Refining the assessment of disrupted maternal communication: Using item response models to identify central indicators of disrupted behavior

Abstract

The Atypical Maternal Behavior Instrument for Assessment and Classification (AMBIANCE; Bronfman, Madigan, & Lyons-Ruth, 2009-2014; Bronfman, Parsons, & Lyons-Ruth, 1992-2004) is a widely used and well-validated measure for assessing disrupted forms of caregiver responsiveness within parent-child interactions. However, it requires evaluating approximately 150 behavioral items from videotape and extensive training to code, thus making its use impractical in most clinical contexts. Accordingly, the primary aim of the current study was to identify a reduced set of behavioral indicators most central to the AMBIANCE coding system using latent-trait item response theory (IRT) models. Observed mother-infant interaction data previously coded with the AMBIANCE was pooled from laboratories in both North America and Europe (N = 343). Using 2-parameter logistic IRT models, a reduced set of 45 AMBIANCE items was identified. Preliminary convergent and discriminant validity was evaluated in relation to classifications of maternal disrupted communication assigned using the full set of AMBIANCE indicators, to infant attachment disorganization, and to maternal sensitivity. The results supported the construct validity of the refined item set, opening the way for development of a brief screening measure for disrupted maternal communication. IRT models in clinical scale refinement and their potential for bridging clinical and research objectives in developmental psychopathology are discussed.

Figure 1.

Item characteristic and item information curves for eight indicators of AMBIANCE subdimension 2A: “role confusion.” Full item code descriptors are provided in Table 1. Chosen indicators were selected to facilitate visual interpretation.

Figure 2.

Item characteristic and item information curves for eight indicators of AMBIANCE subdimension 3A: “fearful behavior.” Full item code descriptors are provided in Table 1. Chosen indicators were selected to facilitate visual interpretation.

Figure 3.

Item characteristic and item information curves for AMBIANCE subdimension 3B: “disorientation: disorganized or dissociative behavior.” Full item code descriptors are provided in Table 1. Chosen indicators were selected to facilitate visual interpretation.

Figure 4.

Item characteristic and item information curves for AMBIANCE subdimension 4A: “physical communications.” Full item code descriptors are provided in Table 1. Chosen indicators were selected to facilitate visual interpretation.

Figure 5.

Item characteristic and item information curves for eight indicators of AMBIANCE subdimension 5A: “creates physical distance from infant.” Full item code descriptors are provided in Table 1. Chosen indicators were selected to facilitate visual interpretation.

Figure 6.

Test information function for AMBIANCE subdimension 2A: “role confusion.” Note that the test information function is reflective of the total set of AMBIANCE indicators for a given latent trait.

Figure 7.

Receiver operating characteristic (ROC) analysis curve for the item response theory (IRT) based refined AMBIANCE summary score in detecting maternal disrupted classification status as defined using the AMBIANCE protocol. Area under the curve = 0.85, p < .01.

Figure 8.

Raw data, descriptive statistics, and inferential statistics (RDI) plot of significant mean difference in item response theory (IRT) based refined AMBIANCE summary scores between disorganized and not disorganized infants. Note that the RDI plot contains four main elements that allow for greater empirical resolution into the patterning of data (relative, e.g., to bar plots): points reflected by darkened dots reflect raw data points; the vertical shaded bar reflects central tendencies; the bean reflects a smoothed density; and the shaded rectangle reflects an inference interval (e.g., frequentist confidence interval, as in this example).