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非风险和风险育儿中产前和产后的母亲表征:探究对母婴喂养互动的影响。

Prenatal and postnatal maternal representations in nonrisk and at-risk parenting: exploring the influences on mother-infant feeding interactions.

作者信息

Tambelli Renata, Odorisio Flaminia, Lucarelli Loredana

机构信息

Sapienza University of Rome.

出版信息

Infant Ment Health J. 2014 Jul-Aug;35(4):376-88. doi: 10.1002/imhj.21448. Epub 2014 Jun 19.

DOI:10.1002/imhj.21448
PMID:25798489
Abstract

The aim of this study was to investigate the mother-infant relationship in depressive, psychosocial, and cumulative-risk parenting by assessing prenatal and postnatal maternal representations and mother-infant interactions during feeding at 4 months of age. The sample consisted of 167 mother-infant pairs: 41 nonrisk women, 40 depressive-risk women, 40 psychosocial-risk women, and 46 cumulative-risk women. During pregnancy, the women were interviewed about psychosocial-risk variables. Maternal representations and depressive symptoms were evaluated during pregnancy and again when the infants were 3 and 4 months old, respectively. All mother-infant pairs were observed in 20-min video recordings during breast-feeding. Maternal Integrated/balanced representations were more frequent in the nonrisk group whereas the maternal Nonintegrated/ambivalent category was more represented in the cumulative-risk group during pregnancy and after the infant's birth. At 4 months, the cumulative-risk group of mothers and infants showed a lack of reciprocity, conflictual communicative exchanges, and higher food refusal behavior. Moreover, at 4 months, differences between the quality of mother-infant feeding interactions and the quality of prenatal and postnatal maternal representations emerged, showing less adequate maternal scaffolding in the Nonintegrated/ambivalent and Restricted/disengaged women. This study has rich implications for intervention to support the affective and communicative caregiving system and to prevent infant feeding problems and mother-infant relational disturbances in childhood.

摘要

本研究的目的是通过评估产前和产后母亲的表征以及4个月大婴儿喂养期间的母婴互动,来调查抑郁、心理社会和累积风险育儿中的母婴关系。样本包括167对母婴:41名无风险女性、40名抑郁风险女性、40名心理社会风险女性和46名累积风险女性。在孕期,对这些女性进行了心理社会风险变量的访谈。分别在孕期以及婴儿3个月和4个月大时评估母亲的表征和抑郁症状。在母乳喂养期间,对所有母婴对进行了20分钟的视频记录观察。在孕期和婴儿出生后,无风险组中母亲的整合/平衡表征更为常见,而累积风险组中母亲的非整合/矛盾类别更为突出。在4个月时,累积风险组的母婴表现出缺乏互惠性、冲突性的交流以及更高的食物拒绝行为。此外,在4个月时,母婴喂养互动质量与产前和产后母亲表征质量之间出现了差异,表明非整合/矛盾和受限/脱离接触的女性提供的母亲支持较少。本研究对于支持情感和沟通照料系统以及预防儿童期婴儿喂养问题和母婴关系障碍的干预具有丰富的启示意义。

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