PMH-C Infant Bonding 3 — Questions and Answers
Question 1: Which theoretical framework emphasizes that an infant's internal working model of relationships is built through repeated early bonding interactions?
- Object relations theory
- Attachment theory (Bowlby) (Correct answer)
- Social learning theory
- Cognitive developmental theory
Correct answer: Attachment theory (Bowlby)
Bowlby's attachment theory proposes that infants construct internal working models based on repeated experiences with caregivers that guide future relationships.
Question 2: A mother who experienced childhood trauma is struggling with bonding. Which perinatal mental health intervention has the strongest evidence for improving mother-infant interaction in this population?
- Psychodynamic individual therapy only
- Dyadic or parent-infant therapy such as Child-Parent Psychotherapy (CPP) (Correct answer)
- Pharmacotherapy alone
- Group therapy without infant present
Correct answer: Dyadic or parent-infant therapy such as Child-Parent Psychotherapy (CPP)
Child-Parent Psychotherapy (CPP) has robust evidence for improving attachment in mothers with trauma histories by addressing the dyadic relationship directly.
Question 3: Which of the following is a recognized risk factor for impaired maternal-infant bonding?
- Vaginal delivery
- Previous successful breastfeeding
- Infant admission to the NICU (Correct answer)
- Second or subsequent birth
Correct answer: Infant admission to the NICU
NICU admission disrupts early skin-to-skin contact and continuous caregiving, significantly increasing risk of bonding difficulties.
Question 4: The 'still face' paradigm developed by Tronick demonstrates which important concept about infant bonding?
- Infants are indifferent to caregiver emotional states
- Infants are highly sensitive to breaks in contingent social interaction and show distress (Correct answer)
- Infants prefer inanimate objects to social stimulation
- Maternal depression has no observable impact on infant behavior
Correct answer: Infants are highly sensitive to breaks in contingent social interaction and show distress
Tronick's still face experiment showed infants rapidly detect and are distressed by a caregiver's unresponsive face, demonstrating the importance of contingent interaction.
Question 5: A nurse asks how to support bonding for a mother who had an emergency cesarean section and is recovering in the ICU. What is the BEST guidance?
- Delay all contact until the mother is discharged from ICU
- Bring the infant to the bedside for skin-to-skin contact as soon as medically feasible (Correct answer)
- Have the father serve as primary caregiver and exclude the mother until recovery
- Initiate formal bonding assessment before any contact is allowed
Correct answer: Bring the infant to the bedside for skin-to-skin contact as soon as medically feasible
Facilitating skin-to-skin contact as soon as medically safe, even in the ICU, supports bonding and is now standard practice in many institutions.
Question 6: Which feeding method is associated with elevated oxytocin levels and enhanced maternal-infant bonding in the postpartum period?
- Formula feeding with a bottle
- Breastfeeding (Correct answer)
- Cup feeding
- Nasogastric tube feeding
Correct answer: Breastfeeding
Breastfeeding stimulates repeated oxytocin release through nipple stimulation, reinforcing maternal bonding behaviors with each feeding.
Question 7: When assessing maternal-infant bonding, the Postpartum Bonding Questionnaire (PBQ) screens for which of the following?
- Only postpartum depression severity
- Impaired bonding, rejection, anxiety, and risk of abuse (Correct answer)
- Infant developmental milestones
- Paternal involvement in caregiving
Correct answer: Impaired bonding, rejection, anxiety, and risk of abuse
The PBQ is a validated tool assessing multiple dimensions of bonding difficulty including emotional rejection, anxiety about caregiving, and potential for harm.
PMH-C Infant Bonding 3
Which theoretical framework emphasizes that an infant's internal working model of relationships is built through repeated early bonding interactions?