Lehnig Franziska, Linde Katja, Schmidt Viktoria, Nagl Michaela, Martini Julia, Stepan Holger, Kersting Anette
IFB AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany.
Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany.
PLoS One. 2024 Dec 31;19(12):e0316374. doi: 10.1371/journal.pone.0316374. eCollection 2024.
Maternal-foetal attachment (MFA) seems essential for adapting to motherhood and the healthy development of the child, with direct implications for clinical practice. It is often assessed using the Maternal Antenatal Attachment Scale (MAAS), which covers two dimensions: quality and intensity of attachment. However, studies including the MAAS presented missing or inadequate psychometric properties. Therefore, the current study aimed to investigate the reliability and validity of both the original and the recently introduced brief German version of the MAAS.
Data from 184 pregnant women from a longitudinal study were used. Women (≥ 18 years old) were recruited between the 18th and 22nd weeks of gestation while waiting for routine prenatal diagnostic appointments. Participants answered the MAAS, together with other questionnaires measuring maternal mental health, self-esteem, and social support. For both versions of the MAAS (19 items vs. 13 items), item characteristics, confirmatory factor analysis, internal consistency, and test-retest reliability were calculated and compared. Moreover, associations between the brief German MAAS and theoretically related constructs were analysed using correlation coefficients.
In this study, item analyses revealed better psychometric properties for the brief German MAAS than for the original MAAS, with a significant reduction in items with inadequate discriminatory power. The internal consistency (α ≥ .69) and test-retest reliability (ICC ≥ .62) were acceptable to good for both MAAS versions. With regard to structural validity, factor analysis of the German MAAS presented acceptable to good global model fit indices for the model with correlated factors (GFI > .90; RMSEA ≤ .08; SRMR < .10) in the current sample. In contrast, most global model fit indices of the original MAAS were not acceptable. The construct validity of the German MAAS was demonstrated on the basis of small-to-moderate correlations with a variety of constructs (e.g., measures of depression, anxiety, stress).
According to the present results, the brief German version of the MAAS represents a reliable and valid measurement instrument of MFA for use in clinical practice. Further studies examining possible cut-off values are needed to identify pregnant women with significant attachment difficulties who may benefit from additional support.
母婴依恋（MFA）对于适应母亲角色和儿童的健康发展似乎至关重要，对临床实践有直接影响。它通常使用母性产前依恋量表（MAAS）进行评估，该量表涵盖两个维度：依恋的质量和强度。然而，包含MAAS的研究显示出心理测量特性缺失或不足。因此，本研究旨在调查原始版和最近推出的德语简版MAAS的信度和效度。
使用了来自一项纵向研究的184名孕妇的数据。招募年龄≥18岁的女性，她们在妊娠第18至22周期间等待常规产前诊断预约时参与研究。参与者回答了MAAS，以及其他测量产妇心理健康、自尊和社会支持的问卷。针对MAAS的两个版本（19项与13项），计算并比较了项目特征、验证性因素分析、内部一致性和重测信度。此外，使用相关系数分析了德语简版MAAS与理论相关构念之间的关联。
在本研究中，项目分析显示德语简版MAAS的心理测量特性优于原始版MAAS，具有不足区分能力的项目显著减少。两个MAAS版本的内部一致性（α≥.69）和重测信度（ICC≥.62）均可接受至良好。关于结构效度，在当前样本中，德语MAAS的因素分析显示具有相关因素的模型的整体模型拟合指数可接受至良好（GFI>.90；RMSEA≤.08；SRMR<.10）。相比之下，原始MAAS的大多数整体模型拟合指数不可接受。德语MAAS的构念效度通过与多种构念（例如抑郁、焦虑、压力测量）的小到中等相关性得到证明。
根据目前的结果，德语简版MAAS是一种可靠且有效的MFA测量工具，可用于临床实践。需要进一步研究以确定可能的临界值，以识别有显著依恋困难的孕妇，她们可能会从额外的支持中受益。
