Infant Behavior & Development 38 (2015) 6776

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Infant Behavior and Development

A categorical approach to infants individual differences

during the Still-Face paradigm
Rosario Montirosso a, , Erica Casini a , Livio Provenzi a , Samuel P. Putnam b ,
Francesco Morandi c , Claudia Fedeli a , Renato Borgatti d
a
0-3 Centre for the Study of Social Emotional Development of the At-Risk Infant - Scientic Institute, IRCCS Eugenio Medea,
Bosisio Parini (Lecco), Italy
b
Department of Psychology, Bowdoin College, Brunswick, ME, USA
c
Pediatric Unit, Sacra Famiglia Hospital, Erba (Como), Italy
d
Neuropsychiatry and Neurorehabilitation Unit, Scientic Institute, IRCCS Eugenio Medea, Bosisio Parini (Lecco), Italy

a r t i c l e

i n f o

Article history:
Received 24 June 2014
Received in revised form 15 October 2014
Accepted 8 December 2014
Keywords:
Individual differences
Cluster analysis
Early motherinfant interaction
Face-to-Face-Still-Face paradigm

a b s t r a c t
Cluster analysis was used to create patterns of individual differences reecting infant behaviors during the initial interaction episode of the Face-to-Face Still-Face (FFSF) paradigm. The
clusters were used as the basic unit of analysis for studying infant and maternal behavior and
dyadic coordination (i.e., matching and reparation) across FFSF. Seventy-ve 4-month-old
infants participated with their mothers. Cluster analysis identied three patterns: a Socially
Engaged cluster (33%) exhibited high levels of social engagement with their mothers; a Disengaged cluster (60%) showed a tendency to be low in social interaction and a Negatively
Engaged cluster (7%) showed high negative emotionality. During the Still-Face episode,
the Socially Engaged cluster reacted by reducing focus on their mother and shifting their
attention elsewhere, while infants in the Disengaged cluster reduced focus on the environment. Although both the Socially Engaged and Disengaged clusters increased in negative
emotionality during the Still-Face, the Socially Engaged group largely recovered during the
Reunion, whereas the Disengaged group displayed more negative emotion. The Negatively
Engaged cluster demonstrated high levels of negative affect throughout the entire procedure. Mothers of Negatively Engaged infants showed less positive engagement and more
social monitoring than mothers in other clusters during all episodes. Dyadic interaction
differed between groups, with greater levels of matching and reparations in the engaged
group, less in the Disengaged group, and very little coordination in the Negatively Engaged
cluster. Findings highlight the role of distinctive patterns of infants individual differences
in determining early dyadic functioning.
2015 Elsevier Inc. All rights reserved.

1. Introduction
During face-to-face interactions, infants and their caregivers participate in an emotional communication system in which
they are mutually involved in complex patterns of social exchanges (Hsu & Fogel, 2003). Parents are viewed as the primary contributors to this exchange, but research has also demonstrated that early individual differences in socio-emotional

Corresponding author at: 0-3 Centre for the Study of Social Emotional Development of the At-Risk Infant, Scientic Institute, IRCCS Eugenio Medea,
via Don Luigi Monza 20, 23846 Bosisio Parini, LC, Italy. Tel.: +39 031 877494.
E-mail address: rosario.montirosso@bp.lnf.it (R. Montirosso).
http://dx.doi.org/10.1016/j.infbeh.2014.12.015
0163-6383/ 2015 Elsevier Inc. All rights reserved.

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behavior play an important role as well (Cole, Michel, & Teti, 1994; Eisenberg et al., 1996; Kochanska, Murray, & Harlan,
2000; Rothbart, Ziaie, & OBoyle, 1992). These characteristics of the child are believed to affect the motherinfant relationship, parenting behavior and the infants ability to cope with stress (Bates, Schermerhorn, & Petersen, 2012; Crockenberg
& Acredolo, 1983; Rothbart & Bates, 2006). For example, infant irritability has been associated with less parental warmth
(Kochanska, Friesenborg, Lange, & Martel, 2004) and more harsh parenting (Rhoades et al., 2011), and less responsive infant
behavior (Bates & Pettit, 2007; Bates et al., 2012).
Past research has suggested that infants individual differences should be particularly apparent in conditions that elicit
stress, such as maternal unavailability during the Face-to-Face Still-Face (FFSF) paradigm (Tronick, Als, Adamson, Wise,
& Brazelton, 1978; Gunning, Halligan, & Murray, 2013; Tarabulsy et al., 2003; Yoo & Reeb-Sutherland, 2013). The FFSF
typically consists of three episodes during which the parent is asked to engage in typical face-to-face interaction (Play
episode), to cease interaction and maintain a neutral expression (Still-Face episode) and, nally, to resume interaction
(Reunion episode). Importantly, the Play episode allows for assessment of the interactive tendencies of the infant, whereas
the Still-Face and Reunion are informative regarding the infants reactivity to, and recovery from, relational perturbation,
respectively (Mesman, van Ijzendoorn, & Bakermans-Kranenburg, 2009). Compared with the initial interaction episode,
there is generally an increase in mean levels of negative facial expressions and decreases in mean levels of infant smiling
and gazes toward the parent during the Still-Face episode (the so called, Still-Face effect; Adamson & Frick, 2003; Montirosso,
Cozzi, Tronick, & Borgatti, 2012). Beyond this general trend, however, there is considerable individual variability in infant
reactions during the procedure. Ekas, Haltigan, and Messinger (2012) found that only three-quarters of infants displayed the
expected changes in pattern of gazes to the parent, smiles, and positive social bids in transition from Play to the Still-Face
episode. Furthermore, positive displays have been also observed in infants during the Still-Face episode (Bazhenova, 1980;
Braungart-Rieker, Garwood, Powers, & Notaro, 1998; Fogel, 1982; Lamb, Morrison, & Malkin, 1987; Mayes & Carter, 1990;
Tronick et al., 1978; Weinberg & Tronick, 1996). For example, Mayes and Carter (1990) reported that 23% of 3-to-4-month-old
infants showed either some positive affect or no negative affect during the Still-Face presentation, demonstrating the ability
to maintain engagement with a non-engaging adult. During the Reunion episode, infants typically exhibit recovery from the
distress elicited by the maternal Still-Face, characterized by an increase in smiling and eye-contact with mother, labeled
Reunion effect (Adamson & Frick, 2003). As with reactions to the Still-Face, however, there is considerable variability in infant
reactions to Reunion. For instance, in one recent study, fewer than 20% of infants showed the expected changes in negative
affect from the Still-Face to the Reunion episode (Mesman, Linting, Joosen, Bakermans-Kranenburg, & van Ijzendoorn, 2013).
A recent development in understanding of variability in infant reactions during the FFSF involves creation of categories
to describe common patterns of response. To this end, Papousek (2007) combined observational measures (i.e., infant gaze,
smiles, and distress signals) during the FFFS into ve categories. The largest group of infants (Pattern A; 30%) showed a
behavioral pattern characterized by positive emotionality and high visual contact with the mother. Pattern B (20%) included
infants who showed a pattern characterized by positive emotionality, high interest in distal and proximal objects and low
visual contact with the mother. Pattern C (13%) was characterized by under-involvement with mother and physical objects.
The remaining patterns involved greater negative affect among the infants, with pattern D (27% of infants) characterized
by inconsolable crying and escalating arousal through the three episodes of the FFSF, and pattern E (10% of infants) characterized by negative emotionality and gaze avoidance toward mothers. This study shows that a categorical approach to
observation allows for identication of dramatic individual differences in infants patterns of behavior during the FFSF. However, these ndings suffer of the lack of an objective statistical procedure to create the patterns, thus, systematic study on
early constellations of infants individual differences using a categorical approach to behaviors during the FFSF has been
widely unexplored. In order to overcome this limitation in the present study, cluster analysis was used to identify patterns
of infants individual differences during social interaction with mothers, with these clusters used as predictors of behaviors
demonstrated by infants, mothers, and dyads during the subsequent Still-Face and Reunion episodes.
Cluster analysis is a multivariate and inherently atheoretical statistical procedure which starts with a dataset containing information about a sample of entities and attempts to reorganize these entities into relatively homogeneous groups
(Aldenderfer & Blasheld, 1984). Clustering involves sorting cases or variables according to their similarity on one or more
dimensions and producing groups that maximize within-group similarity and minimize between-group similarity (Henry,
Tolan, & Gorman-Smith, 2005). Cluster analysis has proven to be useful in demonstrating the variability of a cohort, providing
more information than group analyses per s (Glenn, Cunningham, Poole, Reeves, & Weidling, 2008). The clustering methods
have been successfully employed in infant temperament research (Janson & Mathiesen, 2008), in parenting studies during
infancy (Meteyer & Perry-Jenkins, 2009) and in analyses of caregivers behavior during free interaction (Hofer, Hohenberger,
Hauf, & Aschersleben, 2008). This approach was also employed to categorize both infant and maternal gaze direction and
vocalization within a play condition (Kawai et al., 2010), infant looking features when presented with different kinds of
object-in-motion video stimuli (Kutsuki, Kuroki, Egami, Ogura, & Itakura, 2009), and infants at risk for autism during a video
interaction task based on the FFSF paradigm, that is by a TV-video interaction (Merin, Young, Ozonoff, & Rogers, 2007). In the
present study we used cluster analysis to create patterns of individual differences reecting the infant behaviors during the
initial interaction episode of the FFSF paradigm (Play), using cluster membership as the basic unit of analysis for examination
of infant and maternal behavior and dyadic coordination across FFSF.
Within a transactional perspective of motherinfant interaction (Fiese & Sameroff, 1989), when evaluating individual differences in infant behavior, one should take into account parental behavior and dyadic coordination (Montirosso, Borgatti,
Trojan, Zanini, & Tronick, 2010; Provenzi, Borgatti, Menozzi, & Montirosso, 2015; Tronick & Cohn, 1989). Studies adopting

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69

the FFSF paradigm have found that maternal behavior affects infants behavioral response to social stress (Mesman et al.,
2009). Infants that showed lower negative emotionality in response to the exposure to the Still-Face episode had mothers
who were attentive to their infants and detected their signals during a face-to-face interaction (Grant, McMahon, Reilly, &
Austin, 2010). Recently, maternal contingent responding was related to more infant positive affect during the FFSF episodes
(Lowe et al., 2012) and more social signals during the maternal Still-Face (Mcquaid, Bibok, & Carpendale, 2010). As for dyadic
coordination, motherinfant dyads can be different in the extent to which mothers and infants respond to each others affective and behavioral displays. The Mutual Regulation Model (MRM; Gianino & Tronick, 1988) argues that the interaction is
organized by a bidirectional exchange of communicative signals that are used by the infant and the caregiver to coordinate
the interaction and cope with the stress of unavoidable interactive mis-coordination. Indeed, research has documented that
motherinfant interactions, rather than being characterized by high levels of coordination, are characterized by phases of
mismatch and repair (Tronick & Gianino, 1986). Ruptures in coordination are followed by reparations, which have been
regarded to have an important developmental function, given that infants can experience transitions from negative states
to positive/neutral emotional states. When successful, the reparation leads to a sense of control and effectiveness in the
infant and to the promotion of interactive skills (Tronick & Cohn, 1989). Thus, both the maternal behavior and the degree
of dyadic coordination (i.e., matching and reparation rate) may play important roles in infants emotional responsiveness
and their capacities for coping with stress (Carter, Mayes, & Pajer, 1990; Tronick & Cohn, 1989). To the best of our knowledge, no study has evaluated cluster-based patterns of infants behavior during social interaction to maternal behavior and
dyadic coordination during the FFSF paradigm. This procedure is particularly well-suited for exploration of maternal and
interactive behavior, as it involves interaction that occurs both prior to, and following, a dramatic interruption in interaction. Understanding the impact of infant behavior during a normative Play episode upon the ways that the mother and
dyad negotiate this situation can inform understanding of associations between the parentchild relationship and infants
emotion regulation.
Our rst aim was to identify by cluster analysis relatively homogenous subsets of individual differences in socialemotional behavior in 4-month-olds infants during the initial episode of FFSF. Following identication of meaningful
typologies of infants individual differences, our second research question was to investigate possible differences in infant
behavior during the subsequent two episodes of the FFSF as a function of the cluster groups. Finally, we examined whether
cluster groups were related to maternal and dyadic coordination (i.e., matching and reparation rate) during the normal interaction, Still-Face, and Reunion episodes. Based on previous literature, we predicted that typologies in which infants exhibited
more negative behaviors could be associated with: higher infant emotional negativity during both maternal unresponsiveness and in the episode after the relational perturbation; lesser social maternal engagement; and lower dyadic coordination.
On the other hand, we expected that infants who show more initial positive affect and/or social engagement could exhibit
less reactivity across Still-Face and Reunion episodes; more maternal engagement; and higher dyadic coordination.

2. Materials and methods

2.1. Participants
Seventy-ve 4-month-old infants and their mothers were enrolled at the Sacra Famiglia Hospital (Erba, Italy). Infants
eligibility criteria were: full-term delivery (gestational age 37 weeks), appropriate weight for gestational age (birth weight
2500 g), Apgar scores of at least 8 at 5 min, no congenital abnormalities, and uncomplicated prenatal, perinatal, and neonatal
courses. Eligibility criteria for mothers were as follows: not single-parent, not underage, free of drug use, and no documented
emotional disorders.

2.1.1. Infants and maternal characteristics

The sample consisted of 75 infants (N = 38 females). Infants average age was 4.33 months (SD = 0.28). Mothers average
age was 34.5 years (SD = 4.19). Mothers had at least a high school degree (mean education level = 14.20, SD = 3.48), were
middle class (Hollingshead (1975) socioeconomic status index = 60.41, SD = 20.09) and had no signicant levels of depressive
symptoms using the Beck Depression Inventory (Beck, Ward, Mendelson, Mock, & Erlbaugh, 1961) (mean scores = 5.56,
SD = 3.45; with a cut-off score greater than 12).

2.2. Procedures
Mothers were rst contacted during the last trimester of pregnancy and were told that the study concerned motherinfant
interactive and communicative behaviors. Mothers who expressed an interest in participating were subsequently recontacted when their infants were approximately 4-months-old. The protocol included a video-recording of the FFSF
motherinfant interaction and completion of a socio-demographic form and questionnaire on maternal depressive symptoms. The study was approved by the Ethics Committee of the Scientic Institute, IRCCS Eugenio Medea and written informed
consent was obtained from both parents of every participant infant.

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2.3. Measures
2.3.1. Face-to-Face Still-Face paradigm
Motherinfant dyads were videotaped during the FFSF paradigm at a time when infants were rested and alert, usually
between 9 a.m. and noon. The procedure was initiated after a brief period of the infants adaptation to the lab environment
and when the infants were quiet and in a state of calm. Mothers were assured that the examiner would stop the Still-Face and
begin the Reunion episode if their infants became too distressed (i.e., crying and arching back for longer than 30 s) and that
they could stop the procedure at any time. Mothers sat approximately 40 cm in front of the infants. The paradigm consists
of three episodes: (1) 2 min of face-to-face play interaction (Play), (2) 2 min of maternal Still-Face (Still-Face), and (3) 2 min
of post-still-face interaction (Reunion). Prior to video recording, mothers were instructed to play with their infants as they
normally do at home during the Play and Reunion episodes. For the Still-Face episode mothers were instructed to pose a
neutral, expressionless face to their infants, to look at them, but not to smile, talk to, or touch them. Each episode (Play,
Still-Face and Reunion) was separated by a 15 s inter-trial interval during which the mother was instructed to turn her back
to the infant. Mothers wore an earphone over which they heard pre-recorded instructions telling them when to start or stop
an episode. No infant was dropped from the sample as a result of crying or excessive distress during the FFSF paradigm.
Two cameras were used, with one focused on the infant and the other on the caregiver. The signals from the two cameras
were edited off-line to produce a single image with simultaneous frontal view of the face, hands and torso of infant and
mother.
2.3.2. Coding of maternal and infant behavior
Infants and mothers behaviors were coded micro-analytically in 1 s time intervals, using the Infant and Caregiver Engagement Phases (ICEP; Weinberg & Tronick, 1998) system. The ICEP includes a set of mutually exclusive infant and mother
engagement codes. For the infant, the engagement codes were: (1) negative engagement: the infant displays negative facial
expressions, such as distress, crying, or grimacing, complaining, being fussy, crying vocalizations, may be actively protesting
or withdrawn; (2) object/environment engagement: the infant is looking at objects that are either proximal (e.g., infant
seat) or distal (e.g., camera); (3) social monitoring: the infant looks at the mother with neutral or interested facial affect;
and (4) positive engagement: the infant looks at the mother while smiling. For the caregiver, the engagement codes were:
(1) negative engagement: the adult is negative, intrusive, hostile, or withdrawn; (2) non-infant-focused engagement: the
caregiver is not attending to the infant and is involved in a non-infant focused activity; (3) social monitoring: the adult looks
at infant with neutral/interested expression or with positive vocalizing; and (4) positive engagement: the caregiver looks at
infant and displays facial expressions of joy (e.g., smiles, laughter, exaggerated expressions). Caregiver and infant behaviors
were coded off-line from videotapes, using software specically developed by the Bioengineering Laboratory of the Scientic
Institute, IRCCS Eugenio Medea. This software allowed the input of ICEP codes while simultaneously viewing both mother
and infant video playback. Video clips were played at normal speed during coding, with the possibility of stopping or running
them in slow motion, in order to accurately determine whether and what kind of code change had occurred, thus recognizing
every behavioral shift.
2.4. Reliability
Coders were trained with a gold standard sample of 10 videotapes (agreement > 75%). Following coding, 50% of the Play,
Still-Face and Reunion episodes were randomly selected and assessed for agreement between two independent coders. The
mean percentage of agreement and Cohens kappa were, respectively, 80 and .71 for infants behavior, and 85 and .75 for
caregivers behavior.
2.5. Plan of analyses
2.5.1. Data reduction
The infant and mother variables were calculated as proportions by dividing the total time each code occurred by the
total length of the episode. For caregivers, variables for Negative engagement and Non-infant focused engagement were
equivalent to zero and not used. Two separate measures of dyadic coordination, Matching and Reparation Rate, were derived.
Following procedures from previous studies (Montirosso et al., 2010; Weinberg, Tronick, Cohn, & Olson, 1999), Matching
was dened as the extent to which mothers and infants shared joint ICEP codes (e.g., infant and mother simultaneously
in positive engagement in the same 1 second interval). Negative engagement matches and Non-infant focused engagement matches were not calculated given that mothers never exhibited these behaviors. Proportion scores were calculated
for social monitoring and positive engagement matching by dividing the match score for each by the total time during
which either the mother or the infant was in each state. A total matching score was then computed as mean of the social
monitoring match and positive engagement match proportion scores. Reparation Rate was dened as a measure of the frequency of transitions from mismatching to matching dyadic phases and vice versa, expressed as the rate of change per
second.

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71

2.6. Clustering strategy

ICEP codes of the 75 infants behaviors during the initial episode of FFSF were subject to cluster analysis using SPSS
17.0 for Windows (Chicago, IL, USA). Between-groups average linkage method was used and squared Euclidean distance
served as the proximity index. The criteria used to select the number of clusters included the possibility to differentiate the
outcome measures and their intelligibility (Aldenderfer & Blasheld, 1984). Solutions with two, three, and four clusters were
attempted, and at the end, a three-group solution was selected, as it produced the clearest distinctions among the clusters.
2.7. Statistical analysis
Due to the relatively small sample size, and given that the distributional assumptions associated with statistical parametric procedures were not met (e.g., some ICEP codes were signicantly skewed), appropriate non-parametric tests
were applied to test differences between the clusters in terms of infant and maternal ICEP codes and coordination measures. Specically, cluster scores for the infant, maternal, and dyadic variables in each episode of FFSF were compared
using k-unrelated-samples KruskalWallis tests. Signicant effects were evaluated in pairwise comparisons using the
MannWhitney U test for two unmatched samples. Because all mothers were instructed to behave in the same manner
during the Still-Face, the caregivers and dyadic variables were examined only during Play and Reunion episodes.
3. Results
3.1. Three-cluster solution
Clusters representing infant behavior during play were composed of three separate groups: Socially Engaged (N = 25, 33% of the whole sample), Disengaged (N = 45, 60% of the whole sample) and Negatively Engaged (N = 5, 7% of the whole sample). Table 1 contains descriptive statistics and KruskalWallis
tests comparing clusters on all variables. The Socially Engaged cluster was composed of infants who spent over half the Play episode in social monitoring and a relatively high proportion of time in object/environment engagement. Furthermore, these infants showed a moderate percentage of positive
engagement and a very low proportion of negative engagement. The Disengaged cluster was composed of infants who spent the large majority of the play
period in object/environment engagement and a moderate percentage of time in social monitoring. In addition, these infants showed a low percentage
both of positive engagement and negative engagement. The Negatively Engaged cluster was composed of infants who spent most of the period in negative
engagement, a moderate percentage of time in object/environment engagement, very low levels of social monitoring and a virtual absence of positive
engagement.
As shown in Table 1, KruskalWallis comparisons conrmed the distinctions between the clusters, as signicant differences were found for all infant
behaviors in the play period. Pairwise comparisons indicated that the Negatively Engaged cluster showed higher negative engagement than Socially Engaged

Table 1
Means and standard deviations and KruskalWallis tests (2 ) for infant and maternal engagement and for measures of dyadic coordination across FFSF.

Infant

Play

Still-Face

Reunion

Caregiver

Play
Reunion

Dyad

Play
Reunion

Socially Engaged
cluster

Disengaged cluster

Negatively Engaged
cluster

Clusters
comparison

(N = 25)
Mean

(N = 45)
Mean

SD

(N = 5)
Mean

2

SD

SD

Negative Engagement
Object/Environment
Social Monitoring
Positive Engagement
Negative Engagement
Object/Environment
Social Monitoring
Positive Engagement
Negative Engagement
Object/Environment
Social Monitoring
Positive Engagement

.03a
.33a
.51a
.13a
.18a
.50a
.31a
.01
.12a
.56a
.27a
.05a

.06
.19
.14
.10
.25
.27
.23
.02
.23
.27
.20
.07

.05a
.80b
.14b
.02b
.18a
.67b
.15b
.00
.30b
.52a
.14b
.05a,b

.07
.13
.09
.04
.25
.27
.18
.01
.35
.32
.12
.11

.73b
.24a
.03c
.00b
.75b
.18c
.07b
.00
.85c
.13b
.02c
.00

.22
.23
.04
.00
.29
.18
.12
.00
.15
.14
.03
.00

17.52**
49.91**
52.46**
21.14**
10.42**
14.37**
13.21**
2.92
15.86**
7.53*
17.62**
6.07*

Social Monitoring
Positive Engagement
Social Monitoring
Positive Engagement

.75a
.25a
.80a
.20

.25
.25
.25
.25

.80a
.20a
.77a
.23a

.18
.18
.23
.23

.99b
.01b
.95b
.05b

.01
.01
.11
.11

8.31*
8.16*
5.41
5.41

Matching
Reparation rate
Matching
Reparation rate

.48a
.23a
.23a
.16a

.17
.09
.19
.11

.11b
.09b
.13a,b
.08b

.09
.06
.14
.06

.07b
.03c
.05b
.03c

.04
.04
.04
.04

41.52**
36.63**
7.55*
17.27**

Note: Means with different subscripts are signicantly different from each other at p < .05.

Negative engagement and non-infant focused engagement were not reported because their proportion were equivalent to zero.

Negative engagement matches and non-infant focused engagement matches were not calculated given that mothers did not exhibit these behaviors.

Rate of change for second.
*
p < 0.5.
**
p < 0.01.

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R. Montirosso et al. / Infant Behavior & Development 38 (2015) 6776

cluster (U = 0.00; p = 0.00) and Disengaged cluster (U = 0.00; p = 0.00). The Disengaged cluster showed less object/environment engagement than the Socially
Engaged cluster (U = 21.00; p = 0.00) and Negatively Engaged cluster (U = 2.00; p = 0.00). Socially Engaged infants showed higher levels of social monitoring
than Disengaged infants (U = 1.00; p = 0.00) and Negatively Engaged infants (U = 0.00; p = 0.00), with a signicant difference between the last two clusters
(U = 29.50; p = 0.01). Socially Engaged infants also showed higher positive engagement than the Disengaged cluster (U = 241.5; p = 0.00) and Negatively
Engaged cluster (U = 17.50; p = 0.01).
3.2. Cluster comparisons: maternal and dyadic behaviors during Play
As reported in Table 1 KruskalWallis test revealed signicant differences for maternal positive engagement and social monitoring among the
three clusters. Pairwise comparisons suggested that Negatively Engaged cluster mothers exhibited a greater proportion of social monitoring than both
the Socially Engaged cluster (U = 17.50; p = 0.01) and the Disengaged cluster (U = 22.5; p = 0.00). Conversely, Negatively Engaged cluster mothers exhibited a lower proportion of positive engagement than both the Socially Engaged cluster (U = 17.50; p = 0.01) and the Disengaged cluster (U = 24.00;
p = 0.00).
A signicant effect of cluster also emerged for dyadic variables. For matching, pairwise comparisons suggested that the dyads of the Socially Engaged
cluster showed higher levels of matching than dyads of the Disengaged cluster (U = 33.50; p = 0.00) and Negatively Engaged cluster (U = 1.00; p = 0.03). Socially
Engaged dyads showed a higher reparation rate than those of the Disengaged cluster (U = 104.50; p = 0.00) and Negatively Engaged cluster (U = 3.00; p = 0.00),
with the Disengaged cluster demonstrating more reparation than the Negatively Engaged cluster (U = 44; p = 0.03).
3.3. Cluster comparisons: infant behaviors during Still-Face
As shown in Table 1, a cluster effect emerged for all infant behaviors except positive engagement. Pairwise comparisons suggested that Negatively
Engaged cluster showed higher negative engagement than the Socially Engaged (U = 10.00; p = 0.00) and Disengaged clusters (U = 15.00; p = 0.00). The
Disengaged cluster displayed higher levels of object/environment engagement than Socially Engaged cluster (U = 356.50; p = 0.01) and Negatively Engaged
cluster (U = 19.00; p = 0.00), with the Socially Engaged cluster demonstrating more object/environment engagement than the Negatively Engaged cluster
(U = 18.50; p = 0.01). Socially Engaged infants showed higher levels of social monitoring than those of the Disengaged cluster (U = 302.00; p = 0.00) and
Negatively Engaged cluster (U = 21.50; p = 0.02).
3.4. Cluster comparisons: infant, maternal, and dyadic behavior during Reunion
A cluster effect was found for all infant behaviors (see Table 1). Pairwise comparisons suggested that Negatively Engaged cluster showed higher
negative engagement than the Socially Engaged cluster (U = 4.00; p = 0.00) and Disengaged cluster (U = 24.00; p = 0.00), with higher negative engagement
in the Disengaged than the Engaged cluster (U = 363.0; p = 0.01). Furthermore, Negatively Engaged infants displayed lower levels of object/environment
engagement than those of the Socially Engaged cluster (U = 11.00; p = 0.00) and Disengaged cluster (U = 36.50; p = 0.01). Socially Engaged cluster showed
higher levels of social monitoring than the Disengaged cluster (U = 314.00; p = 0.00) and Negatively Engaged cluster (U = 4.50; p = 0.00), with higher monitoring in the Disengaged cluster than the Negatively Engaged cluster (U = 29.00; p = 0.01). Positive engagement was higher in the Socially Engaged
cluster than the Negatively Engaged cluster (U = 22.50; p = 0.02). KruskalWallis tests revealed no signicant differences among the three clusters for
maternal engagement. Nevertheless, pairwise comparisons suggested that Negatively Engaged cluster mothers exhibited a greater proportion of social
monitoring than those in the Disengaged cluster (U = 47.00; p = 0.03). Conversely, Negatively Engaged cluster mothers exhibited a lower proportion
of positive engagement than those in the Disengaged cluster (U = 47.00; p = 0.03). Finally, a signicant effect of cluster emerged for dyadic variables.
Pairwise comparisons suggested that the dyads of the Socially Engaged cluster showed higher levels of matching than those of Disengaged cluster
(U = 318.5; p = 0.01). The Socially Engaged dyads also showed higher levels of reparation rate than those of Disengaged dyads (U = 285.00; p = 0.00)
and of Negatively Engaged dyads (U = 7.50; p = 0.00), with higher levels of reparation in the Disengaged than Negatively Engaged cluster (U = 50.50;
p = 0.04).

4. Discussion
In this study, cluster analysis was used to categorize a sample of 4 month-old infants on the basis of their behaviors
during the rst normal face-to-face interaction of the FFSF, with these clusters forming a base with which infant, maternal
and dyadic behavior in the Still-Face procedure were examined. Cluster analyses revealed distinct groups of infants. A Socially
Engaged cluster made up of 33% of the infants showed high levels of social responsiveness and was moderately positive in the
interaction with their mothers as compared to the other two clusters. In contrast, the majority of infants (60%; Disengaged
cluster) showed a tendency to be only mildly engaged in the social exchanges with their mothers, spending much of the
play period focused on other aspects of their environment and expressing little positive or negative emotion. Finally, a small
(7%) subset of infants (Negatively Engaged cluster) spent the majority of the initial episode expressing negative affect, a
moderate amount of time examining their surroundings, and demonstrated minimal attention to their mothers, expressing
no positive affect.
The distinctiveness of these groups supports the use of the clustering approach to delineate clear patterns of individual
differences among infants. Importantly, these ndings resonate with prior literature. The Socially Engaged group appears
to be similar to the 30% of infants described by Papousek (2007) as displaying Pattern A, characterized by high positive
affect and engagement with their mother. The Disengaged cluster in the current study shows a strong overlap with Patterns
B and C, who were relatively uninvolved with their mother, and together comprised 43% of infants in Papouseks sample.
Finally, our Negatively Engaged cluster is comparable to the small group in the earlier study that demonstrated high levels
of negativity throughout the procedure. Importantly, both the nature and size of our groups is comparable to those obtained
in previous research, despite the fact that our patterns were not based on a priori dened congurations of infant behaviors,
but on the within-group similarity of the infants characteristics. Overall this evidence validates the use of the clustering
approach to delineate clear patterns of individual differences.
Only 33% of infants (Socially Engaged cluster) reacted to the procedure with typical Still-Face effect by diminishing positive
focus on their caregiver and expressing increased levels of negative affect. The relative infrequency of this behavior pattern,

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73

however, is not surprising when considered in conjunction with the ndings of Mesman et al. (2013), who found that at
ages 3 and 6 months just a minority of infants (417%) exhibited the classic pattern of changes in negative emotionality
and gaze. Infants did react to the mothers unresponsivity with increased levels of negative affect, but did not increase or
decrease in their attention to their mother. Whereas the Socially Engaged cluster demonstrated a classic Reunion effect, with
a moderate negative emotionality exhibited when mothers resumed interaction during the Reunion, the Disengaged infants
exhibited a strong increase of negativity. Finally, a minority of infants (i.e., Negatively Engaged cluster), showed a consistent
pattern across the episodes of the FFSF paradigm: no positive affect, very low social monitoring and, above all, high levels
of negative engagement. Taken together, these results add to evidence from previous studies (Mesman et al., 2013; Yoo &
Reeb-Sutherland, 2013) suggesting there are signicant differences in the way infants react to the Still-Face episode and
recover from the Reunion episode, and that these differences are signicantly inuenced by individual differences in the
social interaction style of the infants.
In analysis of the maternal behaviors associated with each cluster, we found that mothers of Negatively Engaged cluster
showed a clear difference in their behaviors when compared with mothers of Socially Engaged and Disengaged clusters. In these latter groups, mothers exhibited high levels of positive socio-emotional behaviors in the interaction with
their infants, while the mothers of Negatively Engaged infants were more likely to elicit their infants attention (i.e.,
social monitoring) and were more likely to express low positive affect during the interaction. These differences offer support for the view that mothers of Negatively Engaged infants used different behaviors to help their infants to maintain
affective regulation. Moreover, we did not nd differences among the three clusters for maternal socio-demographic characteristics and depressive symptomatology, so that these factors did not appear sufcient to account for the individual
differences in the infants behavior observed in the Negatively Engaged cluster. Possibly, some specic infant characteristics (i.e., high negativity, no positivity and low social contact) solicit these types of monitoring behaviors from the
caregiver, who adjust their behavior to modulate the reactivity of their infants (Jahromi, Putnam, & Stifter, 2004), perhaps because they regarded high negativity of their infants as a challenge or/and as a signal of special need (Crockenberg,
1986).
Moving beyond the level of individual mother and infant behavior, a nal aim of this study concerned dyadic coordination
associated with patterns of infants individual differences. There were dramatic differences among the clusters. Regarding
matching, while the Socially Engaged cluster dyads spent over 35% of their interaction time in matching states (primarily
matching social or positive behaviors), the Disengaged cluster and Negatively Engaged cluster spent far more of their interaction time in mismatching states, respectively 88% and 94%. Regarding repairs to the interaction, in the Socially Engaged
cluster the average of repair rate was about once every 5.1 s, while in the Disengaged cluster was about once every 11.7 s
and in the Negatively Engaged cluster was even higher, only once every 33.3 s. A possible interpretation of this pattern of
ndings is that the infants greater disengagement from their mothers (i.e., Disengaged cluster) and more negative emotional
expressivity (i.e., Negatively Engaged cluster) may make it harder for these dyads to move to coordinated state in which both
members of the dyad are simultaneously attending to one another or expressing positive affect. The dyadic coordination
changes across FFSF episodes also showed signicant differences among the three clusters. Previous studies have suggested
that, after the stress of the Still-Face, both infants and mothers nd it more difcult to coordinate their social behavior and
maintain a mutual engagement (Montirosso et al., 2010; Weinberg & Tronick, 1996; Weinberg et al., 1999). Accordingly, the
mothers and infants of the Socially Engaged cluster showed fewer attempts at reparation during Reunion than during Play
and found it more difcult to move to joint states. In contrast, the Negatively Engaged and Disengaged dyads maintained
similar levels of mutual engagement and reparation rate across the Play and Reunion contexts. These results seem to indicate
that infants and mothers not only took longer to repair interactive errors and to move into joint social and positive states,
but also that in these dyads the processes of reparation and mutual regulation were hard and complex, regardless of the
Still-Face effect.
Collectively, the ndings of the present study suggest that the higher levels of attention toward mothers and positive
engagement observed in the Socially Engaged infants may contingently inuence maternal responses, which in turn enhance
dyadic coordination. In contrast, Disengaged infants, who allocate less attention to their mothers, may contribute to a
situation in which dyads may need to work hard to keep the interaction well organized. Finally, Negatively Engaged infants
shifted the attention toward their mothers only temporarily, perhaps overloading mothers capability to help the infant
lower their experience and expression of negative emotion (Harman, Rothbart, & Posner, 1997). Mothers in these dyads
appeared to respond by increasing the attention toward the infant (i.e., higher social monitoring), but were largely unable to
repair the interaction and move to mutual engagement. In the perspective of the MRM (Tronick & Gianino, 1986) a possible
scenario is that infants who experience several episodes of mismatching and few reparations due to a higher reactivity
and no positivity might become overloaded, incapable of reducing negative engagement, and less available to promote
moments of positive exchanges with their mothers (Tronick, 2007). These interpretations, however, must be considered
with respect to characteristics of the FFSF procedure. Prior research (Jahromi et al., 2004) suggests that, in response to infant
distress, mothers should use more vigorous soothing behaviors, such as holding and actively rocking their infants, rather
than the limited techniques that can be used during a face-to-face interaction (e.g., touching, vocal soothing, distraction,
vocalizations). Regardless, these ndings indicate that patterns of play behaviors before the Still-Face contribute to infant,
mother, and dyadic responses to the maternal Still-Face and Reunion episodes, highlighting the fact that infant characteristics
are important in accounting for the transactional nature of motherinfant interactions and the ability of infants to cope with
the stress (Mesman et al., 2013).

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It is necessary to note some limitations of the study. First, it should be noted that cluster analysis is fundamentally
a sample-related procedure, and thus the clusters emerged in this study are not automatically representative of other
populations of infants. Second, while the Negatively Engaged cluster did not differ from the others two for infants and
maternal socio-demographic characteristics, more detailed assessments of this subgroup of infants would be warranted
to better understand the precursors of their lower emotion regulation. At this stage it is not possible to rule out that
these individual characteristics could be related to genetic and/or epigenetic factors (Lester, Marsit, Conradt, Bromer, &
Padbury, 2012; Pluess, Stevens, & Belsky, 2013). Future work should explore the antecedents of these individual differences. Third, given that infant behavior in the FFSF does not seem to be particularly stable across time (Melinder, Forbes,
Tronick, Fikke, & Gredebck, 2010; Mesman et al., 2013), the individual difference in association to the three clusters
observed across FFSF may not steady throughout infant development. This reduces the generalizability of our results to older
infants.
Despite these caveats, our ndings suggest that, as mentioned, cluster analysis is a valuable approach to the infant
research, as it offers the possibility to describe meaningful subgroups of infants dened by similarities along multiple
dimensions of interest, allowing to link these subgroups to the quality of the motherinfant interactions. Beyond our
application to the FFFS procedure, clustering techniques have more broad implications for the investigation of individual differences in the context of early dyadic interactions. For example, emerging ndings suggest the importance of
longitudinal research examining infants negative emotionality as factor which moderate parentinfant mutuality (Kim &
Kochanska, 2012). Cluster analysis offers a unique advantage for testing the developmental trajectories of the infantmother
mutuality, starting from well-dened groups of infants that emerge from the data, which may more accurately represent
underlying categories of children, rather than from groups of infants grouped on more conventional bases (e.g., median
splits).
Returning to our ndings, although, further research is warranted, the categorical approach used in this study revealed
the presence of distinctive patterns of individual differences in typically developing infants that shed light on the different ways in which infants and their parents can face a stressful social condition. Our ndings provide evidence that
the typical Still-Face effect and Reunion effect across the FFSF procedure were qualied by dissimilar ways in which
these effects occur. In a certain sense, it seems reasonable to claim that there is not only one type of Still-Face effect
and/or Reunion effect, and that a minority of infants might do not exhibit both these effects at all. Finally, this study
extends previous work by exploring the association between infants individual differences and dyadic coordination,
suggesting that infant characteristics are essential to our understanding the dyadic complexities of the motherinfant
system.
Conict of interest
There are no nancial disclosures or conicts of interest for any authors.
Acknowledgements
The authors wish to thank the nursing and clinician staff from the Pediatric Unit of the Sacra Famiglia Hospital of Erba
(Como), Italy. Many thanks to colleague Viola Brenna for her help in data collection and technical assistance. We also wish to
thank Sonia Cozzupoli, Anna Del Signore, and Lorenzo Giusti for their help in data coding: when the research was conducted
they were graduating students in psychology at the Catholic University of Milan. Finally, we extend a special thanks to infants
and their mothers who took part in this research. This research was supported by funds from the Italian Health Ministery
(Ricerca Corrente 2007) to Scientic Institute, IRCCS Eugenio Medea.
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