Temperamental profile and attachment in preterm children with moderate prematurity during the preschool age

Background Preterm birth is characterized by prematurity (functional and organic immaturity related to gestational age <32 weeks) and constitutes not only a risk condition for the child’s survival and the development characteristics after the birth, also represents a specific factor that is responsible for the. Neonatal developmental trajectory is characterized by the interruption of prenatal maturation processes that guide the development of the temperament (Hack, Fanaroff, 1999; Saigal, 2006), as well as the precursors of the attachment bond. In particular, with regard to the temperament, the literature evidences the existence of temperamental profiles characterized by motor restlessness, distractibility, and high emotional reactivity in preterm infants (Nigg, Goldsmith, Sachek, 2004; Hughes, et al, 2002). With regard to the attachment bond, some studies highlights the development of risk relational styles, among preterm infants and their parents (Brisch, Bechinger, Betzler et al., 2005) and reports to insecure attachment relationship (Fava Vizziello, Calvo, 1997). In light of these considerations, the study investigates the temperamental profile in preterm children with moderate prematurity during the preschool age. The research is defined through a model of reading (Thomas, Chess, 1989) that identified six specific typical dimensions of temperamental (motor control activity, attention, inhibition novelty, social orientation and positive/negative emotionality). Besides, the study investigates the attachment relationship, considering child's internal working models and its representation (Ainsworth et al., 1978), exploring, in addition, the possible correlation with the profile temperamental. Method The study involved a group of 50 children at the average age of 5.5 years, were born preterm (gestational age = 31 weeks, SD = 2; average birth weight = 1800 g., Ds = 350 gr., without neurological, genetic and malformative diseases,). Besides, the study involved a control group of 65 children at the same age, born at term without pre-and perinatal complications. Among the instruments, it was used the QUIT (Italian Questionnaires of Temperament, Axia, 2002), in the manner provided for children from 3 to 6 years. This specific instrument is divided into 60 items with Likert response scale ranging from “almost never” (1) to "almost always" (6), to evaluation, by parents and teachers, the areas considered (attention, social orientation, inhibition to novelty, motor control activity, positive and negative emotionality). Still, it was somministrated to children the SAT (Separation Anxiety Test, Attili, 2001). It is a specific tool for the identification of the attachment representation and the quality of the attachment bond, in terms of security, insecurity, ambivalence, and disorganization. Results The data were analyzed using parametric and no parametric statistic. In particular, it was used the one-way ANOVA through the Fisher's F test, to investigate possible differences between preterm children and those born at term in the areas of temperament; it was also used the U’s test of Mann-Withney to investigate possible differences between preterm children and those born at term with regard to the attachment styles. Besides, we used the Spearman’s ρ test to investigate the possible correlation between the two variables, The results show that preterm children compared with term births, have a "normal" temperament profile (Axia, op. Cit.) and statistically significant higher scores, in the scale of positive emotionality (F (1) = 7.5 p <.05). With regard to the attachment relationship, the two groups do not differ (U = 1319 p = 0.87), characterizing by an safe attachment. Finally, it emerges in the group of preterm infants, a statistically significant correlation between secure attachment and positive emotionality (rho = .303 and P = .01). Conclusions The results do not stand in continuity with field contributions, that highlight "difficult" temperamental profiles and insecure attachment styles in preterm children, directing some reflections on the importance of the relationship between child's "organic lead" of temperament and the caregiver’s response.