Zietlow Anna-Lena, Schlüter Myriam Kim, Nonnenmacher Nora, Müller Mitho, Reck Corinna
Centre for Psychosocial Medicine, General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany.
Matern Child Health J. 2014 Oct;18(8):1873-80. doi: 10.1007/s10995-014-1431-1.
The aim of this study was to analyze the impact of maternal postpartum depression and/or anxiety disorders according to DMS-IV on maternal self-confidence throughout infancy and early childhood. Exploratively, associations between maternal attachment insecurity and maternal self-confidence at pre-school age were examined. The sample (N = 54) of this prospective longitudinal study was comprised of n = 27 women with postpartum depression and/or anxiety disorders according to DSM-IV criteria and n = 27 healthy women without present or history of mental health disorders or psychotherapy. Data was collected in the postpartum period (M = 60.08 days) and at pre-school age (M = 4.7 years). Subjects were recruited between 2004 and 2011 in South Germany. Data revealed a significant difference in maternal self-confidence between clinical and control group at child's pre-school age: Women with postpartum depression and/or anxiety disorder scored lower on maternal self-confidence than healthy controls, but only if they had current SCID-diagnoses or partly remitted symptoms. According to explorative analyses maternal attachment insecurity turned out to be the strongest predictor of maternal self-confidence at pre-school age besides maternal mental health status. The results emphasize the impact of attachment insecurity and maternal mental health regarding maternal self-confidence leading to potential adverse long-term consequences for the mother-child relationship. Attachment based interventions taking maternal self-confidence into account are needed.
本研究的目的是根据《精神疾病诊断与统计手册》第四版（DSM-IV）分析产后抑郁和/或焦虑症对母亲在婴儿期和幼儿期自信心的影响。探索性地研究了母亲依恋不安全感与学前年龄母亲自信心之间的关联。这项前瞻性纵向研究的样本（N = 54）包括n = 27名根据DSM-IV标准患有产后抑郁和/或焦虑症的女性，以及n = 27名没有精神健康障碍或心理治疗史的健康女性。数据在产后阶段（M = 60.08天）和学前年龄（M = 4.7岁）收集。研究对象于2004年至2011年在德国南部招募。数据显示，在孩子学前年龄时，临床组和对照组母亲的自信心存在显著差异：患有产后抑郁和/或焦虑症的女性在母亲自信心方面的得分低于健康对照组，但只有在她们目前有精神疾病诊断与统计手册（SCID）诊断或症状部分缓解的情况下才是如此。根据探索性分析，除了母亲的心理健康状况外，母亲依恋不安全感是学前年龄母亲自信心的最强预测因素。研究结果强调了依恋不安全感和母亲心理健康对母亲自信心的影响，这可能会对母婴关系产生潜在的长期不良后果。需要采取考虑到母亲自信心的基于依恋的干预措施。
