Skip to main content Accessibility help

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

  • John D. Haltigan (a1), Sheri Madigan (a2) (a3), Elisa Bronfman (a4), Heidi N. Bailey (a5), Catherine Borland-Kerr (a6), Roger Mills-Koonce (a7) and Karlen Lyons-Ruth (a4)...


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.


Corresponding author

Address correspondence and reprint requests to: John D. Haltigan, Department of Psychiatry, University of Toronto, Toronto, Canada; E-mail:


Hide All

We are grateful to our collaborators and colleagues who contributed data for this project and to the families who participated in the studies. Further work with the refined Atypical Maternal Behavior Instrument for Assessment and Classification item set presented in this manuscript is being supported by the Social Sciences and Humanities Research Council of Canada.



Hide All
Ainsworth, M. D. S., Blehar, M., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the Strange Situation. Hillsdale, NJ: Erlbaum.
Albanese, M. T., & Knott, M. (1994). Bootstrapping latent variable models for binary response. British Journal of Mathematical and Statistical Psychology, 47, 235246. doi:10.1111/j.2044-8317.1994.tb01036.x
Baker, F. B. (2001). The basics of item response theory. College Park, MD: University of Maryland, ERIC Clearinghouse on Assessment and Evaluation.
Bernier, A., & Meins, E. (2008). A threshold approach to understanding the origins of attachment disorganization. Developmental Psychology, 44, 969982. doi:10.1037/0012-1649.44.4.969
Bock, R. D., & Aitkin, M. (1981). Marginal maximum likelihood estimation of item parameters: Application of EM algorithm. Psychometrika, 46, 443459. doi:10.1007/BF02293801
Bronfman, E., Madigan, S., & Lyons-Ruth, K. (2009–2014). Disrupted Maternal Behavior Instrument for Assessment and Classification (AMBIANCE): Manual for coding disrupted affective communication (2nd ed.). Unpublished manuscript, Harvard University Medical School.
Bronfman, E. T., Parsons, E., & Lyons-Ruth, K. (1992–2008). Disrupted Maternal Behavior Instrument for Assessment and Classification (AMBIANCE): Manual for coding disrupted affective communication (1st ed.). Unpublished manuscript, Harvard University Medical School.
Bronfman, E. T., Parsons, E., & Lyons-Ruth, K. (1992–2004). Disrupted Maternal Behavior Instrument for Assessment and Classification (AMBIANCE), Version 2.1. Unpublished manuscript, Harvard Medical School.
Canty, A., & Ripley, B. (2016). boot: Bootstrap R (S-Plus) Functions. R package version 1.3-18 [Computer software]. Vienna: R Foundation for Statistical Computing.
Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155159. doi:10.1037//0033-2909.112.1.155
Cole, D. A., Cai, L., Martin, N. C., Findling, R. L., Youngstrom, E. A., Garber, J., … Forehand, R. (2011). Structure and measurement of depression in youths: Applying response theory to clinical data. Psychological Assessment, 23, 819833. doi:10.1037/a0023518
Cook, K. F., Kallen, M. A., & Amtmann, D. (2009). Having a fit: Impact of the number of items and distribution of data on traditional criteria for assisting IRT's unidimensionality assumption. Quality of Life Research, 18, 447460. 10.1007/s11136-009-9464-4
Cooke, D. J., & Michie, C. (1997). An item response theory analyses of the Hare Psychopathy Checklist—Revised. Psychological Assessment, 9, 314. doi:10.1037/1040-3590.9.1.3
Cronbach, L. J., & Meehl, P. E. (1955). Construct validity in psychological tests. Psychological Bulletin, 52, 281302. doi:10.1037/h0040957
Cyr, C., Euser, E. M., Bakermans-Kranenburg, M. J., & van IJzendoorn, M. H. (2010). Attachment security and disorganization in maltreating and high-risk families: A series of meta-analyses. Development and Psychopathology, 22, 87108. doi:10.1017/S0954579409990289
de Menezes, L. M. (1999). On fitting latent class models for binary data: The estimation of standard errors. British Journal of Mathematical and Statistical Psychology, 52, 149168. doi:10.1348/000711099159026
Edelen, M. O., & Reeve, B. B. (2007). Applying item response theory (IRT) modeling to questionnaire development, evaluation, and refinement. Quality of Life Research, 16, 518. doi:10.1007/s11136-007-9198-0
Egeland, B., Pianta, R., & O'Brien, M. (1993). Maternal intrusiveness in infancy and child maladaptation in early school years. Development and Psychopathology, 5, 359370. doi:10.1017/S0954579400004466
Fearon, R. P., Bakermans-Kranenburg, M. J., van IJzendoorn, M. H., Lapsley, A.-M., & Roisman, G. I. (2010). The significance of insecure attachment and disorganization in the development of children's externalizing behavior: A meta-analytic study. Child Development, 81, 435456. doi:10.1111/j.1467-8624.2009.01405.x
Finkelman, M. D., Green, J. G., Gruber, M. J., & Zaslavsky, A. M. (2011). A zero- and K-inflated mixture model for health questionnaire data. Statistics in Medicine, 30, 10281043. doi:10.1002/sim.4217
Floyd, F. J., & Widaman, K. F. (1995). Factor analysis in the development and refinement of clinical assessment instruments. Psychological Assessment, 7, 286299. doi:10.1037/1040-3590.7.3.286
Forbes, L. M., Evans, E. M., Moran, G., & Pederson, D. R. (2007). Change in disrupted maternal behavior predicts change in attachment disorganization from 12 to 24 months in a high-risk sample. Child Development, 78, 955971. doi:10.1111/j.1467-8624.2007.01043.x
Forero, C. G., & Maydeu-Olivares, A. (2009). Estimation of IRT graded response models: Limited versus full information methods. Psychological Methods, 14, 275299. doi:10.1037/a0015825
Fraley, R. C., Waller, N. G., & Brennan, K. A. (2000). An item response theory analysis of self-report measures of adult attachment. Journal of Personality and Social Psychology, 78, 350365. doi:10.1037//0022-3514.78.2.350
Goldberg, S., Gotowiec, A., & Simmons, R. J. (1995). Infant-mother attachment and behavior problems in healthy and chronically ill preschoolers. Developmental and Psychopathology, 7, 267282. doi:10.1017/S0954579400006490
Gordon, R. A. (2015). Measuring constructs in family science: How can item response theory improve precision and validity? Journal of Marriage and Family, 77, 147176. doi:10.1111/jomf.12157
Haltigan, J. D., Leerkes, E., Supple, A. J., & Calkins, S. D. (2013). Infant negative affect and maternal interactive behavior during the still-face procedure: The moderating role of adult attachment states of mind. Attachment and Human Development, 16, 149173. doi:10.1080/14616734.2013.863734
Haltigan, J. D., Leerkes, E., Wong, M. S., Fortuna, K., Roisman, G. I., Supple, A. J., … Plamondon, A. (2014). Adult attachment states of mind: Measurement invariance across ethnicity and associations with maternal sensitivity. Child Development, 85, 10191035. doi:10.1111/cdev.12180
Haltigan, J. D., & Roisman, G. I. (2015). Infant attachment insecurity and dissociative symptomatology: Findings from the NICHD study of early child care and youth development. Infant Mental Health Journal, 36, 3041. doi:10.1002/imhj.21479
Hobson, R. P., Patrick, M., Crandell, L., García-Pérez, R., & Lee, A. (2005). Personal relatedness and attachment in infants of mothers with borderline personality disorder. Development and Psychopathology, 17, 329347. doi:10.1017/S0954579405050169
Hobson, R. P., Patrick, M., Hobson, J. A., Crandell, L., Bronfman, E., & Lyons-Ruth, K. (2009). How mothers with borderline personality disorder relate to their one-year-old infants. British Journal of Psychiatry, 195, 16. doi:bjp.bp.108.060624
Kim, Y., & Pilkonis, P. A. (1999). Selecting the most informative items in the IIP scales for personality disorders: An application of item response theory. Journal of Personality Disorders, 13, 157174. doi:10.1521/pedi.1999.13.2.157
Krueger, R. F., Nichol, P. E., Hicks, B. M., Markon, K. E., Patrick, C. J., Iacono, W. G., & McGue, M. (2004). Using latent trait modeling to conceptualize an alcohol problems continuum. Psychological Assessment, 16, 107119. doi:10.1037/1040-3590.16.2.107
Langenbucher, J. W., Labouvie, E., Martin, C. S., Sanjuan, P. M., Bavly, L., Kirisci, L., & Chung, T. (2004). An application of item response theory analysis to alcohol, cannabis, and cocaine criteria in DSM-IV. Journal of Abnormal Psychology, 113, 7280. doi:10.1037/0021-843X.113.1.72
Lyons-Ruth, K., Alpern, L., & Repacholi, B. (1993). Disorganized infant attachment classification and maternal psychosocial problems as predictors of hostile-aggressive behavior in the preschool classroom. Child Development, 64, 572585. doi:10.2307/1131270
Lyons-Ruth, K., Bronfman, E., & Atwood, G. (1999). A relational diathesis model of hostile-helpless states of mind: Expressions in mother-infant interaction. In Solomon, J. & George, C. (Eds.), Attachment disorganization (pp. 3370). New York: Guilford Press.
Lyons-Ruth, K., Bronfman, E., & Parsons, E. (1999). Maternal frightened, frightening or disrupted behavior and disorganized infant attachment patterns. Monographs of the Society for Research in Child Development, 64(3, Serial No. 258).
Lyons-Ruth, K., Bureau, J.-F., Holmes, B., Easterbrooks, A., & Brooks, N. (2013). Borderline symptoms and suicidality/self-injury in late adolescence: Prospectively observed relationship correlates in infancy and childhood. Psychiatry Research, 206, 273281. doi:10.1016/j.psychres.2012.09.030
Lyons-Ruth, K., Connell, D., Grunebaum, H., & Botein, S. (1990). Infants at social risk: Maternal depression and family support services as mediators of infant development and security of attachment. Child Development, 61, 8598. doi:10.1111/j.1467-8624.1990.tb02762.x
Lyons-Ruth, K., & Jacobvitz, D. (2016). Attachment disorganization from infancy to adulthood: Neurobiological correlates, parenting context, and pathways to disorder. In Cassidy, J. & Shaver, P. R. (Eds.), Handbook of attachment: Theory, research, and clinical applications (3rd ed., pp. 667695). New York: Guilford Press.
Lyons-Ruth, K., Pechtel, P., Yoon, S. A., Anderson, C. M., & Teicher, M. H. (2016). Disorganized attachment in infancy predicts greater amygdala volume in adulthood. Behavioural Brain Research, 308, 8393. doi:10.1016/j.bbr.2016.03.050
Macfie, J., McElwain, N. L., Houts, R. M., & Cox, M. J. (2005). Intergenerational transmission of role reversal between parent and child: Dyadic and family systems internal working models. Attachment and Human Development, 7, 5165. doi:10.1080/14616730500039663
Madigan, S., Bakermans-Kranenburg, M. J., van IJzendoorn, M. H., Moran, G., Pederson, D. R., & Benoit, D. (2006). Unresolved states of mind, anomalous parental behavior, and disorganized attachment: A review and meta-analysis of a transmission gap. Attachment and Human Development, 8, 89111. doi:10.1080/14616730600774458
Madigan, S., Brumariu, L. E., Villani, V., Atkinson, L., & Lyons-Ruth, K. (2016). Representational and questionnaire measures of attachment: A meta-analysis of relations to child internalizing and externalizing problems. Psychological Bulletin, 142, 367399. doi:10.1037/bul0000029
Madigan, S., Voci, S., & Benoit, D. (2011). Stability of disrupted caregiver behaviors over six years and associations with disorganized infant-caregiver attachment. Attachment and Human Development, 13, 237252. doi:10.1080/14616734.2011.562410
Main, M., & Hesse, E. (1990). Parents’ unresolved traumatic experiences are related to infant disorganized status: Is frightened and/or frightening parental behavior the linking mechanism? In Greenberg, M. T., Cicchetti, D., & Cummings, E. M. (Eds.), Attachment in the preschool years: Theory, research, and intervention (pp. 161182). Chicago: University of Chicago Press.
Main, M., & Solomon, J. (1990). Procedures for identifying infants as disorganized/disoriented during the Ainsworth Strange Situation. In Greenberg, M. T., Cicchetti, D., & Cummings, M. (Eds.), Attachment in the preschool years: Theory, research, and intervention (pp. 121160). Chicago: University of Chicago Press.
Martin, C. S., Chung, T., Kirisci, L., & Langenbucher, J. W. (2006). Item response theory analysis of diagnostic criteria for alcohol and cannabis use disorders in adolescents: Implications for DSM-V. Journal of Abnormal Psychology, 115, 807814. doi:10.1037/0021-843X.115.4.807
Maxwell, S. E. (2004). The persistence of underpowered studies in psychological research: Causes, consequences, and remedies. Psychological Methods, 9, 147163. doi:10.1037/1082-989X.9.2.147
Mayseless, O., Bartholomew, K., Henderson, A., & Trinke, S. (2004). “I was more her mom than she was mine”: Role reversal in a community sample. Family Relations, 53, 7886. doi:10.1111/j.1741-3729.2004.00011.x
Mills-Koonce, W. R., Willoughby, M. T., Rehder, P. D., Gottfredson, N., Bronfman, E., Madigan, S., & Lyons-Ruth, K. (2017). Associations between disrupted maternal caregiving and oppositional defiant and callous-unemotional behaviors differ for boys versus girls. Manuscript submitted for publication.
Muthén, B. O. (1989). Dichotomous factor analysis of symptom data. Sociological Methods and Research, 18, 1965.
Muthén, L. K., & Muthén, B. O. (1998–2012). Mplus user's guide (7th ed.). Los Angeles: Author.
NICHD Early Child Care Research Network. (1997). The effects of infant childcare on infant-mother attachment security: Results of the NICHD study of early childcare. Child Development, 68, 860879. doi:10.2307/1132038
NICHD Early Child Care Research Network. (2001). Child-care and family predictors of preschool attachment and stability from infancy. Developmental Psychology, 37, 847862. doi:10.1037/0012-1649.37.6.847
NICHD Early Child Care Research Network. (2004). Father's and mother's parenting behavior and beliefs as predictors of child social adjustment in the transition to school. Journal of Family Psychology, 18, 628638. doi:10.1037/0893-3200.18.4.628
NICHD Early Child Care Research Network. (2005). Child care and child development. New York: Guilford Press.
Ondersma, S. J., Chaffin, M. J., Mullins, S. M., & LeBreton, J. M. (2005). A brief form of the child abuse potential inventory: Development and validation. Journal of Clinical Child and Adolescent Psychology, 34, 300311. doi:10.1207/s15374424jccp3402_9
Osterlind, S. J., & Everson, H. T. (2009). Differential item functioning (Vol. 161). Thousand Oaks, CA: Sage.
R Core Team. (2016). R: A language and environment for statistical computing [Computer software]. Vienna: R Foundation for Statistical Computing. Retrieved from
Reise, S. P., & Waller, N. G. (2009). Item response theory and clinical measurement. Annual Review of Clinical Psychology, 5, 2748. doi:10.1146/annurev.clinpsy.032408.153553
Rizopoulos, D. (2006). ltm: An R package for latent variable modelling and item response theory analyses. Journal of Statistical Software, 17, 125.
Sheridan, M. A., & McLauglin, K. A. (2014). Dimensions of early experience and neural development: Deprivation and threat. Trends in Cognitive Sciences, 18, 580585. doi:10.1016/j.tics.2014.09.001
Shi, Z., Bureau, J.-F., Easterbrooks, M. A., Zhao, X., & Lyons-Ruth, K. (2012). Childhood maltreatment and prospectively observed quality of early care as predictors of antisocial personality disorder features. Infant Mental Health Journal, 33, 5569. doi:10.1002/imhj.20295
Sroufe, L. A., Jacobvitz, D., Mangelsdorf, S., DeAngelo, E., & Ward, M. J. (1985). Generational boundary dissolution between mothers and their preschool children: A relationship systems approach. Child Development, 56, 317325. doi:10.2307/1129722
Steiger, J. H. (1980). Tests for comparing elements of a correlation matrix. Psychological Bulletin, 87, 245251. doi:10.1037/0033-2909.87.2.245
Sterba, S. K., Copeland, W., Egger, H. L., Costello, E. J., Erkanli, A., & Angold, A. (2010). Longitudinal dimensionality of adolescent psychopathology: Testing the differentiation hypothesis. Journal of Child Psychology and Psychiatry, 51, 871884. doi:10.1111/j.1469-7610.2010.02234.x
Swaminathan, H., Hambleton, R. K., Sireci, S. G., Xing, D., & Rizavi, S. M. (2003). Small sample estimation in dichotomous item response models: Effect of priors based on judgmental information on the accuracy of item parameter estimates. Applied Psychological Measurement, 27, 2751. doi:10.1177/0146621602239475
Teicher, M., Samson, J., Anderson, C., & Ohashi, K. (2016). The effects of childhood maltreatment on brain structure, function and connectivity. Nature Reviews Neuroscience, 17, 652666. doi:10.1038/nrn.2016.111
Tereno, S., Madigan, S., Lyons-Ruth, K., Plamondon, A., Atkinson, L., Guedeney, N., … Guedeney, A. (2017). Assessing mechanisms of effect in a randomized home-visiting trial: Reduced disrupted maternal communication decreases infant disorganization. Development and Psychopathology, 29, 637649. doi:10.1017/S0954579417000232
van IJzendoorn, M. H., Schuengel, C., & Bakermans-Kranenburg, M. J. (1999). Disorganized attachment in early childhood: Meta-analysis of precursors, concomitants, and sequalae. Development and Psychopathology, 11, 225249. doi:10.1017/S0954579499002035
Wall, M. M., Park, J. Y., & Moustaki, I. (2015). IRT modeling in the presence of zero-inflation with application to psychiatric disorder severity. Applied Psychological Measurement, 39, 583597. doi:10.1177/0146621615588184

Related content

Powered by UNSILO

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

  • John D. Haltigan (a1), Sheri Madigan (a2) (a3), Elisa Bronfman (a4), Heidi N. Bailey (a5), Catherine Borland-Kerr (a6), Roger Mills-Koonce (a7) and Karlen Lyons-Ruth (a4)...


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.