Centre for Women's Mental Health, Division of Psychiatry, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
Arch Womens Ment Health. 2009 Jun;12(3):123-34. doi: 10.1007/s00737-009-0066-5. Epub 2009 Apr 1.
This review aims to consider evidence for the impact of maternal psychopathology on the child's attachment to the mother, and the role of this in mediating the known transmission of developmental and clinical risk to children. The studies reviewed focus on mothers with depression and psychotic disorder. A number of studies (mainly of mothers with depression) demonstrate an association between insecure/disorganised infant attachments and severe maternal psychopathology, whether chronic or current, in the presence of comorbid disorder, maternal insecure or unresolved attachment state of mind, trauma/loss, or low parenting sensitivity. Whether such effects last into middle childhood, however, is unclear. Our understanding of the role of attachment in determining developmental trajectories in this group is at an early stage. Some evidence suggests that attachment may have a role in mediating the intergenerational transmission of internalizing and other problems in this group, although the presence of co-occurring contextual risk factors may account for the variability in findings. A multifactorial longitudinal approach is needed to elucidate such factors. However, the current literature highlights which subgroups are likely to be vulnerable and provides an evidence-based rationale for taking an attachment-based approach to intervention in this group.
本次综述旨在探讨母亲精神病理学对儿童与母亲依恋关系的影响，并研究其在介导已知发育和临床风险向儿童传递过程中的作用。综述研究的重点是患有抑郁症和精神分裂症的母亲。多项研究（主要针对患有抑郁症的母亲）表明，在存在共病障碍、母亲不安全或未解决的依恋心理状态、创伤/丧失或低育儿敏感度的情况下，婴儿依恋的不安全感/组织不良与严重的母亲精神病理学之间存在关联。然而，这种影响是否会持续到儿童中期尚不清楚。我们对这一群体中依恋在决定发展轨迹方面的作用的理解还处于早期阶段。有证据表明，依恋在介导这一群体中内化和其他问题的代际传递中可能起作用，尽管共存的情境风险因素可能解释了研究结果的变异性。需要采用多因素纵向方法来阐明这些因素。然而，目前的文献强调了哪些亚组可能容易受到影响，并为在这一群体中采取基于依恋的干预措施提供了基于证据的理由。
