Barnett Douglas, Clements Melissa, Kaplan-Estrin Melissa, McCaskill John W, Hunt Kelli Hill, Butler Christine M, Schram Jill L, Janisse Heather C
Department of Psychology.
J Fam Psychol. 2006 Mar;20(1):100-107. doi: 10.1037/0893-3200.20.1.100.
In this longitudinal study, the authors investigated individual differences in how families adapt to a child's congenital disorder. Family impact, maternal grief resolution, and child attachment were assessed among 74 mothers and their toddlers with a neurological disorder or disfigurement. Fifty dyads were reevaluated 16 months later. For children with neurological compared with disfigurement diagnoses, there was a greater likelihood of negative impact on family, unresolved maternal grief, and insecure attachment at Time 1. Children classified as secure were significantly more likely to have mothers classified as resolved regarding their reactions to their children's diagnosis. Maternal grief resolution was significantly stable (77%) over time and mediated the relation between type of diagnosis and child security. With time, negative impact of child condition on the family decreased and percentage of children classified as secure increased, suggesting that on average families improved. Results suggest that helping parents come to terms emotionally and cognitively with their child's condition may be a useful focus for intervention.
在这项纵向研究中,作者调查了家庭如何适应孩子先天性疾病方面的个体差异。对74名患有神经系统疾病或身体畸形的母亲及其学步儿童评估了家庭影响、母亲悲伤情绪的缓解情况以及孩子的依恋情况。16个月后对其中50对母子进行了重新评估。与身体畸形诊断的孩子相比,患有神经系统疾病诊断的孩子在研究开始时对家庭产生负面影响、母亲悲伤情绪未得到缓解以及依恋不安全的可能性更大。被归类为安全型依恋的孩子,其母亲对孩子诊断反应被归类为情绪缓解的可能性显著更高。随着时间推移,母亲悲伤情绪的缓解情况显著稳定(77%),并介导了诊断类型与孩子安全感之间的关系。随着时间推移,孩子病情对家庭的负面影响减少,被归类为安全型依恋的孩子比例增加,这表明平均而言家庭状况有所改善。结果表明,帮助父母在情感和认知上接受孩子的病情可能是干预的一个有益重点。