Fonagy Peter, Sleed Michelle, Baradon Tessa
University College London and Anna Freud Centre, London.
Anna Freud Centre, London and University of Witwatersrand, Johannesburg.
Infant Ment Health J. 2016 Mar-Apr;37(2):97-114. doi: 10.1002/imhj.21553. Epub 2016 Mar 4.
There is a dearth of good-quality research investigating the outcomes of psychoanalytic parent-infant psychotherapy (PIP). This randomized controlled trial investigated the outcomes of PIP for parents with mental health problems who also were experiencing high levels of social adversity and their young infants (<12 months). Dyads were clinically referred and randomly allocated to PIP or a control condition of standard secondary and specialist primary care treatment (n = 38 in each group). Outcomes were assessed at baseline and at 6-month and 12-month follow-ups. The primary outcome was infant development. Secondary outcomes included parent-infant interaction, maternal psychopathology, maternal representations, maternal reflective functioning, and infant attachment. There were no differential effects over time between the groups on measures of infant development, parent-infant interaction, or maternal reflective functioning. Infant attachment classifications, measured only at the 12-month follow-up, did not differ between the groups. There were favorable outcomes over time for the PIP-treated dyads relative to the control group on several measures of maternal mental health, parenting stress, and parental representations of the baby and their relationship. The findings indicate potential benefits of parent-infant psychotherapy for improving mothers' psychological well-being and their representations of their baby and the parent-infant relationship.
目前缺乏高质量的研究来探究精神分析式母婴心理治疗(PIP)的效果。这项随机对照试验研究了PIP对患有心理健康问题且面临高水平社会逆境的父母及其年幼婴儿(<12个月)的效果。研究对象由临床转介而来,并被随机分配至PIP组或标准二级及专科初级保健治疗的对照组(每组n = 38)。在基线、6个月及12个月随访时对结果进行评估。主要结局是婴儿发育。次要结局包括母婴互动、母亲精神病理学、母亲的心理表征、母亲的反思功能以及婴儿依恋。在婴儿发育、母婴互动或母亲反思功能的测量指标上,两组随时间推移没有差异。仅在12个月随访时测量的婴儿依恋分类,两组之间没有差异。在母亲心理健康、育儿压力以及母亲对婴儿及其关系的心理表征的多项测量指标上,相对于对照组而言,接受PIP治疗的研究对象随时间推移有良好的结局。研究结果表明,母婴心理治疗对于改善母亲的心理健康以及她们对婴儿和母婴关系的心理表征具有潜在益处。