Mother-child interactions among children with visual impairment: Addressing maternal attachment style, depression-anxiety symptoms, and child's behavioral problems.

Objective: The birth of a visually impaired child leads to stress, disappointment, and medical challenges for the family due to the economic and financial costs, unmet expectations of other family members, and social embarrassment-isolation of the family from society. In these families, mothers are exposed to the stressors more often than other family members, because, in most families, they are the primary caregivers. In this study, we examined the relationship between maternal attachment styles, maternal depression and anxiety levels, and behavioral problems of children with visual impairment.

Methods: This is a case-control study. In the study group, there were 35 children with visual impairment, and in the control group, there were 31 healthy children. All mothers completed adult attachment style dimensions scales, beck depression, and anxiety inventories, and the aberrant behaviour checklist.

Results: Our results demonstrated that children with visual impairment have higher levels of behavior problems including irritability, stereotypic behavior, and inappropriate speech when compared with healthy controls. Contrary to our expectations depression and anxiety, scores of mothers were similar, also, there was not a difference in terms of maternal attachment types. Interestingly, there was a positive relationship between secure attachment and depression among mothers of the visual impairment group. In other words, securely attached mothers were more depressive. On the other hand, there was a positive relationship between anxious/ambivalent attachment and the child's irritability.

Conclusion: The relationship between maternal depression and secure attachment could be a consequence of higher maternal sensitivity due to a child's impairment and should be evaluated in future studies.