Isosävi Sanna, Diab Safwat Y, Kangaslampi Samuli, Qouta Samir, Kankaanpää Saija, Puura Kaija, Punamäki Raija-Leena
University of Tampere.
Al-Quds Open University.
Infant Ment Health J. 2017 Sep;38(5):617-633. doi: 10.1002/imhj.21658. Epub 2017 Aug 21.
We examined how diverse and cumulated traumatic experiences predicted maternal prenatal mental health and infant stress regulation in war conditions and whether maternal mental health mediated the association between trauma and infant stress regulation. Participants were 511 Palestinian mothers from the Gaza Strip who reported exposure to current war trauma (WT), past childhood emotional (CEA) and physical abuse, socioeconomic status (SES), prenatal mental health problems (posttraumatic stress disorder and depression symptoms), and perceived stress during their secondtrimester of pregnancy as well as infant stress regulation at 4 months. While all trauma types were associated with high levels of prenatal symptoms, CEA had the most wide-ranging effects and was uniquely associated with depression symptoms. Concerning infant stress regulation, mothers' CEA predicted negative affectivity, but only among mothers with low WT. Against hypothesis, the effects of maternal trauma on infant stress regulation were not mediated by mental health symptoms. Mothers' higher SES was associated with better infant stress regulation whereas infant prematurity and male sex predisposed for difficulties. Our findings suggest that maternal childhood abuse, especially CEA, should be a central treatment target among war-exposed families. Cumulated psychosocial stressors might increase the risk for transgenerational problems.
我们研究了在战争环境中，不同类型和累积的创伤经历如何预测母亲的产前心理健康和婴儿的压力调节能力，以及母亲的心理健康是否介导了创伤与婴儿压力调节之间的关联。研究参与者为来自加沙地带的511名巴勒斯坦母亲，她们报告了当前遭受的战争创伤（WT）、童年时期的情感虐待（CEA）和身体虐待、社会经济地位（SES）、产前心理健康问题（创伤后应激障碍和抑郁症状）、孕期第二个月时感知到的压力，以及婴儿4个月时的压力调节能力。虽然所有类型的创伤都与高水平的产前症状相关，但CEA的影响最为广泛，且与抑郁症状有独特关联。关于婴儿的压力调节，母亲的CEA可预测消极情感，但仅在遭受低水平WT的母亲中如此。与假设相反，母亲创伤对婴儿压力调节的影响并未通过心理健康症状介导。母亲较高的SES与更好的婴儿压力调节相关，而婴儿早产和男性性别则易出现困难。我们的研究结果表明，母亲童年期受虐，尤其是CEA，应成为战争暴露家庭的核心治疗靶点。累积的心理社会压力源可能会增加代际问题的风险。
