Mudra Susanne, Göbel Ariane, Möhler Eva, Stuhrmann Lydia Yao, Schulte-Markwort Michael, Arck Petra, Hecher Kurt, Diemert Anke
Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Saarland University Medical Center, Hamburg, Germany.
Front Psychiatry. 2022 Jun 3;13:844291. doi: 10.3389/fpsyt.2022.844291. eCollection 2022.
Behavioral inhibition, characterized by shyness, fear and avoidance of novel stimuli, has been linked with internalizing personality traits in childhood, adolescence and early adulthood, and particularly later social anxiety disorder. Little is known about the relevance of potential prenatal precursors and early predictors for the development of inhibited behavior, such as infant vulnerability and family risk factors like parental anxiety and overprotection. Pregnancy-related anxiety has been associated with both infant temperament and maternal overprotective parenting. Thus, the aim of this study was investigating the predictive relevance of prenatal pregnancy-related anxiety for behavioral inhibition in toddlerhood, by considering the mediating role of maternal overprotection and infant distress to novelty.
As part of a longitudinal pregnancy cohort, behavioral inhibition at 24 months postpartum was assessed in = 170 mother-child pairs. Maternal pregnancy-related anxiety was examined in the third trimester of pregnancy, and maternal overprotection and infant distress to novelty at 12 months postpartum.
Mediation analysis with two parallel mediators showed that the significant direct effect of pregnancy-related anxiety on child behavioral inhibition was fully mediated by infant distress to novelty < 0.001 and maternal overprotection ( < 0.05). The included variables explained 26% of variance in behavioral inhibition. A subsequent explorative mediation analysis with serial mediators further showed a significant positive association between distress to novelty and maternal overprotective parenting ( < 0.05).
Results indicate a predictive relevance of both infant and maternal factors for the development of behavioral inhibition in toddlerhood. Mothers who perceived more pregnancy-related anxiety showed more overprotective parenting and had infants with more distress to novelty. Further, mothers being more overprotective reported their child to be more inhibited in toddlerhood. Our findings also indicate the stability of reported infant distress to novelty as one aspect of later behavioral inhibition. Addressing specific forms of parental anxiety from pregnancy on and in interaction with child-related variables seems to be a promising approach for future studies and clinical interventions.
行为抑制的特征为害羞、恐惧和回避新异刺激，与儿童期、青少年期及成年早期的内化性人格特质相关，尤其是与后期的社交焦虑障碍有关。对于潜在的产前先兆因素和早期预测指标与抑制行为发展的相关性，例如婴儿易感性以及父母焦虑和过度保护等家庭风险因素，人们了解甚少。与怀孕相关的焦虑与婴儿气质及母亲过度保护型养育方式均有关联。因此，本研究的目的是通过考虑母亲过度保护和婴儿对新异刺激的苦恼的中介作用，探讨产前与怀孕相关的焦虑对幼儿期行为抑制的预测相关性。
作为一个纵向妊娠队列研究的一部分，对170对母婴进行了产后24个月时行为抑制的评估。在妊娠晚期检查母亲与怀孕相关的焦虑，在产后12个月检查母亲的过度保护和婴儿对新异刺激的苦恼。
对两个平行中介变量的中介分析表明，与怀孕相关的焦虑对儿童行为抑制的显著直接效应完全由婴儿对新异刺激的苦恼（P<0.001）和母亲过度保护（P<0.05）所中介。纳入的变量解释了行为抑制中26%的变异。随后对系列中介变量的探索性中介分析进一步表明，对新异刺激的苦恼与母亲过度保护型养育方式之间存在显著正相关（P<0.05）。
结果表明婴儿因素和母亲因素对幼儿期行为抑制的发展均具有预测相关性。感知到更多与怀孕相关焦虑的母亲表现出更多的过度保护型养育方式，且其婴儿对新异刺激的苦恼更多。此外，过度保护程度更高的母亲报告其孩子在幼儿期更易出现行为抑制。我们的研究结果还表明，所报告的婴儿对新异刺激的苦恼作为后期行为抑制的一个方面具有稳定性。从孕期开始并结合与儿童相关的变量来处理特定形式的父母焦虑，似乎是未来研究和临床干预的一个有前景的方法。
