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产后情感联结:母亲抑郁及成人依恋风格的影响

Postpartum bonding: the impact of maternal depression and adult attachment style.

作者信息

Nonnenmacher N, Noe D, Ehrenthal J C, Reck C

机构信息

Department of General Psychiatry, Heidelberg University Hospital, Voßstraße 2, 69115, Heidelberg, Germany.

Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Thibautstr. 1, 69115, Heidelberg, Germany.

出版信息

Arch Womens Ment Health. 2016 Oct;19(5):927-35. doi: 10.1007/s00737-016-0648-y. Epub 2016 Jun 14.

Abstract

Maternal depression poses a risk for the developing mother-infant relationship. Similarly, maternal insecure attachment styles may limit the ability to adequately connect with the newborn during the postpartum period. The aim of this study was to investigate the effect of maternal depression and insecure attachment (insecure and dual/disorganized) on maternal bonding in a sample of n = 34 women with depression according to DSM-IV and n = 59 healthy women. Maternal depression was assessed 3 to 4 months postpartum with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), bonding with the Postpartum Bonding Questionnaire, and maternal attachment style with the Attachment Style Interview. Women with current and lifetime depression as well as women with dual/disorganized attachment style reported lower bonding. Explorative analysis revealed that depression partially mediated the link between dual/disorganized attachment style and bonding with a medium-sized mediation effect. The combination of maternal depression and dual/disorganized attachment style may pose a special risk constellation for the developing mother-infant bond that should be addressed in prevention and early intervention programs.

摘要

母亲抑郁会对母婴关系的发展构成风险。同样,母亲不安全的依恋模式可能会限制产后与新生儿建立充分联系的能力。本研究的目的是在一个样本中调查母亲抑郁和不安全依恋(不安全和双重/混乱型)对母婴联结的影响,该样本包括34名符合《精神疾病诊断与统计手册》第四版(DSM-IV)的抑郁女性和59名健康女性。产后3至4个月,采用DSM-IV轴I障碍结构化临床访谈(SCID-I)评估母亲抑郁情况,采用产后联结问卷评估联结情况,采用依恋风格访谈评估母亲的依恋模式。患有当前和终生抑郁的女性以及具有双重/混乱型依恋模式的女性报告的联结水平较低。探索性分析表明,抑郁部分介导了双重/混乱型依恋模式与联结之间的联系,具有中等程度的中介效应。母亲抑郁和双重/混乱型依恋模式的组合可能会对母婴联结的发展构成特殊的风险组合,应在预防和早期干预项目中加以解决。

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