THE DEVELOPMENT OF THE LOUIS MACRO (MOTHER AND CHILD RISK OBSERVATION) FORMS - ASSESSING PARENT-INFANT-CHILD RISK IN THE PRESENCE OF MATERNAL MENTAL-ILLNESS

Objective: The theoretical framework and psychometric properties of th e MACRO (Mother and Child Risk Observation) 1 and 2 forms (age 0 to 1 year) are presented. The MACRO forms provide ratings on five domains-- three related to parenting, two on infant (or child) characteristics a nd maternal mental state. Case vignettes illustrate their clinical uti lity. Method: Ratings on the MACRO of 110 mother-infant and 85 mother- toddler consecutive admissions to a South Australian psychiatric in-pa tient mother-infant unit provided data on internal consistency, interr ater, and test-retest reliability. Results: Internal consistency was b etween .79 to .95 for all MACRO domains. item-total correlations were between .39 and .90 with the exception of one item, Social Support. Di stributions of item scores indicated acceptable discrimination. Interr ater reliability was .79 or above for all domains. Test-retest reliabi lity after 7 days was .71 or above. Conclusions: Preliminary psychomet ric investigations of the MACRO was favorable. Should further validity investigations prove satisfactory, the MACRO will provide a valuable clinical and research tool. The MACRO offers a convenient framework fo r assessing risk and interpreting the impact of maternal mental illnes s upon children within a context that permits consideration of factors such as illness severity, parenting practices, and child contribution to outcome. (C) 1997 Elsevier Science Ltd.