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边缘型人格障碍、抑郁障碍和无诊断母亲的婴儿去抑制依恋行为。

Disinhibited attachment behavior among infants of mothers with borderline personality disorder, depression, and no diagnosis.

机构信息

Department of Psychiatry.

Department of Psychology.

出版信息

Personal Disord. 2019 Mar;10(2):163-172. doi: 10.1037/per0000312. Epub 2019 Jan 10.

Abstract

Disinhibited attachment behavior is related to early institutional rearing and to later social maladaptation. It is also seen among infants reared at home whose mothers have histories of child maltreatment or psychiatric hospitalization. However, little is known about the maternal psychiatric diagnoses that might be associated with disinhibited behavior or the mechanisms through which maternal diagnosis might influence infant behavior. In the current study (N = 59), 2 maternal diagnoses, borderline personality disorder (BPD; n = 13) and depression (n = 15), were compared with a no diagnosis group (n = 31) on extent of infant disinhibited behavior. Disinhibited infant behavior was assessed at infant age of 12-18 months using the validated Rating of Infant-Stranger Engagement. Mother-infant interaction was coded using the Atypical Maternal Behavior Instrument for Assessment and Classification. Results indicated that infants of mothers with BPD were significantly more likely to be rated as disinhibited in their behavior toward the stranger compared with infants of mothers with depression and with no diagnosis. Disinhibited behavior was further related to the quality of mother-infant interaction, and maternal frightened/disoriented interaction partially mediated the effect of maternal BPD on infant disinhibited behavior. Disinhibited behavior among previously institutionally reared infants is relatively resistant to intervention after toddlerhood and is associated with maladaptation into adolescence. Therefore, high priority should be placed on understanding the developmental trajectories of home-reared infants with disinhibited behavior and on providing early assessment and early parenting support to mothers with BPD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

摘要

去抑制型依恋行为与早期的机构养育以及后来的社会适应不良有关。在家中抚养的婴儿中也可以看到这种行为,他们的母亲有虐待儿童或精神科住院的病史。然而,对于可能与去抑制行为相关的母亲精神科诊断,或者母亲诊断可能通过何种机制影响婴儿行为,我们知之甚少。在目前的研究中(N=59),将 2 种母亲诊断,边缘型人格障碍(BPD;n=13)和抑郁症(n=15),与无诊断组(n=31)在婴儿去抑制行为的程度上进行了比较。使用经过验证的婴儿-陌生人互动评估量表,在婴儿 12-18 个月大时评估婴儿的去抑制行为。使用异常母亲行为评估和分类工具对母婴互动进行编码。结果表明,与患有抑郁症和无诊断的母亲的婴儿相比,患有 BPD 的母亲的婴儿在对陌生人的行为方面更容易被评为去抑制。去抑制行为进一步与母婴互动的质量有关,母亲的恐惧/迷失方向的互动部分介导了母亲 BPD 对婴儿去抑制行为的影响。在幼儿期之后,以前在机构中养育的婴儿的去抑制行为相对难以干预,并且与青春期适应不良有关。因此,应高度重视理解具有去抑制行为的在家中养育的婴儿的发展轨迹,并为患有 BPD 的母亲提供早期评估和早期育儿支持。(美国心理协会,2019 年)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8242/6404520/295035a184b6/nihms-1013844-f0001.jpg

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