence 

Against Women Scales (SVAWS; Marshall, 1992) at both in-person interviews. The SVAWS is a 

46-item measure that assesses psychological, physical, and sexual violence on a 4-point scale 

ranging from “Never” to “Many Times”. Examples of items include “punched you” and 

“destroyed something belonging to you”. Women completed the SVAWS for two specific time 

periods: at the first visit for the prenatal time period, and at the second visit for the first year 

postpartum. Marshall reported coefficient alphas of .89 to .96 for subscales of the SVAWS. A 

continuous IPV variable was created by summing items 9-46, and a dichotomous yes/no variable 

was created, with mothers categorized as “yes” if they endorsed items 9 or above.  

 

Maternal Depression. To assess pre- and postpartum maternal depression, women 

completed the Beck Depression Inventory (BDI; Beck, Ward, Mendelson, Moch, & Erbaugh, 

1961) at the first and second visits. The BDI is a 21-item scale that assesses depressive 

symptoms over the prior 2 weeks. Examples of symptoms assessed are guilt and suicidality. 

Beck and colleagues reported a coefficient alpha of .91 (Beck, Steer, Ball, & Ranieri, 1996) and 

a test-retest correlation of .93 (Beck, Steer, & Brown, 1996). A continuous sum score was 

created, as was a dichotomous yes/no. For the dichotomous variable, women were categorized as 

having depression if they were at or above the recommended clinical cutoff of 10 (10 yields good 

sensitivity and specificity; e.g., Norris, Gallagher, Wilson & Winograd, 1987).   

 

36 

Maternal Representations. The Working Model of the Child Interview (WMCI; Zeanah, 

Benoit, Hirshberg, Barton & Regan, 1994) is a semi-structured interview to examine mothers’ 

perceptions about their infants and motherhood. The WMCI interview was conducted postpartum 

and was coded along qualitative and content scales. Maternal representations were coded on six 

qualitative scales assessing representations of the infant (Zeanah, Benoit, Barton, & Hirshberg, 

1996) and one code assessing representations of the self (Huth-Bocks, Levendosky, Bogat, & 

von Eye, 2004; modified from Slade et al., 1994). The qualitative scales encompassed (1) 

Richness of Perceptions, how richly the mother describe the infant; (2) Openness to Change, how 

flexibly the mother integrates new information about the infant; (3) Intensity of Involvement, 

how psychologically involved the mother is in the relationship with the infant; (4) Coherence, 

how organized and logical the mother’s narrative about her infant and their relationship is; (5) 

Caregiving Sensitivity, how descriptive the mother is of her infant’s biological needs and 

emotional states; and (6) Acceptance, how accepting the mother is of her infant and the challenge 

of parenting. Mothers were given a 1 (none) to 5 (extreme) rating for each scale, with 5 

indicating higher levels of each construct. The Maternal Self-Efficacy scale assessed whether the 

mother perceives herself to be a competent, effective parent and her expectations of herself in the 

mothering role. Mothers were again rated from 1 (total lack of self-efficacy) to 5 (overestimating 

self-efficacy). For this scale, a score of 3 represented the most secure representation of the self as 

mother. The scales were used to create a latent maternal representation variable (a similar latent 

variable was confirmed and created by Huth-Bocks and colleagues (2004) for prepartum 

representations). A higher score on this latent factor suggested a higher quality maternal 

representation.  

 

37 

 

Interviews were audiotaped and transcribed by trained transcribers. Two graduate 

students were trained to code the WMCI. The graduate students were supervised by a master 

coder, who coded half of the interviews. Inter-rater reliability was assessed using percent 

agreement (80%) and Cohen’s kappa (.62, p < .001). 

 

Demographic Risk. Given the potential effect of demographic risk on maternal parenting 

behaviors like touch (such as through increased maternal stress, reduced resources, and systemic 

inequality; e.g., Aber, Jones, & Cohen, 2000; Angley, Divney, Magriples, & Kershaw, 2015), 

demographic risk was controlled. Participants provided information regarding their race, marital 

status, education, and income (assessed via Medicaid status). These variables were coded 

dichotomously with a score of “1” indicating risk. Previous research has supported the use of 

cumulative risk scores over the use of individual risk variables (Sameroff, Seifer, Baldwin, & 

Baldwin, 1993). Risk variables were summed to create a 0-4 total risk score.  

 

Infant Sex. Research has suggested that mothers may parent their young sons and 

daughters differently (e.g., Ahl, Fausto-Sterling, Garcia-Coll, & Seifer, 2013; Barnett & 

Scaramella, 2017), although research is mixed (for review, see Endendijk, Groeneveld, 

Bakermans-Kranenburg, & Mesman, 2016). Infant sex was assessed in the demographic 

questionnaire when infants were 1 year old. Sex was coded dichotomously (-1 = female, 1 = 

male) and examined in each analysis. 

 

Mother-Infant Touch. Mother-infant touch was examined during an 8 minute segment 

of the 12 minute free play. Maternal touch behaviors and infant touch behaviors were coded at 5-

second intervals to describe the purpose of the touch, tactile responses to the other’s touch, and 

for mothers, whether the touch was intrusive. Touch purpose codes were adapted from Jean and 

Stack’s Functions of Touch Scale (2009), and included affectionate, instrumental, 

 

38 

accidental/passive, negative, and no touch. Each time a touch occurred, the other member of the 

dyad received a code for his or her response to the touch. Only touch responses that occurred 

within the same or the subsequent interval were considered to be a response. Responses were 

coded as positive/neutral, negative, and no touch.  

Coding Plan and Ethogram  

Maternal and infant touch were examined during the middle 8 minutes of the 12 minute 

free play. Coders watched the tapes on a large monitor to code maternal touch and infant touch at 

5 second intervals. The videos were viewed through a program that stopped the video at 5-

second intervals to allow the research assistants to record their codes. Each video was watched 

twice, and maternal touch and infant touch were coded during separate viewings. The codes were 

recorded and compiled in Qualtrics. Touch was coded along three streams – touch initiation 

(affectionate, instrumental, accidental/passive, negative, and no touch), other touch response 

(positive/neutral, negative, and no touch), and whether touch was intrusive (maternal touch 

only). Touch bids (mother or infant initiate a touch but do not make physical contact and do not 

complete the touch behavior) were also coded, although were ultimately not examined due to a 

low incidence rate. Each touch purpose type that occurred during an interval was marked as 

present. If a touch initiation code was assigned, a touch response code was also assigned. It was 

possible for more than one touch purpose and more than one touch response to be assigned 

during one 5-second interval. See Appendix A for the description of the coding scheme and 

procedures that was provided to coders.   

 

 

 

39 

Coding 

 

Mother-infant touch videos were coded by the author and 3 trained undergraduate coders. 

The undergraduate coders were trained to reliability by the author, such that each undergraduate 

coder was reliable with the author (80% agreement or greater), who was the gold standard coder. 

The undergraduate coders were blind to the study hypotheses, IPV exposure status, and maternal 

depression codes. Mothers and infants in the same dyad were coded by different coders to ensure 

within-dyad independence in coding practices. Each coder (undergraduate and the author) coded 

approximately 25% of the videos. In addition, the author double-coded an additional 15% of the 

videos to assess interrater reliability.  The double-coded videos were chosen at random. 

Reliability was assessed throughout the coding process, to ensure that coders remained reliable 

and did not drift. Discrepancies were discussed and resolved by the coders during meetings. 

Cohen’s kappa (Cohen, 1960) was used to calculate reliability. This calculation takes the 

probability of chance agreement into account, and has been used by prior research on mother-

infant touch with similar methods (multiple observations per minute, several qualitative streams), 

suggesting that Cohen’s kappa is a parsimonious and appropriate choice.  

The results suggest acceptable agreement across all touch initiation codes. Cohen’s kappa 

for maternal affectionate touch was .91 (very good), maternal instrumental touch was .90 (very 

good), maternal passive touch was .87 (very good), maternal negative touch was .80 (good), 

infant affectionate touch was .74 (good), infant instrumental was .74 (good), infant passive touch 

was .59 (moderate), and infant negative touch was .89 (very good). Maternal and infant bids 

were not examined for agreement or included in the analyses due to low incidence rates. Results 

also suggested acceptable agreement across touch response codes, except for negative maternal 

touch responses, which did not occur in the double-coded videos and could not be assessed for 

 

40 

agreement. Cohen’s kappa for maternal positive/neutral touch response was .58 (moderate), 

maternal no touch response was .62 (good), infant positive/neutral touch response was .81 (very 

good), infant no touch response was .73 (good), and infant negative touch response was .90 (very 

good). As negative maternal touch responses did not occur in the double-coded videos, the 

overall incidence was assessed across the 174 mothers. Four mothers responded with negative 

touch once and two mothers responded with negative touch twice across the interactions. Given 

the low incidence rate, this variable was removed from the analyses.  

Missing Data 

 

Missing data for the 174 dyads was minimal. One dyad was missing the WMCI coding 

due to taping problems during the interview and was therefore not included in the mediation 

analyses. During the mother-infant free play, occasionally mother and/or infant were not visible 

on camera due to moving out of the frame, facing away from the camera, or over-exposure of the 

tape. These instances were coded as “no visible touch”.  

Data Analytic Approach 

 

Because touch behavior was assessed for both mothers and infants, multilevel modeling 

was used to evaluate Aims 1, 2 and 3, except for Hypotheses 1c and 1d. In these analyses, the 

dyad was treated as the upper-level unit and the individual (i.e., mother or infant) was treated as 

the lower level unit.  Each model predicted a particular type of touch behavior that the mother 

and infant engaged in. Random effects included in the models were separate residual variances 

for mothers and infants, as well as a covariance between mothers and infants to model 

nonindependence between scores. Three types of fixed effects models were run.  The first type of 

model tested for differences in touch behavior as a function of role (i.e., differences in touch 

 

41 

behavior for mothers versus infants). These models included an IPV variable from either the 

pregnancy or postpartum period which was measured either continuously or categorically, a 

depression variable likewise measured in either pregnancy or postpartum and either continuously 

or categorically, as well as infant sex, which was effect coded 1 = boys -1 = girls. In addition, 

each model included demographic risk as a control variable. Continuous measures of IPV and 

depression were grand-mean centered, as was the risk variable.  The fixed effect model also 

included interactions between role and IPV to test whether the effect of IPV on touch differed for 

mothers and infants.  Similarly the models included interactions between role and depression.  

The three-way interactions between role, IPV (or depression) and infant sex were also included 

to test for differences in effects as a function of infant sex. The models did not include 

interactions between IPV and depression.  

 

If role differences emerged, simple slope multilevel analyses were used to estimate 

effects of IPV and depression separately for touch behavior by mothers and infants.  

Furthermore, if there was evidence that results differed by infant sex, a follow-up analysis to 

estimate separate results for mothers and infants in which the infant was either male or female 

was conducted. 

 

The mediation analyses in Hypotheses 1c and 1d were conducted using structural 

equation modeling (SEM). For the analyses, a maternal representation latent factor was created. 

In the full model, pregnancy and postpartum IPV and pregnancy and postpartum depression were 

entered as predictors of maternal affectionate, instrumental, passive, negative, and no touch 

behavior. IPV and depression were again examined as both continuous and categorical variables. 

The continuous IPV and depression variables, as well as demographic risk, were grand-mean 

centered. Demographic risk and infant biological sex were controlled for in the model. The 

 

42 

maternal representation factor was entered as a mediator of the relationship between the 

predictors (IPV, depression) and the dependent variables (maternal touch behavior). 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

43 

RESULTS 

 

Descriptive statistics were calculated for each variable. Means, standard deviations, and 

correlations are presented in Tables 1-5.  Hypotheses 1a, 1b, 2, and 3 were tested using SPSS 

Version 24. Hypotheses 1c and 1d were examined using MPlus Version 8.1 (Muthén & Muthén, 

1998-2017). 

For ease of presentation, the results section is divided by hypotheses such that results 

relevant to hypotheses involving IPV effects on mothers’ behavior are presented first, then 

results for the effects of depression on mothers’ behavior are presented.  Results concerning 

infant behavior follow in the same order. The results of each aim are followed by a brief 

summary of the significant findings.  

 

In the following results sections, for the analyses treating IPV and depression as 

continuous variables “A” tables will present the interaction model that tests for differences for 

mothers versus infants, “B” tables will show the simple slopes for role effects and estimates the 

regression coefficients separately for mothers and infants, and “C” tables will present the simple 

slopes for follow-up for infant sex interactions, thus estimating regression coefficients when 

infants were male or female. If there was no evidence of interactions with role “B” tables will not 

be presented, and if there was no evidence of interactions with infant sex, “C” tables will not be 

presented. For the analyses treating IPV and depression as categorical variables, “A” tables will 

present the interaction model, and “B” tables will show the estimated marginal means for the 

significant interactions. For the mediation analyses, estimates are presented for the 3 pathways 

(direct path from predictor to mediator, direct path from mediator to outcome, and indirect path 

from predictor to outcome), with one table for each mediation analysis. 

 

44 

Aim 1 

The first aim was to determine whether IPV and maternal depression predict maternal 

touch behaviors.  

Hypothesis 1a. Controlling for maternal depression, mothers with pregnancy or 

postpartum IPV were predicted to use less affectionate and more negative touch compared to 

non-exposed mothers. In addition, mothers with IPV were predicted to use more intrusive touch 

than non-exposed mothers. In addition, mothers with IPV were expected to touch their infants 

less overall. 

With regard to affectionate touch, Table 6a presents the MLM results predicting 

affectionate touch as a function of role, continuous pregnancy IPV, continuous maternal 

depression, and infant sex. As can be seen in the Table, there was a role main effect indicating 

that mothers engaged in more affectionate touch than babies.  There was also a main effect of 

IPV which was qualified by a role by IPV interaction as well as a role by IPV by infant sex 

interaction.  Table 6b presents the simple slopes for IPV and depression separately for mothers 

and babies, and indicates that the effects of IPV on affectionate touch are limited to mothers.  

The role by IPV by infant sex interaction suggests that the effect of IPV on affectionate touch by 

mothers differs for male and female infants.  Specifically, as shown in Table 6c, for mothers of 

boys, greater pregnancy IPV is associated with more affectionate touch.  No such effects 

emerged for mothers of female infants.  

Table 7a presents the results predicting affectionate touch as a function of continuous 

postpartum IPV, continuous postpartum depression, and infant sex. There was again a role main 

 

45 

effect indicating that mothers engaged in more affectionate touch than infants. There were no 

main effects or interactions for postpartum IPV or infant sex on maternal affectionate touch. 

No significant main effects or interactions were found in the categorical pregnancy IPV 

analysis aside from a role main effect, again demonstrating that mothers engaged in more 

affectionate touch than infants (Table 8a). Likewise, only the role main effect emerged as 

significant in analyses with the categorical postpartum IPV variable predicting affectionate touch 

(Table 9a). 

With regard to negative touch, Table 10a presents the MLM results predicting negative 

touch as a function of role, continuous pregnancy IPV, continuous maternal depression, and 

infant sex. There was a role main effect indicating that mothers engaged in less negative touch 

than infants. There were no main effects or interactions for pregnancy IPV or infant sex on 

maternal negative touch. In addition, there was a main effect of demographic risk, with greater 

demographic risk predicting increased negative touch.  

Table 11a presents the results predicting negative touch as a function of continuous 

postpartum IPV, continuous postpartum depression, and infant sex. There was again a role main 

effect indicating that mothers engaged in less negative touch than infants. As was the case for 

pregnancy IPV, there were no main effects or interactions of postpartum IPV or infant sex on 

maternal negative touch.  

The results for analyses treating pregnancy IPV as categorical are presented in Table 12a. 

The results again demonstrate a role main effect indicating that mothers engaged in less negative 

touch than infants. There was also a role by infant sex and a role by IPV by infant sex 

interaction. Table 12b presents the estimated marginal means for the interactions. The interaction 

 

46 

effects were driven by infant touch behavior and will therefore be further elucidated in 

Hypothesis 2a.  

The results for categorical postpartum IPV are presented in Table 13a. The findings 

indicate a main effect of role demonstrating that mothers engaged in less negative touch than 

their infants. In addition, the findings demonstrate a main effect for IPV and infant sex, 

suggesting that postpartum IPV exposure was associated with increased negative touch as was 

male infant sex. There was also an interaction between role, IPV, and infant sex. Table 13b 

presents the estimated marginal means for the interaction. The interaction effects were specific to 

infant touch behavior and will therefore be examined further in Hypothesis 2a.  

With regard to intrusive touch, Tables 14a-17a present the MLM results predicting 

intrusive touch as a function of IPV, maternal depression, and infant sex. As can be seen in the 

tables, IPV (pregnancy and postpartum; continuous and categorical) and infant sex did not show 

evidence of main effects or interactions predicting maternal intrusive touch.   

With regard to no touch, Table 18a presents MLM results predicting total intervals 

without touch as a function of role, continuous pregnancy IPV, continuous pregnancy 

depression, and infant sex. There was a main effect of role indicating that mothers had fewer 

intervals in which there was no touch than infants. The main effect of role was also qualified by 

a role by IPV interaction. Table 18b presents the simples slopes, and indicates that mothers with 

pregnancy IPV had fewer no touch intervals than mothers without pregnancy IPV.  

Table 19a presents the results predicting total intervals without touch as a function of 

continuous postpartum IPV, continuous postpartum depression, and infant sex. There was again 

a role main effect indicating that mothers had fewer intervals in which there was no touch than 

 

47 

infants. There were no main effects or interactions for postpartum IPV or infant sex on intervals 

without touch.  

The results of the categorical analysis predicting total intervals without touch as a 

function of categorical pregnancy IPV, categorical pregnancy depression, and infant sex are 

presented in Table 20a. There was a role main effect indicating that mothers had fewer intervals 

in which there was no touch than infants did. There were no main effects or interactions for 

pregnancy IPV or infant sex on intervals without touch.  

Table 21a presents the results of the categorical analysis predicting total intervals without 

touch as a function of categorical postpartum IPV, categorical postpartum depression, and infant 

sex. Again, there was a role main effect indicating that mothers had fewer intervals in which 

there was no touch than infants did. There were no main effects or interactions for categorical 

postpartum IPV or infant sex on intervals without touch. 

Instrumental and passive touch were also coded. Given that it was not hypothesized that 

these touch types would be predicted by IPV, the results are presented in Appendix B. 

Hypothesis 1b. Controlling for IPV, mothers with pregnancy or postpartum depression 

were predicted to use more intrusive touch. In addition, mothers with depression were expected 

to touch their infants more overall. 

With regard to intrusive touch, as noted above, Table 14a presents the MLM results 

predicting intrusive touch as a function of continuous pregnancy IPV, continuous pregnancy 

depression, and infant sex. As can be seen in the table, there was a main effect of pregnancy 

depression, suggesting that mothers with more pregnancy depression engaged in more intrusive 

touch behavior. There were no interactions involving depression.  

 

48 

Table 15a presents the results for the analysis assessing intrusive touch as a function of 

continuous postpartum IPV, continuous postpartum depression, and infant sex. As with 

pregnancy depression, there was a main effect of postpartum depression, indicating that mothers 

with higher postpartum depression engaged in more intrusive touch behavior than mothers 

without lower postpartum depression. No interactions involving depression emerged. 

Tables 16a and 17a present the MLM results predicting intrusive touch as a function of 

categorical IPV, categorical maternal depression, and infant sex. As can be seen in the tables, 

there was no evidence of main effects or interactions of maternal depression (pregnancy and 

postpartum) or infant sex on maternal intrusive touch.  

With regard to no touch, Tables 18a-21a present the MLM results predicting total 

intervals without touch as a function of role, IPV, maternal depression, and infant sex. As can be 

seen in the tables, maternal depression (pregnancy and postpartum; continuous and categorical) 

neither material depression nor infant sex predicted maternal intrusive touch.  

Affectionate, negative, instrumental and passive touch were also coded. Given that it was 

not hypothesized that these touch types would be predicted by maternal depression, the results 

are presented in Appendix B. 

Hypothesis 1c. The detrimental effect of IPV on touch behaviors was predicted to be 

partly explained by postpartum maternal representations. Pregnancy and postpartum IPV were 

predicted to affect developing maternal representations, which in turn were predicted to affect 

how a mother touches her child. Thus, postpartum maternal representations were expected to 

partially mediate the relationship between IPV and maternal touch behaviors.  

 

49 

For the analyses, a maternal representation latent factor was created. This factor was 

initially predicted to have 7 indicators. However, 2 indicators were removed due to problems 

with the variables. Specifically, Openness to Change and Maternal Self-Efficacy were not used 

due to low coding reliability (calculated as a Pearson correlation coefficient; Openness to 

Change r = .58; Maternal Self-Efficacy r = .55). In addition, several of the indicators were highly 

correlated (r > .70), which was accounted for in the final factor (see Figure 2). Model fit was 

excellent. Higher scores on the factor suggest a more balanced maternal representation of the 

infant. 

Pregnancy IPV, postpartum IPV, pregnancy depression, and postpartum depression were 

entered as predictors of maternal affectionate, instrumental, passive, negative, and no touch 

behavior. Demographic risk and infant biological sex were controlled for in the model. The 

maternal representation factor was entered as a mediator of the relationship between the 

predictors and dependent variables. For both the continuous and the categorical models, the 

models did not converge. Therefore, each touch type was run in a separate analysis. 

Demographic risk predicted less balanced maternal representations in each of the following 

analyses. See Figure 3 for an example of the mediation model using affectionate touch with 

continuous risk predictors.  

Table 22 presents the SEM results for the continuous model predicting maternal 

representations as a mediator between the predictors (pregnancy IPV and postpartum IPV) and 

maternal use of affectionate touch behavior. As can be seen in the table, maternal representations 

did not mediate the relationship. However, maternal representations did predict affectionate 

touch, with more balanced representations predicting increased use of affectionate touch. 

 

50 

Consistent with findings from the analyses in hypothesis 1a, pregnancy IPV predicted increased 

use of affectionate touch in this model.  

Table 23 presents the SEM results for the categorical model predicting maternal 

representations as a mediator between the predictors (pregnancy IPV and postpartum IPV) and 

maternal use of affectionate touch behavior. Maternal representations did not mediate the 

relationship between the predictors and maternal use of affectionate touch behavior. As with the 

continuous analysis, maternal representations predicted affectionate touch, with more balanced 

representations predicting increased use of affectionate touch. 

Table 24 presents the SEM results for the continuous model predicting maternal 

representations as a mediator between the predictors (pregnancy IPV and postpartum IPV) and 

maternal use of instrumental touch behavior. Maternal representations did not mediate the 

relationship between the predictors and maternal use of instrumental touch behavior.  

The SEM results for the categorical model predicting maternal representations as a 

mediator between the predictors (pregnancy IPV and postpartum IPV) and maternal use of 

instrumental touch behavior are presented in Table 25. As can be seen in the table, maternal 

representations did not mediate the relationship between the predictors and maternal use of 

instrumental touch behavior.  

Table 26 presents the SEM results for the continuous model predicting maternal 

representations as a mediator between the predictors (pregnancy IPV and postpartum IPV) and 

maternal use of passive touch behavior. Maternal representations did not mediate the relationship 

between the predictors and maternal use of passive touch behavior. 

 

51 

Table 27 presents the SEM results for the categorical model predicting maternal 

representations as a mediator between the predictors (pregnancy IPV and postpartum IPV) and 

maternal use of passive touch behavior. Maternal representations did not mediate the relationship 

between the predictors and maternal use of passive touch behavior. 

Table 28 presents the SEM results for the continuous model predicting maternal 

representations as a mediator between the predictors (pregnancy IPV and postpartum IPV) and 

maternal use of negative touch behavior. Maternal representations did not mediate the 

relationship between the predictors and maternal use of negative touch behavior.  

Table 29 presents the SEM results for the categorical model predicting maternal 

representations as a mediator between the predictors (pregnancy IPV and postpartum IPV) and 

maternal use of negative touch behavior. Maternal representations did not mediate the 

relationship between the predictors and maternal use of negative touch behavior.  

Table 30 presents the SEM results for the continuous model predicting maternal 

representations as a mediator between the predictors (pregnancy IPV and postpartum IPV) and 

maternal no touch behavior. Maternal representations did not mediate the relationship between 

the predictors and maternal no touch behavior.  

The SEM results for the categorical model predicting maternal representations as a 

mediator between the predictors (pregnancy IPV and postpartum IPV) and maternal no touch 

behavior are presented in Table 31. As can be seen in the table, maternal representations did not 

mediate the relationship between the predictors and maternal no touch behavior.  

Hypothesis 1d. The detrimental effect of maternal depression on touch behaviors was 

predicted to be partly explained by postpartum maternal representations. Pregnancy and 

 

52 

postpartum maternal depression were predicted to affect developing maternal representations, 

which in turn were predicted to affect how a mother touches her child. Thus, postpartum 

maternal representations were expected to partially mediate the relationship between maternal 

depression and maternal touch behaviors. 

Table 22 presents the SEM results for the continuous model predicting maternal 

representations as a mediator between the predictors (pregnancy depression and postpartum 

depression) and maternal use of affectionate touch behavior. As can be seen in the table, 

maternal representations did not mediate the relationship. As noted in Hypothesis 1c, maternal 

representations predicted affectionate touch, with more balanced representations predicting 

increased use of affectionate touch.  

Table 23 presents the SEM results for the categorical model predicting maternal 

representations as a mediator between the predictors (pregnancy depression and postpartum 

depression) and maternal use of affectionate touch behavior. Maternal representations did not 

mediate the relationship between the predictors and maternal use of affectionate touch behavior.  

Table 24 presents the SEM results for the continuous model predicting maternal 

representations as a mediator between the predictors (pregnancy depression and postpartum 

depression) and maternal use of instrumental touch behavior. Maternal representations did not 

mediate the relationship between the predictors and maternal use of instrumental touch behavior.  

Table 25 presents the SEM results for the categorical model predicting maternal 

representations as a mediator between the predictors (pregnancy depression and postpartum 

depression) and maternal use of instrumental touch behavior. As can be seen in the table, 

 

53 

maternal representations did not mediate the relationship between the predictors and maternal 

use of instrumental touch behavior.  

Table 26 presents the SEM results for the continuous model predicting maternal 

representations as a mediator between the predictors (pregnancy depression and postpartum 

depression) and maternal use of passive touch behavior. Maternal representations did not 

mediate the relationship between the predictors and maternal use of passive touch behavior. 

Table 27 presents the SEM results for the categorical model predicting maternal 

representations as a mediator between the predictors (pregnancy depression and postpartum 

depression) and maternal use of passive touch behavior. Maternal representations did not 

mediate the relationship between the predictors and maternal use of passive touch behavior. 

Table 28 presents the SEM results for the continuous model predicting maternal 

representations as a mediator between the predictors (pregnancy depression and postpartum 

depression) and maternal use of negative touch behavior. Maternal representations did not 

mediate the relationship between the predictors and maternal use of negative touch behavior.  

Table 29 presents the SEM results for the categorical model predicting maternal 

representations as a mediator between the predictors (pregnancy depression and postpartum 

depression) and maternal use of negative touch behavior. Maternal representations did not 

mediate the relationship between the predictors and maternal use of negative touch behavior.  

Table 30 presents the SEM results for the continuous model predicting maternal 

representations as a mediator between the predictors (pregnancy depression and postpartum 

depression) and maternal no touch behavior. Maternal representations did not mediate the 

relationship between the predictors and maternal no touch behavior.  

 

54 

The SEM results for the categorical model predicting maternal representations as a 

mediator between the predictors (pregnancy depression and postpartum depression) and maternal 

no touch behavior are presented in Table 31. As can be seen in the table, maternal 

representations did not mediate the relationship between the predictors and maternal no touch 

behavior.  

Aim Summary. In sum, mothers of male infants used more affectionate touch if they 

were exposed to pregnancy IPV than mothers without pregnancy IPV exposure. In addition, 

mothers with pregnancy IPV touched their male and female infants more overall. IPV was not 

associated with the use of negative touch. Mothers with pregnancy or postpartum depression 

engaged in more intrusive touch with their infants than mothers without pregnancy or postpartum 

depression. Postpartum maternal representations did not mediate the relationship between 

pregnancy or postpartum IPV/depression and maternal touch behavior.  

Aim 2  

The second aim was to examine the relationship between IPV-exposure, maternal 

depression, and infant touch. 

Hypothesis 2a. Controlling for maternal depression, infant touch was predicted to differ 

between IPV-exposed and non-exposed infants. Types of touch used, overall amount of touch, 

and proportions of each type of touch were predicted to vary. Given the more exploratory nature 

of the infant touch analyses, the predictions were intentionally broad.   

With regard to affectionate touch, as noted, the results in Table 6a indicated the presence 

of interactions involving role and infant sex predicting affectionate touch.  However, as seen in 

Table 6c, the statistically significant effects of pregnancy IPV were limited to the mothers’ 

 

55 

behavior.  The same finding emerged in analyses of postpartum IPV (Table 7a).  Tables 8a and 

9a indicated no effects of either categorical IPV variable on infant affectionate touch.   

With regard to instrumental touch, the results in Table 32a indicated the presence of 

interactions involving role, the continuous pregnancy IPV variable, and infant sex predicting 

instrumental touch. However, as seen in Tables 32b and 32c, the statistically significant effects 

of pregnancy IPV were specific to mothers. The same finding emerged in the categorical analysis 

of pregnancy IPV (Tables 34a and 34b).  Tables 33a and 35a indicated no effects of the 

continuous postpartum IPV variable or the categorical postpartum IPV variable on infant 

instrumental touch. 

With regard to passive touch The results in tables 36a-39a indicated that IPV (pregnancy 

and postpartum; continuous and categorical) and infant sex did not exert main effects on infant 

passive touch. No interactions involving IPV emerged.  

With regard to negative touch, Tables 10a and 11a present results indicating that the 

continuous IPV variable (pregnancy and postpartum) and infant sex did not exert main effects on 

infant negative touch. No interactions involving IPV emerged. 

Table 12a indicated the presence of a role by infant sex interaction. Table 12b presents 

the estimated marginal means, and indicates that male infants engage in more negative touch 

than female infants. There was also a role by infant sex by IPV interaction. The estimated 

marginal means of the interaction suggest that male infants exposed to pregnancy IPV (when 

calculated as a categorical variable) use more negative touch than males not exposed to 

pregnancy IPV. 

 

56 

Table 13a indicated that there was a role by infant sex interaction, IPV by infant sex 

interaction, and role by IPV by infant sex interaction. The estimated marginal means for the 

interactions are presented in Table 13b. The results suggest that male infants exposed to 

postpartum IPV (when calculated as a categorical variable) use more negative touch than male 

infants not exposed to postpartum IPV.  

With regard to no touch, the results in tables 18a-21a indicated that IPV (pregnancy and 

postpartum; continuous and categorical) and infant sex did not exert main effects on infant no 

touch behavior. No interactions involving IPV emerged. 

Hypothesis 2b. Controlling for IPV, infant touch was predicted to differ between infants 

of mothers with depression and infants of mothers without depression. Types of touch used, 

overall amount of touch, and proportions of each type of touch were predicted to vary. 

With regard to affectionate touch, the results in tables 6a-9a indicated that maternal 

depression (pregnancy and postpartum; continuous and categorical) and infant sex did not exert 

main effects on infant affectionate touch. No interactions involving depression emerged. 

With regard to instrumental touch, the results in table 32a indicated that the continuous 

pregnancy depression variable and infant sex did not exert main effects on infant instrumental 

touch. No interactions involving depression emerged. 

Table 33a indicated the presence of a role by depression by infant sex interaction. Table 

33b presents the simple slopes for the interaction. As can be seen in Table 33c, male infants of 

mothers with postpartum depression (when calculated as a continuous variable) used more 

instrumental touch than male infants of mothers without postpartum depression. The same 

pattern was not demonstrated in female infants.  

 

57 

Table 34a indicated the presence of a role by depression interaction, and a role by 

depression by infant sex interaction. The estimated marginal means are presented in Table 34b, 

and suggest that the effect of the categorical pregnancy depression variable on instrumental 

touch is specific to mothers and not to infants.   

The results in table 35a indicated that the categorical postpartum depression and infant 

sex did not exert main effects on infant instrumental touch. No interactions involving depression 

emerged.  

With regard to passive touch, the results presented in tables 36a-39a indicated that 

maternal depression (pregnancy and postpartum; continuous and categorical) and infant sex did 

not exert main effects on infant passive touch. No interactions involving depression emerged.  

With regard to negative touch, the results presented in tables 10a-13a indicated that 

maternal depression (pregnancy and postpartum; continuous and categorical) and infant sex did 

not exert main effects on infant negative touch. No interactions involving depression emerged.  

With regard to no touch, the results presented in tables 18a-21a indicated that depression 

(pregnancy and postpartum; continuous and categorical) and infant sex did not exert main effects 

on infant no touch behavior. No interactions involving depression emerged. 

Aim Summary. In sum, male infants who were exposed to pregnancy or postpartum IPV 

engaged in more negative touch with their mothers than nonexposed male infants. In addition, 

male infants of mothers with postpartum depression engaged in more instrumental touch with 

their mothers than male infants of mothers without postpartum depression. The same patterns 

were not demonstrated in female infants. 

 

 

58 

Aim 3 

The third aim was to determine mother and infant tactile responses to touch in relation to IPV 

and maternal depression.  

 

Hypothesis 3a.  During an interaction, touch and attempts to touch may elicit a range of 

tactile responses from the recipient of the touch or touch attempts. It was predicted that maternal 

and infant tactile responses to touch would vary between mother-infant dyads who have 

experienced pregnancy or postpartum IPV and mother-infant dyads who have not. Mothers and 

infants with IPV exposure were predicted to respond with more no touch or negative touch (e.g., 

push) than mothers and infants without IPV exposure.  

 

With respect to maternal positive/neutral touch responses, Table 40a presents the MLM 

results predicting maternal positive/neutral touch response to infant touch as a function of role, 

continuous pregnancy IPV, continuous maternal depression, and infant sex. As can be seen in the 

table, there was a role main effect indicating that mothers engaged in fewer positive/neutral 

touch responses than infants. IPV demonstrated a main effect, which was qualified by a role by 

IPV interaction, and a role by IPV by infant sex interaction. The interaction effects, which are 

presented in Tables 40b and 40c, were specific to infant touch response behavior and will 

therefore be examined further below. 

Table 41a presents the results predicting maternal positive/neutral touch response to 

infant touch as a function of continuous postpartum IPV, continuous postpartum depression, and 

infant sex. There was again a role main effect indicating that mothers engaged in fewer 

positive/neutral touch responses than infants. There were no main effects or interactions for 

postpartum IPV or infant sex on maternal positive/neutral touch responses. 

 

59 

Tables 42a-43a present the results predicting maternal positive/neutral touch response to 

infant touch as a function of the categorical IPV variable, categorical maternal depression, and 

infant sex. As can be seen in the tables, IPV (pregnancy and postpartum) and infant sex did not 

show evidence of main effects or interactions predicting maternal positive/neutral touch response 

to infant touch. 

 

With respect to maternal negative touch responses, Tables 44a and 45a present the results 

predicting maternal negative touch response to infant touch as a function of the continuous IPV 

variable, continuous maternal depression, and infant sex. As can be seen in the tables, IPV 

(pregnancy and postpartum) and infant sex did not demonstrate main effects or interactions for 

maternal negative touch response to infant touch. 

 

Table 46a presents the results predicting maternal negative touch response to infant touch 

as a function of role, categorical pregnancy IPV, categorical pregnancy depression, and infant 

sex. As can be seen in the table, there was a role main effect indicating that mothers used fewer 

negative touch responses to infant touch than infants did to maternal touch. There was also a role 

by IPV interaction, which was specific to infant touch response behavior and will therefore be 

further described below. The interaction is presented in Table 46b.  

Table 47a presents the results predicting maternal negative touch response to infant touch 

as a function of role, categorical postpartum IPV, categorical postpartum depression, and infant 

sex. As can be seen in the table, there was a role main effect indicating that mothers used fewer 

negative touch responses to infant touch than infants did to maternal touch. There was also a 

main effect of IPV, which was qualified by a role by IPV interaction. Table 47b presents the 

simple slopes, and indicates that the effect of postpartum IPV on negative touch responses is 

limited to infants.  

 

60 

 

With respect to maternal no touch responses, Tables 48a-51a present the MLM results 

predicting maternal no touch response to infant touch as a function of IPV, maternal depression, 

and infant sex. As can be seen in the tables, IPV (pregnancy and postpartum; continuous and 

categorical) and infant sex did not exert main effects on maternal no touch response. There was a 

main effect of role indicating that mothers used fewer no touch responses than infants did.  

 

With respect to infant positive/neutral touch responses, as noted, the results in Table 40a 

indicated the presence of a role by IPV interaction, and a role by IPV by infant sex interaction. 

Table 40b presents the simple slopes for the effect of role, and indicates that the effect was 

limited to babies. The role by IPV by infant sex, which is presented in Table 40c, suggests that 

effect of pregnancy IPV (when calculated as a continuous variable) on infant positive/neutral 

touch responses differs by infant sex. Specifically, for male infants, pregnancy IPV is associated 

with more positive/neutral touch responses. The effect was not found in female infants.  

The results presented in Table 41a indicated that there were no main effects of 

postpartum IPV (when calculated as a continuous variable) or infant sex on infant 

positive/neutral touch responses. No interactions involving IPV emerged. 

The results presented in tables 42a and 43a indicated that IPV (pregnancy and 

postpartum, calculated as categorical variables) and infant sex did not exert main effects on 

infant positive/neutral touch response to maternal touch. No interactions involving IPV emerged. 

 

With respect to infant negative touch response, the results presented in tables 44a and 45a 

indicated that IPV (pregnancy and postpartum, calculated as continuous variables) and infant sex 

did not demonstrate main effects on infant negative touch response to maternal touch. No 

interactions involving IPV emerged. 

 

61 

 

The results presented in table 46a indicated the presence of a role by pregnancy IPV 

(calculated as a categorical variable) interaction, which is presented in Table 46b. The interaction 

suggests that the effect of pregnancy IPV on negative touch responses was limited to infants. 

Specifically, greater pregnancy IPV was associated with more negative touch responses by 

infants. No sex differences emerged.  

The results presented in table 47a indicated the presence of a role by postpartum IPV 

interaction (calculated as a categorical variable), which is presented in Table 47b. The interaction 

suggests that the effect of postpartum IPV on negative touch responses was limited to infants. 

Specifically, greater postpartum IPV was associated with more negative touch responses by 

infants. No sex differences emerged. 

 

With respect to infant no touch responses, the results presented in tables 48a-51a 

indicated that IPV (pregnancy and postpartum; continuous and categorical) and infant sex did not 

exert main effects on infant no touch response. No interactions involving IPV emerged. 

 

It was not hypothesized that IPV would predict differences in maternal and infant touch 

responses to specific touch types. However, these analyses were run and are presented in 

Appendix D.  

Hypothesis 3b. It was predicted that maternal and infant tactile responses to touch would 

vary between mother-infant dyads who have experienced pregnancy or postpartum maternal 

depression and mother-infant dyads who have not. Infants with exposure to maternal depression 

were predicted to respond to maternal touch with more no touch or negative touch (e.g., push) 

than infants without exposure to maternal depression. Mothers with depression were predicted to 

more often respond to infant touch with a touch response than mothers without depression. 

 

62 

With respect to maternal positive/neutral touch responses, Table 40a presents the MLM 

results predicting maternal positive/neutral touch response to infant touch as a function of role, 

continuous pregnancy IPV, continuous maternal depression, and infant sex. As can be seen in the 

table, there was a role main effect indicating that mothers engaged in fewer positive/neutral 

touch responses than infants. There was also a role by depression interaction, which is presented 

in Table 40b. The interaction effect was specific to infant touch response behavior and will be 

discussed further below.  

Table 41a presents the results predicting maternal positive/neutral touch response to 

infant touch as a function of continuous postpartum IPV, continuous postpartum depression, and 

infant sex. There was again a role main effect indicating that mothers engaged in fewer 

positive/neutral touch responses than infants. There were no main effects or interactions for 

postpartum depression or infant sex on maternal positive/neutral touch responses. 

Tables 42a and 43a present the results predicting maternal positive/neutral touch response 

to infant touch as a function of categorical IPV, categorical maternal depression, and infant sex. 

As can be seen in the tables, depression (pregnancy and postpartum) and infant sex did not 

demonstrate main effects or interactions for maternal positive/neutral touch response to infant 

touch. 

With respect to maternal negative touch responses, Tables 44a and 45a present the results 

predicting maternal negative touch response to infant touch as a function of continuous IPV, 

continuous maternal depression, and infant sex. As can be seen in the tables, depression 

(pregnancy and postpartum) and infant sex did not demonstrate main effects or interactions for 

maternal negative touch response to infant touch. 

 

63 

Table 46a presents the results predicting maternal negative touch response to infant touch 

as a function of role, categorical pregnancy IPV, categorical pregnancy depression, and infant 

sex. As can be seen in the table, there was a role main effect indicating that mothers used fewer 

negative touch responses to infant touch than infants did to maternal touch. The main effect of 

role was qualified by a role by depression by infant sex interaction. Table 46b presents the 

estimated marginal means. The results suggested that the effect of pregnancy depression was 

specific to infants and varied by sex, which will be further described below.  

Table 47a presents the results predicting maternal negative touch response to infant touch 

as a function of role, categorical postpartum IPV, categorical postpartum depression, and infant 

sex. As can be seen in the table, there was a role main effect indicating that mothers used fewer 

negative touch responses to infant touch than infants did to maternal touch. Postpartum 

depression and infant sex did not exert main effects on maternal negative touch response to 

infant touch. 

With respect to maternal no touch responses, Tables 48a-51a present the results 

predicting maternal no touch response to infant touch as a function of IPV, maternal depression, 

and infant sex. As can be seen in the tables, depression (pregnancy and postpartum; continuous 

and categorical) and infant sex did not exert main effects on maternal no touch response. There 

was a main effect of role indicating that mothers used fewer no touch responses than infants did. 

With respect to infant positive/neutral touch responses, the results presented in table 40a 

indicated the presence of a role by depression interaction, and the simple slopes are presented in 

Table 40b. The interaction suggests that infants exposed to pregnancy depression engaged in 

fewer positive/neutral touch responses than infants who were not exposed to pregnancy 

depression. The effect did not vary by infant sex. 

64 

 

The results presented in tables 41a-43a indicated that there were no main effects of 

continuous postpartum depression, categorical depression (pregnancy and postpartum) or infant 

sex on infant positive/neutral touch responses. No interactions involving depression emerged. 

With respect to infant negative touch responses, the results presented in tables 44a and 

45a indicated that depression (pregnancy and postpartum, calculated as continuous variables) and 

infant sex did not exert main effects on infant negative touch response to maternal touch. No 

interactions involving depression emerged. 

The results presented in table 46a indicated the presence of a role by pregnancy 

depression (calculated as a categorical variable) by infant sex interaction, which is presented in 

Table 46b. The results suggest that pregnancy depression was associated with negative touch 

responses by infants, and the effect varied by infant sex. Specifically, for female infants 

pregnancy depression was associated with fewer negative touch responses than female infants 

not exposed to pregnancy depression, while for male infants pregnancy depression was 

associated with more negative touch responses than male infants not exposed to pregnancy 

depression. The interaction is also presented in Figure 4.  

The results presented in table 47a indicated that there were no main effects of postpartum 

depression (calculated as a categorical variable) or infant sex on infant negative touch response 

to maternal touch. No interactions involving depression emerged.  

With respect to infant no touch responses, the results presented in tables 48a-51a 

indicated that depression (pregnancy and postpartum; continuous and categorical) and infant sex 

did not exert main effects on infant no touch response to maternal touch. No interactions 

involving depression emerged. 

 

65 

It was not hypothesized that maternal depression would predict differences in maternal 

and infant touch responses to specific touch types. However, these analyses were run and are 

presented in Appendix D. 

Aim Summary. In sum, IPV and depression predicted differences in infant touch 

responses but not maternal touch responses. Male infants who were exposed to pregnancy IPV 

engaged in more positive/neutral touch responses in response to maternal touch behavior. Both 

male and female infants who were exposed to pregnancy IPV also engaged in more negative 

touch responses to maternal touch. In addition, male and female infants who were exposed to 

pregnancy depression engaged in fewer positive touch responses to maternal touch. Male infants 

of mothers with pregnancy depression engaged in more negative touch responses than male 

infants of mothers with no pregnancy depression. The reverse pattern was demonstrated in 

female infants (see Figure 4). 

 

 

 

 

 

 

 

 

 

 

66 

DISCUSSION 

 

The overarching aim of the current study was to examine mother-infant touch within a 

free-play interaction, taking into account the broader context within which maternal caregiving 

and the mother-infant relationship were occurring. The first objective was to examine the effect 

of two common forms of risk on maternal touch behavior, considering the timing and severity of 

the risk factors. An additional aim was to propose and examine a potential mechanism through 

which risk might exert effects on maternal touch. The second objective was to better understand 

the effect of risk on infant touch behavior, again considering timing, severity, and type of risk. 

The final objective was to obtain a basic understanding of interactive touch behavior between 

mother and infant by examining how each responds to the other’s touch, and how these 

responses may be influenced by risk. While several of the hypotheses were not supported by the 

findings in the current study, the results highlight the effect of risk on maternal caregiving and on 

mother-infant interactive behavior. 

 

The results provide support for touch as an important form of communication in mother-

infant interactive behavior. How and how much mother and infant touched one another varied 

across dyads. As noted above, Solomon and George (1996) theorized that maternal caregiving is 

influenced by caregiving across the lifespan, particularly early experiences of caregiving and the 

proximal caregiving environment (e.g., maternal representations of infant and self, maternal 

health, environmental stressors, partner relationship, infant cues). In the present study, proximal 

factors that have been established as predictors of caregiving – IPV and maternal depression – 

were examined specifically as predictors of maternal touch and infant touch behavior. The 

effects of IPV and maternal depression on maternal and infant touch varied, with the results 

 

67 

suggesting that both the timing and the type of stressor had different, and at times antithetical, 

implications for maternal and infant touch.  

 

With regard to the first aim, it was hypothesized that IPV victimization would be 

associated with fewer affectionate, more negative, and more intrusive touch behaviors, and that 

mothers exposed to IPV would touch their infants less overall. However, the results 

demonstrated that more pregnancy IPV was associated with the use of more touch throughout the 

interaction, no differences in use of negative or intrusive touch behavior, and more affectionate 

touch in mothers of baby boys. Postpartum IPV was not associated with maternal touch behavior. 

These results underscore the importance of the pregnancy period for postpartum parenting, 

which is consistent with existing research that supports pregnancy as a critical time for the 

development of the maternal identity and maternal parenting (Ammaniti et al., 1992). The 

finding that pregnancy IPV predicts more maternal touch initiated throughout an interaction 

suggests that the increased maternal touch may serve a particular role. First, research suggests 

that male partners who engage in IPV provide less parenting support overall and engage in more 

negative parenting behaviors than male partners who do not perpetrate IPV (Bancroft, Silverman, 

& Ritchie, 2011; Burnette, Ferreira, & Buttell, 2017; Peled, 2000; Simmons, Lehmann, & Dia, 

2009). Therefore, it may be that these mothers received less support from their partners during 

pregnancy and have taken on more parenting responsibilities postpartum, which was then 

reflected in mothers’ use of more touch behavior throughout the lab interaction. Second, the 

increased touch may suggest that the IPV experienced during pregnancy may have led mothers to 

see themselves as needing to compensate for or protect the infant postpartum. As a result, these 

mothers may engage in more hands-on parenting postpartum to make up for the IPV or to control 

the infant’s behavior to protect the infant from a previously or currently violent partner. This 

 

68 

would be consistent with extant research that has found that mothers may engage in certain 

parenting behaviors to protect their children from the emotionally and physically harmful effects 

of IPV, either by engaging in warmer, more nurturing parenting (Levendosky et al., 2003) or by 

engaging in more controlling parenting (Buchanan, Power, & Verity, 2013; Lapierre, 2010).  

The potential that mothers in this sample engaged in compensatory parenting is further 

underscored by the finding that mothers specifically used more affectionate touch behaviors with 

their male infants if they were exposed to pregnancy IPV. Mothers in this sample may have 

increased their use of affectionate touch with their male infants if they were exposed to 

pregnancy IPV in an attempt to model positive interactive behaviors and prevent their sons from 

becoming like their fathers. There is limited research on the differential effect of IPV on 

maternal compensatory parenting of infants based on child sex, but research in mothers of older 

children has suggested that mothers report using sex-specific strategies to combat the effects of 

IPV, such as engaging in parenting that encourages assertiveness in female children and empathy 

in male children (Pels, Rooij, & Distelbrink, 2015). It may be that sex-specific compensatory 

strategies are evident already in infancy.   

It is notable that IPV-exposed mothers did not engage in more negative touch behaviors 

with their infants. Research suggests that IPV-exposed mothers may engage in more punitive, 

harsh parenting (e.g., Boeckel et al., 2014; Holden & Ritchie, 1991), perhaps as a result of their 

own emotional dysregulation, limited emotional resources, distorted perceptions of the child’s 

behavior or more maladaptive parenting models (e.g., early parental attachment figures and later 

romantic attachment figures). It is possible that the IPV-exposed mothers in the present sample 

engage in more negative parenting behaviors, but that these behaviors were not captured within 

the interaction, either because the behaviors are not touch-related (e.g., they may be verbal, 

 

69 

gestural, or related to neglect), the behaviors occur infrequently, or the present paradigm 

indirectly discouraged a full range of parenting behavior. Mothers were aware of being watched 

and recorded, and may have been concerned about the child being removed from their care. In 

addition, the instructions that mothers were given (interact with your child as you normally 

would at home, including feeding or changing if need be) may have prompted certain types of 

caregiving over other interactive behaviors. Lastly, the setting – though potentially stressful for 

the infant because it was unfamiliar – may have been devoid of stressors that may make negative 

parenting behaviors more likely (e.g., the abusive partner, stressful home responsibilities). 

It was also hypothesized that mothers with depression would engage in more intrusive 

touch and touch their infants more overall than their nondepressed counterparts. As predicted, 

mothers with pregnancy and/or postpartum depression engaged in more intrusive touch behavior, 

which is consistent with existing research (e.g., Cohn & Tronick, 1989; Fergus et al., 1998; 

Herrera et al., 2004). Mothers with pregnancy or postpartum depression have been found to 

engage in more developmentally inappropriate parenting behaviors that are mismatched with the 

child’s cues, such as more invasive or disrupting touch. However, contrary to predictions, 

mothers with pregnancy and/or postpartum depression did not touch their infants in more time 

intervals than nondepressed mothers. Thus, the mothers with pregnancy or postpartum 

depression in the present study engaged in a similar amount of touch throughout the interaction 

than nondepressed mothers, but the touch they engaged in was more likely to be intrusive. 

Given that postpartum IPV did not predict differences in maternal touch but postpartum 

depression did, this may suggest different ways in which these stressors affect maternal touch (or 

parenting behavior more broadly). It may be that the effect of IPV on parenting is more 

dependent on the external environment (e.g., is there a present threat of violence or is the child’s 

 

70 

safety at risk), and therefore postpartum IPV may exert a noticeable effect on parenting when 

parenting is observed in environments in which the IPV is salient. The effect of depression on 

parenting may be more related to the disruptive effect of depression on a mother’s ability to 

appropriately read and respond to her child’s cues, which may be more stable across 

environments during a depressive episode.  

With respect to the second objective of the first aim, which predicted that maternal 

representations would mediate the relationship between risk (IPV and depression) and maternal 

touch behavior, the findings did not support the hypotheses. It was posited that risk factors such 

as IPV and depression would shape how mothers think of themselves in the maternal role and 

their ability to care for a baby, which would in turn be reflected in differences in maternal touch 

behavior. In the present study, IPV did not predict postpartum maternal representations. While 

pregnancy depression predicted less balanced maternal representations, representations did not 

mediate the relationship between pregnancy depression and any maternal touch. Maternal 

representations were associated with affectionate touch behavior, with more balanced 

representations predicting more affectionate touch. One would expect that how a mother thinks 

about herself as a caregiver and her ability to recognize and provide for her child’s needs would 

be shaped by the mother’s environment. Indeed, past research on the same sample has found that 

maternal representations were predicted by IPV (Huth-Bocks, Levendosky, Theran et al., 2004) 

and that maternal representations predicted parenting (Dayton et al., 2010). However, both of the 

aforementioned studies examined maternal representations as mutually exclusive categories 

(balanced, disengaged, and distorted) rather than as a continuous latent variable. This represents 

 

71 

a different way of conceptualizing maternal representations3 and these studies aimed to answer a 

different type of question. In addition, while Dayton et al. examined parenting in the same free 

play as the current project, parenting was assessed using 6 global codes of parenting behavior 

(sensitivity, disengagement, controlling manipulation, covert hostility, warmth, and joy) and did 

not specifically focus on aspect of parenting such as touch behavior4. Prior research that has 

found a relationship between IPV and a continuous latent representations variable (Huth-Bocks, 

Levendosky, Bogat et al., 2004) combined IPV with demographic risk to create a latent risk 

variable. In the present study, it may be that IPV and depression did not predict representations 

because both often occur episodically (American Psychiatric Association, 2013; Devries et al., 

2013), which would suggest that many of the women in the present study would have had 

periods of time during which IPV or depression levels were lower. This may have allowed for 

maternal representations to develop also during periods of lower stress, less threat, and less 

emotional disengagement. Conversely, the demographic risk variable in the present study, which 

encompassed more stable stressors like SES, did predict less balanced representations. Therefore, 

it may be that maternal representations are not the mechanism through which IPV and depression 

affect maternal touch behavior. 

The findings of the second aim, which was to examine risk and infant touch, suggested 

that both IPV and depression predict differences in infant touch behavior. Notably, exposure to 

pregnancy or postpartum IPV predicted increased negative touch behavior, such as hitting, 

                                                           
3 To examine whether the present mediation findings differed from prior research as a consequence of examining 
maternal representations as a latent continuous variable rather than a categorical variable, the mediation analyses 
were re-run with an effects coded categorical maternal representations variable (balanced and nonbalanced (distorted 
or disengaged)) as the mediator. The mediation analyses remained nonsignificant, suggesting that the present 
findings were not nonsignificant as a consequence of how the mediator was calculated. 
4 Of note, both the Huth-Bocks and Dayton studies used pregnancy representations rather than postpartum 
representations in their analyses. To ensure that the difference in findings was not due to the timing of the 
representations, the analyses were replicated in the present study with pregnancy representations, and the findings 
remained consistent (see Appendix C and Figure 5). 

 

72 

kicking, and pushing, by male infants only. The effect was found when IPV was examined 

categorically, suggesting that the effect may have been less dependent on the severity of the IPV 

and rather was associated with the presence of IPV. The sex-specific effects suggest several 

possible pathways through which IPV could result in differences in touch by baby boys. First, 

the effect may be due to exposure: for the pregnancy period, exposure to maternal stress 

hormones in utero, resulting in prenatal programming and more negative emotionality or reactive 

behavior postpartum; and for the postpartum period, exposure to the IPV itself, resulting in 

increased stress and dysregulation. Second, the effect of IPV may be indirect: maternal 

experience of IPV at the hands of her male partner during pregnancy or postpartum may result in 

differences between how mothers parent their baby boys versus their baby girls5. These 

differences in parenting may result in differences in infant emotion regulation and expression of 

negative emotions. These potential pathways will be examined further in the following 

paragraphs. 

As noted previously, research suggests that prenatal exposure to maternal stress can result 

in prenatal programming of the fetus, which may be evident in developmental differences in the 

postnatal period (for review, see Hicks et al., 2019). Though research has found sex-specific 

differences in how maternal stress affects child outcomes, the results are mixed as to whether 

male offspring or female offspring are at greater risk of negative outcomes. Gerardin and 

colleagues (2011), for example, found that maternal pregnancy depression predicted greater 

difficulty in “regulation of states” for newborn male infants relative to female infants, and 

increased anxiety in those same male infants at 1 year of age. The early assessment within 

                                                           
5 Importantly, these differences are not suggested to be exclusive to mothers. Maternal parenting is examined in the 
present paper due to the focus on mother-infant touch and because paternal parenting was not assessed. 

 

73 

several days of birth allowed the authors to postulate that the sex effects were due to the 

pregnancy environment and not due to differences in parenting behavior or the postpartum 

environment. Similarly, Khashan et al. (2011) and Fineberg et al. (2016) also found that prenatal 

stress was associated with greater risk for poor outcomes (increased risk for affective disorders 

and increased risk for schizophrenia, respectively) in males but not in females. Other research 

has found females to be at greater risk, suggesting that further research is necessary to 

understand the discrepancy. 

It is possible that postpartum exposure to IPV may result in sex differences in how 

infants touch their mothers, with males and females exhibiting different signs of dysregulation 

(e.g., males engaging in more externalizing behaviors, such as negative touch, and females 

having more internalizing problems, such as anxiety) when stressed due to being raised in a 

periodically unpredictable and perhaps frightening environment. Research suggests that male 

children exhibit more physically aggressive behavior than female children beginning around 1 – 

1.5 years of age (Alink et al., 2006; Baillargeon et al., 2007), and the magnitude of the effect 

increases through childhood and into adulthood (for review, see Archer, 2000; Côté, 2007), with 

adult males continuing to exhibit more physical aggression and females utilizing more relational 

aggression (Archer & Coyne, 2005). In addition, the use of more aggressive behavior in early 

childhood predicts a rising trajectory of aggressive behavior across time, and children who are 

exposed to risk factors during pregnancy and postpartum (such as demographic risk or family 

dysfunction) are at greater risk of this pattern of aggression (Tremblay et al., 2004). Furthermore, 

exposure to early adversity, such as child maltreatment, has been found to exacerbate the sex 

effect, such that children engage in more sex-stereotypic types of aggression when dysregulated 

(Cullerton-Sen et al., 2008). Therefore, postpartum IPV exposure may result in increased 

 

74 

physical aggression in the form of negative touch behavior among male infants when they 

become dysregulated. This tendency towards physically aggressive interactive behavior among 

risk-exposed males in infancy may be indicative of the beginning of a trajectory of increased 

physical aggression into childhood, adolescence and adulthood.    

These touch differences may also be learned within the context of attachment 

relationships and may be more reflective of differences in how parents raise and socialize their 

male and female infants within the context of pregnancy and postpartum IPV (for review, see 

Tailor & Letourneau, 2012). Research suggests that from birth, parents respond to child 

behaviors in ways that socialize their baby girls and baby boys to engage in behaviors that 

conform to societal norms for gendered behavior (for girls, nurturing and deferent behavior; and 

for boys, dominant and aggressive behavior; Birns et al., 1994; Brody, 2000; Keenan & Shaw, 

1997). This sex-role socialization may be particularly evident in homes with IPV, where parents 

have been found to hold more sex-role stereotypic beliefs (Burge, 1981; Morris, 2009). 

Therefore, male infants in homes with IPV may receive feedback from their parents that 

promotes increased aggressive behavior which, in the present study, may be reflected in 

increased negative touch.  

In addition to the increased sex-role socialization, there may also be differences in how 

IPV-exposed mothers perceive and respond to their male infants versus their female infants. As 

noted above, mothers with pregnancy IPV engaged in distinctive touch behaviors that varied by 

infant sex. While the lab-observed differences suggested an increase in positively-valenced touch 

behaviors only, it is possible that these mothers engage in other parenting behaviors that promote 

negative touch in male infants. Research has found that IPV-exposed mothers worry that their 

baby boys will grow up to perpetrate IPV (Levendosky, Lynch, & Graham-Bermann, 2000), 

 

75 

which could result in parenting behaviors in response to this fear (e.g., mothers may attempt to 

combat negative behavior in their baby boys by responding with affectionate parenting, 

potentially reinforcing negative behavior; or mothers may respond to their male infants with 

more punitive behavior, resulting in increased dysregulation and more negative infant behavior). 

Research has also found that mothers with pregnancy IPV may interpret fetal behaviors in a 

distorted and negative way (such as interpreting a kick as violent and intended to hurt the 

mother) (Huth-Bocks et al., 2004). These pregnancy representations are significantly related to 

postpartum representations (Theran et al., 2005), likely continuing to result in altered 

interpretations of infant behavior and, therefore, differences in how mothers respond to infant 

cues. The effect would be expected to be strongest in mothers of male infants. However, these 

distortions would likely be captured in the measure of maternal representations in the present 

study, which did not mediate the relationship between IPV-exposure and maternal touch 

behavior, and therefore may be less likely to explain differences in male infant touch behavior.  

Postpartum depression was also associated with differences in infant behavior, with more 

severe postpartum depression predicting increased instrumental touch by male infants. Given that 

pregnancy depression did not predict differences in infant touch behavior, this suggests that the 

relationship between infant touch and maternal depression is likely due to parenting differences. 

Depressed mothers have been found to respond with developmentally inappropriate parenting 

behaviors, engaging in less responsive parenting with younger, more dependent infants than 

nondepressed mothers, and more restrictive, hands on parenting with older infants than their 

nondepressed counterparts (Herrera et al., 2004). With instrumental touch, which is a touch 

behavior intended to communicate and meet a need, this increase may suggest that male infants 

of depressed mothers have learned to engage in more agentic behavior and alert their mothers to 

 

76 

their needs to increase the likelihood of having that need met. In addition, this increase in 

instrumental touch may be a learned behavior. As noted in the appendix, mothers with 

postpartum depression engaged in more instrumental touch with their male infants than did 

depressed mothers of female infants. However, research examining the relationship between 

maternal depression, infant sex, and maternal parenting is limited. Cornish and colleagues (2006) 

did not find evidence to support a role of infant sex in the effect of postpartum depression on 

maternal self-reported experiences of parenting.  

The final aim, which postulated that IPV and depression would predict maternal and 

infant tactile responses to one another’s touch, was partially supported. IPV and depression 

during pregnancy or postpartum did not predict differences in how mothers responded to infants’ 

touch, but did predict differences in how infants responded to mothers’ touch. It was posited that 

IPV may affect maternal psychological and physical perception of touch, leading touch to be 

experienced as more negative or threatening, and therefore resulting in altered touch responses. 

However, the results of the present study do not provide support for alterations in the maternal 

perception of touch behavior. Rather, mothers with pregnancy or postpartum IPV were similarly 

responsive to infant touch as nonexposed mothers. Depression was expected to be associated 

with differences in maternal touch responses given extant research on more discordant parenting 

in depressed mothers, but the findings did not suggest differences. Considering that maternal 

depression predicted differences in the touch behaviors initiated by mothers, it may be that infant 

touch behaviors provided mothers (depressed and nondepressed) with helpful cues to the infant’s 

needs, and these cues were perceived in a similar way regardless of depression. Indeed, research 

suggests that touch perception, outside of perception of pain, is not altered in depressed 

individuals (Klauenberg et al., 2008). Rather, it may be that perception of other cues (e.g., facial 

 

77 

expression; Rubinow & Post, 1992) is impaired in depressed mothers, resulting in differences in 

other types of parenting behavior but no significant differences in touch responses to infant 

touch.   

Infant touch responses, however, varied as a function of both IPV and depression. 

Specifically, male infants responded with more positive/neutral touch to any maternal touch if 

the dyad had been exposed to more pregnancy IPV. This finding is not surprising given that 

mothers with more pregnancy IPV used more affectionate touch with their male infants. 

Therefore, the increased positive/neutral touch responses observed in male infants was likely in 

response to the increased affectionate touch these infants received from their mothers, providing 

support for the role that maternal touch may play in shaping infant touch. In addition, both male 

and female infants who were exposed to any IPV pre- or postnatally engaged in more negative 

touch responses to any maternal touch. Given the increase in both positive and negative 

responses for male infants, these findings may indicate that male infants were more reactive to 

maternal touch behavior overall. The finding suggests several possible mechanisms – it may be 

that exposure to maternal stress hormones during pregnancy is associated with more negative 

touch responses postnatally, perhaps due to increased dysregulation or alterations in touch 

perception. It is also possible that the effects are indirect - pregnancy and postpartum IPV may 

result in differences in parenting or differences in the home environment that lead to increases in 

negative touch responding. These environmental differences may not have been evident in the 

present study because they may not be specific to touch or specific to maternal parenting more 

broadly. The findings of increased positive/neutral touch responses and increased negative touch 

responses are not necessarily counter to one another. IPV exposure may be associated with 

increased infant sensitivity to stimuli, particularly in male infants, resulting in increased negative 

 

78 

as well as increased positive touch responses. This increased sensitivity to maternal touch may 

derive from more mixed parenting behaviors by IPV-exposed mothers, particularly with infant 

sons, or infants being programmed by the prenatal or postnatal environment to respond more 

strongly to stimuli.   

With respect to depression, more pregnancy depression predicted fewer positive/neutral 

touch responses by male and female infants to any maternal touch. Further, pregnancy 

depression predicted more negative touch responses in males, and less negative touch responses 

in females. The absence of pregnancy depression predicted more negative touch responses in 

females, and less negative touch responses in males. Research suggests that exposure to 

pregnancy depression is associated with differences in infant emotionality and behavior 

postpartum (e.g., Davis et al., 2004; Davis et al., 2007; Zhang et al., 2018). As the effects were 

specific to the pregnancy period in the present study, and maternal touch behavior did not vary as 

a function of pregnancy versus postpartum depression, this may suggest that the effect is due to 

prenatal programming. Indeed, pregnancy stress is associated with increased aggression and 

externalizing behaviors postpartum in males, but increased emotionality in females (Glover & 

Hill, 2012; Sandman, Glynn, & Davis, 2013), which may help to explain increased negative 

touch responses in males exposed to pregnancy depression in the present sample.  However, as 

infant emotions were not coded in the present study, it is difficult to determine whether female 

infants who were exposed to pregnancy depression were more emotionally reactive and 

dysregulated. Research suggests that these more overt challenging behaviors by male infants of 

depressed mothers may make it more challenging for mothers to interact with their male infants 

and make repairs when infant expectations or needs aren’t met, further reinforcing the infant’s 

dysregulation and externalizing behaviors (Tronick & Reck, 2009).  

 

79 

Overall, while mother-infant touch was not able to be assessed dyadically and 

dynamically, conceptually it was examined in such a way so as to provide insight into maternal 

and infant touch during an interaction, how they each respond to one another’s touch, and how 

different risk factors may affect this process. Pregnancy IPV demonstrated the greatest effect in 

mother-son dyads, with mothers engaging in more active, warm touch and infant sons initiating 

more negative touch but responding to maternal touch with more positive/neutral touch 

responses (in addition to more negative touch responses, although this pattern was also 

demonstrated in female infants). There were no sex differences in the effect of depression on 

maternal touch, but infant touch and responses differed by sex in the context of depression. 

Mothers with pregnancy or postpartum depression used more intrusive touch with their infants, 

whereas male infants tended to use more instrumental touch if they were exposed to postpartum 

depression and respond with more negative touch if they were exposed to pregnancy depression. 

Taken together, the results suggest that the effect of risk on maternal touch depends on the type, 

timing, and severity of the risk, and some types of risk may engender differences in how mothers 

parent their male versus their female infants. In addition, male infants may be differently 

susceptible to the effects of risk, leading to greater touch responsivity and reactivity by male 

infants. While some of the differential effects of risk on male and female touch behaviors may be 

attributable to observed differences in maternal parenting, the absence of sex differences in 

maternal touch behavior due to depression but the presence of sex differences in infant touch 

behavior due to depression suggest that additional factors are at play, such as other parenting 

differences, environmental differences, or differential susceptibility to prenatal programming.  

 

 

 

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Limitations 

The present study has several limitations that provide direction for future research. 

Firstly, touch could not be examined as a continuous, dyadic process that occurs across time. 

This is partly due to the large imbalance between how often mothers initiate touch with their 

infants and how often infants initiate touch. There are also several measurement limitations. For 

example, mother-infant touch was examined in a lab setting rather than in a more typical setting 

for mother and infant. The setting was new to both mother and infant, and mothers were aware of 

being videotaped and observed, which may have resulted in different behaviors than mother and 

infant might engage in at home6. However, observing mother and infant within the home is not 

an option for dyads experiencing IPV as it potentially puts mother and infant at increased risk of 

violence. Additionally, several of the constructs of interest relied on self-report data, which may 

be subject to socially desirable responding. Women who experience IPV may feel ashamed or 

traumatized by their experiences, or may be concerned about their children being removed from 

the home due to IPV and therefore underreport. Furthermore, the measure of IPV relied on 

retrospective reporting, which may have also resulted in underreporting.  

Implications 

 

Theoretical Implications. The present research provides evidence for the role that 

environmental and mental health stressors play in maternal caregiving, and suggests that the 

effects can vary by type of stressor. While one type of stressor may inform parenting in a way 

that results in adaptive parenting intended to combat risk (e.g., pregnancy IPV leading to more 

                                                           
6 To examine whether the observed touch was associated with maternal self-reported parenting, which may be more 
reflective of day-to-day interactions, maternal touch behavior was correlated with the Nurturing subscale of the 
Parent Behavior Checklist (Fox, 1994), which mothers had also completed at the same lab visit. However, none of 
the touch scales correlated with self-reported nurturing parenting behavior.  

 

81 

affectionate touch with infant sons), others may interfere with sensitive, attuned parenting, 

perhaps by impeding maternal perception of or ability to respond to infant cues, thereby 

potentially increasing risk (e.g., pregnancy and postpartum depression predicting more intrusive 

maternal touch). The findings do not, however, suggest that stressors such as IPV and maternal 

depression affect maternal touch by shaping developing maternal representations. This study also 

supports the understanding that early learning happens in the context of attachment relationships 

(e.g., mothers with pregnancy IPV engaged in more instrumental touch with their infant sons, 

and male infants who were exposed to pregnancy IPV also engaged in more instrumental touch 

with their mothers, suggesting that the baby boys may be modeling the care they have received). 

These early interactions lay the foundation for later interactive behavior and expectations of 

caregiving. Moreover, these results may also provide support for the intergenerational 

transmission of violence in male children exposed to IPV, which may already be evident in 

interactive touch behaviors in infancy.   

Clinical Implications. The findings may have implications for interventions aimed at 

targeting the detrimental effects of IPV and maternal psychopathology on the mother-child 

relationship and child outcomes. Clinicians can support the positive parenting behaviors that 

mothers may develop to compensate for IPV-exposure, and provide additional support to reduce 

other demonstrated effects of IPV and maternal depression on mothers and mothering (e.g., 

physiological changes; increased emotion dysregulation; confusing, frightening, inconsistent, or 

intrusive parenting; blunted affect). These interventions can be provided in an individual or 

dyadic format, with the benefit of a dyadic format being that the clinician can comment on the 

infant’s state and the mother-infant relationship to help mothers mentalize their infants. 

Postpartum interventions may also benefit from including a touch intervention to increase 

 

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nurturing maternal touch, as maternal touch of the infant has been shown to improve maternal 

factors (e.g., depression), infant outcomes (e.g., infant emotion regulation, attachment, physical 

development), and the mother-infant relationship. Nevertheless, it may also be important to 

consider that while touch interventions have generally been associated with improved outcomes, 

in the present study, male infants exposed to pregnancy IPV reacted to maternal touch with more 

negative touch behavior. Therefore, a touch intervention may also be activating for certain 

infants and increase dysregulation.  Lastly, given that the early parent-child relationship lays the 

foundation for the child’s understanding of relationships, supporting the mother-infant 

relationship will have implications for the child beyond infancy, into adolescence and adulthood. 

 

Research Implications. This study represents a step towards understanding the effects of 

trauma and other stressors during pregnancy and the postpartum period on mother and infant. 

Furthermore, the results demonstrate that the type of risk and the time period of exposure have 

differential effects on interactive touch outcomes. The pregnancy period emerged as an 

important predictor, underscoring the value in examining stressors during the pregnancy period 

when studying the mother-infant relationship. Stressors during this time period demonstrated 

implications for mothering, and for infant behavior towards the mother, potentially as a result of 

prenatal programming, or through the effects of stressors on maternal caregiving. A finding that 

may benefit from further clarification is the role of severity versus general exposure to IPV and 

depression. For mothers, significant effects were found when IPV and depression were examined 

as continuous variables, suggesting that the extent to which risk predicted changes in maternal 

touch depended on the severity of the risk. Conversely, the majority of the findings for infants 

were when IPV and depression were examined as categorical variables, suggesting that the 

 

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presence of IPV or clinically significant depression was sufficient to produce an effect on infant 

touch and touch responses. 

 

Future research should examine whether early differences in mother-infant touch predict 

later differences in child outcomes or the mother-child relationship. Understanding whether 

interactive differences observed at 1 year of age have implications for later functioning may 

provide additional information for better understanding which differences may be most 

important to target with interventions. In addition, further research on the role of sex differences 

and the relationship between risk and child outcomes may be beneficial. Indeed, research 

suggests a connection between early adversity (such as prenatal maternal stress exposure or 

postnatal exposure to IPV or maternal depression) and emotion regulation difficulties in early 

childhood (e.g., Fong, Hawes, & Allen, 2017; Monk, Spicer, & Champagne, 2012), which in turn 

predict aggressive behavior later in childhood (e.g.,Crockenberg, Leerkes, & Bárrig Jó, 2008; 

Holmes, Yoon, & Berg, 2017). Furthermore, research has demonstrated that the degree to which 

emotion regulation difficulties are associated with later aggression varies by the biological sex of 

the child, although the findings are mixed as to whether the effect is stronger in male or female 

children (e.g., Bowie, 2010; Cummings, Pepler, & Moore, 1999; Eisenberg et al., 2001). This 

discrepancy suggests that there may be additional factors contributing to later aggression.  

Future research may also benefit from examining other interactive behaviors to provide a 

more nuanced understanding of touch and of the mother-infant relationship. For example, coding 

maternal and infant emotion and non-touch behaviors or including maternal and infant 

physiological arousal across an interaction may provide insight into the relationship between 

risk, touch, and emotion regulation. Lastly, the present study examined the effect of stressors 

during pregnancy and the first year postpartum, which oversimplifies and muddies the 

 

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implications of stress for mother and infant. Research has demonstrated that there are sensitive 

periods for the effects of stressors on fetal and infant development, suggesting that a more 

precise understanding of the timing of IPV and depression may be necessary for understanding 

how, why, and to what extent these stressors may affect infants overall and interactive behavior 

more specifically. Moreover, the timing of the stressors likely also has implications for how 

maternal parenting is affected, not only because how a mother thinks about herself and her child 

shifts across pregnancy, but also because of the physical, physiological, and neurocognitive 

changes that occur across pregnancy (e.g., Pearson et al., 2010; Pearson et al., 2009). Therefore, 

different aspects of mothering may be more vulnerable at some points of the pregnancy over 

others and further research is necessary to elucidate the role of timing in the effect of stressors on 

parenting more broadly, and touch specifically.  

Conclusion 

 

This study represents a contribution to the growing mother-infant touch literature. 

Overall, the findings demonstrated that pregnancy and postpartum IPV and depression predict 

differences in how mother and infant touch one another. Male infants in general were more 

vulnerable to the effects of IPV and depression on touch, potentially due to differences in 

maternal behavior, an increased sensitivity to prenatal effects of stress, or increased sensitivity to 

the postnatal home environment. In addition, infant touch overall varied more as a function of 

IPV and depression than maternal touch, suggesting that infants may be more sensitive to the 

stressors. Alternatively, it may be that the effects of IPV and depression on maternal touch were 

not strongly elicited in the lab setting or were more evident in other parenting behaviors. 

Ultimately, the effect of IPV and depression on mother-infant touch suggests a potential pathway 

 

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through which these stressors may exert more long-term change on interactive behavior and 

expectations of caregiving.    

 

 

 

 

 

 

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APPENDICES 

 

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APPENDIX A: Coding Manual for Mother-Infant Touch 

Touch Purpose 

*NOTE: Only provide a touch purpose code if the primary person being coded INITIATED the 

touch (either in the current or prior 5-second window)* 

1.  Affectionate/Playful 

a.  Definition: The purpose of the touch is typically to soothe, establish a connection, 

communicate safety or positive feelings, or show caring. This is nurturing touch 

that demonstrates an effort to show affection to the other person. Affectionate 

touch may also arise in the context of playful behaviors.  

b.  Mother examples: 

i.  Mother gently rubs her child’s back. 

ii.  Mother picks up her crying infant to provide comfort. 

iii.  Mother tickles her infant’s stomach while the infant laughs. 

iv.  Mother moves to rest her hands on her baby, in a way that is not accidental 

or instrumental. 

1.  Note: If mother’s hands continue to rest on her baby in the next 5 

seconds, code the first 5 seconds as Affectionate, and the next 5 

seconds as Passive. 

v.  Mother bounces baby while holding baby 

c.  Infant examples: 

i.  Infant strokes his mother’s face. 

ii.  Infant holds onto mother when frightened. 

iii.  Infant leans into mother 

 

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1.  Note: If infant continues to passively lean for the next 5 seconds, 

code the first 5 seconds as Affectionate, and the next 5 as Passive. 

2.  Instrumental  

a.  Definition: The purpose of this touch is to take care of the needs of the other or 

the self. This touch is typically goal-directed. This code will be restricted to 

specific behaviors: 

i.  Lifting 

ii.  Diaper change 

1.  Note: code as being WITHOUT object 

iii.  Adjusting clothing 

iv.  Feeding 

1.  Including wiping baby’s face 

2.  Note: if with bottle or juicebox (etc.), code as being WITHOUT 

object 

3.  Note: the person must make contact with the other person for this 

to be coded. If, for example, mother is holding a cheerio in her 

hand, and baby reaches out to grab it but does not touch mother, 

both would receive No Touch codes 

v.  Tapping (e.g., to get attention) 

vi.  Baby using mother to push him/herself up 

vii.  Holding (if baby is held out, away from the mother’s body) 

1.  Note: if baby is held close to the body, code as Affectionate 

viii.  Wiping face/nose 

 

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b.  Mother examples: 

i.  Mother wipes her infant’s mouth after her infant eats. 

ii.  Mother changes her infant’s diaper, using only the necessary contact to 

complete the change (additional touches during the change may 

necessitate additional codes). 

c.  Infant examples: 

i.  Infant places his hands on his mother to push himself into a standing 

position. 

ii.  Infant actively clings to mother while mother is holding infant. 

iii.  Infant slides out of mother’s lap and uses mother’s body to get out of her 

lap. 

1.  Note: if mother does not help infant, code her response as 

“Passive/Accidental” 

d.  Note: If the instrumental behavior includes Affectionate touch, code both 

behaviors 

3.  Accidental/Passive 

a.  Definition: This touch has no explicit purpose and typically occurs accidentally or 

during the course of another behavior.  For passive touch, this require little to no 

active muscle engagement. 

b.  Mother examples: 

i.  Mother’s arm grazes infant’s body as she reaches for a toy. 

ii.  Mother’s hands touch infant’s hands as she gives him a toy. 

 

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iii.  Mother placed infant in her lap in a prior 5-second window, and now the 

infant remains seated in the mother’s lap. 

c.  Infant examples: 

i.  Infant hands mother a toy and his hand grazes hers in the process. 

ii.  Infant climbed into mother’s lap in a prior 5-second window, and remains 

passively seated in the mother’s lap in the subsequent window(s) 

d.  Note: A touch that was coded as active in a prior 5-second window can become 

passive if mother and infant are still in contact but no longer actively moving 

(e.g., a mother strokes her infant’s back and then leaves her hand resting on the 

infant’s back without movement or muscle engagement). The touch goes from 

actively engaging muscles to passive resting.  

4.  Negative 

a.  Definition: The purpose of the touch is to inflict harm or pain, or punish the other 

person. This touch may or may not be intended as negative. Negative touch may 

also be insensitive or cold. Negative touch may also be behavior done in 

frustration or with intent to restrain. Negative touch can be minor (i.e., it does not 

need to be a big negative touch in order to count). 

b.  Mother examples: 

i.  Mother hits, pinches, or grabs her child. 

ii.  Mother pushes her child. 

iii.  Mother restrains infant in place despite infant trying to move away. 

c.  Infant examples: 

i.  Infant pinches his mother. 

 

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ii.  Infant hits his mother. 

iii.  Infant pushes away from his mother. 

iv.  Infant kicks mother in frustration while having diaper changed. 

5.  No touch 

a.  Definition: The person is not engaging in a touch he or she initiated. No touch 

occurs.  

b.  If touch is unclear, also code no touch 

i.  Example: 

1.  A toy obstructed the view, or mother and infant were angled in 

such a way that it is unclear whether touch occurred, or mother and 

infant are both off screen. 

ii.  Note: only code unclear if no other type of touch is coded. If part of the 

touch was unclear, but you saw another type of touch during the 5-second 

window, code only the other type of touch. 

6.  Bid  

a.  Definition: Reaching behavior with the intent of initiating touch with the other, 

but touch does not occur on the part of the person who initiated it. 

b.  Mother example:  

i.  Mother reaches towards her infant, and the infant withdraws. 

Consequently, the mother’s attempt to touch her infant is not successful. 

ii.  Mother reaches towards her infant, and the infant steps towards her and 

completes the touch.  

 

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1.  Note: in this scenario, both infant and mother would be considered 

to have initiated the touch – the mother with a Bid, and the infant 

with the Affectionate or Instrumental touch (depending). 

2.   

c.  Infant example: 

i.  Infant reaches up to the mother to indicate wanting to be held, but does not 

make physical contact with the mother because the mother steps back.  

ii.  Infant reaches up to the mother to indicate wanting to be held, but stops 

short of making physical contact with the mother. The mother, however, 

reaches down and completes the touch. 

1.  Note: in this scenario, both infant and mother would be considered 

to have initiated the touch – the infant with a Bid, and the mother 

with the Affectionate or Instrumental touch (depending). 

d.  Note: if someone is reaching to touch, but touch occurs in the subsequent 5-

second period, do not code as bid. You may need to skip ahead and go back while 

coding to determine if something is a bid. 

e.  Note: Only code bid if it is a bid for touch, not, for example, a bid for play. If 

baby is reaching for mother and no touch occurs, code bid. If mother holds out a 

toy for the baby, do not code bid. 

Touch Purpose Notes: 

1.  If the person being coded holds a toy/food/etc. out to the other person, and the other 

person takes the object, this is not automatically given a touch purpose code (or coded as 

 

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touch with an object). It is only given a touch purpose code if the person holds out the 

toy/food/etc. and touches the other person with the object intentionally or passively. 

2.  For touch bids: 

a.  If the person being coded holds a toy/food/etc. out to the other person, this is not 

automatically a touch bid. It is only a touch bid if the person holds out the 

toy/food/etc. and tries to touch the other person with it.  

b.  If a person just shakes an item in front of the other person, this is not a touch bid. 

3.  The other person may complete the touch, but the person who initiated the touch still 

receives the touch bid code (e.g., if an infant reaches towards his mother to initiate 

holding (but does not touch his mother), and his mother completes the touch by picking 

up the infant, then the infant would receive a touch bid code and the mother would be 

assigned a touch response code).  

4.  POTENTIALLY CONFUSING CODES: 

a.  If coding the infant (for example): 

i.  Mother lifts baby into her lap and baby passively allows him/herself to be 

lifted: baby coded No Touch for the Touch Purpose code 

ii.  Baby remains passively seated in mothers lap after mother lifts baby into 

lap: baby coded No Touch for the Touch Purpose code 

iii.  However, if baby initiates a touch after having been seated in mother’s 

lap, give baby a touch purpose code 

b.  If coding the infant or the mother: 

i.  If both mother and infant initiate a touch, both would receive Touch 

Purpose codes in their respective codings. 

 

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c.  Some touch behaviors may require more than 1 touch code 

i.  For example, if mother changes her baby’s diaper in her lap, you may 

code both Instrumental (the changing) and Passive (passive contact of 

having baby on the lap). This is because this type of touch is different 

from the mother changing the baby on the floor.  

d.  Special Circumstance: Baby sliding out of mother’s lap 

i.  If coding the baby: 

1.  Code baby’s Touch Purpose as Instrumental 

2.  Code mother’s Touch Response as Passive/Accidental (unless 

mother helps or engages in an active touch behavior) 

ii.  If coding the mother: 

1.  Code mother’s Touch Purpose as Passive/Accidental 

2.  Code infant’s Touch Response as Passive/Accidental 

e.  If any of these are unclear, let me know! I have examples of each scenario! 

Other Touch Response 

1.  Positive/Neutral 

a.  Definition: While or shortly after being touched, the person who was touched 

(Person B) responds by touching the person who touched them (Person A) in a 

positive or neutral way. Positive touch responsiveness is characterized by a warm, 

affectionate, playful or connective touch. Neutral touch responsiveness is 

characterized by being absent of an emotional valence. 

b.  Mother examples: 

 

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i.  When the infant touches his mother, mother responds by affectionately 

picking up and holding the infant. 

c.  Infant examples: 

i.  When the mother touches her infant, infant responds by playfully pushing 

his head into his mother. 

2.  Negative 

a.  Definition: While or shortly after being touched, the person who was touched 

(Person B) responds by touching the person who touched them (Person A) in a 

negative way. Negative touch responsiveness is characterized by a harsh, 

punitive, hurtful, restrictive or avoidant (e.g., pushing away) touch. Negative 

touch responses may also occur when a member of the dyad is frustrated or upset 

and may not be intended to be hurtful. 

b.  Mother examples: 

i.  When the infant touches his mother, mother responds by pushing her 

infant. 

ii.  When the infant tries to push away, mother restrains the infant to keep him 

in place. 

c.  Infant examples: 

i.  When the mother touches her infant, the infant responds by pushing his 

mother away. 

ii.  While mother is changing the infant’s diaper, the infant is upset and kicks 

her. 

 

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d.  NOTE: this can include withdrawal behavior (i.e., an intentional absence of touch 

being coded as a touch behavior) if the withdrawal is negative 

e.  NOTE: negative responses can also include restraint (e.g., baby is trying to move 

away and mom continues to hold onto the baby – even if the mom’s touch 

purpose is instrumental. To the baby, this feels like a negative response) 

3.  Accidental/Passive  

a.  Definition: While or after being touched, the person who was touched (Person B) 

maintains a tactile response by continuing to remain in contact with the person 

who touched them (Person A) in a passive way. Passive touch means that muscles 

are not straining to complete the touch. 

i.  Note: This code can also be given after an initial touch response code was 

assigned in a prior 5-second interval. That is, an active touch response 

occurred in a prior 5-second interval and now passively continues. 

b.  Mother example: 

i.  When the infant touches his mother, the mother responds by resting her 

hand on the infant’s face (positive/neutral touch response) and continues 

to rest her hand on the infant’s face for the subsequent 5-second interval 

(passive touch response) as the infant continues to touch her in the same 

way. 

c.  Infant examples: 

i.  Mother picks up her infant and sets the infant in her lap. The infant 

passively accepts the movement, but otherwise does not respond with a 

tactile behavior. 

 

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ii.  When the mother tickles her infant, who is lying prone on the ground 

between her legs the infant responds by placing his feet on her legs 

(positive/neutral touch response) and continues to rest his feet on his 

mother’s legs as she is tickling him in the subsequent 5-second interval 

(passive touch response). 

4.  No touch 

a.  Definition: No tactile response occurs in response to the other’s touch. This code 

can be given for a neutral withdrawal. 

b.  Examples: 

i.  Mother reaches for her infant (bid), her infant does not respond. No tactile 

contact occurs between mother and infant. 

ii.  Infant is resting his legs on his mother as she changes him. When she’s 

done, she pats the infant to let him know. He moves his legs up in 

response, but does not appear upset or as if he wants to get away from his 

mother. His response is coded as No Touch because it is a neutral 

withdrawal. 

iii.  Mom rests a book on the baby as she reads to him. The baby touches the 

book in response. Baby’s response is coded as No Touch because he 

touched the book and not his mother.  

c.  If touch response is unclear, also code no touch 

i.  Note: only code unclear if no other type of touch response is coded. 

 

 

 

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Other Touch Response Notes: 

1.  To determine valence of touch response (positive/neutral, negative), coders may use other 

communicative cues, such as vocalizations, facial expressions, gaze, and body 

movements. 

a.  However, only code a positive/neutral, or negative response to touch if the person 

being touched responds with tactile behavior. If the person being touched cries when 

touched but does not respond with tactile behavior (e.g., pushing the toucher away), 

code passive touch if the person being touched does not move and remains in physical 

contact, no touch if the person being touched withdraws in a neutral way (i.e., an 

absence of touch), or negative touch if the person withdraws in a negative way (e.g., 

pushing the toucher).  

2.  If person B is already touching person A when person A initiates touch, code the valence 

of person B’s touch behavior as the “other touch response” (even if person B’s touch 

behavior did not noticeably change in response to person A’s touch).  

Qualifiers 

1.  Intrusive 

a.  Note: Only give mothers intrusive codes 

i.  If a baby’s code seems intrusive, note the time and the dyad, and send the 

information to Nicola 

b.  Note: Negative touch is not necessarily intrusive, but it can be. Positive touch and 

instrumental touch also have the potential to be intrusive.  

 

99 

c.  To determine whether a touch is intrusive, coders may use other communicative 

cues, such as vocalizations, facial expressions, gaze, and body movements from 

both members of the dyad. 

2.  Touch with object 

a.  Do not include feeding unless mother makes no other physical contact with infant 

while feeding the infant 

b.  If mom is changing the baby’s diaper and touches the baby through the diaper, do 

not code as touch with object 

3.  Note: For coding, you can select more than one qualifier for a touch purpose code 

a.  e.g., if affectionate/playful touch occurs twice during the 5-second period, once 

with an object and once without, code both qualifiers 

Interaction Quality 

1.  At the end of each video, please select one or more of the following to describe the video: 

a.  Mother Mostly Attuned/Sometimes Attuned/Occasionally Attuned/Not Attuned 

i.  Attuned: mother is responsive to baby and often correctly anticipates 

baby’s needs. 

b.  Infant was in mother’s lap 

i.  This should occur for at least several minutes of the video 

c.  Mother and infant were next to each other without touching or interacting with 

each other 

i.  This should occur for at least several minutes of the video 

d.  Mother and infant were engaged with each other, but typically not with using 

touch 

 

100 

i.  E.g., using play, verbally 

ii.  This should occur for significant portions of the video 

e.  Mother was intrusive 

i.  This should be used if the intrusive behavior was not tactile. This can 

include shaking objects in the baby’s face, cornering the baby, etc. 

f.  Examples of possible things to fill in for the “Other” response: 

i.  If mother said something unusual or mean to the baby (“You’re a bad 

baby”) 

ii.  If mother or infant engage in an unusual behavior (e.g., mother mocks 

baby, mother claps in baby’s face, baby runs away from mother in a way 

that is fearful) 

iii.  Providing context (e.g., if infant was asleep, or mother was changing the 

baby’s diaper for most of the video)  

Differentials 

  Sometimes the same touch activity will be coded differently depending on the quality of 

the touch. 

o  E.g., maternal caregiving behaviors may be coded as instrumental, affectionate or 

even negative depending on how the behavior is done 

Procedures 

1.  Check the assignment spreadsheet to see which video you will be coding and who in the 

dyad you will be coding. The start time for each tape will begin at 2:01, which is 2 

minutes and 1 second from the start of the free play. Set the bin to 4.98 seconds. 

 

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2.  Mark each observed touch purpose code(s) as present during the 4.98-second period.   

3.  If touch occurred, indicate whether touch was made with an object (e.g., mother touches 

infant with a toy). Do not assign a code if no touch occurred or if touch was unclear. 

4.  If touch occurred, indicate whether touch was intrusive. Do not assign a code if no touch 

occurred or if touch was unclear. 

5.  If touch or a touch bid occurred during the 4.98-second interval, indicate how the other 

person responded to the touch during the same 4.98-second interval. Choose the 

predominant response. 

General Notes:  

1.  If the same touch behavior is continued over several intervals, code the touch purpose for 

all of the intervals that the touch actively spans. If the touch becomes passive contact, 

code passive. 

 

 

 

 

 

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APPENDIX B: IPV, Depression, and Maternal Touch 

To examine the effects of IPV and depression on maternal instrumental and passive 

touch, multilevel modeling was run in SPSS. For additional information about the analysis, 

please see the “Data Analytic Approach” section.  

IPV and Maternal Touch 

Instrumental Touch. Table 32a presents the MLM results predicting instrumental touch 

as a function of role, continuous pregnancy IPV, continuous pregnancy depression, and infant 

sex. As can be seen in the Table, there was a role main effect indicating that mothers engaged in 

more instrumental touch than babies. There was also a main effect of IPV which was qualified 

by a role by IPV interaction as well as a role by IPV by infant sex interaction.  Table 32b 

presents the simple slopes for IPV and depression separately for mothers and babies, and 

indicates that the effects of IPV on instrumental touch are specific to mothers. The role by IPV 

by infant sex interaction suggests that the effect of IPV on instrumental touch by mothers differs 

for male and female infants.  Specifically, as shown in Table 32c, for mothers of boys, greater 

pregnancy IPV is associated with more instrumental touch.  No such effects emerged for mothers 

of female infants.  

Table 33a presents the results predicting instrumental touch as a function of continuous 

postpartum IPV, continuous postpartum depression, and infant sex. There was again a role main 

effect indicating that mothers engaged in more instrumental touch than infants. There were no 

main effects of postpartum IPV or infant sex on maternal instrumental touch. 

The categorical pregnancy IPV results are presented in Table 34a. There was a main 

effect of IPV and a role by IPV interaction. As shown in table 34b, mothers with pregnancy IPV 

engaged in more instrumental touch than mothers without pregnancy IPV.  

 

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The categorical results for postpartum IPV are presented in Table 35a. The results again 

demonstrate a role main effect indicating that mothers engaged in more instrumental touch than 

infants. As can be seen in the table, IPV and infant sex did not show evidence of main effects or 

interactions predicting maternal instrumental touch. 

Passive Touch. Tables 36a-39a present the MLM results predicting passive touch as a 

function of IPV, maternal depression, and infant sex. As can be seen in the tables, IPV 

(pregnancy and postpartum; continuous and categorical) and infant sex did not show evidence of 

main effects predicting maternal passive touch. Role demonstrated a main effect, suggesting that 

mothers engaged in more passive touch than infants.  

Depression and Maternal Touch 

Affectionate Touch. Tables 6a-9a present the MLM results predicting affectionate touch 

as a function of IPV, maternal depression, and infant sex. As can be seen in the tables, maternal 

depression (pregnancy and postpartum; continuous and categorical) and infant sex did not show 

evidence of main effects predicting maternal affectionate touch. Role demonstrated a main 

effect, suggesting that mothers engaged in more affectionate touch than infants.  

Negative. Tables 10a-13a present the MLM results predicting negative touch as a 

function of IPV, maternal depression, and infant sex. As can be seen in the tables, maternal 

depression (pregnancy and postpartum; continuous and categorical) and infant sex did not show 

evidence of main effects predicting maternal negative touch. Role demonstrated a main effect, 

suggesting that mothers engaged in less negative touch than infants.  

 

Instrumental. Table 32a presents the MLM results predicting instrumental touch as a 

function of role, continuous pregnancy IPV, continuous pregnancy depression, and infant sex. As 

 

104 

can be seen in the Table, there was a role main effect indicating that mothers engaged in more 

instrumental touch than babies. There was also a role by depression interaction, suggesting that 

the effect of depression on instrumental touch varied for mothers and infants. However, follow-

up analyses indicated that the effect was not significant for mothers or infants.  

 

Table 33a presents the results predicting instrumental touch as a function of continuous 

postpartum IPV, continuous postpartum depression, and infant sex. As can be seen in the table, 

there was a role by depression by infant sex interaction. Specifically, as shown in Table 33c, for 

mothers of girls, greater postpartum depression was associated with less instrumental touch. No 

effects emerged for mothers of male infants.   

Table 34a presents the results predicting instrumental touch as a function of categorical 

pregnancy IPV, categorical pregnancy depression, and infant sex. The main effect of role was 

qualified by a role by depression and a role by depression by infant sex interaction. The role by 

depression interaction suggests that the effects of depression on instrumental touch are limited to 

mothers. The role by depression by infant sex interaction suggests that the effect of depression 

on instrumental touch by mothers differs for male and female infants. Specifically, as shown in 

Table 34b, for mothers of girls, greater pregnancy depression is associated with less instrumental 

touch. There were no such effects for mothers of male infants.  

Table 35a presents the results predicting instrumental touch as a function of categorical 

postpartum IPV, categorical postpartum depression, and infant sex. Aside from a role main 

effect, there were no main or interactive effects of postpartum depression on maternal 

instrumental touch.  

 

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Passive Touch. Tables 36a-39a present the MLM results predicting passive touch as a 

function of IPV, maternal depression, and infant sex. As can be seen in the tables, maternal 

depression (pregnancy and postpartum; continuous and categorical) and infant sex did not exert 

main effects on maternal passive touch. Role demonstrated a main effect, suggesting that 

mothers engaged in more passive touch than infants. 

 

 

 

 

 

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APPENDIX C: Pregnancy Representations 

 

To determine whether maternal pregnancy representations mediated the relationship 

between pregnancy IPV/pregnancy depression and maternal touch, additional SEM analyses 

were run with a pregnancy representation latent factor. The latent factor is presented in Figure 5 

For additional information about the analysis, please see the “Data Analytic Approach” section. 

Tables 52-61 present the SEM results for the continuous and categorical models. As with the 

postpartum representations, pregnancy representations also did not mediate the relationship 

between pregnancy IPV/pregnancy depression and maternal touch behavior.  

 

 

 

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APPENDIX D: Specific Touch Predicting Specific Touch Responses 

 

Multilevel modeling was used to assess whether there were patterns of specific touch 

types and specific touch responses that varied as a function of pregnancy IPV, postpartum IPV, 

pregnancy depression, and postpartum depression. In these analyses, the dyad was treated as the 

upper-level unit, and the individual was treated as the lower level unit. Four types of fixed effects 

models were run. The first type of model tested for differences in touch behavior as a function of 

role. These models included an IPV variable from either the pregnancy or postpartum period 

which was measured either continuously or categorically, a depression variable likewise 

measured in either pregnancy or postpartum and either continuously or categorically, a 

categorical touch variable (1 = affectionate touch, 2 = instrumental touch, 3 = passive touch, 4 = 

negative touch), and a categorical touch response variable (1 = no touch response, 2 = 

positive/neutral touch response, 3 = negative touch response). Continuous measures of IPV and 

depression were grand-mean centered. The fixed effect model also included interactions between 

role and IPV to test whether the effect of IPV on touch differed for mothers and infants.  

Similarly the models included interactions between role and depression.  Four-way interactions 

between role, IPV (or depression), touch, and touch response were also included to test for 

differences in effects as a function of touch and touch responses.  

If a role by IPV (or depression) by touch by touch response interaction emerged, simple 

slope multilevel analyses were used to estimate effects of IPV (or depression) separately for each 

individual touch type by response by role. If there was evidence for interactive effects for 

specific touch types, a follow up analysis was run using the significant touch type(s). The follow-

up examined the interaction between IPV (or depression), the significant touch type(s), specific 

 

108 

touch responses, and role. Finally, if there was evidence that the results differed by role, the final 

analysis estimated separate results for mothers and infants. 

In the following results sections, for the continuous analyses, “A” tables will present the 

interaction model, “B” tables will present simple slopes for role, “C” tables will present the 

simple slopes for specific touch types, and “D” tables will present the simple slopes for specific 

touch responses. The categorical analyses were not significant and will therefore be presented in 

one table for the pregnancy period and one table for the postpartum period.   

Table 62a presents the MLM results predicting total touch/touch responses as a function 

of role, continuous pregnancy IPV, continuous pregnancy depression, touch, and touch 

responses. As can be seen in the table, there was a role by IPV by touch by touch response 

interaction. There was no interaction for depression. Table 62b presents the simple slopes for 

IPV separately for each touch type, and indicates that the effect of IPV on touch/touch responses 

is specific to instrumental touch. Table 62c presents the simple slopes for the role by IPV by 

instrumental touch by touch response interaction. There was a role by IPV by instrumental touch 

by positive/neutral touch response interaction. Specifically, as can be seen in Table 62d, for 

mothers, pregnancy IPV was associated with infants responding to maternal instrumental touch 

with positive/neutral touch responses. No other touch and touch response patterns emerged as a 

function of pregnancy IPV.  

 

 

 

 

 

 

 

109 

Table 1: 

Correlations and Means for Mother Touch 

APPENDIX E: Tables 

1 
- 

.24** 

.16* 

2 
 

- 

7 
 

 

 

 

 
 

- 

5 
 

 

 

 

6 
 

 

 

 

 
- 

4 
 

 

 

- 

.33** 

.06 

3 
 

 

- 

.12 

.46** 

.32** 
-.15* 

 
1. Pregnancy 
IPV 
2. Postpartum 
IPV 
3. Pregnancy 
Depression 
4. Postpartum 
Depression 
5. Dem Risk 
6. Baby 
Biological Sex 
7. Affectionate 
Touch  
8. Instrumental 
Touch 
9. Passive Touch 
10. Negative 
Touch 
11. No Touch 
12. Intrusive 
Touch 
Note. * indicates p is significant at < 0.05, ** indicates p is significant at < .001 

-.58** 
.18* 

.31** 
.00 

.39** 
.12 

.08 
-.17* 

-.72 
.15* 

.11 
.18* 

.00 
.18* 

.16* 
-.13 

-.06 
.00 

-.12 
.03 

.00 
-.08 

-.10 
-.05 

-.05 
.08 

.09 
-.03 

-.06 
.05 

-.11 

-.06 

-.08 

-.09 

-.03 
.08 

.04 

-.01 

.41** 

.00 

.02 

.09 

.13 

.07 
-.03 

-.08 

-.07 

- 

-.02 

.00 
.02 

.12 
.08 

8 
 

 

 

 

 
 

 

- 

 

 

 

110 

9 
 

10 
 

11 
 

12 
 

 

 

 

 
 

 

 

- 
.06 

 

 

 

 
 

 

 

 
- 

 

 

 

 
 

 

 

 
 

 

 

 

 
 

 

 

 
 

Mean (SD) 
3.59 (8.73) 

2.87 (8.53) 

10.22 (6.94) 

5.70 (5.54) 

1.53 (1.20)  

- 

6.86 (9.24) 

11.32 (12.47) 

12.49 (19.50) 

.11 (.44) 

-.86** 
-.05 

-.10 
.19* 

- 

-.10 

 
- 

70.62 (22.67) 

.09 (.54) 

Table 2: 

Correlations and Means for Infant Touch  

1 
- 

.06 

7 
 

- 

5 
 

 

 

 

6 
 

 

 

 

 
- 

8 
 

4 
 

 

 

- 

.16* 

.33** 

3 
 

 

- 

.12 

.46** 

.24** 

2 
 

- 

 
1. Pregnancy 
IPV 
2. Postpartum 
IPV 
3. Pregnancy 
Depression 
4. Postpartum 
Depression 
5. Dem Risk 
6. Baby 
Biological Sex 
7. Affectionate 
Touch  
8. Instrumental 
Touch 
9. Passive Touch 
10. Negative 
Touch 
11. No Touch 
Note. * indicates p is significant at < 0.05, ** indicates p is significant at < .001 

.28** 
.07 

.32** 
.05 

.32** 
-.15* 

.08 
-.17* 

.16* 
-.13 

-.09 
.09 

-.11 
.02 

.07 
-.03 

.00 
.06 

.01 
.09 

.04 
.08 

.00 
.07 

-.55** 

-.64** 

.17* 

-.01 

 

 

 

 
 

 

-.08 

.03 

-.08 

.04 

.40** 

 

 

 

 
 

-.01 

.05 

.00 

.00 

.00 

.08 

-.02 

.06 

- 

-.02 

-.04 

.05 

.02 

-.07 

9 
 

 

 

 

 
 

 

 

- 
.11 

10 
 

11 
 

Mean (SD) 
3.59 (8.73) 

 

 

 

 
 

 

 

 
- 

 

 

 

 
 

 

 

 
 

2.87 (8.53 

10.22 (6.94) 

5.70 (5.54) 

1.53 (1.20)  

- 

2.29 (5.54) 

2.33 (4.00) 

9.10 (13.18) 
.37 (1.45) 

-.90** 

-.19* 

- 

82.53 (16.60) 

- 

 

 

 

 

111 

8 
 
 
 

 

 
 

 

- 

.08 

9 
 
 
 

 

 
 

 

 

- 

Mean (SD) 
3.59 (8.73) 
2.87 (8.53 
10.22 (6.94) 

5.70 (5.54) 

1.53 (1.20)  

- 

12.09 (17.60) 

.05 (.26) 

1.98 (2.04) 

Table 3: 

Correlations and Means for Maternal Touch Response to Infant Touch 

1 
- 

.16* 

.03 

.12 

.46** 

3 
 
 
- 

7 
 
 
 

5 
 
 
 

 

- 

4 
 
 
 

- 

.24** 
.33** 

2 
 
- 
.06 

 
1. Pregnancy IPV 
2. Postpartum IPV 
3. Pregnancy 
Depression 
4. Postpartum 
Depression 
5. Dem Risk 
6. Baby Biological 
Sex 
7. Positive/Neutral 
Touch Response  
9. Negative Touch 
Response 
10. No Touch 
Response 
Note. * indicates p is significant at < 0.05, ** indicates p is significant at < .001 

.32** 
-.15* 

.08 
-.17* 

.16* 
-.13 

.16* 

.19* 

-.01 

-.02 

6 
 
 
 

 

 
- 

.02 

.08 

.07 
-.03 

-.01 

-.05 

-.03 

-.06 

-.07 

.07 

-.09 

.23** 

-.06 

-.06 

-.02 

 

 
 

- 

.09 

.11 

-.02 

 

 

 

 

112 

8 
 
 
 

 

 
 

 

- 

9 
 
 
 

 

 
 

 

 

Mean (SD) 
3.59 (8.73) 
2.87 (8.53 
10.22 (6.94) 

5.70 (5.54) 

1.53 (1.20)  

- 

25.87 (30.01) 

.86 (2.70) 

.19** 

- 

4.10 (3.74) 

Table 4: 

Correlations and Means for Infant Touch Response to Maternal Touch 

1 
- 

.05 

.16* 

3 
 
 
- 

.12 

.46** 

5 
 
 
 

 

- 

4 
 
 
 

- 

.24** 
.33** 

2 
 
- 
.06 

 
1. Pregnancy IPV 
2. Postpartum IPV 
3. Pregnancy 
Depression 
4. Postpartum 
Depression 
5. Dem Risk 
6. Baby Biological 
Sex 
7. Positive/Neutral 
Touch Response  
8. Negative Touch 
Response 
9. No Touch 
Response 
Note. * indicates p is significant at < 0.05, ** indicates p is significant at < .001 

.32** 
-.15* 

.08 
-.17* 

.16* 
-.13 

6 
 
 
 

 

 
- 

.03 

.08 

.04 

.06 

.07 

.00 

-.15* 

-.14 

.03 

.04 

.03 

.02 

.07 
-.03 

7 
 
 
 

 

 
 

- 

-.09 

.03 

-.05 

-.02 

-.06 

-.01 

.28** 

.23** 

 

 

 

 

113 

Table 5: 

Correlations between Mother and Infant Touch  

 

Aff Touch Baby 

Ins Touch Baby 

Pas Touch Baby 

Neg Touch Baby 

No Touch Baby 

Aff Touch Mom 

Ins Touch Mom 

Pas Touch Mom 

Neg Touch Mom 

No Touch Mom 

.47** 

.40** 

.38** 

.04 

-.41** 

.37** 

.19* 

.21** 

.03 

-.29** 

.35** 

.31** 

.54** 

.15* 

-.55** 

Note. * indicates p is significant at < 0.05, ** indicates p is significant at < .001 

.17* 

.32** 

-.01 

.10 

-.19* 

-.49** 

-.42** 

-.56** 

-.14 

.61** 

 

 

 

 

 

 

114 

Table 6: 

Correlations between IPV, Depression, and WMCI Subscales 

 

1. Pregnancy IPV 

2. Postpartum IPV 

3. Pregnancy 
Depression 
4. Postpartum 
Depression 
5. Dem Risk 

6. Baby Biological 
Sex 
7. Richness of 
Perceptions  
8. Intensity of 
Involvement 
9. Coherence 

10. Caregiving 
Sensitivity 
11. Acceptance 

1 

- 

.24** 

.33** 

.16* 

.32** 

-.15* 

-.18* 

-.18* 

-.12 

-.23** 

-.24** 

2 

 

- 

.06 

.12 

.08 

-.17* 

-.07 

-.04 

.06 

-.13 

-.02 

3 

 

 

- 

.46** 

.16* 

-.13 

4 

 

 

 

- 

5 

 

 

 

 

.07 

-.03 

- 

-.02 

6 

 

 

 

 

 

- 

 

 

 

 

 

 

7 

8 

9 

10 

11 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

- 

 

 

 

 

 

 

 

 

 

.57** 

- 

 

 

 

 

 

 

 

 

 

 

-.17* 

-.02 

-.32** 

.05 

- 

-.19* 

-.02 

-.33** 

-.01 

.70** 

- 

-.17* 

-.34** 

-.03 

-.14 

-.34** 

-.42** 

-.36** 

-.06 

-.44** 

.00 

.08 

.07 

.39** 

.51** 

.47** 

.57** 

.52** 

.63** 

.61* 

.74** 

- 

Note. * indicates p is significant at < 0.05, ** indicates p is significant at < .001 

 

 

 

115 

Table 7: 

Correlations between WMCI Subscales and Maternal Touch 

 

1. Richness of 
Perceptions  
2. Intensity of 
Involvement 
3. Coherence 

4. Caregiving 
Sensitivity 
5. Acceptance 

1 

- 

.70** 

.39** 

.51** 

2 

 

- 

.47** 

.57** 

3 

 

 

- 

.57** 

4 

 

 

 

- 

.52** 

.63** 

.61** 

.74** 

6. Affectionate Touch 

7. Instrumental 
Touch  
8. Passive Touch 

9. Negative Touch 

10. No Touch 

.18* 

.17* 

.10 

-.12 

-.15* 

.13 

.06 

.06 

-.11 

-.07 

.03 

-.03 

.07 

-.04 

-.01 

.10 

.10 

.16* 

-.04 

-.14 

5 

 

 

 

 

- 

.15* 

.12 

.08 

-.03 

-.12 

6 

 

 

 

 

 

- 

 

 

 

 

 

 

.41** 

- 

.31** 

.39** 

.01 

.12 

- 

.06 

-.58** 

-.72** 

-.86** 

7 

8 

9 

10 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

- 

-.10 

 

 

 

 

 

 

 

 

 

- 

Note. * indicates p is significant at < 0.05, ** indicates p is significant at < .001 

 

 

 

 

116 

Table 8: 

Percentage of Initiated Touch Behavior that Received a Touch Response 

Initiated Touch 

Percentage Receiving Other Touch Response  

Maternal Affectionate Touch 

Maternal Instrumental Touch 

Maternal Passive Touch 

Maternal Negative Touch 

Infant Affectionate Touch 

Infant Instrumental Touch  

Infant Passive Touch 

Infant Negative Touch 

 

 

 

 

 

79.15% 

85.89% 

91.72% 

65.00% 

93.48% 

94.57% 

82.45% 

70.77% 

 

117 

Table 9a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and continuous pregnancy IPV and depression on 
affectionate touch  

 

Estimate 

Standard Error 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

4.833 

2.407 

.144 

-.105 

-.025 

.099 

-.056 

.391 

.194 

.007 

.111 

-.011 

.094 

.483 

.310 

.064 

.075 

.483 

.040 

.048 

.310 

.062 

.076 

.040 

.048 

.373 

df 

167 

168 

171 

167 

167 

168 

168 

168 

167 

168 

168 

168 

167 

t 

10.00 

7.75 

2.26 

-1.40 

-.05 

2.50 

-1.16 

1.26 

3.13 

.09 

2.79 

-.23 

.25 

p 

.000 

.000 

.025 

.164 

.959 

.013 

.248 

.209 

.002 

.931 

.006 

.815 

.801 

 

 

 

 

118 

Table 9b: 

Estimating separate role effects for mother and infants testing the effects of infant sex and continuous pregnancy IPV and depression 
on affectionate touch 

Role: Mother 

Role: Baby 

p 

.000 

.001 

.135 

.596 

.001 

.965 

Estimate (SE) 

t(df) 

2.426 (.429) 

5.66 (167) 

.04 (.06) 

-.049 (.067) 

-.416 (.429) 

.083 (.055) 

.018 (.067) 

.78 (167) 

-.74 (167) 

-.97 (167) 

1.51 (167) 

.27 (167) 

p 

.000 

.435 

.462 

.334 

.132 

.791 

 

 

Role 

Role x IPV 

Role x Dep 

Estimate (SE) 

t(df) 

7.241 (.690) 

10.50(167) 

.243 (.090) 

2.72 (173) 

-.161 (.107) 

-1.5 (168) 

Role x Infant Sex 

.366 (.690) 

.53 (167) 

Role x IPV x Infant Sex 

.305 (.088) 

3.45 (167) 

Role x Dep x Infant Sex 

-.005 (.107) 

-.04 (169) 

 

 

 

 

 

 

 

119 

Table 9c: 

Estimating separate effect estimates for mothers with male versus female infants for continuous pregnancy IPV and depression on 
affectionate touch 

 

Role: Mother 

 

Role: Baby 

Sex: Boy 

Sex: Girl 

Sex: Boy 

Sex: Girl 

 

Est (SE) 

t(df) 

p 

Est (SE) 

t(df) 

p 

Est (SE) 

t(df) 

p 

Est 
(SE) 

2.842 
(.611) 

-.039     
(.065) 

-.067 
(.083) 

t(df) 

p 

4.65 
(167) 

-.59 
(167) 

-.81 
(167) 

.000 

.555 

.419 

 

 

 

Sex 

IPV x Role 
x Sex 

Dep x Role 
x Sex 

7.607 
(.969) 

.549 
(.146) 

-.165 
(.168) 

7.85 (167) 

.000 

3.77 (169) 

.000 

-.98 (169) 

.326 

6.875 
(.982) 

-.062 
(.103) 

-.156 
(.133) 

7.00 
(167) 

-.60 
(173) 

-1.17 
(167) 

.000 

.549 

.243 

2.010 
(.603) 

.128 
(.091) 

-.031 
(.105) 

3.33 
(167) 

1.41 
(167) 

-.30 
(167) 

.001 

.162 

.766 

 

 

 

 

 

 

120 

Table 10a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and continuous postpartum IPV and depression on 
affectionate touch 

 

Estimate 

Standard Error 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

4.561 

2.300 

-.054 

-.113 

-.200 

-.028 

-.030 

.272 

-.012 

-.032 

.013 

-.005 

.177 

.504 

.322 

.078 

.090 

.504 

.049 

.057 

.322 

.077 

.090 

.049 

.057 

.358 

df 

167 

168 

168 

167 

167 

168 

168 

168 

167 

168 

168 

168 

167 

t 

9.06 

7.13 

-.69 

-1.26 

-.40 

-.56 

-.52 

.84 

-.15 

-.35 

.26 

-.09 

.50 

p 

.000 

.000 

.491 

.208 

.692 

.575 

.607 

.400 

.878 

.726 

.793 

.926 

.621 

 

 

 

 

121 

 

Table 11a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and categorical pregnancy IPV and depression on 
affectionate touch 

F 

54.556 

45.475 

.130 

.238 

.029 

.058 

.017 

1.820 

.242 

2.353 

1.317 

.019 

.239 

df 

181 

168 

172 

168 

166 

168 

168 

168 

166 

167 

168 

168 

164 

 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

 

 

 

p 

.000 

.000 

.719 

.627 

.864 

.810 

.897 

.179 

.624 

.127 

.253 

.890 

.916 

122 

Table 12a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and categorical postpartum IPV and depression on 
affectionate touch 

 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

F 

24.976 

22.326 

.004 

2.322 

.183 

1.386 

.144 

.667 

.164 

.123 

1.314 

.200 

.349 

df 

181 

168 

169 

169 

165 

168 

168 

168 

167 

166 

168 

168 

164 

 

 

 

 

p 

.000 

.000 

.952 

.137 

.669 

.241 

.705 

.415 

.686 

.726 

.253 

.655 

.844 

123 

Table 13a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and continuous pregnancy IPV and depression on negative 
touch 

 

Estimate 

Standard Error 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

.264 

-.147 

.009 

.006 

.067 

-.007 

-.012 

-.105 

.007 

.014 

-.007 

-.011 

.061 

.059 

.056 

.008 

.009 

.059 

.007 

.009 

.056 

.008 

.009 

.007 

.009 

.029 

df 

167 

168 

173 

168 

167 

168 

168 

168 

167 

169 

168 

168 

167 

t 

4.46 

-2.62 

1.19 

.64 

1.13 

-.93 

-1.36 

-1.88 

.87 

1.51 

-1.03 

-1.28 

2.09 

p 

.000 

.010 

.237 

.526 

.259 

.354 

.176 

.062 

.386 

.134 

.305 

.203 

.038 

 

 

 

 

124 

Table 14a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and continuous postpartum IPV and depression on negative 
touch 

 

Estimate 

Standard Error 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

.269 

-.145 

.013 

.014 

.071 

-.010 

-.012 

-.103 

.017 

.011 

-.011 

-.008 

.061 

.059 

.057 

.009 

.011 

.059 

.009 

.010 

.057 

.009 

.011 

.009 

.010 

.028 

df 

167 

168 

168 

168 

167 

168 

168 

168 

168 

168 

168 

168 

167 

t 

4.53 

-2.55 

1.41 

1.33 

1.19 

-1.19 

-1.21 

-1.81 

1.88 

1.02 

-1.30 

-.82 

2.22 

p 

.000 

.012 

.160 

.185 

.235 

.237 

.228 

.072 

.062 

.310 

.197 

.413 

.028 

 

 

 

 

125 

Table 15a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and categorical pregnancy IPV and depression on negative 
touch 

 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x Infant Sex x IPV 

Role x Infant Sex x Depression 

Demographic Risk 

F 

18.186 

8.900 

1.763 

.401 

2.672 

1.540 

1.506 

6.365 

1.581 

1.304 

4.314 

.066 

2.813 

df 

191 

168 

175 

170 

168 

168 

168 

168 

168 

169 

168 

168 

164 

 

 

 

 

p 

.000 

.003 

.186 

.528 

.104 

.216 

.222 

.013 

.210 

.255 

.039 

.798 

.027 

126 

Table 15b: 

Estimated marginal means for the effects of role, infant sex, and categorical pregnancy IPV and depression on negative touch  

 

Mean 

Standard Error 

df 

177 

166 

175 

171 

166 

165 

175 

170 

172 

169 

166 

165 

165 

164 

95% CI 

[.225, .694] 

[.024, .188] 

[-.109, .523] 

[.371, 1.054] 

[.046, .259] 

[-.051, .170] 

[-.145, .653] 

[-.349, .669] 

[-.041, .691] 

[.488, 1.712] 

[-.043, .229] 

[.051, .373] 

[-.025, .214] 

[-.168, .217] 

.119 

.042 

.160 

.173 

.054 

.056 

.202 

.258 

.185 

.310 

.069 

.081 

.061 

.097 

127 

 

Role 

Baby 

Mother 

Role x Infant Sex 

Infant - Female 

Infant - Male 

Mother - Female 

Mother - Male 

Infant - Female - No 

Infant - Female - Yes 

Infant - Male - No 

Role x Infant Sex x 
IPV 

.460 

.106 

.207 

.712 

.153 

.060 

.254 

.160 

.325 

Infant - Male - Yes 

1.100 

Mother - Female - No 

Mother - Female - Yes 

Mother - Male - No 

Mother - Male - Yes 

.093 

.212 

.095 

.025 

 

 

 

 

 

 

Table 16a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and categorical postpartum IPV and depression on negative 
touch 

 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

F 

20.999 

9.633 

6.899 

.283 

5.219 

3.162 

.401 

6.858 

6.823 

.062 

5.131 

.222 

2.756 

df 

190 

168 

172 

171 

167 

168 

168 

168 

169 

168 

168 

168 

164 

 

 

 

 

p 

.000 

.002 

.009 

.596 

.024 

.077 

.527 

.010 

.010 

.804 

.025 

.638 

.030 

128 

Table 16b: 

Estimated marginal means for the effects of role, infant sex, and categorical postpartum IPV and depression on negative touch 

 

 

Mean 

Standard Error 

Role 

IPV 

Infant Sex 

 

Baby 

Mother 

No 

Yes 

Female 

Male 

Role x Infant Sex 

Infant - Female 

Infant - Male 

Mother - Female 

Mother - Male 

IPV x Infant Sex 

Male - No 

Male - Yes 

Female - No 

Female - Yes 

Role x Infant Sex x 
IPV 

Infant - Female - No 

.612 

.145 

.198 

.559 

.199 

.558 

.236 

.989 

.163 

.127 

.197 

.202 

.200 

.916 

.265 

 

 

Infant - Female - Yes 

.206 

129 

.149 

.052 

.084 

.127 

.104 

.123 

.190 

.227 

.063 

.074 

.120 

.150 

.114 

.199 

.220 

.279 

df 

177 

167 

184 

182 

181 

178 

173 

172 

166 

166 

180 

174 

173 

176 

172 

170 

95% CI 

[.318, .907] 

[.042, .248] 

[.033, .364] 

[.309, .808] 

[-.006, .404] 

[.315, .801] 

[-.140, .612] 

[.541, 1.436] 

[.038, .288] 

[-.019, .273] 

[-.039, .433] 

[-.095, .498] 

[-.025, .424] 

[.524, 1.308] 

[-.169, .699] 

[-.344, .757] 

Table 16b (cont’d) 

 

Infant - Male - No 

Infant - Male - Yes 

Mother - Female - No 

Mother - Female - Yes 

Mother - Male - No 

Mother - Male - Yes 

 

 

 

 

 

 

 

 

 

 

 

 

.367 

1.610 

.129 

.197 

.032 

.119 

 

.211 

.367 

.073 

.089 

.067 

.119 

 

170 

171 

166 

165 

165 

165 

 

[-.050, .784] 

[.885, 2.335] 

[-.015, .272] 

[.021, .373] 

[-.100 .165] 

[-.013, .456] 

130 

Table 17a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and continuous pregnancy IPV and depression on intrusive 
touch 

 

Estimate 

Standard Error 

Intercept 

IPV 

Depression 

Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Demographic Risk 

.269 

.006 

.023 

.079 

.000 

-.004 

-.066 

.075 

.010 

.011 

.075 

.010 

.012 

.066 

df 

167 

167 

167 

167 

167 

167 

167 

t 

3.62 

.61 

1.98 

1.06 

-.04 

-.37 

-1.01 

p 

.000 

.541 

.049 

.292 

.965 

.712 

.316 

 

 

 

 

 

131 

Table 18a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and continuous postpartum IPV and depression on intrusive 
touch 

 

Estimate 

Standard Error 

Intercept 

IPV 

Depression 

Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Demographic Risk 

.293 

.002 

.039 

.058 

.013 

-.007 

-.044 

.074 

.011 

.013 

.074 

.011 

.013 

.062 

df 

167 

167 

167 

167 

167 

167 

167 

t 

3.94 

.16 

2.96 

.78 

1.15 

-.51 

-.71 

p 

.000 

.877 

.004 

.435 

.250 

.610 

.476 

 

 

 

 

 

132 

Table 19a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and categorical pregnancy IPV and depression on intrusive 
touch 

 

Intercept 

IPV 

Depression 

Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Demographic Risk 

F 

7.884 

3.336 

.164 

2.010 

.279 

.160 

1.322 

df 

164 

164 

164 

164 

164 

164 

164 

 

 

 

 

 

p 

.000 

.070 

.686 

.158 

.598 

.690 

.264 

133 

Table 20a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and categorical postpartum IPV and depression on intrusive 
touch 

 

Intercept 

IPV 

Depression 

Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Demographic Risk 

F 

7.525 

.112 

1.873 

.656 

1.094 

.809 

.949 

df 

164 

164 

164 

164 

164 

164 

164 

 

 

 

 

 

 

 

 

 

 

p 

.007 

.739 

.173 

.419 

.297 

.370 

.437 

134 

Table 21a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and continuous pregnancy IPV and depression on no touch 

 

Estimate 

Standard Error 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

75.902 

-6.093 

-.316 

.195 

-.845 

-.179 

.261 

-.599 

-.385 

-.219 

-.161 

.060 

.264 

1.345 

.690 

.178 

.209 

1.346 

.088 

.107 

.690 

.173 

.211 

.088 

.107 

1.116 

df 

167 

168 

169 

167 

167 

168 

168 

168 

167 

168 

168 

168 

167 

t 

56.43 

-8.83 

-1.78 

.93 

-.63 

-2.03 

2.45 

-.87 

-2.23 

-1.04 

-1.82 

.56 

.24 

p 

.000 

.000 

.077 

.353 

.531 

.044 

.015 

0386 

.027 

.300 

.071 

.577 

.813 

 

 

 

 

 

135 

Table 21b: 

Estimating separate effects for mothers and infants testing the effects of infant sex and continuous pregnancy IPV and depression on 
no touch 

Role: Mother 

Role: Baby 

 

 

Role 

Role x IPV 

Role x Dep 

Estimate (SE) 

t(df) 

69.808 (1.711) 

40.79(167) 

-.496 (.224) 

-2.21 (173) 

.456 (.266) 

1.72 (168) 

p 

.000 

.028 

.088 

.400 

.014 

.551 

Estimate (SE) 

t(df) 

81.995 (1.281) 

63.99 (167) 

-.137 (.170) 

-.067 (.199) 

-.246 (1.282) 

-.224 (.164) 

-.279 (.201) 

-.81 (167) 

-.33 (167) 

-.19 (167) 

-1.36 (167) 

-1.39 (167) 

p 

.000 

.422 

.738 

.848 

.174 

.167 

136 

Role x Infant Sex 

-1.445 (1.712) 

-.84 (167) 

Role x IPV x Infant Sex 

-.546 (.219) 

-2.49 (167) 

Role x Dep x Infant Sex 

-.159 (.267) 

-.60 (169) 

 

 

 

 

Table 22a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and continuous postpartum IPV and depression on no touch  

 

Estimate 

Standard Error 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

76.625 

-5.904 

.170 

.259 

-.357 

.059 

.138 

-.507 

.059 

-.398 

.047 

-.173 

-.115 

1.381 

.708 

.213 

.247 

1.381 

.109 

.126 

.708 

.212 

.248 

.109 

.126 

1.071 

df 

167 

168 

167 

167 

167 

168 

168 

168 

167 

167 

168 

168 

167 

t 

55.49 

-8.34 

.80 

1.05 

-.26 

.54 

1.10 

-.72 

.28 

-1.20 

.43 

-1.38 

-.11 

p 

.000 

.000 

.427 

.295 

.797 

.590 

.275 

.475 

.780 

.230 

.666 

.171 

.915 

 

 

 

 

 

137 

Table 23a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and categorical pregnancy IPV and depression on no touch 

 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

F 

2093.338 

62.988 

.159 

.102 

.234 

.128 

3.109 

.221 

.626 

3.598 

.618 

.837 

.653 

df 

173 

168 

168 

166 

165 

168 

168 

168 

165 

166 

168 

168 

164 

 

 

 

 

 

p 

.000 

.000 

.690 

.750 

.629 

.721 

.080 

.639 

.430 

.060 

.433 

.362 

.625 

138 

Table 24a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and categorical postpartum IPV and depression on no touch 

 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

F 

1354.963 

32.693 

.014 

.409 

.405 

.034 

1.809 

2.525 

.879 

.783 

.070 

Role x Depression x Infant Sex 

2.488 

Demographic Risk 

.895 

df 

173 

168 

167 

166 

164 

168 

168 

168 

165 

165 

168 

168 

164 

 

 

 

 

 

p 

.000 

.000 

.907 

.523 

.526 

.854 

.180 

.114 

.350 

.378 

.792 

.117 

.468  

139 

Table 25: 

Maternal representations mediating the relationship between continuous IPV/depression and affectionate touch 

 

Path: Predictor           Mediator 

Pregnancy IPV -> Maternal Reps 

Postpartum IPV -> Maternal Reps 

Pregnancy Depression -> Maternal Reps 

Postpartum Depression -> Maternal Reps 

Path: Mediator            Outcome 

b 

 

-.001 

.000 

-.026 

.010 

 

SE of b 

 

.005 

.004 

.007 

.007 

 

Maternal Reps -> Affectionate Touch 

3.613 

1.780 

Path: Predictor           Outcome (Direct) 

Pregnancy IPV -> Affectionate Touch 

Postpartum IPV -> Affectionate Touch 

Pregnancy Depression -> Affectionate Touch 

Postpartum Depression -> Affectionate Touch 

Path: Predictor           Outcome (Indirect) 

Pregnancy IPV -> Affectionate Touch 

Postpartum IPV -> Affectionate Touch 

Pregnancy Depression -> Affectionate Touch 

Postpartum Depression -> Affectionate Touch 

 

 

 

.176 

-.112 

-.026 

-.141 

 

-.005 

-.001 

-.095 

.038 

 

140 

 

.088 

.083 

.125 

.141 

 

.017 

.016 

.051 

.032 

 

β 

 

-.021 

-.002 

-.346 

.110 

 

.206 

 

.166 

-.103 

-.019 

-.085 

 

-.004 

-.001 

-.071 

.023 

 

p 

 

.785 

.972 

.000 

.154 

 

.042 

 

.047 

.181 

.837 

.315 

 

.786 

.972 

.062 

.238 

 

Table 25 (cont’d) 
 
Control Variables 

Demographic Risk -> Maternal Reps 

Infant Sex -> Maternal Reps 

Demographic Risk -> Affectionate Touch 

Infant Sex -> Affectionate Touch 

-.194 

.014 

.529 

.221 

.038 

.072 

.690 

1.395 

-.441 

.014 

.068 

.012 

.000 

.843 

.443 

.874 

Model fit: Free parameters = 31; Χ² = 27.5777, DF = 32, p = .690; RMSEA = .000; CFI = 1.000; R² = .064, p = .088 

 

 

 

 

 

 

141 

Table 26: 

Maternal representations mediating the relationship between categorical IPV/depression and affectionate touch 

 

Path: Predictor           Mediator 

Pregnancy IPV -> Maternal Reps 

Postpartum IPV -> Maternal Reps 

Pregnancy Depression -> Maternal Reps 

Postpartum Depression -> Maternal Reps 

Path: Mediator            Outcome 

b 

 

-.010 

.020 

-.306 

.099 

 

Maternal Reps -> Affectionate Touch 

3.942 

Path: Predictor           Outcome (Direct) 

Pregnancy IPV -> Affectionate Touch 

Postpartum IPV -> Affectionate Touch 

Pregnancy Depression -> Affectionate Touch 

Postpartum Depression -> Affectionate Touch 

Path: Predictor           Outcome (Indirect) 

Pregnancy IPV -> Affectionate Touch 

Postpartum IPV -> Affectionate Touch 

Pregnancy Depression -> Affectionate Touch 

Postpartum Depression -> Affectionate Touch 

 

 

 

.897 

-1.168 

1.552 

-2.618 

 

-.041 

.078 

1.208 

.391 

 

142 

SE of b 

 

.094 

.093 

.088 

.096 

 

1.770 

 

1.795 

1.788 

1.662 

1.837 

 

.369 

.369 

.621 

.414 

 

β 

 

-.009 

.016 

-.292 

.076 

 

.224 

 

.046 

-.055 

.084 

-.114 

 

-.002 

.004 

-.066 

.017 

 

p 

 

.911 

.833 

.000 

.301 

 

.026 

 

.617 

.513 

.350 

.154 

 

.911 

.833 

.052 

.344 

 

Table 26 (cont’d) 
 
Control Variables 

Demographic Risk -> Maternal Reps 

Infant Sex -> Maternal Reps 

Demographic Risk -> Affectionate Touch 

Infant Sex -> Affectionate Touch 

-.193 

.043 

.750 

.129 

.038 

.073 

.698 

1.397 

-.439 

.041 

.097 

.007 

.000 

.558 

.283 

.926 

Model fit: Free parameters = 31; Χ² = 27.611, DF = 32, p = .689; RMSEA = .000; CFI = 1.000; R² = .045, p = .170  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

143 

Table 27: 

Maternal representations mediating the relationship between continuous IPV/depression and instrumental touch 

 

Path: Predictor           Mediator 

Pregnancy IPV -> Maternal Reps 

Postpartum IPV -> Maternal Reps 

Pregnancy Depression -> Maternal Reps 

Postpartum Depression -> Maternal Reps 

Path: Mediator            Outcome 

b 

 

-.001 

.000 

-.026 

.010 

 

SE of b 

 

.005 

.004 

.007 

.007 

 

Maternal Reps -> Instrumental Touch 

3.582 

2.366 

Path: Predictor           Outcome (Direct) 

Pregnancy IPV -> Instrumental Touch 

Postpartum IPV -> Instrumental Touch 

Pregnancy Depression -> Instrumental Touch 

Postpartum Depression -> Instrumental Touch 

Path: Predictor           Outcome (Indirect) 

Pregnancy IPV -> Instrumental Touch 

Postpartum IPV -> Instrumental Touch 

Pregnancy Depression -> Instrumental Touch 

Postpartum Depression -> Instrumental Touch 

 

 

 

.303 

-.167 

-.222 

-.036 

 

-.004 

-.001 

-.094 

-.037 

 

144 

 

.119 

.112 

.168 

.189 

 

.017 

.016 

.065 

.036 

 

β 

 

-.021 

-.003 

-.346 

.109 

 

.151 

 

.212 

-.114 

-.123 

-.016 

 

-.003 

.000 

-.052 

.016 

 

p 

 

.787 

.964 

.000 

.157 

 

.130 

 

.011 

.136 

.187 

.849 

 

.790 

.964 

.150 

.297 

 

Table 27 (cont’d) 
 
Control Variables 

Demographic Risk -> Maternal Reps 

Infant Sex -> Maternal Reps 

Demographic Risk -> Instrumental Touch 

Infant Sex -> Instrumental Touch 

-.194 

.014 

.791 

-.590 

.038 

.072 

.927 

1.874 

-.441 

.013 

.076 

-.024 

.000 

.848 

.394 

.753 

Model fit: Free parameters = 31; Χ² = 31.559, DF = 32, p = .489; RMSEA = .000; CFI = 1.000; R² = .070, p = .065 

 

 

 

 

 

145 

Table 28: 

Maternal representations mediating the relationship between categorical IPV/depression and instrumental touch 

 

Path: Predictor           Mediator 

Pregnancy IPV -> Maternal Reps 

Postpartum IPV -> Maternal Reps 

Pregnancy Depression -> Maternal Reps 

Postpartum Depression -> Maternal Reps 

Path: Mediator            Outcome 

b 

 

-.012 

.018 

-.307 

.099 

 

Maternal Reps -> Instrumental Touch 

3.769 

Path: Predictor           Outcome (Direct) 

Pregnancy IPV -> Instrumental Touch 

Postpartum IPV -> Instrumental Touch 

Pregnancy Depression -> Instrumental Touch 

Postpartum Depression -> Instrumental Touch 

Path: Predictor           Outcome (Indirect) 

Pregnancy IPV -> Instrumental Touch 

Postpartum IPV -> Instrumental Touch 

Pregnancy Depression -> Instrumental Touch 

Postpartum Depression -> Instrumental Touch 

 

 

 

6.121 

.795 

-3.120 

-.272 

 

-.045 

.069 

-1.155 

.375 

 

146 

SE of b 

 

.094 

.093 

.088 

.096 

 

2.326 

 

2.386 

2.376 

2.209 

2.441 

 

.354 

.354 

.771 

.427 

 

β 

 

-.011 

.015 

-.292 

.076 

 

.159 

 

.230 

.028 

-.125 

-.009 

 

-.002 

.002 

-.046 

.012 

 

p 

 

.900 

.845 

.000 

.300 

 

.105 

 

.010 

.738 

.158 

.911 

 

.900 

.846 

.134 

.381 

 

Table 28 (cont’d) 
 
Control Variables 

Demographic Risk -> Maternal Reps 

Infant Sex -> Maternal Reps 

Demographic Risk -> Instrumental Touch 

Infant Sex -> Instrumental Touch 

-.192 

.042 

.640 

.177 

.038 

.073 

.928 

1.856 

-.438 

.040 

.061 

.007 

.000 

.567 

.490 

.924 

Model fit: Free parameters = 31; Χ² = 32.504, DF = 32, p = .442; RMSEA = .010; CFI = .999; R² = .072, p = .062 

 

 

 

147 

Table 29: 

Maternal representations mediating the relationship between continuous IPV/depression and passive touch 

 

Path: Predictor           Mediator 

Pregnancy IPV -> Maternal Reps 

Postpartum IPV -> Maternal Reps 

Pregnancy Depression -> Maternal Reps 

Postpartum Depression -> Maternal Reps 

Path: Mediator            Outcome 

b 

 

-.001 

.000 

-.026 

.010 

 

SE of b 

 

.005 

.004 

.007 

.007 

 

Maternal Reps -> Passive Touch 

5.568 

3.793 

Path: Predictor           Outcome (Direct) 

Pregnancy IPV -> Passive Touch 

Postpartum IPV -> Passive Touch 

Pregnancy Depression -> Passive Touch 

Postpartum Depression -> Passive Touch 

Path: Predictor           Outcome (Indirect) 

Pregnancy IPV -> Passive Touch 

Postpartum IPV -> Passive Touch 

Pregnancy Depression -> Passive Touch 

Postpartum Depression -> Passive Touch 

 

 

 

.034 

-.126 

-.052 

-.346 

 

-.007 

-.001 

-.145 

.057 

 

148 

 

.189 

.178 

.268 

.301 

 

.026 

.024 

.104 

.055 

 

β 

 

-.020 

-.004 

-.345 

.108 

 

.150 

 

.015 

-.055 

-.018 

-.098 

 

-.003 

-.001 

-.052 

.016 

 

p 

 

.790 

.950 

.000 

.162 

 

.142 

 

.856 

.479 

.846 

.250 

 

.793 

.951 

.160 

.304 

 

Table 29 (cont’d) 
 
Control Variables 

Demographic Risk -> Maternal Reps 

Infant Sex -> Maternal Reps 

Demographic Risk -> Passive Touch 

Infant Sex -> Passive Touch 

-.194 

.014 

1.377 

-.810 

.038 

.072 

1.479 

2.986 

-.441 

.013 

.084 

-.021 

.000 

.849 

.352 

.786 

Model fit: Free parameters = 31; Χ² = 24.619, DF = 32, p = .821; RMSEA = .000; CFI = 1.000; R² = .035, p = .222 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

149 

Table 30: 

Maternal representations mediating the relationship between categorical IPV/depression and passive touch 

 

Path: Predictor           Mediator 

Pregnancy IPV -> Maternal Reps 

Postpartum IPV -> Maternal Reps 

Pregnancy Depression -> Maternal Reps 

Postpartum Depression -> Maternal Reps 

Path: Mediator            Outcome 

b 

 

-.012 

.018 

-.305 

.098 

 

Maternal Reps -> Passive Touch 

6.277 

Path: Predictor           Outcome (Direct) 

Pregnancy IPV -> Passive Touch 

Postpartum IPV -> Passive Touch 

Pregnancy Depression -> Passive Touch 

Postpartum Depression -> Passive Touch 

Path: Predictor           Outcome (Indirect) 

Pregnancy IPV -> Passive Touch 

Postpartum IPV -> Passive Touch 

Pregnancy Depression -> Passive Touch 

Postpartum Depression -> Passive Touch 

 

 

 

-1.709 

.959 

1.157 

-3.446 

 

-.075 

.115 

-1.914 

.615 

 

150 

SE of b 

 

.094 

.093 

.088 

.096 

 

3.753 

 

3.822 

3.806 

3.538 

3.910 

 

.590 

.589 

1.239 

.699 

 

β 

 

-.011 

.015 

-.291 

.075 

 

.169 

 

-.041 

.021 

.030 

-.071 

 

-.002 

.003 

-.049 

.013 

 

p 

 

.898 

.845 

.001 

.307 

 

.094 

 

.655 

.801 

.744 

.378 

 

.899 

.846 

.122 

.379 

 

Table 30 (cont’d) 
 
Control Variables 

Demographic Risk -> Maternal Reps 

Infant Sex -> Maternal Reps 

Demographic Risk -> Passive Touch 

Infant Sex -> Passive Touch 

-.192 

.042 

1.535 

-.490 

.038 

.073 

1.489 

2.974 

-.439 

.040 

.094 

-.013 

.000 

.567 

.303 

.869 

Model fit: Free parameters = 31; Χ² = 25.361, DF = 32, p = .791; RMSEA = .000; CFI = 1.000; R² = .026, p = .309 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

151 

Table 31: 

Maternal representations mediating the relationship between continuous IPV/depression and negative touch 

 

Path: Predictor           Mediator 

Pregnancy IPV -> Maternal Reps 

Postpartum IPV -> Maternal Reps 

Pregnancy Depression -> Maternal Reps 

Postpartum Depression -> Maternal Reps 

Path: Mediator            Outcome 

Maternal Reps -> Negative Touch 

Path: Predictor           Outcome (Direct) 

Pregnancy IPV -> Negative Touch 

Postpartum IPV -> Negative Touch 

Pregnancy Depression -> Negative Touch 

Postpartum Depression -> Negative Touch 

Path: Predictor           Outcome (Indirect) 

Pregnancy IPV -> Negative Touch 

Postpartum IPV -> Negative Touch 

Pregnancy Depression -> Negative Touch 

Postpartum Depression -> Negative Touch 

 

 

b 

 

-.001 

.000 

-.026 

.010 

 

.009 

 

.003 

-.002 

-.009 

.006 

 

.000 

.000 

.000 

.000 

 

152 

SE of b 

 

.005 

.004 

.007 

.007 

 

.084 

 

.004 

.004 

.006 

.007 

 

.000 

.000 

.002 

.001 

 

β 

 

-.020 

-.003 

-.346 

.109 

 

.011 

 

.056 

-.040 

-.135 

.072 

 

.000 

.000 

-.004 

.001 

 

p 

 

.788 

.962 

.000 

.159 

 

.911 

 

.508 

.600 

.151 

.395 

 

.918 

.965 

.911 

.911 

 

Table 31 (cont’d) 
 
Control Variables 

Demographic Risk -> Maternal Reps 

Infant Sex -> Maternal Reps 

Demographic Risk -> Passive Touch 

Infant Sex -> Passive Touch 

-.193 

.014 

.068 

-.085 

.038 

.072 

.033 

.067 

-.441 

.013 

.185 

-.096 

.000 

.845 

.039 

.205 

Model fit: Free parameters = 31; Χ² = 24.613, DF = 32, p = .821; RMSEA = .000; CFI = 1.000; R² = .054, p = .105 

 

 

 

 

 

 

 

 

 

 

 

153 

Table 32: 

Maternal representations mediating the relationship between categorical IPV/depression and negative touch 

 

Path: Predictor           Mediator 

Pregnancy IPV -> Maternal Reps 

Postpartum IPV -> Maternal Reps 

Pregnancy Depression -> Maternal Reps 

Postpartum Depression -> Maternal Reps 

Path: Mediator            Outcome 

Maternal Reps -> Negative Touch 

Path: Predictor           Outcome (Direct) 

Pregnancy IPV -> Negative Touch 

Postpartum IPV -> Negative Touch 

Pregnancy Depression -> Negative Touch 

Postpartum Depression -> Negative Touch 

Path: Predictor           Outcome (Indirect) 

Pregnancy IPV -> Negative Touch 

Postpartum IPV -> Negative Touch 

Pregnancy Depression -> Negative Touch 

Postpartum Depression -> Negative Touch 

 

 

b 

 

-.011 

.019 

-.305 

.098 

 

.018 

 

-.026 

.152 

-.099 

.014 

 

.000 

.000 

-.005 

.002 

 

154 

SE of b 

 

.093 

.093 

.088 

.096 

 

.082 

 

.085 

.084 

.078 

.087 

 

.002 

.002 

.025 

.008 

 

β 

 

-.010 

.016 

-.292 

.075 

 

.021 

 

-.028 

.150 

-.112 

.013 

 

.000 

.000 

-.006 

.002 

 

p 

 

.908 

.837 

.001 

.305 

 

.830 

 

.756 

.071 

.206 

.872 

 

.919 

.882 

.830 

.833 

 

Table 32 (cont’d) 
 
Control Variables 

Demographic Risk -> Maternal Reps 

Infant Sex -> Maternal Reps 

Demographic Risk -> Negative Touch 

Infant Sex -> Negative Touch 

-.192 

.042 

.073 

-.060 

.038 

.073 

.033 

.066 

-.439 

.041 

.198 

-.068 

.000 

.561 

.027 

.362 

Model fit: Free parameters = 31; Χ² = 25.384, DF = 32, p = .790; RMSEA = .000; CFI = 1.000; R² = .065, p = .072 

 

 

 

 

 

 

 

 

155 

Table 33: 

Maternal representations mediating the relationship between continuous IPV/depression and no touch 

 

Path: Predictor           Mediator 

Pregnancy IPV -> Maternal Reps 

Postpartum IPV -> Maternal Reps 

Pregnancy Depression -> Maternal Reps 

Postpartum Depression -> Maternal Reps 

Path: Mediator            Outcome 

b 

 

-.001 

.000 

-.026 

.010 

 

SE of b 

 

.005 

.004 

.007 

.007 

 

Maternal Reps -> No Touch 

-6.639 

4.341 

Path: Predictor           Outcome (Direct) 

Pregnancy IPV -> No Touch 

Postpartum IPV -> No Touch 

Pregnancy Depression -> No Touch 

Postpartum Depression -> No Touch 

Path: Predictor           Outcome (Indirect) 

Pregnancy IPV -> No Touch 

Postpartum IPV -> No Touch 

Pregnancy Depression -> No Touch 

Postpartum Depression -> No Touch 

 

 

 

-.359 

.270 

.239 

.303 

 

.008 

.002 

.174 

-.068 

 

156 

 

.218 

.205 

.308 

.346 

 

.031 

.029 

.119 

.065 

 

β 

 

-.020 

-.004 

-.346 

.109 

 

-.154 

 

-.138 

.101 

.073 

.074 

 

.003 

.001 

.053 

-.017 

 

p 

 

.788 

.958 

.000 

.159 

 

.126 

 

.099 

.189 

.437 

.380 

 

.791 

.958 

.146 

.295 

 

Table 33 (cont’d) 
 
Control Variables 

Demographic Risk -> Maternal Reps 

Infant Sex -> Maternal Reps 

Demographic Risk -> No Touch 

Infant Sex -> No Touch 

-.194 

.014 

-1.204 

-1.694 

.038 

.072 

1.699 

3.433 

-.441 

.013 

-.064 

-.037 

.000 

.849 

.478 

.622 

Model fit: Free parameters = 31; Χ² = 26.588, DF = 32, p = .737; RMSEA = .000; CFI = 1.000; R² = .056, p = .108 

 

 

 

 

 

 

 

157 

Table 34: 

Maternal representations mediating the relationship between categorical IPV/depression and no touch 

 

Path: Predictor           Mediator 

Pregnancy IPV -> Maternal Reps 

Postpartum IPV -> Maternal Reps 

Pregnancy Depression -> Maternal Reps 

Postpartum Depression -> Maternal Reps 

Path: Mediator            Outcome 

b 

 

-.012 

.018 

-.306 

.099 

 

Maternal Reps -> No Touch 

-7.463 

Path: Predictor           Outcome (Direct) 

 

Pregnancy IPV -> No Touch 

-2.430 

Postpartum IPV -> No Touch 

Pregnancy Depression -> No Touch 

Postpartum Depression -> No Touch 

Path: Predictor           Outcome (Indirect) 

Pregnancy IPV -> No Touch 

Postpartum IPV -> No Touch 

Pregnancy Depression -> No Touch 

Postpartum Depression -> No Touch 

 

 

-.809 

.478 

4.036 

 

.089 

-.136 

2.284 

-.739 

 

158 

SE of b 

 

.094 

.093 

.088 

.096 

 

4.329 

 

4.429 

4.410 

4.100 

4.531 

 

.701 

.700 

1.445 

.829 

 

β 

 

-.011 

.015 

-.292 

.076 

 

-.173 

 

-.050 

-.016 

.011 

.072 

 

.002 

-.003 

.050 

-.013 

 

p 

 

.899 

.845 

.000 

.302 

 

.085 

 

.583 

.854 

.907 

.373 

 

.899 

.846 

.114 

.373 

 

Table 34 (cont’d) 
 
Control Variables 

Demographic Risk -> Maternal Reps 

Infant Sex -> Maternal Reps 

Demographic Risk -> No Touch 

Infant Sex -> No Touch 

-.192 

.042 

-1.516 

-2.286 

.038 

.073 

1.723 

3.446 

-.438 

.040 

-.080 

-.051 

.000 

.567 

.379 

.507 

Model fit: Free parameters = 31; Χ² = 27.500, DF = 32, p = .694; RMSEA = .000; CFI = 1.000; R² = .033, p = .246 

 

 

 

 

 

 

 

 

 

 

159 

Table 35a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and continuous pregnancy IPV and depression on 
instrumental touch 

 

Estimate 

Standard Error 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

7.141 

4.824 

.170 

-.097 

.133 

.226 

-.162 

-.001 

.148 

.141 

.194 

.086 

-.040 

.516 

.447 

.067 

.080 

.516 

.057 

.069 

.447 

.066 

.080 

.057 

.069 

.275 

df 

167 

168 

173 

168 

167 

168 

168 

168 

168 

169 

168 

168 

167 

t 

13.83 

10.79 

2.53 

-1.21 

.26 

3.95 

-2.34 

.00 

2.24 

1.76 

3.39 

1.24 

-.15 

p 

.000 

.000 

.012 

.227 

.798 

.000 

.021 

.999 

.026 

.080 

.001 

.216 

.884 

 

 

160 

Table 35b: 

Estimating separate effects for mothers and infants testing the effects of infant sex and continuous pregnancy IPV and depression on 
instrumental touch  

Role: Mother 

Role: Baby 

 

 

Role 

Role x IPV 

Role x Dep 

Estimate (SE) 

t(df) 

11.965 (.914) 

13.09 (167) 

.396 (.118) 

3.37 (170) 

-.259 (.142) 

-1.83 (168) 

p 

.000 

.001 

.069 

.886 

.004 

.111 

Estimate (SE) 

t(df) 

2.317 (.313) 

7.41 (167) 

-.057 (.042) 

-1.37 (167) 

.065 (.049) 

.133 (.313) 

1.33 (167) 

.43 (167) 

-.046 (.040) 

-1.15 (167) 

.056 (.049) 

1.13 (167) 

p 

.000 

.173 

.186 

.670 

.251 

.259 

161 

Role x Infant Sex 

.132 (.914) 

.14 (168) 

Role x IPV x Infant Sex 

.343 (.117) 

2.93 (168) 

Role x Dep x Infant Sex 

.227 (.142) 

1.60 (168) 

 

 

 

 

 

 

Table 35c: 

Estimating separate effect estimates for mothers with male versus female infants for continuous pregnancy IPV and depression on 
instrumental touch 

 

Role: Mother 

 

Role: Baby 

Sex: Boy 

Sex: Girl 

Sex: Boy 

Sex: Girl 

 

Est (SE) 

t(df) 

p 

Est (SE) 

t(df) 

p 

Est 
(SE) 

2.450 
(.439) 

-.103 
(.066) 

.120 
(.077) 

t(df) 

p 

Est (SE) 

t(df) 

p 

5.58 
(167) 

-1.55 
(167) 

1.56 
(167) 

.000 

.123 

.120 

2.183 
(.445) 

-.011 
(.048) 

.009 
(.060) 

4.90 
(167) 

-.22 
(167) 

.000 

.824 

.15 (167) 

.880 

 

 

 

 

 

 

 

 

Sex 

IPV x Role x 
Sex 

Dep x Role x 
Sex 

12.097 
(1.284) 

.739 
(.192) 

-.032 
(.222) 

9.42 
(168) 

3.84 
(168) 

-.14 
(168) 

.000 

.000 

.887 

11.834 
(1.302) 

.053 
(.135) 

-.487 
(.176) 

.000 

.693 

.006 

9.09 
(168) 

.40 
(170) 

-2.76 
(168) 

 

162 

 

 

 

 

Table 36a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and continuous postpartum IPV and depression on 
instrumental touch 

 

Estimate 

Standard Error 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

6.847 

4.573 

-.023 

.010 

-.022 

-.033 

-.112 

-.204 

-.010 

.240 

.029 

.187 

-.098 

.535 

.476 

.082 

.095 

.535 

.073 

.085 

.476 

.082 

.096 

.073 

.085 

.257 

df 

167 

168 

168 

168 

167 

168 

168 

168 

168 

168 

168 

168 

167 

t 

12.80 

9.61 

-.28 

.10 

-.04 

-.46 

-1.32 

-.43 

-.13 

2.51 

.39 

2.20 

-.38 

p 

.000 

.000 

.782 

.917 

.967 

.650 

.190 

.669 

.899 

.013 

.696 

.029 

.704 

 

 

 

 

163 

Table 36b: 

Estimating separate effects for mothers and infants testing the effects of infant sex and continuous postpartum IPV and depression on 
instrumental touch  

Role: Mother 

Role: Baby 

 

 

Role 

Role x IPV 

Role x Dep 

Estimate (SE) 

t(df) 

11.420 (.964) 

11.85 (167) 

-.056 (.148) 

-.38 (168) 

-.102 (.172) 

-.59 (168) 

p 

.000 

.705 

.554 

.815 

.902 

.014 

Estimate (SE) 

t(df) 

2.274 (.312) 

7.29 (167) 

.010 (.048) 

.122 (.056) 

.181 (.312) 

-.039 (.048) 

.053 (.056) 

.22 (167) 

2.18 (167) 

.58 (167) 

-.81 (167) 

.95 (167) 

p 

.000 

.829 

.031 

.562 

.417 

.345 

164 

Role x Infant Sex 

-.226 (.964) 

-.23 (167) 

Role x IPV x Infant Sex 

.018 (.148) 

.12 (168) 

Role x Dep x Infant Sex 

.426 (.172) 

2.48 (168) 

 

 

 

 

 

Table 36c: 

Estimating separate effect estimates for mothers with male versus female infants for continuous postpartum IPV and depression on 
instrumental touch  

 

Role: Mother 

 

Role: Baby 

Sex: Boy 

Sex: Girl 

Sex: Boy 

Sex: Girl 

 

 

 

 

Est (SE) 

t(df) 

p 

Sex 

IPV x Role x Sex 

11.195 
(1.368) 

-.038 
(.268) 

Dep x Role x Sex 

.324 (.246) 

8.18 
(167) 

-.14 
(168) 

1.32 
(168) 

.000 

.888 

.190 

 

 

 

 

 

 

Est 
(SE) 

11.656 
(1.357) 

-.074 
(.126) 

-.528 
(.239) 

t(df) 

p 

Est (SE) 

t(df) 

p 

Est (SE) 

t(df) 

p 

.000 

.556 

.029 

8.58 
(167) 

-.59 
(168) 

-2.21 
(167) 

2.455 
(.443) 

-.029 
(.087) 

.175 
(.080) 

5.54 
(167) 

-.33 
(167) 

2.17 
(167) 

.000 

.743 

.031 

2.092 
(.439) 

.049 
(.041) 

.069 
(.078) 

.000 

.226 

.378 

4.76 
(167) 

1.22 
(167) 

.88 
(167) 

165 

Table 37a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and categorical pregnancy IPV and depression on 
instrumental touch 

 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

F 

146.713 

107.408 

6.804 

2.531 

.069 

8.138 

6.442 

.019 

.626 

11.156 

.070 

Role x Depression x Infant Sex 

6.722 

Demographic Risk 

.822 

 df 

192 

168 

175 

170 

168 

168 

168 

168 

168 

170 

168 

168 

164 

 

 

 

 

p 

.000 

.000 

.010 

.113 

.793 

.005 

.012 

.891 

.430 

.001 

.792 

.010 

.513 

166 

Table 37b: 

Estimated marginal means for the effects of role, infant sex, and categorical pregnancy IPV and depression on instrumental touch 

 

 

Mean 

Standard Error 

Role 

IPV 

Role x IPV 

Baby 

Mother 

No 

Yes 

Infant - No 

Infant - Yes 

Mother - No 

Mother - Yes 

Role x Depression 

Infant - No 

Infant - Yes 

Mother - No 

Mother - Yes 

Infant - No 

Infant - Yes 

Mother - No 

Mother - Yes 

 

Depression x Infant 
Sex 

 

 

1.980 

12.174 

5.508 

8.646 

1.918 

2.042 

9.098 

15.249 

1.613 

2.347 

14.286 

10.061 

9.637 

4.228 

6.263 

8.180 

 

.389 

1.007 

.685 

.968 

.461 

.613 

1.174 

1.712 

.540 

.490 

1.479 

1.332 

1.149 

1.031 

1.199 

1.079 

 

167 

df 

165 

180 

195 

178 

165 

165 

181 

172 

165 

165 

174 

175 

175 

178 

176 

173 

 

95% CI 

[1.211, 2.749] 

[10.186, 14.161] 

[4.158, 6.858] 

[6.735, 10.556] 

[1.008, 2.828] 

[.831, 3.253] 

[6.782, 11.413] 

[11.871, 18.628] 

[.548, 2.679] 

[1.380, 3.313] 

[11.367, 17.205] 

[7.432, 12.689] 

[7.369, 11.904] 

[2.193, 6.262] 

[3.897, 8.629] 

[6.050, 10.310] 

 

Table 37b (cont’d) 

 

 

Role x Depression x 
Infant Sex 

Infant - Female - No 

2.101 

Infant - Female - Yes 

Infant - Male - No 

Infant - Male - Yes 

1.704 

1.125 

2.989 

Mother - Female - No 

17.172 

Mother - Female - Yes 

6.751 

Mother - Male - No 

Mother - Male - Yes 

11.400 

13.371 

 

 

 

 

 

 

 

 

 

 

 

 

 

.722 

.655 

.754 

.671 

2.038 

1.820 

2.126 

1.924 

 

164 

165 

164 

164 

171 

173 

171 

170 

 

[.676, 3.527] 

[.412, 2.997] 

[-.364, 2.615] 

[1.664, 4.314] 

[13.148, 21.196] 

[3.158, 10.344] 

[7.205, 15.596] 

[9.573, 17.168] 

168 

Table 38a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and categorical postpartum IPV and depression on 
instrumental touch 

 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

F 

81.552 

51.250 

1.112 

.005 

1.376 

.872 

.360 

1.081 

.289 

4.181 

.257 

Role x Depression x Infant Sex 

2.954 

Demographic Risk 

.742 

df 

191 

168 

172 

171 

167 

168 

168 

168 

169 

168 

168 

168 

164 

 

 

 

 

p 

.000 

.000 

.293 

.944 

.242 

.352 

.549 

.300 

.591 

.042 

.613 

.088 

.565 

169 

Table 38b: 

Estimated marginal means for the effects of role, infant sex, and categorical postpartum IPV and depression on instrumental touch 

df 

165 

178 

181 

173 

177 

174 

95% CI 

[1.282, 3.213] 

[8.895, 14.129] 

[5.488, 9.181] 

[1.555, 7.913] 

[4.250, 8.413] 

[5.526, 12.714] 

 

 

Mean 

Standard Error 

Role 

Baby 

Mother 

Infant Sex x Depression  Female - No 

Female - Yes 

Male - No 

Male - Yes 

 

 

 

 

 

 

 

 

2.247 

11.512 

7.334 

4.734 

6.331 

9.120 

.489 

1.326 

.936 

1.611 

1.055 

1.821 

170 

Table 39a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and continuous pregnancy IPV and depression on passive 
touch  

 

Estimate 

Standard Error 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

11.140 

1.604 

.130 

-.144 

.083 

-.028 

-.163 

-.244 

.223 

.064 

.012 

-.120 

-.264 

1.117 

.644 

.147 

.174 

1.117 

.083 

.100 

.644 

.143 

.175 

.083 

.100 

.888 

df 

167 

168 

170 

167 

167 

168 

168 

168 

167 

168 

168 

168 

167 

t 

9.98 

2.49 

.88 

-.83 

.08 

-.34 

-1.64 

-.40 

1.56 

.37 

.14 

-1.20 

-.30 

p 

.000 

.014 

.378 

.407 

.941 

.733 

.103 

.705 

.122 

.714 

.889 

.231 

.767 

 

 

 

 

171 

Table 40a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and continuous postpartum IPV and depression on passive 
touch  

 

Estimate 

Standard Error 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

10.741 

1.590 

-.162 

-.289 

-.214 

-.028 

-.111 

-.114 

-.053 

.101 

-.075 

.036 

.081 

1.127 

.655 

.174 

.201 

1.127 

.100 

.117 

.655 

.173 

.202 

.100 

.117 

.845 

df 

167 

168 

167 

167 

167 

168 

168 

168 

167 

168 

168 

168 

167 

t 

9.53 

2.43 

-.93 

-1.44 

-.19 

-.28 

-.95 

-.17 

-.30 

.50 

-.75 

.31 

.10 

p 

.000 

.016 

.354 

.152 

.849 

.781 

.342 

.862 

.761 

.619 

.457 

.756 

.924 

 

 

 

 

172 

Table 41a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and categorical pregnancy IPV and depression on passive 
touch 

 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

F 

51.053 

4.187 

.214 

.001 

.000 

.180 

.908 

.605 

.273 

.531 

2.167 

.000 

.397 

df 

176 

168 

169 

166 

165 

168 

168 

168 

165 

166 

168 

168 

164 

 

 

 

 

p 

.000 

.042 

.644 

.978 

.991 

.672 

.342 

.438 

.602 

.467 

.143 

.982 

.811 

173 

Table 42a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and categorical postpartum IPV and depression on passive 
touch 

 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

F 

26.303 

1.896 

.532 

.339 

.010 

.302 

1.936 

.053 

.939 

.100 

.355 

.963 

.681 

df 

176 

168 

167 

167 

165 

168 

168 

168 

165 

165 

168 

168 

164 

 

 

 

 

p 

.000 

.170 

.467 

.561 

.919 

.584 

.166 

.819 

.334 

.752 

.552 

.328 

.606 

174 

Table 43a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and continuous pregnancy IPV and depression on 
positive/neutral touch response 

 

Estimate 

Standard Error 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

19.860 

-7.230 

.456 

-.400 

-.105 

-.262 

.397 

-.060 

.560 

.173 

-.297 

.047 

-.540 

1.648 

.848 

.217 

.256 

1.649 

.109 

.131 

.848 

.211 

.258 

.109 

.131 

1.201 

df 

167 

168 

172 

168 

167 

168 

168 

168 

167 

169 

168 

168 

167 

t 

12.05 

-8.52 

2.11 

-1.55 

-.06 

-2.41 

3.02 

-.07 

2.65 

.67 

-2.73 

.36 

-.45 

p 

.000 

.000 

.037 

.124 

.949 

.017 

.003 

.944 

.009 

.502 

.007 

.723 

.654 

 

 

 

 

175 

Table 43b: 

Estimating separate effects for mothers and infants testing the effects of infant sex and continuous pregnancy IPV and depression on 
positive/neutral touch response 

Role: Mother 

Role: Baby 

 

 

Role 

Role x IPV 

Role x Dep 

Estimate (SE) 

t(df) 

12.630 (1.361) 

9.28 (167) 

.194 (.181) 

1.07 (167) 

.001 (.212) 

.01 (167) 

p 

.000 

.285 

.996 

.904 

.135 

.304 

Estimate (SE) 

t(df) 

27.090 (2.241) 

12.09 (167) 

.719 (.291) 

2.469 (173) 

-.793 (.348) 

-2.28 (168) 

-.045 (2.241) 

.857 (.287) 

.126 (.349) 

-.02 (167) 

2.98 (167) 

.36 (169) 

p 

.000 

.015 

.024 

.984 

.003 

.717 

176 

Role x Infant Sex 

-.165 (1.362) 

-.12 (167) 

Role x IPV x Infant Sex 

.263 (.175) 

1.50 (167) 

Role x Dep x Infant Sex 

.220 (.214) 

1.03 (167) 

 

 

 

 

 

Table 43c: 

Estimating separate effect estimates for mothers with male versus female infants for continuous pregnancy IPV and depression on 
positive/neutral touch response 

 

Role: Mother 

 

Role: Baby 

Sex: Boy 

Sex: Girl 

Sex: Boy 

Sex: Girl 

 

Est (SE) 

t(df) 

p 

Est (SE) 

t(df) 

p 

Est (SE) 

t(df) 

8.59 
(167) 

3.33 
(169) 

-1.22 
(169) 

p 

Est (SE) 

t(df) 

p 

.000 

.001 

.224 

27.135 
(3.190) 

-.138 
(.333) 

-.920 
(.432) 

8.51 
(167) 

-.41 
(173) 

-2.13 
(167) 

.000 

.680 

.035 

 

 

 

Sex 

IPV x Role x 
Sex 

Dep x Role x 
Sex 

12.465 
(1.913) 

.456 
(.289) 

.221 
(.334) 

6.52 
(167) 

1.58 
(167) 

.000 

.116 

.66 (167) 

.510 

12.794 
(1.938) 

-.069 
(.208) 

-.219 
(.263) 

.000 

.741 

.406 

6.60 
(167) 

-.33 
(167) 

-.83 
(167) 

27.045 
(3.148) 

1.576 
(.473) 

-.667 
(.546) 

 

 

 

 

177 

Table 44a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and continuous postpartum IPV and depression on 
positive/neutral touch response 

 

Estimate 

Standard Error 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

18.862 

-6.831 

-.262 

-.417 

-.739 

.110 

.270 

.105 

-.119 

.239 

.066 

-.195 

-.095 

1.704 

.884 

.262 

.304 

1.704 

.136 

.157 

.884 

.262 

.305 

.136 

.157 

1.148 

df 

167 

168 

168 

167 

167 

168 

168 

168 

167 

168 

168 

168 

167 

t 

11.07 

-7.73 

-1.00 

-1.37 

-.43 

.82 

1.72 

.12 

-.45 

.78 

.49 

-1.24 

-.08 

p 

.000 

.000 

.320 

.172 

.665 

.416 

.088 

.905 

.650 

.434 

.628 

.218 

.934 

 

 

178 

Table 45a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and categorical pregnancy IPV and depression on 
positive/neutral touch response 

 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

F 

78.010 

55.901 

.202 

.521 

.009 

.271 

3.383 

.003 

.432 

2.899 

.120 

Role x Depression x Infant Sex 

1.317 

Demographic Risk 

.834 

df 

185 

168 

173 

168 

166 

168 

168 

168 

166 

168 

168 

168 

164 

 

 

 

 

p 

.000 

.000 

.654 

.471 

.923 

.603 

.068 

.960 

.512 

.090 

.729 

.253 

.505 

179 

Table 46a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and categorical postpartum IPV and depression on 
positive/neutral touch response 

 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

F 

37.970 

24.542 

.052 

1.002 

.024 

.053 

2.095 

.540 

1.062 

.200 

.001 

1.926 

1.129 

df 

185 

168 

170 

169 

166 

168 

168 

168 

167 

166 

168 

168 

164 

 

 

 

 

p 

.000 

.000 

.820 

.318 

.876 

.819 

.150 

.463 

.304 

.655 

.972 

.167 

.345 

180 

Table 47a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and continuous pregnancy IPV and depression on negative 
touch response 

 

Estimate 

Standard Error 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

.473 

-.425 

.004 

.012 

.043 

-.006 

-.011 

-.068 

-.002 

.028 

.003 

-.027 

.018 

.105 

.104 

.013 

.016 

.105 

.013 

.016 

.104 

.013 

.016 

.013 

.016 

.018 

df 

168 

168 

168 

168 

168 

168 

168 

168 

168 

168 

168 

168 

167 

t 

4.50 

-4.07 

.31 

.72 

.41 

-.44 

-.69 

-.66 

-.16 

1.73 

.23 

-1.69 

1.03 

p 

.000 

.000 

.760 

.472 

.682 

.659 

.495 

.512 

.872 

.086 

.820 

.094 

.304 

 

 

 

 

181 

Table 48a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and continuous postpartum IPV and depression on negative 
touch response 

df 

168 

168 

168 

168 

168 

168 

168 

168 

168 

168 

168 

168 

167 

t 

4.52 

-4.12 

.98 

.85 

.50 

-1.13 

-1.04 

-.77 

.89 

1.87 

-.89 

-1.94 

1.04 

p 

.000 

.000 

.328 

.395 

.619 

.259 

.300 

.444 

.373 

.063 

.376 

.054 

.300 

 

Estimate 

Standard Error 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

 

.477 

-.430 

.016 

.016 

.053 

-.018 

-.019 

-.080 

.014 

.035 

-.014 

-.036 

.017 

 

 

.106 

.104 

.016 

.019 

.106 

.016 

.019 

.104 

.016 

.019 

.016 

.019 

.017 

182 

Table 49a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and categorical pregnancy IPV and depression on negative 
touch response 

 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

F 

24.849 

21.243 

5.290 

.109 

.044 

5.453 

.098 

.115 

1.358 

7.880 

2.104 

7.131 

.654 

df 

172 

168 

169 

168 

168 

168 

168 

168 

168 

168 

168 

168 

164 

 

 

 

 

p 

.000 

.000 

.023 

.742 

.834 

.021 

.755 

.735 

.245 

.006 

.149 

.008 

.625 

183 

Table 49b: 

Estimated marginal means for the effects of role, infant sex, and categorical pregnancy IPV and depression on negative touch response 

Mean 

Standard Error 

.217 

.025 

.128 

.189 

.252 

.373 

.030 

.040 

.225 

.201 

.235 

.213 

.445 

.396 

.464 

.421 

df 

169 

164 

173 

169 

169 

168 

164 

164 

169 

169 

169 

168 

168 

168 

168 

168 

95% CI 

[.620, 1.478] 

[.000, .100] 

[.025, .531] 

[.448, 1.193] 

[.008, 1.004] 

[.855, 2.328] 

[-.008, .110] 

[-.029, .127] 

[.423, 1.312] 

[-.211, .581] 

[-.160, .766] 

[.422, 1.262] 

[.773, 2.530] 

[-.456, 1.110] 

[-.330, 1.501] 

[.801, 2.462] 

 

Role 

IPV 

 

Role x IPV 

 

 

 

 

Baby 

Mother 

No 

Yes 

Baby - No 

Baby - Yes 

Mother - No 

Mother - Yes 

Infant Sex x Depression 

Female - No 

 

 

 

Female - Yes 

Male - No 

Male - Yes 

1.049 

.050 

.278 

.820 

.506 

1.592 

.051 

.049 

.868 

.185 

.303 

.842 

Role x Depression x Infant 
Sex 

Infant - Female - No 

1.651 

 

 

 

 

Infant - Female - Yes 

Infant - Male - No 

Infant - Male - Yes 

.327 

.585 

1.632 

184 

Table 49b (cont’d) 

 

Mother - Female - No 

Mother - Female - Yes 

Mother - Male - No 

Mother - Male - Yes 

 

 

 

 

 

 

 

 

 

 

.084 

.044 

.021 

.052 

 

.047 

.042 

.049 

.043 

 

164 

164 

164 

164 

 

[-.008, .176] 

[-.004, .127] 

[-.076, .117] 

[-.034, .137] 

185 

Table 50a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and categorical postpartum IPV and depression on negative 
touch response 

 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

F 

22.378 

21.913 

7.837 

.126 

3.181 

10.069 

.204 

3.951 

.495 

2.764 

.304 

Role x Depression x Infant Sex 

3.057 

Demographic Risk 

.785 

df 

172 

168 

168 

168 

167 

168 

168 

168 

168 

168 

168 

168 

164 

 

 

 

 

p 

.000 

.000 

.006 

.723 

.076 

.002 

.652 

.048 

.483 

.098 

.582 

.082 

.537 

186 

Table 50b: 

Estimated marginal means for the effects of role, infant sex, and categorical postpartum IPV and depression on negative touch 
response 

 

Role 

IPV 

 

Role x IPV 

 

 

 

 

Baby 

Mother 

No 

Yes 

Baby – No  

Baby – Yes  

Mother – No  

Mother – Yes  

Role x Infant Sex 

Baby – Female  

Baby – Male  

Mother – Female 

Mother – Male 

 

 

 

 

 

 

 

df 

169 

164 

170 

170 

168 

168 

164 

164 

168 

168 

164 

164 

95% CI 

[.761, 1.850] 

[-.041, .084] 

[.041, .611] 

[.571, 1.433] 

[.030, 1.152] 

[1.172, 2.869] 

[-.001, .122] 

[-.109, .076] 

[.086, 1.483] 

[.993, 2.660] 

[-.030, .122] 

[-.091, .086] 

Mean 

Standard Error 

.276 

.032 

.144 

.218 

.284 

.430 

.031 

.047 

.354 

.422 

.038 

.045 

1.306 

.022 

.326 

1.002 

.591 

2.020 

.060 

-.017 

.784 

1.827 

.046 

-.002 

187 

Table 51a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and continuous pregnancy IPV and depression on no touch 
response 

 

Estimate 

Standard Error 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

3.079 

-1.047 

.001 

.044 

.317 

-.023 

.008 

.091 

.012 

.031 

-.015 

.038 

.148 

.171 

.157 

.022 

.027 

.171 

.020 

.024 

.157 

.022 

.027 

.020 

.024 

.123 

df 

165 

168 

171 

166 

165 

168 

168 

168 

166 

167 

168 

168 

167 

t 

17.99 

-6.65 

.05 

1.68 

1.85 

-1.12 

.33 

.58 

.56 

1.14 

-.74 

1.55 

1.21 

p 

.000 

.000 

.959 

.095 

.066 

.263 

.742 

.562 

.577 

.255 

.462 

.124 

.229 

 

 

 

 

188 

Table 52a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and continuous postpartum IPV and depression on no touch 
response  

 

Estimate 

Standard Error 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

3.110 

-1.067 

.024 

.024 

.311 

.009 

.015 

.129 

.045 

.047 

-.005 

.023 

.129 

.172 

.160 

.026 

.031 

.172 

.025 

.028 

.160 

.026 

.031 

.025 

.028 

.116 

df 

166 

168 

167 

166 

166 

168 

168 

168 

166 

167 

168 

168 

167 

t 

18.10 

-6.68 

.89 

.77 

1.81 

.35 

.54 

.81 

1.72 

1.52 

-.20 

.80 

1.11 

p 

.000 

.000 

.375 

.442 

.072 

.726 

.588 

.421 

.087 

.130 

.840 

.427 

.267 

 

 

 

 

189 

Table 53a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and categorical pregnancy IPV and depression on no touch 
response 

 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

F 

224.750 

43.215 

.265 

.993 

4.020 

1.520 

1.081 

.852 

.014 

.935 

.737 

.113 

1.715 

df 

183 

168 

171 

166 

164 

168 

168 

168 

164 

165 

168 

168 

164 

 

 

 

 

p 

.000 

.000 

.607 

.321 

.047 

.219 

.300 

.357 

.906 

.335 

.392 

.738 

.149 

190 

Table 54a: 

Multilevel regression coefficients estimating the effects of role, infant sex, and categorical postpartum IPV and depression on no 
touch response 

 

Intercept 

Role 

IPV 

Depression 

Infant Sex 

Role x IPV 

Role x Depression 

Role x Infant Sex 

IPV x Infant Sex 

Depression x Infant Sex 

Role x IPV x Infant Sex 

Role x Depression x Infant Sex 

Demographic Risk 

F 

163.631 

26.247 

.109 

2.337 

8.240 

1.676 

.587 

.444 

.950 

3.271 

.123 

.597 

2.357 

df 

183 

168 

169 

168 

164 

168 

168 

168 

165 

165 

168 

168 

164 

 

 

 

 

p 

.000 

.000 

.741 

.128 

.005 

.197 

.445 

.506 

.331 

.072 

.726 

.441 

.056 

191 

Table 55:  

Pregnancy maternal representations mediating the relationship between continuous IPV/depression and affectionate touch 

 

Path: Predictor           Mediator 

Pregnancy IPV -> Maternal Reps 

Pregnancy Depression -> Maternal Reps 

Path: Mediator            Outcome 

b 

 

-.007 

-.028 

 

Maternal Reps -> Affectionate Touch 

1.456 

Path: Predictor           Outcome (Direct) 

Pregnancy IPV -> Affectionate Touch 

Pregnancy Depression -> Affectionate Touch 

Path: Predictor           Outcome (Indirect) 

Pregnancy IPV -> Affectionate Touch 

Pregnancy Depression -> Affectionate Touch 

Control Variables 

Demographic Risk -> Maternal Reps 

Infant Sex -> Maternal Reps 

Demographic Risk -> Affectionate Touch 

Infant Sex -> Affectionate Touch 

 

.156 

-.114 

 

-.010 

-.041 

 

-.299 

.039 

.264 

.451 

SE of b 

 

.007 

.008 

 

1.153 

 

.088 

.111 

 

.012 

.034 

 

.049 

.105 

.700 

1.398 

β 

 

-.075 

-.249 

 

.124 

 

.147 

-.085 

 

-.009 

-.031 

 

-.453 

.025 

.034 

.024 

Model fit: Free parameters = 27; Χ² = 49.279, DF = 24, p = .002; RMSEA = .078; CFI = .964; R² = .032, p = .231  

 

 

192 

p 

 

.310 

.001 

 

.207 

 

.077 

.304 

 

.427 

.233 

 

.000 

.709 

.707 

.747 

Table 56:  

Pregnancy maternal representations mediating the relationship between continuous IPV/depression and instrumental touch 

 

Path: Predictor           Mediator 

Pregnancy IPV -> Maternal Reps 

Pregnancy Depression -> Maternal Reps 

Path: Mediator            Outcome 

b 

 

-.007 

-.028 

 

Maternal Reps -> Instrumental Touch 

1.174 

Path: Predictor           Outcome (Direct) 

Pregnancy IPV -> Instrumental Touch 

Pregnancy Depression -> Instrumental Touch 

Path: Predictor           Outcome (Indirect) 

Pregnancy IPV -> Instrumental Touch 

Pregnancy Depression -> Instrumental Touch 

Control Variables 

Demographic Risk -> Maternal Reps 

Infant Sex -> Maternal Reps 

Demographic Risk -> Instrumental Touch 

Infant Sex -> Instrumental Touch 

 

.270 

-.276 

 

-.008 

-.033 

 

-.299 

.039 

.442 

-.174 

SE of b 

 

.007 

.008 

 

1.541 

 

.118 

.148 

 

.013 

.044 

 

.049 

.105 

.939 

1.873 

β 

 

-.075 

-.248 

 

.074 

 

.189 

-.154 

 

-.006 

-.018 

 

-.453 

.025 

.042 

-.007 

Model fit: Free parameters = 27; Χ² = 47.772, DF = 24, p = .003; RMSEA = .075; CFI = .967; R² = .047, p = .136  

 

 

193 

p 

 

.311 

.001 

 

.446 

 

.022 

.062 

 

.541 

.455 

 

.000 

.709 

.638 

.926 

Table 57:  

Pregnancy maternal representations mediating the relationship between continuous IPV/depression and passive touch 

 

Path: Predictor           Mediator 

Pregnancy IPV -> Maternal Reps 

Pregnancy Depression -> Maternal Reps 

Path: Mediator            Outcome 

b 

 

-.007 

-.028 

 

Maternal Reps -> Passive Touch 

2.899 

Path: Predictor           Outcome (Direct) 

Pregnancy IPV -> Passive Touch 

Pregnancy Depression -> Passive Touch 

Path: Predictor           Outcome (Indirect) 

Pregnancy IPV -> Passive Touch 

Pregnancy Depression -> Passive Touch 

Control Variables 

Demographic Risk -> Maternal Reps 

Infant Sex -> Maternal Reps 

Demographic Risk -> Passive Touch 

Infant Sex -> Passive Touch 

 

.017 

-.219 

 

-.020 

-.082 

 

-.298 

.037 

1.168 

-.640 

SE of b 

 

.007 

.008 

 

2.488 

 

.187 

.235 

 

.026 

.073 

 

.049 

.105 

1.493 

2.970 

β 

 

-.075 

-.247 

 

.117 

 

.007 

-.078 

 

-.009 

-.029 

 

-.452 

.023 

.072 

-.016 

Model fit: Free parameters = 27; Χ² = 53.353, DF = 24, p = .001; RMSEA = .084; CFI = .959; R² = .020, p = .359  

 

 

194 

p 

 

.309 

.001 

 

.244 

 

.930 

.352 

 

.442 

.265 

 

.000 

.728 

.434 

.829 

Table 58:  

Pregnancy maternal representations mediating the relationship between continuous IPV/depression and negative touch 

 

Path: Predictor           Mediator 

Pregnancy IPV -> Maternal Reps 

Pregnancy Depression -> Maternal Reps 

Path: Mediator            Outcome 

b 

 

-.007 

-.028 

 

Maternal Reps -> Negative Touch 

-.008 

Path: Predictor           Outcome (Direct) 

Pregnancy IPV -> Negative Touch 

Pregnancy Depression -> Negative Touch 

Path: Predictor           Outcome (Indirect) 

Pregnancy IPV -> Negative Touch 

Pregnancy Depression -> Negative Touch 

Control Variables 

Demographic Risk -> Maternal Reps 

Infant Sex -> Maternal Reps 

Demographic Risk -> Negative Touch 

Infant Sex -> Negative Touch 

 

.002 

-.007 

 

.000 

.000 

 

-.299 

.040 

.064 

-.077 

SE of b 

 

.007 

.008 

 

.057 

 

.004 

.005 

 

.000 

.002 

 

.049 

.106 

.034 

.066 

β 

 

-.075 

-.249 

 

-.015 

 

.046 

-.108 

 

.001 

.004 

 

-.452 

.023 

.173 

-.087 

Model fit: Free parameters = 27; Χ² = 47.488, DF = 24, p = .003; RMSEA = .075; CFI = .967; R² = .049, p = .126  

 

 

195 

p 

 

.307 

.001 

 

.888 

 

.574 

.193 

 

.889 

.888 

 

.000 

.705 

.057 

.246 

Table 59:  

Pregnancy maternal representations mediating the relationship between continuous IPV/depression and no touch 

 

Path: Predictor           Mediator 

Pregnancy IPV -> Maternal Reps 

Pregnancy Depression -> Maternal Reps 

Path: Mediator            Outcome 

b 

 

-.007 

-.028 

 

Maternal Reps -> No Touch 

-2.240 

Path: Predictor           Outcome (Direct) 

Pregnancy IPV -> No Touch 

Pregnancy Depression -> No Touch 

Path: Predictor           Outcome (Indirect) 

Pregnancy IPV -> No Touch 

Pregnancy Depression -> No Touch 

Control Variables 

Demographic Risk -> Maternal Reps 

Infant Sex -> Maternal Reps 

Demographic Risk -> No Touch 

 

-.304 

.428 

 

.015 

.063 

 

-.299 

.038 

-.585 

Infant Sex -> No Touch 

-2.274 

SE of b 

 

.007 

.008 

 

2.857 

 

.216 

.272 

 

.024 

.082 

 

.049 

.105 

1.724 

3.432 

β 

 

-.075 

-.248 

 

-.078 

 

-.117 

.131 

 

.006 

.019 

 

-.453 

.024 

-.031 

-.050 

Model fit: Free parameters = 27; Χ² = 49.897, DF = 24, p = .002; RMSEA = .079; CFI = .964; R² = .031, p = .235 

 

 

196 

p 

 

.311 

.001 

 

.433 

 

.160 

.115 

 

.533 

.441 

 

.000 

.717 

.734 

.508 

Table 60:  

Pregnancy maternal representations mediating the relationship between categorical IPV/depression and affectionate touch 

 

Path: Predictor           Mediator 

Pregnancy IPV -> Maternal Reps 

Pregnancy Depression -> Maternal Reps 

Path: Mediator            Outcome 

b 

 

.002 

-.277 

 

Maternal Reps -> Affectionate Touch 

3.722 

Path: Predictor           Outcome (Direct) 

Pregnancy IPV -> Affectionate Touch 

Pregnancy Depression -> Affectionate Touch 

Path: Predictor           Outcome (Indirect) 

Pregnancy IPV -> Affectionate Touch 

Pregnancy Depression -> Affectionate Touch 

Control Variables 

Demographic Risk -> Maternal Reps 

Infant Sex -> Maternal Reps 

Demographic Risk -> Affectionate Touch 

Infant Sex -> Affectionate Touch 

 

.346 

.673 

 

.006 

-1.033 

 

-.194 

.040 

.732 

.290 

SE of b 

 

.088 

.083 

 

1.767 

 

1.680 

1.571 

 

.327 

.561 

 

.039 

.073 

.703 

1.395 

β 

 

.001 

-.264 

 

.212 

 

.018 

.036 

 

.000 

-.056 

 

-.441 

.038 

.095 

.016 

Model fit: Free parameters = 27; Χ² = 20.963, DF = 24, p = .641; RMSEA = .000; CFI = 1.000; R² = .032, p = .265 

 

 

197 

p 

 

.985 

.001 

 

.035 

 

.837 

.668 

 

.985 

.065 

 

.000 

.585 

.298 

.835 

Table 61:  

Pregnancy maternal representations mediating the relationship between categorical IPV/depression and instrumental touch 

 

Path: Predictor           Mediator 

Pregnancy IPV -> Maternal Reps 

Pregnancy Depression -> Maternal Reps 

Path: Mediator            Outcome 

b 

 

.000 

-.278 

 

Maternal Reps -> Affectionate Touch 

3.746 

Path: Predictor           Outcome (Direct) 

Pregnancy IPV -> Affectionate Touch 

Pregnancy Depression -> Affectionate Touch 

Path: Predictor           Outcome (Indirect) 

Pregnancy IPV -> Affectionate Touch 

Pregnancy Depression -> Affectionate Touch 

Control Variables 

Demographic Risk -> Maternal Reps 

Infant Sex -> Maternal Reps 

Demographic Risk -> Affectionate Touch 

Infant Sex -> Affectionate Touch 

 

6.399 

-3.125 

 

.000 

-1.041 

 

-.194 

.039 

.637 

.105 

SE of b 

 

.088 

.083 

 

2.314 

 

2.218 

2.075 

 

.329 

.701 

 

.039 

.073 

.929 

1.842 

β 

 

.000 

-.265 

 

.158 

 

.240 

-.125 

 

.000 

-.042 

 

-.441 

.037 

.061 

.004 

Model fit: Free parameters = 27; Χ² = 26.445, DF = 24, p = .331; RMSEA = .024; CFI = .995; R² = .072, p = .039 

 

 

198 

p 

 

.999 

.001 

 

.106 

 

.004 

.132 

 

.999 

.137 

 

.000 

.593 

.493 

.955 

Table 62:  

Pregnancy maternal representations mediating the relationship between categorical IPV/depression and passive touch 

 

Path: Predictor           Mediator 

Pregnancy IPV -> Maternal Reps 

Pregnancy Depression -> Maternal Reps 

Path: Mediator            Outcome 

b 

 

.000 

-.276 

 

Maternal Reps -> Passive Touch 

6.051 

Path: Predictor           Outcome (Direct) 

Pregnancy IPV -> Passive Touch 

Pregnancy Depression -> Passive Touch 

Path: Predictor           Outcome (Indirect) 

Pregnancy IPV -> Passive Touch 

Pregnancy Depression -> Passive Touch 

Control Variables 

Demographic Risk -> Maternal Reps 

Infant Sex -> Maternal Reps 

Demographic Risk -> Passive Touch 

Infant Sex -> Passive Touch 

 

-1.520 

.256 

 

-.002 

-1.673 

 

-.194 

.039 

1.517 

-.518 

SE of b 

 

.088 

.083 

 

3.740 

 

3.560 

3.330 

 

.531 

1.123 

 

.039 

.073 

1.493 

2.957 

β 

 

.000 

-.264 

 

.163 

 

-.037 

.007 

 

.000 

-.043 

 

-.441 

.037 

.093 

-.013 

Model fit: Free parameters = 27; Χ² = 19.456, DF = 24, p = .727; RMSEA = .000; CFI = 1.000; R² = .021, p = .363 

 

 

199 

p 

 

.998 

.001 

 

.106 

 

.669 

.939 

 

.998 

.134 

 

.000 

.591 

.310 

.861 

Table 63:  

Pregnancy maternal representations mediating the relationship between categorical IPV/depression and negative touch 

 

Path: Predictor           Mediator 

Pregnancy IPV -> Maternal Reps 

Pregnancy Depression -> Maternal Reps 

Path: Mediator            Outcome 

Maternal Reps -> Negative Touch 

Path: Predictor           Outcome (Direct) 

Pregnancy IPV -> Negative Touch 

Pregnancy Depression -> Negative Touch 

Path: Predictor           Outcome (Indirect) 

Pregnancy IPV -> Negative Touch 

Pregnancy Depression -> Negative Touch 

Control Variables 

Demographic Risk -> Maternal Reps 

Infant Sex -> Maternal Reps 

Demographic Risk -> Negative Touch 

Infant Sex -> Negative Touch 

b 

 

.001 

-.276 

 

.021 

 

.030 

-.080 

 

.000 

-.006 

 

-.193 

.039 

.073 

-.075 

SE of b 

 

.088 

.082 

 

.082 

 

.079 

.074 

 

.002 

.023 

 

.038 

.072 

.033 

.066 

β 

 

.001 

-.264 

 

.024 

 

.032 

-.091 

 

.000 

-.006 

 

-.441 

.038 

.198 

-.085 

Model fit: Free parameters = 27; Χ² = 18.756, DF = 24, p = .765; RMSEA = .000; CFI = 1.000; R² = .047, p = .132 

 

 

200 

p 

 

.989 

.001 

 

.802 

 

.703 

.282 

 

.989 

.802 

 

.000 

.587 

.028 

.257 

Table 64:  

Pregnancy maternal representations mediating the relationship between categorical IPV/depression and no touch 

 

Path: Predictor           Mediator 

Pregnancy IPV -> Maternal Reps 

Pregnancy Depression -> Maternal Reps 

Path: Mediator            Outcome 

b 

 

.000 

-.277 

 

Maternal Reps -> No Touch 

-7.165 

Path: Predictor           Outcome (Direct) 

Pregnancy IPV -> No Touch 

Pregnancy Depression -> No Touch 

Path: Predictor           Outcome (Indirect) 

Pregnancy IPV -> No Touch 

Pregnancy Depression -> No Touch 

Control Variables 

Demographic Risk -> Maternal Reps 

Infant Sex -> Maternal Reps 

Demographic Risk -> No Touch 

Infant Sex -> No Touch 

 

-2.537 

1.573 

 

.001 

1.987 

 

-.194 

.039 

-1.488 

-2.285 

SE of b 

 

.088 

.083 

 

4.312 

 

4.125 

3.859 

 

.630 

1.306 

 

.039 

.073 

1.728 

3.427 

β 

 

.000 

-.264 

 

-.166 

 

-.052 

.035 

 

.000 

.044 

 

-.441 

.037 

-.079 

-.051 

Model fit: Free parameters = 27; Χ² = 21.480, DF = 24, p = .610; RMSEA = .000; CFI = 1.000; R² = .028, p = .287 

 

 

201 

p 

 

.998 

.001 

 

.097 

 

.539 

.684 

 

.998 

.128 

 

.000 

.592 

.389 

.505 

Table 65a: 

Multilevel regression coefficients estimating the effects of role, touch, and IPV/depression touch responses 

 

Continuous Pregnancy IPV x Role x Touch x Response 

Continuous Pregnancy Dep x Role x Touch x Response 

Continuous Postpartum IPV x Role x Touch x Response 

Continuous Postpartum Dep x Role x Touch x Response 

Categorical Pregnancy IPV x Role x Touch x Response 

Categorical Pregnancy Dep x Role x Touch x Response 

Categorical Postpartum IPV x Role x Touch x Response 

Categorical Postpartum Dep x Role x Touch x Response 

F 

2.585 

1.583 

.300 

.705 

1.884 

1.811 

.089 

1.182 

df 

2040 

2040 

2040 

2040 

2040 

2040 

2040 

2040 

p 

.017 

.148 

.937 

.646 

.080 

.093 

.997 

.313 

 

 

 

 

 

202 

Table 65b: 

Estimating separate effects for role, different touch types and continuous pregnancy IPV on touch responses 

 

IPV x Role x Affectionate Touch x Response 

IPV x Role x Instrumental Touch x Response 

IPV x Role x Passive Touch x Response 

IPV x Role x Negative Touch x Response 

F 

1.060 

3.214 

2.806 

.015 

df 

2064 

2064 

2064 

2064 

p 

.347 

.040 

.061 

.985 

 

 

 

 

 

203 

Table 65c: 

Estimating separate effects for role, different touch types and continuous pregnancy IPV on specific touch responses 

 

IPV x Role x Instrumental Touch x Positive Response 

IPV x Role x Instrumental Touch x Negative Response 

IPV x Role x Instrumental Touch x No Response 

F 

11.618 

.012 

.296 

df 

2064 

2064 

2064 

p 

.001 

.913 

.587 

 

 

 

 

 

204 

Table 65d: 

Estimating separate effects for role, different touch types and continuous pregnancy IPV on positive touch response 

 

IPV x Mother x Instrumental Touch x Positive Response 

IPV x Infant x Instrumental Touch x Positive Response 

F 

6.490 

.695 

df 

2076 

1977 

p 

.011 

.405 

 

205 

APPENDIX F: Figures 

 

Pregnancy IPV 

 

Postpartum IPV 

Pregnancy Depression 

Postpartum Depression 

Maternal 

Representations 

Maternal Touch 

Infant Touch 

206 

Figure 1: Theoretical model 

 

 

 

 

 

 

 

 

 

 

Maternal 

Representations 

.276 (.068) 

 

 
)
5
4
1
.
(
 
*
4
2
0

.

1

Richness of 
Perceptions 

Intensity of 
Involvement 

Coherence 

Caregiving 
Sensitivity 

Acceptance 

.505 (.059) 

.398 (.049) 

.330 (.040) 

.241 (.039) 

.201 (.046) 

.224 (.043) 

Figure 2: Maternal postpartum representations. * indicates p < .05 
Model fit: Free parameters = 16; Χ² = 1.405, DF = 4, p = .843; RMSEA = .000; CFI = 1.000 

207 

Pregnancy IPV 

Postpartum 

IPV 

Pregnancy 
Depression 

Postpartum 
Depression 

Demographic 

Risk 

Infant Sex 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

-.026* 

Maternal 

Representations 

3.613* 

Affectionate 

Touch 

 

*
8
0
0

.

Richness of 
Perceptions 

Intensity of 
Involvement 

1

Coherence 

Caregiving 
Sensitivity 

Acceptance 

Figure 3: Maternal representations mediating the effects of IPV and depression on affectionate touch 
* indicates p < .05; Gray lines indicate nonsignificant pathways. 
 

 

 

208 

Female
Male

  

 

e
s
n
o
p
s
e
R
h
c
u
o
T
 
e
v
i
t
a
g
e
N

1.8

1.6

1.4

1.2

1

0.8

0.6

0.4

0.2

0

No IPV

IPV

 

 

Figure 4: The interaction between infant sex, and categorical pregnancy depression on negative infant touch 
response  

 

 

209 

 

 

 

 

 
Maternal 

Representations 

.631 (.104) 

 
)
2
8
0
.
(
 
*
7
4
9

.

Richness of 
Perceptions 

Intensity of 
Involvement 

Coherence 

Caregiving 
Sensitivity 

Acceptance 

.359 (.046) 

.300 (.040) 

.323 (.041) 

.204 (.032) 

.186 (.033) 

.067* (.032) 

Figure 5: Maternal pregnancy representations. * indicates p < .05  
Model fit: Free parameters = 16; Χ² = 10.580, DF = 4, p = .037; RMSEA = .099; CFI = .990 
 

210 

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