Yale Child Study Center, Yale University, 230 South Frontage Road, New Haven, CT, 06520, USA.
Department of Psychology, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
J Abnorm Child Psychol. 2020 Aug;48(8):1089-1103. doi: 10.1007/s10802-020-00639-2.
Premature birth and maternal emotional distress constitute risk factors for feeding disorders. This study examined the roles of maternal cognitions in the link between prematurity, emotional distress and mother-infant maladaptive mealtime dynamics in a sample of 134 families (70 preterm, low medical risk; 64 full-term) followed longitudinally. Specifically, maternal cognitions related to eating and health (perception of child vulnerability and concerns about child's eating) and understanding of mental states (interactional mind-mindedness) were considered. A multiple-mediators model was tested, controlling for infants' weight and breastfeeding history. Although prematurity did not directly predict mealtime dynamics, multiple-mediation analyses revealed indirect pathways: mothers of preterm newborns reported higher emotional distress, which subsequently predicted perception of child vulnerability and concerns about child's eating at 6-months; perception of child vulnerability predicted more conflictual mealtime dynamics, whereas concern about child's eating predicted less reciprocal mealtime dynamics at 12-months. Mind-mindedness at 6-months predicted more reciprocal and less conflictual mealtime dynamics but did not act as a mediator. Implications for understanding pathways from prematurity to feeding disorders are discussed.
早产和产妇情绪困扰构成了喂养障碍的风险因素。本研究在一个 134 个家庭（70 个早产儿，低医疗风险；64 个足月）的纵向随访样本中，考察了母亲认知在早产儿、情绪困扰和母婴不良进餐动态之间关系中的作用。具体来说，考虑了与饮食和健康相关的母亲认知（对孩子脆弱性的感知和对孩子饮食的担忧）以及对心理状态的理解（互动心智意识）。在控制婴儿体重和母乳喂养史的情况下，检验了一个多重中介模型。尽管早产本身并不直接预测进餐动态，但多中介分析显示了间接途径：早产儿的母亲报告了更高的情绪困扰，随后在 6 个月时预测了对孩子脆弱性的感知和对孩子饮食的担忧；对孩子脆弱性的感知预测了更多的冲突性进餐动态，而对孩子饮食的担忧预测了 12 个月时更少的互惠性进餐动态。6 个月时的心智意识预测了更多的互惠性和更少的冲突性进餐动态，但不是中介。讨论了理解从早产到喂养障碍的途径的意义。
