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母亲惊恐障碍:婴儿气质、神经生理学与养育行为

Maternal panic disorder: infant temperament, neurophysiology, and parenting behaviors.

作者信息

Warren Susan L, Gunnar Megan R, Kagan Jerome, Anders Thomas F, Simmens Samuel J, Rones Michelle, Wease Stephen, Aron Emily, Dahl Ronald E, Sroufe L Alan

机构信息

George Washington University, Washington, DC 20037, USA.

出版信息

J Am Acad Child Adolesc Psychiatry. 2003 Jul;42(7):814-25. doi: 10.1097/01.CHI.0000046872.56865.02.

Abstract

OBJECTIVE

To determine whether 4- and 14-month-old infants of mothers with panic disorder (PD) would be more likely to show differences in temperament, neurophysiology (salivary cortisol and sleep), and relationships with their mothers than controls.

METHOD

Two cohorts were recruited: 4-month-old infants with PD mothers (n = 25) and 4-month-old controls (n = 24), and 14-month-old infants with PD mothers (n = 27) and 14-month-old controls (n = 18). Mothers completed diagnostic interviews and questionnaires concerning infant temperament, sleep, and parenting. Infant salivary cortisol samples and standard observational procedures to measure infant temperament, sleep, attachment, and parenting were also used.

RESULTS

Infants with PD mothers did not show more high reactivity, behavioral inhibition, or ambivalent/resistant attachment but did demonstrate different neurophysiology (higher salivary cortisol and more disturbed sleep) than controls. PD mothers also displayed less sensitivity toward their infants and reported parenting behaviors concerning infant sleep and discipline that have been associated with child problems.

CONCLUSIONS

While infants with PD mothers did not show early behavioral differences from controls, they did display neurophysiological divergences consistent with higher arousal/arousability. Such neurophysiological divergences (elevated salivary cortisol and disturbed sleep) might be important early indicators of risk. Helping PD mothers parent their more highly aroused/arousable infants could reduce the development of psychopathology.

摘要

目的

确定患有惊恐障碍(PD)母亲的4个月和14个月大婴儿,与对照组相比,是否更有可能在气质、神经生理学(唾液皮质醇和睡眠)以及与母亲的关系方面表现出差异。

方法

招募了两个队列:患有PD母亲的4个月大婴儿(n = 25)和4个月大的对照组(n = 24),以及患有PD母亲的14个月大婴儿(n = 27)和14个月大的对照组(n = 18)。母亲们完成了关于婴儿气质、睡眠和育儿的诊断访谈和问卷。还使用了婴儿唾液皮质醇样本以及测量婴儿气质、睡眠、依恋和育儿的标准观察程序。

结果

患有PD母亲的婴儿在高反应性、行为抑制或矛盾/抗拒依恋方面没有表现出更多差异,但与对照组相比,确实表现出不同的神经生理学特征(唾液皮质醇水平更高,睡眠更紊乱)。患有PD的母亲对婴儿的敏感性也较低,并报告了与儿童问题相关的关于婴儿睡眠和纪律的育儿行为。

结论

虽然患有PD母亲的婴儿在行为上与对照组没有早期差异,但他们确实表现出与更高唤醒/易唤醒性一致的神经生理学差异。这种神经生理学差异(唾液皮质醇升高和睡眠紊乱)可能是重要的早期风险指标。帮助患有PD的母亲养育更容易被唤醒/易唤醒的婴儿可能会减少精神病理学的发展。

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