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婴儿死亡致父母丧亲之痛:创伤后应激障碍、依恋、应对方式及社会支持方面的性别差异与调节作用

Parents bereaved by infant death: sex differences and moderation in PTSD, attachment, coping and social support.

作者信息

Christiansen Dorte M, Olff Miranda, Elklit Ask

机构信息

Department of Psychology, University of Aarhus, Bartholins Allé 9, 8000 Aarhus C, Denmark; National Centre for Psychotraumatology, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark.

Department of Psychiatry, Academic Medical Center, University of Amsterdam, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands; Arq Psychotrauma Expert Group, Nienoord 5, 1112 XE Diemen, the Netherlands.

出版信息

Gen Hosp Psychiatry. 2014 Nov-Dec;36(6):655-61. doi: 10.1016/j.genhosppsych.2014.07.012. Epub 2014 Aug 7.

Abstract

OBJECTIVE

Parents bereaved by infant death experience a wide range of symptomatology, including posttraumatic stress disorder (PTSD) that may persist for years after the loss. Little research has been conducted on PTSD in fathers who have lost an infant. Mothers report most symptoms to a greater extent than fathers, but not much is known about other sex differences following infant death.

METHOD

The present cross-sectional study examined sex differences in PTSD and sex differences in the relationship between PTSD severity and related variables. Subjects were 361 mothers and 273 fathers who had lost an infant either late in pregnancy, during birth or in the first year of life. Participants filled out questionnaires between 1.2 months and 18 years after the loss (M = 3.4 years).

RESULTS

Mothers reported significantly more PTSD symptoms, attachment anxiety, emotion-focused coping and feeling let down, but significantly lower levels of attachment avoidance than fathers. Attachment anxiety, attachment avoidance and emotion-focused coping were significantly more strongly associated with PTSD severity in mothers than fathers, but only when examined alone. When all variables and time since the loss were examined together, there were no longer any significant moderation effects of sex.

CONCLUSIONS

Persistent posttraumatic symptomatology exists in both mothers and fathers long after the loss. There are several sex differences in severity and correlates of PTSD, and a few moderation effects were identified for attachment and emotion-focused coping. Overall, more similarities than differences were found between mothers and fathers in the associations between PTSD and covariates.

摘要

目的

因婴儿死亡而痛失亲人的父母会经历一系列症状,包括创伤后应激障碍(PTSD),这种症状在丧亲后可能会持续数年。针对失去婴儿的父亲的创伤后应激障碍的研究较少。母亲报告的大多数症状比父亲更严重,但对于婴儿死亡后的其他性别差异知之甚少。

方法

本横断面研究调查了创伤后应激障碍中的性别差异以及创伤后应激障碍严重程度与相关变量之间关系的性别差异。研究对象为361名母亲和273名父亲,他们的婴儿在怀孕后期、分娩期间或出生后第一年死亡。参与者在丧亲后1.2个月至18年之间填写问卷(平均时间为3.4年)。

结果

母亲报告的创伤后应激障碍症状、依恋焦虑、情绪聚焦应对和失望情绪明显多于父亲,但依恋回避水平明显低于父亲。依恋焦虑、依恋回避和情绪聚焦应对与母亲创伤后应激障碍严重程度的关联比与父亲的关联更强,但仅在单独检查时如此。当同时检查所有变量和丧亲后的时间时,性别不再有任何显著的调节作用。

结论

丧亲很久之后,母亲和父亲都存在持续的创伤后症状。在创伤后应激障碍的严重程度和相关性方面存在一些性别差异,并且在依恋和情绪聚焦应对方面发现了一些调节作用。总体而言,在创伤后应激障碍与协变量之间的关联中,母亲和父亲之间的相似之处多于差异。

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