Skip to main content
Log in

Relatedness and Individuation Among Young Adults Born Preterm: The Role of Relationships with Parents and Death Anxiety

  • Published:
Journal of Adult Development Aims and scope Submit manuscript

Abstract

Preterm birth may constitute a risk factor for long-term difficulties when facing developmental tasks of relatedness and individuation in young adulthood. Since these early experiences might leave individuals more susceptible to anxiety, we examined whether relationships with parents and death anxiety mediated the associations between preterm birth and difficulties in relatedness and individuation. The sample included 57 emerging adults who were born preterm, and a paired control group that filled out questionnaires: The Perceptions of Adult Attachment Questionnaire, Personal Assessment of Intimacy in Relationships, the death anxiety test, and projective assessment of death anxiety. Preterm young adults and their counterparts exhibited similar levels of closeness with their parents, with romantic partner, and with best friend. A different picture emerged with regard to differentiation and death anxiety. Preterm young adults exhibited higher levels of emotional reactivity and fusion with others, and higher levels of death anxiety than their counterparts. Death anxiety mediated the relations between preterm birth status and differentiation. It appears that, despite the fact that these youngsters experienced a traumatic event early in their lives, they overcame this difficult experience and were successful in maintaining closeness with close others. In contrast, the traces of the preterm birth might be more pronounced in the domain of differentiation. People who experienced separations from significant others, especially early in life, may develop high levels of death anxiety as death is experienced as the ultimate separation from a close person. Enduring death anxiety might complicate the individuation process. Gender differences that were found are in accord with previous findings. The strengths and limitations of the study as well as suggestions for future research are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182. doi:10.1037/0022-3514.51.6.1173.

    Article  PubMed  Google Scholar 

  • Blake, A., Stewart, A., & Turcan, D. (1975). Parents of babies of very low birth weight: Long-term follow-up. In A. Porter & M. O’Connor (Eds.), Ciba foundation symposium 33—Parent-infant interaction (pp. 271–288). London: Wiley.

    Google Scholar 

  • Blos, P. (1979). Modifications in the classical psychoanalytical model of adolescence. Adolescent Psychiatry, 7, 6–25.

    Google Scholar 

  • Bogenschneider, K., & Pallock, L. (2008). Responsiveness in parent-adolescent relationships: Are influences conditional? Does the reporter matter? Journal of Marriage and Family, 70(4), 1015–1029.

    Article  Google Scholar 

  • Brisch, K. H., Bechinger, D., Betzler, S., Heinemann, H., Kächele, H., Pohlandt, F., et al. (2005). Attachment quality in very low-birthweight premature infants in relation to maternal attachment representations and neurological development. Parenting: Science and Practice, 5(4), 311–331. doi:10.1207/s15327922par0504_1.

    Article  Google Scholar 

  • Caldwell, M. A., & Peplau, L. A. (1982). Sex differences in same-sex friendship. Sex Roles, 8(7), 721–732. doi:10.1007/BF00287568.

    Article  Google Scholar 

  • Cassidy, J., Lichtenstein-Phelps, J., Sibrava, N. J., Thomas, C. L, Jr, & Borkovec, T. D. (2009). Generalized anxiety disorder: Connections with self-reported attachment. Behavior Therapy, 40(1), 23–38. doi:10.1016/j.beth.2007.12.004.

    Article  PubMed  Google Scholar 

  • Collins, W. A., Gleason, T., & Sesma, A, Jr. (1997). Internalization, autonomy, and relationships: Development during adolescence. In J. E. Grusec & L. Kuczynski (Eds.), Parenting and children’s internalization of values: A handbook of contemporary theory (pp. 78–99). Hoboken, NJ: John Wiley.

    Google Scholar 

  • Cox, S. M., Hopkins, J., & Hans, S. L. (2000). Attachment in preterm infants and their mothers: Neonatal risk status and maternal representations. Infant Mental Health Journal, 21(6), 464–480. doi:10.1002/1097-0355(200011/12)21:63.0.CO;2-V.

    Article  Google Scholar 

  • Dalziel, S. R., Lim, V. K., Lambert, A., McCarthy, D., Parag, V., Rodgers, A., et al. (2007). Psychological functioning and health-related quality of life in adulthood after preterm birth. Developmental Medicine and Child Neurology, 49(8), 597–602. doi:10.1111/j.1469-8749.2007.00597.x.

    Article  PubMed  Google Scholar 

  • Easterbrooks, M. A. (1989). Quality of attachment to mother and to father: Effects of perinatal risk status. Child Development, 60(4), 825–830. doi:10.2307/1131023.

    Article  Google Scholar 

  • Eriksson, B. S., & Pehrsson, G. (2003). Relationships between the family’s way of functioning and children’s temperament as rated by parents of pre-term children. Journal of Child Health Care, 7(2), 89–100. doi:10.1177/1367493503007002003.

    Article  PubMed  Google Scholar 

  • Feldman, R. (2007). Maternal versus child risk and the development of parent-child and family relationships in five high-risk populations. Development and Psychopathology, 19(2), 293–312. doi:10.1159/000102392.

    Article  PubMed  Google Scholar 

  • Gailliot, M. T., Schmeichel, B. J., & Baumeister, R. F. (2006). Self-regulatory processes defend against the threat of death: Effects of self-control depletion and trait self-control on thoughts and fears of dying. Journal of Personality and Social Psychology, 91(1), 49–62. doi:10.1037/0022-3514.91.1.49.

    Article  PubMed  Google Scholar 

  • Goldberg, S., Perrotta, M., Minde, K., & Corter, C. (1986). Maternal behavior and attachment in low-birth-weight twins and singletons. Child Development, 57(1), 34–46. doi:10.2307/1130635.

    Article  PubMed  Google Scholar 

  • Goldshmidt, O. T., & Weller, L. (2000). Talking emotions: Gender differences in a variety of conversational contexts. Symbolic Interaction, 23(2), 117–134. doi:10.1525/si.2000.23.2.117.

    Article  Google Scholar 

  • Greeff, A. P., & Malherbe, H. L. (2001). Intimacy and marital satisfaction in spouses. Journal of Sex and Marital Therapy, 27(3), 247–257. doi:10.1080/009262301750257100.

    Article  PubMed  Google Scholar 

  • Grotevant, H. D., & Cooper, C. R. (1986). Individuation in family relationships: A perspective on individual differences in the development of identity and role-taking skill in adolescence. Human Development, 29(2), 82–100. doi:10.1159/000273025.

    Article  Google Scholar 

  • Hack, M. (2009). Adult outcomes of preterm children. Journal of Developmental and Behavioral Pediatrics, 30(5), 460–470. doi:10.1097/DBP.0b013e3181ba0fba.

    Article  PubMed  Google Scholar 

  • Hack, M., Taylor, H. G., Schluchter, M., Andreias, L., Drotar, D., & Klein, N. (2009). Behavioral outcomes of extremely low birth weight children at age 8 years. Journal of Developmental and Behavioral Pediatrics, 30(2), 122–130. doi:10.1097/DBP.0b013e31819e6a16.

    Article  PubMed  Google Scholar 

  • Hack, M., Youngstrom, E. A., Cartar, L., Schluchter, M., Taylor, G. H., Flannery, D. J., et al. (2005). Predictors of internalizing symptoms among very low birth weight young women. Journal of Developmental and Behavioral Pediatrics, 26(2), 93–104. doi:10.1097/00004703-200504000-00004.

    Article  PubMed  Google Scholar 

  • Hallin, A. L., & Stjernqvist, K. (2011). Follow up of adolescents born extremely preterm: Self perceived mental health, social and relational outcomes. Acta Paediatrica, 100(2), 279–283. doi:10.1111/j.1651-2227.2010.01993.x.

    Article  PubMed  Google Scholar 

  • Hill, P. C., & Hood, R. W, Jr. (1999). Affect, religion and unconscious processes. Journal of Personality, 67(6), 1015–1046. doi:10.1111/1467-6494.00081.

    Article  Google Scholar 

  • Hille, E. T. M., Dorrepaal, C., Perenboom, R., Gravenhorst, J. B., Brand, R., & Verloove-Vanhorick, S. P. (2008). Social lifestyle, risk-taking behavior, and psychopathology in young adults born very preterm or with a very low birthweight. The Journal of Pediatrics, 152(6), 793–800. doi:10.1016/j.jpeds.2007.11.041.

    Article  PubMed  Google Scholar 

  • Hohmeister, J., Demirakça, S., Zohsel, K., Flor, H., & Hermann, C. (2009). Responses to pain in school-aged children with experience in a neonatal intensive care unit: Cognitive aspects and maternal influences. European Journal of Pain, 13(1), 94–101. doi:10.1016/j.ejpain.2008.03.004.

    Article  PubMed  Google Scholar 

  • Kajantie, E., Hovi, P., Räikkönen, K., Pesonen, A. K., Heinonen, K., Järvenpää, A. L., Eriksson, J. G., Strang-Karlsson, S., & Andersson, S. (2008). Young adults with very low birth weight: Leaving the parental home and sexual relationships—Helsinki study of very low birth weight adults. Pediatrics, 122(1), 62–72. doi:10.1542/peds.2007-3858.

    Article  Google Scholar 

  • Kastenbaum, R. (1987). Death-related anxiety. In L. Michelson & L. M. Ascher (Eds.), Anxiety and stress disorders: Cognitive-behavioral assessment and treatment (pp. 425–441). New York: Guilford Press.

    Google Scholar 

  • Kastenbaum, R. (2000). The psychology of death (3rd ed.). New York: Springer.

    Google Scholar 

  • Kerr, M. E., & Bowen, M. (1988). Family evaluation: An approach based on Bowen theory. New York: W W Norton & Co.

    Google Scholar 

  • Kim-Appel, D., Appel, J., Newman, I., & Parr, P. (2007). Testing the effectiveness of Bowen’s concept of differentiation in predicting psychological distress in individuals age 62 years or older. The Family Journal, 15(3), 224–233. doi:10.1177/1066480707301291.

    Article  Google Scholar 

  • Korja, R., Savonlahti, E., Haataja, L., Lapinleimu, H., Manninen, H., Piha, J., et al. (2009). Attachment representations in mothers of preterm infants. Infant Behavior and Development, 32(3), 305–311. doi:10.1016/j.infbeh.2009.04.003.

    Article  PubMed  Google Scholar 

  • Lester, B. M., Hoffman, J., & Brazelton, T. B. (1985). The rhythmic structure of mother–infant interaction in term and preterm infants. Child Development, 56(1), 15–27. doi:10.2307/1130169.

    Article  PubMed  Google Scholar 

  • Levy-Shiff, R., Einat, G., Har-Even, D., Mogilner, M., et al. (1994). Emotional and behavioral adjustment in children born prematurely. Journal of Clinical Child Psychology, 23(3), 323–333. doi:10.1207/s15374424jccp2303_10.

    Article  Google Scholar 

  • Lindström, K., Winbladh, B., Haglund, B., & Hjern, A. (2007). Preterm infants as young adults: A Swedish national cohort study. Pediatrics, 120(1), 70–77. doi:10.1542/peds.2006-3260.

    Article  PubMed  Google Scholar 

  • Lubetzky, O., & Gilat, I. (2002). The impact of premature birth on fear of personal death and attachment styles in adolescence. Death Studies, 26(7), 523–543. doi:10.1080/074811802760191690.

    Article  PubMed  Google Scholar 

  • Maccoby, E. E. (1990). Gender and relationships: A developmental account. American Psychologist, 45(4), 513–520. doi:10.1037/0003-066X.45.4.513.

    Article  PubMed  Google Scholar 

  • Macey, T. J., Harmon, R. J., & Easterbrooks, M. A. (1987). Impact of premature birth on the development of the infant in the family. Journal of Consulting and Clinical Psychology, 55(6), 846–852. doi:10.1037/0022-006X.55.6.846.

    Article  PubMed  Google Scholar 

  • MacKinnon, D. P., Warsi, G., & Dwyer, J. H. (1995). A simulation study of mediated effect measures. Multivariate Behavioral Research, 30(1), 41–62. doi:10.1207/s15327906mbr3001_3.

    Article  PubMed  Google Scholar 

  • Mikulincer, M., & Shaver, P. R. (2007). Attachment in adulthood: Structure, dynamics, and change. New York: Guilford Press.

    Google Scholar 

  • Moon, M., & Hoffman, C. D. (2008). Mothers’ and fathers’ differential expectancies and behaviors: Parent × child gender effects. The Journal of Genetic Psychology: Research and Theory on Human Development, 169(3), 261–279. doi:10.3200/GNTP.169.3.261-280.

    Article  Google Scholar 

  • Moster, D., Lie, R. T., & Markestad, T. (2008). Long-term medical and social consequences of preterm birth. The New England Journal of Medicine, 359(3), 262–273. doi:10.1056/NEJMoa0706475.

    Article  PubMed  Google Scholar 

  • Murdock, N. L., & Gore, P. A, Jr. (2004). Stress, coping, and differentiation of self: A test of Bowen theory. Contemporary Family Therapy: An International Journal, 26(3), 319–335. doi:10.1023/B:COFT.0000037918.53929.18.

    Article  Google Scholar 

  • Nadeau, L., Tessier, R., Boivin, M., Lefebvre, F., & Robaey, P. (2003). Extremely premature and very low birthweight infants: A double hazard population? Social Development, 12(2), 235–248. doi:10.1111/1467-9507.00231.

    Article  Google Scholar 

  • Nadeau, L., Tessier, R., Lefebvre, F., & Robaey, P. (2004). Victimization: A newly recognized outcome of prematurity. Developmental Medicine and Child Neurology, 46(8), 508–513. doi:10.1017/S0012162204000854.

    Article  PubMed  Google Scholar 

  • Perrin, E. C., West, P. D., & Culley, B. S. (1989). Is my child normal yet? Advances, 6(3), 14–17.

    Google Scholar 

  • Plunkett, J. W., Klein, T., & Meisels, S. J. (1988). The relationship of preterm infant-mother attachment to stranger sociability at 3 years. Infant Behavior and Development, 11(1), 83–96. doi:10.1016/S0163-6383(88)80018-3

    Article  Google Scholar 

  • Pyhälä, R., Räikkönen, K., Pesonen, A.-K., Heinonen, K., Lahti, J., Hovi, P., et al. (2011). Parental bonding after preterm birth: Child and parent perspectives in the Helsinki study of very low birth weight adults. The Journal of Pediatrics, 158(2), 251–256. doi:10.1016/j.jpeds.2010.07.059.

    Article  PubMed  Google Scholar 

  • Robbins, R. A. (1989). Gender and sex-role stereotypes in scales of death concern. Death Studies, 13(6), 579–591. doi:10.1080/07481188908252334.

    Article  Google Scholar 

  • Rode, S. S., Chang, P.-N., Fisch, R. O., & Sroufe, L. A. (1981). Attachment patterns of infants separated at birth. Developmental Psychology, 17(2), 188–191. doi:10.1037/0012-1649.17.2.188.

    Article  Google Scholar 

  • Rutter, M. (1983). Stress, coping, and development: Some issues and some questions. In N. Garmezy & M. Rutter (Eds.), Stress, coping, and development in children (pp. 1–41). Baltimore: Johns Hopkins University Press.

    Google Scholar 

  • Saigal, S., Stoskopf, B., Streiner, D., Boyle, M., Pinelli, J., Paneth, N., et al. (2006). Transition to adulthood for extremely low-birth-weight infants: Reply. JAMA: Journal of the American Medical Association, 295(22), 2603. doi:10.1001/jama.295.22.2603-b.

    Google Scholar 

  • Schaefer, M. T., & Olson, D. H. (1981). Assessing intimacy: The PAIR Inventory. Journal of Marital and Family Therapy, 7(1), 47–60. doi:10.1111/j.1752-0606.1981.tb01351.x.

    Article  Google Scholar 

  • Scharf, M., Mayseless, O., & Kivenson-Baron, I. (2004). Adolescents’ attachment representations and developmental tasks in emerging adulthood. Developmental Psychology, 40(3), 430–444. doi:10.1037/0012-1649.40.3.430.

    Article  PubMed  Google Scholar 

  • Shulman, S., Laursen, B., Kalman, Z., & Karpovsky, S. (1997). Adolescent intimacy revisited. Journal of Youth and Adolescence, 26(5), 597–617. doi:10.1023/A:1024586006966.

    Article  PubMed  Google Scholar 

  • Skowron, E. A., & Friedlander, M. L. (1998). The Differentiation of Self Inventory: Development and initial validation. Journal of Counseling Psychology, 45(3), 235–246. doi:10.1037/0022-0167.45.3.235.

    Article  Google Scholar 

  • Skowron, E. A., & Schmitt, T. A. (2003). Assessing interpersonal fusion: Reliability and validity of a new DSI Fusion with others subscale. Journal of Marital and Family Therapy, 29(2), 209–222. doi:10.1111/j.1752-0606.2003.tb01201.x.

    Article  PubMed  Google Scholar 

  • Skowron, E. A., Stanley, K. L., & Shapiro, M. D. (2009). A longitudinal perspective on differentiation of self, interpersonal and psychological well-being in young adulthood. Contemporary Family Therapy: An International Journal, 31(1), 3–18. doi:10.1007/s10591-008-9075-1.

    Article  Google Scholar 

  • Templer, D. I. (1970). The construction and validation of a death anxiety scale. Journal of General Psychology, 82(2), 165–177.

    Article  PubMed  Google Scholar 

  • Tessier, R., Nadeau, L., Boivin, M., & Tremblay, R. E. (1997). The social behaviour of 11- to 12-year-old children born as low birthweight and/or premature infants. International Journal of Behavioral Development, 21(4), 795–811. doi:10.1080/016502597384677.

    Article  Google Scholar 

  • Tideman, E., Nilsson, A., Smith, G., & Stjernqvist, K. (2002). Longitudinal follow-up of children born preterm: The mother-child relationship in a 19-year perspective. Journal of Reproductive and Infant Psychology, 20(1), 43–56. doi:10.1080/02646830220106785.

    Article  Google Scholar 

  • Tuason, M. T., & Friedlander, M. L. (2000). Do parents’ differentiation levels predict those of their adult children? And other tests of Bowen theory in a Philippine sample. Journal of Counseling Psychology, 47(1), 27–35. doi:10.1037/0022-0167.47.1.27.

    Article  Google Scholar 

  • Vangelisti, A. L., & Daly, J. A. (1997). Gender differences in standards for romantic relationships. Personal Relationships, 4(3), 203–219. doi:10.1111/j.1475-6811.1997.tb00140.x.

    Article  Google Scholar 

  • Walton, M. D., Harris, A. R., & Davidson, A. J. (2009). It makes me a man from the beating I took: Gender and aggression in children’s narratives about conflict. Sex Roles, 61(5–6), 383–398. doi:10.1007/s11199-009-9636-2.

    Article  Google Scholar 

  • Wille, D. E. (1991). Relation of preterm birth with quality of infant-mother attachment at 1 year. Infant Behavior and Development, 14(2), 227–240. doi:10.1016/0163-6383(91)90007-F.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Miri Scharf.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Scharf, M., Cohen, T. Relatedness and Individuation Among Young Adults Born Preterm: The Role of Relationships with Parents and Death Anxiety. J Adult Dev 20, 212–221 (2013). https://doi.org/10.1007/s10804-013-9172-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10804-013-9172-8

Keywords

Navigation