Heinisch Christine, Galeris Mirijam-Griseldis, Gabler Sandra, Simen Susanne, Junge-Hoffmeister Juliane, Fößel Judith, Spangler Gottfried
Developmental and Educational Psychology, Institute of Psychology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
Department of Paediatric Psychiatry, Psychotherapy and Psychosomatics, Universitätsklinikum Leipzig, Leipzig, Germany.
Front Psychiatry. 2019 Jul 22;10:471. doi: 10.3389/fpsyt.2019.00471. eCollection 2019.
About 15% of mothers suffer from postpartum psychiatric disorders, such as depression, anxiety, or psychosis. Numerous studies have shown maternal caregiving behavior to be negatively affected under these circumstances. The current study sets out to shed light on specific caregiving behaviors of affected mothers in the context of parental mental illness at an early stage. There are several methods to assess maternal caregiving behavior in terms of sensitivity. However, all of them have limitations regarding the peculiarities of mothers with postpartum disorders, that is, changes in affect regulation, and the early onset of the disorder postpartum. With the current study, we provide an adapted method to assess maternal sensitivity based on methods recently approved in attachment research. Two groups of mothers, who were either healthy or had different postpartum disorders, were recorded on video during interactions with their infants. Behaviors were rated regarding responsiveness, promptness, appropriateness, intrusiveness, and positive and negative affect. A first analysis revealed an increased number of deficits on all subscales in mothers with postpartum psychiatric disorders as compared to healthy mothers. Depressive mothers with a single diagnosis had lower scores in responsiveness, promptness, and appropriateness and higher scores on intrusiveness as compared to those in healthy mothers. Here, maternal behavior appears more parent-centered, whereas affect seemed to be relatively unharmed. Moreover, as compared to healthy mothers, mothers with comorbid depression and anxiety symptomatology achieved lower scores on responsiveness, appropriateness, and positive affect and higher scores on intrusiveness and negative affect. It is suggested, that increased deficits are related to the severity of illness in mothers with comorbidities. Results on promptness indicate that these mothers are still capable of maintaining higher vigilance to infant cues. Variance in maternal behavior was relatively high in clinical mothers, showing that some of them are well capable of behaving in a sensitive manner toward their child. One strength of our adapted method is that particular aspects of sensitive parent-child interactions are assessed separately. This may shed light on specific behavior patterns of different postpartum psychiatric disorders, which may in turn relate to specific child outcomes. The manual is open for usage, while reliability testing is required.
约15%的母亲患有产后精神障碍，如抑郁症、焦虑症或精神病。大量研究表明，在这些情况下，母亲的育儿行为会受到负面影响。当前的研究旨在阐明患病母亲在早期父母精神疾病背景下的具体育儿行为。有几种方法可从敏感性方面评估母亲的育儿行为。然而，所有这些方法在产后疾病母亲的特殊性方面都存在局限性，即情感调节的变化以及产后疾病的早期发作。通过当前的研究，我们基于依恋研究中最近认可的方法提供了一种经过调整的方法来评估母亲的敏感性。两组母亲，一组健康，另一组患有不同的产后疾病，在与婴儿互动期间被录像。对行为的反应性、及时性、适当性、侵扰性以及积极和消极情感进行评分。初步分析显示，与健康母亲相比，患有产后精神障碍的母亲在所有子量表上的缺陷数量增加。与健康母亲相比，单一诊断为抑郁症的母亲在反应性、及时性和适当性方面得分较低，而在侵扰性方面得分较高。在这里，母亲的行为似乎更以自我为中心，而情感似乎相对未受影响。此外，与健康母亲相比，患有合并性抑郁和焦虑症状的母亲在反应性、适当性和积极情感方面得分较低，而在侵扰性和消极情感方面得分较高。有人认为，缺陷增加与患有合并症母亲的疾病严重程度有关。关于及时性的结果表明，这些母亲仍然能够对婴儿的线索保持较高的警觉性。临床母亲的行为差异相对较大，表明其中一些母亲有能力以敏感的方式对待自己的孩子。我们调整后的方法的一个优点是，敏感的亲子互动的特定方面是分开评估的。这可能会揭示不同产后精神障碍的特定行为模式，进而可能与特定的儿童结局相关。该手册可供使用，但需要进行可靠性测试。
