Udry-Jørgensen Laura, Pierrehumbert Blaise, Borghini Ayala, Habersaat Stephanie, Forcada-Guex Margarita, Ansermet François, Muller-Nix Carole
University Hospital Lausanne, Switzerland.
University Hospital Geneva, Switzerland.
Infant Ment Health J. 2011 May;32(3):305-318. doi: 10.1002/imhj.20298.
Thirty-three families, each with a premature infant born less than 33 gestational weeks, were observed in a longitudinal exploratory study. Infants were recruited in a neonatal intensive care unit, and follow-up visits took place at 4 months and 12 months of corrected age. The severity of the perinatal problems was evaluated using the Perinatal Risk Inventory (PERI; A.P. Scheiner & M.E. Sexton, 1991). At 4 months, mother-infant play interaction was observed and coded according to the CARE-index (P.M. Crittenden, 2003); at 12 months, the Strange Situation Procedure (SSP; M.D.S. Ainsworth, M.C. Blehar, E. Waters, & S. Wall, 1978) was administered. Results indicate a strong correlation between the severity of perinatal problems and the quality of attachment at 12 months. Based on the PERI, infants with high medical risks more frequently tended to be insecurely attached. There also was a significant correlation between insecure attachment and dyadic play interaction at 4 months (i.e., maternal controlling behavior and infant compulsive compliance). Moreover, specific dyadic interactive patterns could be identified as protective or as risk factors regarding the quality of attachment. Considering that attachment may have long-term influence on child development, these results underline the need for particular attention to risk factors regarding attachment among premature infants.
在一项纵向探索性研究中，观察了33个家庭，每个家庭都有一名孕周小于33周出生的早产儿。婴儿在新生儿重症监护病房招募，随访在矫正年龄4个月和12个月时进行。使用围产期风险量表（PERI；A.P. 谢纳和M.E. 塞克斯顿，1991年）评估围产期问题的严重程度。在4个月时，观察母婴游戏互动，并根据CARE指数（P.M. 克里滕登，2003年）进行编码；在12个月时，实施陌生情境程序（SSP；M.D.S. 安斯沃思、M.C. 布莱哈、E. 沃特斯和S. 沃尔，1978年）。结果表明，围产期问题的严重程度与12个月时的依恋质量之间存在很强的相关性。根据PERI，医疗风险高的婴儿更频繁地倾向于不安全依恋。不安全依恋与4个月时的二元游戏互动（即母亲的控制行为和婴儿的强迫性顺从）之间也存在显著相关性。此外，可以确定特定的二元互动模式是关于依恋质量的保护因素或风险因素。考虑到依恋可能对儿童发展有长期影响，这些结果强调了需要特别关注早产儿中与依恋有关的风险因素。
