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创伤后应激和抑郁症状在母婴关系中的作用。

The role of posttraumatic stress and depression symptoms in mother-infant bonding.

机构信息

Department of Psychology, Catholic University of Croatia, Zagreb, Croatia.

Department of Psychology, Catholic University of Croatia, Zagreb, Croatia.

出版信息

J Affect Disord. 2020 May 1;268:134-140. doi: 10.1016/j.jad.2020.03.006. Epub 2020 Mar 3.

Abstract

BACKGROUND

There is some evidence posttraumatic stress disorder (PTSD) following childbirth may impact on the mother-infant bond. However, the evidence is inconsistent over whether PTSD or co-morbid depressive symptoms are primarily related to impaired bonding. This study therefore aimed to examine the relationship between PTSD symptoms, depressive symptoms and mother-infant bonding.

METHODS

A cross-sectional online study included 603 mothers of infants aged 1-12 months. Measures were taken of PTSD (City Birth Trauma Scale, Ayers et al., 2018) which has two subscales of birth-related PTSD symptoms and general PTSD symptoms; depression (Edinburgh Postnatal Depression Scale, Cox et al., 1987) and mother-infant bonding (Postpartum Bonding Questionnaire, Brockington et al., 2001).

RESULTS

Impaired bonding was related to both dimensions of PTSD symptoms and depressive symptoms in bivariate analysis. Path analysis testing the model of whether depressive symptoms mediated the effect of PTSD symptoms on mother-infant bonding found a differential role of birth-related and general PTSD symptoms. Birth-related PTSD symptoms did not have any effect on bonding or depressive symptoms. In contrast, general PTSD symptoms had a direct effect on bonding and an indirect effect on bonding via depressive symptoms.

LIMITATIONS

Self-report measures of PTSD and depression symptoms were used.

CONCLUSIONS

Further research regarding different aspects of postpartum PTSD, depression and other disorders in the context of mother-infant bonding are needed. Future preventive programs should focus on diminishing symptoms of postpartum PTSD and depression so that the mother-infant bonding remains optimal.

摘要

背景

产后创伤后应激障碍(PTSD)可能会影响母婴关系,这方面有一些证据。然而,关于 PTSD 还是共病抑郁症状与母婴关系受损的关系,证据并不一致。因此,本研究旨在探讨 PTSD 症状、抑郁症状与母婴关系之间的关系。

方法

一项横断面在线研究纳入了 603 名 1-12 个月大婴儿的母亲。采用城市分娩创伤量表(Ayers 等人,2018 年)评估 PTSD,该量表有分娩相关 PTSD 症状和一般 PTSD 症状两个分量表;采用爱丁堡产后抑郁量表(Cox 等人,1987 年)和产后母婴联系问卷(Brockington 等人,2001 年)评估抑郁症状和母婴关系。

结果

在单变量分析中,母婴关系受损与 PTSD 症状和抑郁症状的两个维度有关。路径分析检验 PTSD 症状对母婴关系的影响是否通过抑郁症状中介,发现与分娩相关的 PTSD 症状和一般 PTSD 症状具有不同的作用。与分娩相关的 PTSD 症状对母婴关系或抑郁症状没有任何影响。相比之下,一般 PTSD 症状对母婴关系有直接影响,通过抑郁症状对母婴关系有间接影响。

局限性

使用了 PTSD 和抑郁症状的自我报告测量。

结论

需要进一步研究产后 PTSD、抑郁和其他障碍在母婴关系背景下的不同方面。未来的预防计划应重点减少产后 PTSD 和抑郁的症状,以使母婴关系保持最佳状态。

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