Bergin Christi, McCollough Patricia
University of Missouri - Columbia.
Northeast Ohio Health Services.
Infant Ment Health J. 2009 Jul;30(4):407-423. doi: 10.1002/imhj.20221.
Prenatal substance exposure is linked to adverse outcomes in children. Some adverse outcomes may result from insecure attachment and low-quality caregiving rather than from substance exposure. Little is known about the caregiving of polysubstance-using mothers. To address this, low-income mothers (n = 41) with their substance-exposed 12-month-olds were compared with a nonexposed group case-matched for other risk factors. Maternal sensitivity and involvement were analyzed from 2 hr of videotaped interaction. Attachment was assessed using the Attachment Q-Set. Attachment security and quality of caregiving were quite low for both groups, with no significant differences. In addition, regression analyses revealed that quality of caregiving predicted attachment, but amount of alcohol and cocaine exposure did not. These results suggest that among toddlers with social risk, substance exposure may not predict insecure attachment. Previous research linking attachment to exposure may be better explained by low-quality caregiving. Implications are that substance-exposed children, and nonexposed children with comparable social risk, are likely to need intervention to enhance maternal sensitivity and involvement to improve psychiatric outcomes.
产前物质暴露与儿童的不良后果有关。一些不良后果可能是由于不安全依恋和低质量的养育方式，而非物质暴露所致。对于使用多种物质的母亲的养育方式，人们知之甚少。为了解决这个问题，将41名低收入母亲及其12个月大且有物质暴露的孩子与另一组在其他风险因素上进行病例匹配的未暴露组进行了比较。通过2小时的录像互动分析了母亲的敏感性和参与度。使用依恋Q分类法评估依恋情况。两组的依恋安全性和养育质量都相当低，且无显著差异。此外，回归分析显示，养育质量可预测依恋情况，但酒精和可卡因暴露量则不能。这些结果表明，在有社会风险的幼儿中，物质暴露可能无法预测不安全依恋。先前将依恋与暴露联系起来的研究，或许可以用低质量的养育方式来更好地解释。这意味着，有物质暴露的儿童以及有类似社会风险的未暴露儿童，可能都需要进行干预，以提高母亲的敏感性和参与度，从而改善心理结果。
