Perinatal and Infant Mental Health Services, Women's and Children's Hospital, North Adelaide, South Australia.
The University of Adelaide, Adelaide, South Australia.
Arch Womens Ment Health. 2021 Aug;24(4):641-648. doi: 10.1007/s00737-021-01119-2. Epub 2021 Mar 19.
A pilot study with women with borderline personality disorder (BPD) and their infants showed promising results. This clinical research program sought to discover whether ongoing implementation confirmed preliminary results in relation to maternal mental health and, in addition, whether parenting and the mother-infant relationship showed sufficient improvement. Women with BPD and their infants were referred to a 25-week group program of Mother-Infant Dialectical Behavior Therapy (MI-DBT). During groups, infants were provided care by childcare workers while mothers took part in a skills training session. Mothers and infants then reunited and took part in an activity together that incorporated skills taught in the teaching session. Sixty-nine of 98 women commencing MI-DBT completed the program, demonstrating a 71% completion rate. Women showed improvement on all measures of mental health including depression, anxiety, and BPD symptoms. While women reported improvement in parenting confidence, an objective measure of the mother-infant relationship showed continuation of concerning relationships in a significant percentage. MI-DBT was found to be effective at improving mothers' mental health, both at the initial site and in community settings, with different clinicians and with different childcare options. While there were some improvements found in measures of the mother's perception of the infant-parent relationship, there were no significant improvements in currently used observational measures of the interaction or the infant's social-emotional development, suggesting that additional intervention such as infant-parent therapy may be needed to augment the benefits of MI-DBT to improve outcomes in these areas.
一项针对边缘型人格障碍（BPD）女性及其婴儿的初步研究结果令人鼓舞。该临床研究项目旨在探索正在进行的实施是否证实了与产妇心理健康相关的初步结果，此外，还探索了育儿和母婴关系是否有足够的改善。BPD 女性及其婴儿被转介到为期 25 周的母婴辩证行为治疗（MI-DBT）小组项目中。在小组中，婴儿由儿童保育员照顾，而母亲则参加技能培训课程。之后，母亲和婴儿团聚，一起参加一项活动，其中包括在教学课程中教授的技能。开始接受 MI-DBT 的 98 名女性中有 69 名完成了该项目，完成率为 71%。女性在所有心理健康测量指标上都有所改善，包括抑郁、焦虑和 BPD 症状。虽然女性报告在育儿信心方面有所改善，但对母婴关系的客观衡量仍显示，在很大比例的情况下，母婴关系仍存在令人担忧的情况。研究发现，MI-DBT 不仅在初始地点和社区环境中，而且在不同的临床医生和不同的儿童保育选择下，都能有效改善母亲的心理健康。尽管在母亲对婴儿-父母关系的感知测量方面发现了一些改善，但在目前用于衡量互动或婴儿社会情感发展的观察性测量方面没有显著改善，这表明可能需要额外的干预措施，如婴儿-父母疗法，以增强 MI-DBT 的益处，从而改善这些方面的结果。
