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两个婴儿,两种纽带:双胞胎依恋关系中的挑战。

Two Babies, Two Bonds: Challenges in Attachment Relationships in Twins.

作者信息

Simões Daniela, Soares Tiago, Fernandes Graça

机构信息

Department of Child and Adolescent Psychiatry, Local Health Unit of Western Lisbon, Lisbon, PRT.

Department of Child and Adolescent Psychiatry, Local Health Unit of Santo António, Porto, PRT.

出版信息

Cureus. 2024 Dec 26;16(12):e76422. doi: 10.7759/cureus.76422. eCollection 2024 Dec.

DOI:10.7759/cureus.76422
PMID:39867063
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11763270/
Abstract

The attachment relationship constitutes the first emotionally significant affective bond, usually between the infant and the mother, serving as a model for subsequent relationships. It is considered a vital component of social and emotional development in the early years and an important early indicator of infant mental health. In twins, the attachment process may exhibit unique characteristics, influenced by the dual parenting dynamic and the individual needs of each baby. With this article, we intend to explore the challenges of infant-caregiver relationships and the attachment process in twins through a brief, non-systematic literature review regarding a clinical case of a 21-month-old female born from a twin pregnancy complicated by selective fetal growth restriction (sFGR), prematurity, and very low birth weight. The patient was initially suspected of displaying an insecure ambivalent/resistant attachment style, differing from her twin sister. Studies have shown a high concordance in attachment style between twin pairs, although a higher prevalence of insecure ambivalent/resistant attachment style compared to the general population. This may reflect challenges commonly presented in twin pregnancies and the perinatal period, such as sFGR, prematurity, and feeding difficulties, which increase parental stress that may impair early attachment between parents and infants. Attachment is not a fixed bond. Early identification and intervention in infant-caregiver relationship difficulties within this vulnerable group can help mitigate the challenges of dual parenting, fostering secure bonds and promoting healthy infant development.

摘要

依恋关系构成了第一个具有情感重要意义的情感纽带,通常存在于婴儿与母亲之间,为后续关系树立了典范。它被视为幼儿期社会和情感发展的重要组成部分,也是婴儿心理健康的重要早期指标。在双胞胎中,依恋过程可能呈现出独特的特征,受到双亲养育动态以及每个婴儿个体需求的影响。通过本文,我们打算通过对一个临床病例进行简要的非系统性文献综述,来探讨双胞胎中婴儿与照料者关系及依恋过程所面临的挑战。该临床病例为一名21个月大的女性,其母亲为双胞胎妊娠,并发选择性胎儿生长受限(sFGR)、早产和极低出生体重。该患者最初被怀疑表现出不安全的矛盾/抵抗依恋类型,与她的双胞胎姐姐不同。研究表明,双胞胎之间的依恋类型具有高度一致性,尽管与一般人群相比,不安全的矛盾/抵抗依恋类型更为普遍。这可能反映了双胞胎妊娠和围产期常见的挑战,如选择性胎儿生长受限、早产和喂养困难,这些都会增加父母的压力,可能会损害父母与婴儿之间的早期依恋关系。依恋并非一成不变的纽带。对这一弱势群体中婴儿与照料者关系困难进行早期识别和干预,有助于减轻双亲养育的挑战,培养安全的依恋关系,促进婴儿健康发展。

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本文引用的文献

1
Two babies, two bonds: Frequency and correlates of differential maternal-infant bonding in mothers of twins.两个婴儿,两种联系:双胞胎母亲母婴联系差异的频率及相关因素。
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Ecological momentary assessment of postpartum outcomes in mothers of multiples: lower maternal-infant bonding, higher stress, and more disrupted sleep.多胎产妇产后结局的即时生态学评估:母婴联系减弱、压力增加、睡眠更紊乱。
Arch Womens Ment Health. 2023 Jun;26(3):361-378. doi: 10.1007/s00737-023-01317-0. Epub 2023 Apr 28.
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Insecure attachment and internalizing behavior problems in growth discordant identical twins.成长不一致的同卵双胞胎中的不安全依恋与内化行为问题。
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Long-term effects of selective fetal growth restriction (LEMON): a cohort study of neurodevelopmental outcome in growth discordant identical twins in the Netherlands.选择性胎儿生长受限(LEMON)的长期影响:荷兰生长不一致的同卵双胞胎的神经发育结局的队列研究。
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