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产后创伤后应激症状及母亲对其婴儿的认知

Posttraumatic stress symptoms following childbirth and mothers' perceptions of their infants.

作者信息

Davies John, Slade Pauline, Wright Ingram, Stewart Peter

机构信息

Norfolk and Waveney Mental Health Partnership NHS Trust, United Kingdom.

University of Sheffield, United Kingdom.

出版信息

Infant Ment Health J. 2008 Nov;29(6):537-554. doi: 10.1002/imhj.20197.

Abstract

Postpartum psychological distress can adversely affect the early mother-infant relationship; however, this has not been investigated in relation to posttraumatic stress disorder (PTSD) following childbirth. This article explores whether PTSD symptoms relating to labor and delivery are associated with mothers' early perceptions of their infant. Using labor and childbirth as the stressor criterion, 211 women were assessed at 6 weeks' postpartum for symptoms of intrusions, avoidance, and hyperarousal. Their perceptions of their infants, of mother-to-infant attachment, and infant behavioral characteristics also were evaluated. In sum, 3.8% of the women fulfilled full diagnostic criteria, and a further 21.3% reported clinically significant symptoms on at least one dimension of PTSD. Those meeting full or partial criteria perceived their attachment relationships to be significantly less optimal and reported more negative maternal representations in terms of their infants being less warm and more invasive. They also rated them as being temperamentally more difficult, prone to distress, and less easy to soothe. However, when the effects of depression were partialled, only the effect for perceived warmth remained. Posttraumatic stress symptoms relating to labor and delivery may adversely influence maternal perceptions of infants, with potentially adverse implications for the developing mother-infant relationship. The overlap with depressive symptoms requires further exploration.

摘要

产后心理困扰会对早期母婴关系产生不利影响;然而,尚未有人针对分娩后的创伤后应激障碍(PTSD)对此进行研究。本文探讨与分娩相关的PTSD症状是否与母亲对其婴儿的早期认知有关。以分娩过程作为应激源标准,对211名女性在产后6周时进行了闯入、回避和过度警觉症状的评估。还评估了她们对自己婴儿的看法、母婴依恋情况以及婴儿的行为特征。总体而言,3.8%的女性符合完整的诊断标准,另有21.3%的女性在PTSD的至少一个维度上报告有临床显著症状。那些符合全部或部分标准的女性认为她们的依恋关系明显不那么理想,并且报告称在对婴儿的负面母亲表征方面,婴儿不那么温暖且更具侵入性。她们还将婴儿的气质评定为更难相处、更容易苦恼且更难安抚。然而,当排除抑郁的影响后,仅感知到的温暖这一影响仍然存在。与分娩相关的创伤后应激症状可能会对母亲对婴儿的认知产生不利影响,对正在发展的母婴关系可能产生潜在的不利影响。与抑郁症状的重叠需要进一步探究。

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