Department of Psychiatry and Psychology, Mayo Clinic College of Medicine.
Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center.
Rehabil Psychol. 2013 Aug;58(3):223-232. doi: 10.1037/a0033119.
PURPOSE/OBJECTIVE: To understand how traumatic brain injury (TBI) affects maternal warm responsiveness and negativity over the first 12 months following injury.
METHOD/DESIGN: We used a concurrent cohort research design to examine dyadic interactions in young children with a TBI (n = 78) and a comparison group of young children with orthopedic injuries (OI; n = 112) and their families during the initial weeks following injury (i.e., baseline) and at two follow-up periods (approximately 6 and 12 months later). Trained raters coded videotaped interactions during a free play and structured teaching task for maternal warm responsiveness and negativity.
Mothers in the complicated mild/moderate TBI group, but not those in the severe TBI group, exhibited significantly lower levels of maternal warm responsiveness than mothers in the OI group. However, these differences were observed only at baseline during free play and only at baseline and 6 months postinjury during the structured teaching task, suggesting diminishing adverse effects of complicated mild/moderate TBI on parenting over time postinjury. Analysis failed to reveal group differences in maternal negativity at any of the assessments. Across groups, lower socioeconomic status (SES) was associated with lower levels of warm responsiveness and higher levels of negativity.
CONCLUSIONS/IMPLICATIONS: These findings, though preliminary, indicate possible alterations in mother-child interactions in the months following a TBI.
目的/目标：了解创伤性脑损伤（TBI）如何影响受伤后最初 12 个月内母亲的温暖反应和消极情绪。
方法/设计：我们使用同期队列研究设计，在受伤后的最初几周（即基线）以及两个随访期（大约 6 个月和 12 个月后），检查 TBI 患儿（n=78）及其家庭与骨科损伤（OI；n=112）患儿及其家庭的二元互动。受过训练的评估员对视频记录的自由玩耍和结构化教学任务中的母婴温暖反应和消极情绪进行编码。
复杂轻度/中度 TBI 组的母亲，而不是严重 TBI 组的母亲，表现出明显低于 OI 组母亲的温暖反应水平。然而，这些差异仅在基线时的自由玩耍中以及基线和受伤后 6 个月的结构化教学任务中观察到，表明随着受伤后时间的推移，复杂轻度/中度 TBI 对育儿的不利影响逐渐减弱。分析未能在任何评估中发现母婴消极情绪的组间差异。在所有组别中，较低的社会经济地位（SES）与较低的温暖反应水平和较高的消极情绪水平相关。
结论/意义：尽管这些发现是初步的，但表明 TBI 后几个月内母婴互动可能发生变化。
