When mothers decide whether or not to forego life-sustaining treatments for their children: A preliminary study of psychological correlates

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)

First Committee Member

Margaret Crosbie-Burnett - Committee Chair

Second Committee Member

Carolyn Garwood - Committee Member


The purpose of this study was to determine whether intrapsychic factors could be identified that distinguished mothers who agreed to a Do-Not-Resuscitate (DNR) order from those who refused, and whether the model provided by object relations was a useful way to examine these factors. Twenty mothers volunteered to participate in a study that examined the presence of alienation and attachment insecurity, parental bonding, and the presence of a social support network. These mothers were recruited from a large pediatric hospital and from a long-term pediatric nursing facility.Alienation and insecure attachment were assessed by the Bell Object Relations and Reality Testing Inventory (Bell, 1991). Parental bonding was measured by the Parental Bonding Instrument (Parker, Tupling & Brown, 1979). The presence and adequacy of a social support network was measured by the Social Support Questionnaire (Sarason, Levine, Basham & Sarason, 1983).Analysis including t-tests, chi-square and discriminant function were performed on the data to determine differences between groups. Results indicated that significant differences existed on scales that measure alienation (an object relations concept) and uncertainty of perception (a reality-testing concept). Mothers who had refused the DNR had significantly higher scores on the alienation scale and on the uncertainty of perception scale than the mothers who agreed to the DNR. Conviction to religious beliefs also emerged as a significant difference between the groups, with the mothers who refused the DNR being more religious. The results do not support object relations theory.


Psychology, Developmental; Sociology, Individual and Family Studies; Psychology, Cognitive

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