Dozio Elisabetta, Feldman Marion, Bizouerne Cécile, Drain Elise, Laroche Joubert Mathilde, Mansouri Malika, Moro Marie Rose, Ouss Lisa
Action Against Hunger, Paris, France.
Université Paris Nanterre, Nanterre, France.
Front Psychiatry. 2020 Nov 30;11:480690. doi: 10.3389/fpsyt.2020.480690. eCollection 2020.
The objective of the study was to examine the process of mother to infant trauma transmission among traumatized mothers in humanitarian contexts. We investigated the impact of mothers' post-traumatic stress disorder symptoms on the quality of the dyadic interaction by conducting a microanalysis of mother-infant interactions at specific moments when trauma was recalled, compared to more neutral moments. Twenty-four mother-infant dyadic interactions of traumatized mothers and children aged from 1.5 to 30 months Central Africa, Chad, and Cameroon were videotaped during three sequences: a neutral initial session (baseline) exploring mothers' representations of the infant and of their bonding; a second sequence, "the traumatic narration," in which mothers were asked to talk about the difficult events they had experienced; and a third sequence focusing on a neutral subject. Three minutes of each sequence were coded through a specific grid for microanalysis [based on the scales developed at Bobigny Faculty of Medicine and the work of (1)], according to different communication modalities (touch, visual, and vocal), for both the mother and the child. Impact of traumatic event (IES-R), the level of depression and anxiety (HAD) were investigated in order to have a holistic understanding of the trauma transmission mechanism. The data analysis highlighted significant differences in mothers, children and their interaction during the "traumatic narration": mothers touched and looked at the infant less, looked more absent and smiled less, and looked less at the interviewer; infants looked less at the interviewer, and sucked the breast more. The mother-child interaction "infant self-stimulation-mother looks absent" and "Infant sucks the breast-mother looks absent" occurred more often during the mothers' traumatic narrations. The "absence" of the mother during trauma recall seems to have repercussions on infants' behavior and interaction; infants show coping strategies that are discussed. We found no significant associations between interaction and infant gender and age, the severity of traumatic experience, mothers' depression and anxiety symptoms, and the country of residence. The results of the microanalysis of interaction can shed light on the fundamental role of intermodal exchanges between mother and infant in trauma transmission during mothers' trauma reactivation.
该研究的目的是考察在人道主义背景下受创伤母亲向婴儿传递创伤的过程。我们通过对母亲回忆创伤的特定时刻与更中性时刻的母婴互动进行微观分析，研究了母亲创伤后应激障碍症状对二元互动质量的影响。在中非、乍得和喀麦隆，对24对受创伤母亲及其1.5至30个月大孩子的母婴二元互动进行了录像，共三个环节：一个中性的初始环节（基线），探索母亲对婴儿及其亲密关系的表征；第二个环节，“创伤叙述”，要求母亲谈论她们所经历的困难事件；第三个环节聚焦于一个中性主题。根据不同的沟通方式（触摸、视觉和声音），针对母亲和孩子，通过一个特定的微观分析网格对每个环节的三分钟进行编码[基于博比尼医学院开发的量表以及（1）的研究成果]。为了全面了解创伤传递机制，我们调查了创伤事件影响（IES-R）、抑郁和焦虑水平（HAD）。数据分析突出了在“创伤叙述”期间母亲、孩子及其互动的显著差异：母亲触摸和注视婴儿的次数减少，显得更加心不在焉，微笑减少，看采访者的次数也减少；婴儿看采访者的次数减少，更多地吸吮乳房。在母亲的创伤叙述中，“婴儿自我刺激-母亲心不在焉”和“婴儿吸吮乳房-母亲心不在焉”的母婴互动更频繁出现。母亲在创伤回忆期间的“不在场”似乎对婴儿的行为和互动产生了影响；文中讨论了婴儿表现出的应对策略。我们发现互动与婴儿性别和年龄、创伤经历的严重程度、母亲的抑郁和焦虑症状以及居住国家之间没有显著关联。互动的微观分析结果可以揭示母婴间多模态交流在母亲创伤再激活期间创伤传递中的重要作用。
