Beebe Beatrice, Jaffe Joseph, Buck Karen, Chen Henian, Cohen Patricia, Feldstein Stanley, Andrews Howard
New York State Psychiatric Institute.
Infant Ment Health J. 2008 Sep;29(5):442-471. doi: 10.1002/imhj.20191.
Associations of 6-week maternal depressive symptoms [Center for Epidemiological Studies Depression Scale (CES-D)] with 4-month mother-infant self- and interactive contingency patterns during face-to-face play were investigated in 132 dyads. Self- and interactive contingency (auto- and lagged cross-correlation, respectively) were assessed by multilevel time-series analysis. Infant and mother gaze, facial and vocal affect, touch, and spatial orientation behaviors were coded second-by-second from split-screen videotape, and a multimodal measure of facial-visual "engagement" was constructed, generating nine modality pairings. With higher CES-D, the self-contingency of both partners was lowered in most modalities. With higher CES-D, interactive contingency values were both heightened (in some modalities) and lowered (in others), varying by partner. These results are consistent with an optimal midrange model. With higher CES-D, interactive contingency showed the following patterns: (a) Mothers and their infants had a reciprocal orientational sensitivity; (b) mothers and infants manifested a reciprocal intermodal discordance in attention versus affect coordination, lowering gaze coordination, but heightening affective coordination; (c) infants heightened, but mothers lowered, touch coordination with partner touch-an "infant approach-mother withdraw" touch pattern. Nonlinear analyses indicated that altered self- and interactive contingency were similar at both the low ("denial") as well as the high ("endorsement") poles of depressive symptoms, in half the findings. These complex, multimodal findings define different aspects of communication disturbance, with relevance for therapeutic intervention.
在132对母婴中，研究了6周时母亲的抑郁症状[流行病学研究中心抑郁量表（CES-D）]与4个月时母婴在面对面互动游戏中的自我及互动偶联模式之间的关联。自我及互动偶联（分别为自相关和滞后交叉相关）通过多水平时间序列分析进行评估。从分屏录像带中逐秒编码婴儿和母亲的注视、面部和声音情感、触摸以及空间定向行为，并构建了面部视觉“参与”的多模态测量指标，产生了九种模态配对。CES-D得分越高，大多数模态下双方的自我偶联越低。CES-D得分越高，互动偶联值在某些模态下升高，在另一些模态下降低，因伴侣而异。这些结果与最优的中等范围模型一致。CES-D得分越高，互动偶联呈现出以下模式：（a）母亲和婴儿具有相互的定向敏感性；（b）母亲和婴儿在注意力与情感协调方面表现出相互的多模态不一致，降低了注视协调，但提高了情感协调；（c）婴儿提高了与伴侣触摸的触摸协调，但母亲降低了——一种“婴儿趋近-母亲退缩”的触摸模式。非线性分析表明，在一半的研究结果中，自我和互动偶联的改变在抑郁症状的低（“否认”）和高（“认可”）两极相似。这些复杂的多模态研究结果定义了沟通障碍的不同方面，与治疗干预相关。
