Røhder Katrine, MacBeth Angus, Agnete Davidsen Kirstine, Gumley Andrew, Brennan Jessica, George Carol, Harder Susanne
Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
School of Health in Social Science, University of Edinburgh, Edinburgh, Scotland, United Kingdom.
Infant Ment Health J. 2020 Jan;41(1):56-68. doi: 10.1002/imhj.21824. Epub 2019 Sep 2.
Psychopathology poses a risk for optimal parenting. The current study explored antenatal caregiving representations as markers for later risk of nonoptimal maternal behavior among mothers with severe mental illness. Sixty-five mothers diagnosed with psychosis, bipolar disorder, depression (psychopathology group), and nonclinical controls participated in a longitudinal study from pregnancy to 16 weeks after birth. Mental health diagnoses and caregiving representations were assessed during pregnancy. Maternal behavior was assessed during the 5-min recovery phase of the still-face paradigm at 16 weeks. Mothers with psychopathology reported significantly higher levels of "heightened" caregiving representations (i.e., separation anxiety from the child) than did controls. The only significant diagnostic group difference in perinatal maternal behavior was that mothers diagnosed with depression exhibited more overriding-intrusive behavior than did nonclinical control mothers. Regression modeling results showed that antenatal caregiving representations of "role reversal" predicted significantly lower levels of sensitivity and higher levels of overriding-intrusive behavior independent of the effect of psychopathology. The findings can be interpreted in the context of representational transformation to motherhood during pregnancy. The results provide preliminary evidence for the potential of a new questionnaire measure of caregiving representations as a screening instrument for antenatal representational risk.
精神病理学对最佳养育构成风险。本研究探讨了产前照料表征作为重度精神疾病母亲日后出现非最佳母亲行为风险的标志物。65名被诊断患有精神病、双相情感障碍、抑郁症的母亲（精神病理学组）和非临床对照者参与了一项从怀孕到产后16周的纵向研究。在孕期评估心理健康诊断和照料表征。在产后16周的静脸范式5分钟恢复期评估母亲行为。与对照组相比，患有精神病理学的母亲报告的“过度”照料表征（即与孩子分离的焦虑）水平显著更高。围产期母亲行为方面唯一显著的诊断组差异是，被诊断患有抑郁症的母亲比非临床对照母亲表现出更多的过度侵入性行为。回归模型结果显示，“角色颠倒”的产前照料表征预示着敏感性水平显著降低和过度侵入性行为水平升高，且不受精神病理学影响。这些发现可以在孕期向母亲角色的表征转变背景下进行解释。研究结果为一种新的照料表征问卷测量法作为产前表征风险筛查工具的潜力提供了初步证据。
