University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Eur Child Adolesc Psychiatry. 2016 Jun;25(6):589-600. doi: 10.1007/s00787-015-0775-4. Epub 2015 Sep 23.
To date, parenting stress has rarely been examined in clinical samples of mothers with postpartum comorbid Axis-I disorders and Axis-II personality disorders (PD). Previous research has shown important links between maternal psychopathology and the development of child psychopathology. For these reasons, a clinical sample (N = 54) of mothers with various PD and comorbid depression/anxiety disorders were compared in this study. The clinical sample was divided into three groups based on PD: without PD, other PD, and borderline PD (BPD), and then matched according to depression/anxiety diagnoses and age. Parenting stress index (PSI, Abidin, 1995) scores were compared between these subsamples and to a nonclinical control group. No significant differences were found between mothers with various PD on global PSI scores. However, further examination of the PSI subscale scores revealed that PD were linked to an impaired sense of competence and positive reinforcement in relation to parenting. Compared to mothers with other PD, mothers with BPD had significantly more interpersonal issues. Compared to the nonclinical controls, clinically referred mothers had significantly higher PSI global and subscale scores, with notable PD-specific exceptions. These results illustrate the need for more differentiated treatment options for mothers with postpartum depression and/or anxiety disorders with PD to prevent later development of psychopathology in children of these mothers.
迄今为止,针对产后并发轴 I 障碍和轴 II 人格障碍(PD)的母亲的临床样本,很少有研究关注育儿压力。先前的研究表明,母亲的精神病理学与儿童精神病理学的发展之间存在重要联系。基于这些原因,本研究比较了患有各种 PD 和并发抑郁/焦虑障碍的临床样本(N=54)。该临床样本根据 PD 分为三组:无 PD、其他 PD 和边缘型 PD(BPD),然后根据抑郁/焦虑诊断和年龄进行匹配。将这些亚组与非临床对照组的育儿压力指数(PSI,Abidin,1995)评分进行了比较。在全球 PSI 评分方面,患有各种 PD 的母亲之间没有发现显著差异。然而,对 PSI 子量表评分的进一步检查表明,PD 与育儿方面的能力感和积极强化受损有关。与其他 PD 母亲相比,BPD 母亲在人际关系方面存在更多问题。与非临床对照组相比,临床转介的母亲的 PSI 总分和子量表得分明显更高,但 PD 特定方面存在显著差异。这些结果表明,需要为患有产后抑郁和/或焦虑障碍并伴有 PD 的母亲提供更具差异化的治疗选择,以防止这些母亲的孩子日后出现精神病理学。