Kitamura Toshinori, Hada Ayako, Usui Yuriko, Ohashi Yukiko
Kitamura Institute of Mental Health Tokyo Tokyo Japan.
Kitamura KOKORO Clinic Mental Health Tokyo Japan.
PCN Rep. 2025 Jun 5;4(2):e70127. doi: 10.1002/pcn5.70127. eCollection 2025 Jun.
Clinical attention to and understanding of women with impaired fetal bonding is important for early therapeutic intervention. This study aimed to clarify the clinical characteristics of women belonging to groups derived by cluster analysis of impaired maternal-fetal bonding.
A mixed-method approach was adopted. We conducted a two-wave internet survey targeting pregnant women less than 36 gestational weeks by using a questionnaire (33-item Dimensional Assessment of Mother Baby Organization Questionnaire [DAMBO Q33]) with subsequent online interviews (Dimensional Assessment of Mother and Baby Organization-Research Version). The maternal-fetal bonding disorder items in the DAMBO Q33 were entered into a two-step cluster analysis. Two representative cases from each of the clusters, except for the positive bonding cluster, were selected to describe their clinical pictures. Finally, quantitative data and qualitative data were integrated and interpreted.
A two-step cluster analysis elicited four clusters: bonding disorder ( = 101), ambivalent bonding ( = 156), positive bonding ( = 173), and lack of bonding emotions ( = 122). Women in the bonding disorder cluster were characterized by seriously negative feelings towards the fetus. Women in the ambivalent bonding cluster wished to be pregnant but were not sufficiently ready for the transition into parenthood. Women in the lack of bonding emotions cluster were characterized by a lack of strong interest in pregnancy and the fetus.
Patterns of impaired maternal-fetal bonding were identified. We should not think of a pathological category of mental illness among them but recognize that such parents are targets for professional assessments and supportive (therapeutic) interventions. Understanding the meaning of getting pregnant and difficulties in the process of maternal role attainment is required.
临床关注并理解胎儿情感联结受损的女性对于早期治疗干预至关重要。本研究旨在阐明通过母婴情感联结受损的聚类分析得出的各群体女性的临床特征。
采用混合方法。我们通过问卷（33项母婴组织维度评估问卷 [DAMBO Q33]）对孕周小于36周的孕妇进行了两波网络调查，随后进行在线访谈（母婴组织维度评估 - 研究版）。将DAMBO Q33中的母婴情感联结障碍项目进行两步聚类分析。从除积极情感联结聚类外的每个聚类中选取两个代表性案例来描述其临床表现。最后，对定量数据和定性数据进行整合与解读。
两步聚类分析得出四个聚类：情感联结障碍（n = 101）、矛盾情感联结（n = 156）、积极情感联结（n = 173）和缺乏情感联结情绪（n = 122）。情感联结障碍聚类中的女性对胎儿有严重的负面情绪。矛盾情感联结聚类中的女性希望怀孕，但尚未充分准备好过渡到为人父母的角色。缺乏情感联结情绪聚类中的女性的特点是对怀孕和胎儿缺乏强烈兴趣。
识别出了母婴情感联结受损的模式。我们不应将其中视为一种精神疾病的病理类别，而应认识到这类父母是专业评估和支持性（治疗性）干预的对象。需要理解怀孕的意义以及母亲角色获得过程中的困难。
