Appraisal and Coping Predictors of Mother and Child Outcomes after Newborn Intensive Care

We studied how mothers' appraisals and coping strategies measured before NICU discharge predicted their psychological well-being and infants' development 18 months later. Infants developed more optimally when their mothers held more positive expectations about their development and less so when their mothers used escapist coping strategies. Mothers reported more distressafter discharge when they had expected greater control over their child's development and had used instrumental action coping more often and less distress when they had sought meaning more often. Greater distress was predicted by greater use of minimization coping only for mothers whose children were subsequently diagnosed as developmentally disabled, and the relation between seeking meaning and less subsequent distress was stronger among mothers of the developmentally disabled children. Explanations of these findings are offered from the perspective of cognitive adaptation and coping theory and factors that assist or hinder the development of medically vulnerable infants.