Field T
Department of Pediatrics, University of Miami, School of Medicine, FL 33101.
Monogr Soc Res Child Dev. 1994;59(2-3):208-27.
In summary, emotion dysregulation can develop from brief or more prolonged separations from the mother as well as from the more disturbing effects of her emotional unavailability, such as occurs when she is depressed. Harmonious interaction with the mother or the primary caregiver (attunement) of the mother's physical unavailability were seen in studies of separations from the mother due to her hospitalization or to her conference trips. These separations affected the infants' play behaviors and sleep patterns. Comparisons between hospitalizations and conference trips, however, suggested that the infants' behaviors were more negatively affected by the hospitalizations than the conference trips. This probably related to these being hospitalizations for the birth of another baby--the infants no longer had the special, exclusive relationship with their mothers after the arrival of the new sibling. This finding highlights the critical importance of emotional availability. The mother had returned from the hospital, but, while she was no longer physically unavailable, she was now emotionally unavailable. Emotional unavailability was investigated in an acute form by comparing two laboratory situations, the still face paradigm and the momentary leave taking. The still face had more negative effects on the infants' interaction behaviors than the physical separation. The most extreme form of emotional unavailability, mother's depression, had the most negative effects. The disorganization or emotion dysregulation in this case is more prolonged. Changes in physiology (heart rate, vagal tone, and cortisol levels), in play behavior, affect, activity level, and sleep organization as well as other regulating functions such as eating and toileting, and even in the immune system persist for the duration of the mother's depression. My colleagues and I have suggested that these changes occur because the infant is being chronically deprived of an important external regulator of stimulation (the mother) and thus fails to develop emotion regulation or organized behavioral and physiological rhythms. Finally, individual differences were discussed, including those related to maturity (e.g., prematurity) and temperament/personality (e.g., uninhibited/inhibited or externalizing/internalizing) and those deriving from degree of mother-infant mismatch, such as dissimilar temperaments. Further investigations are needed to determine how long the effects of such early dysregulation endure, how they affect the infant's long-term development, how their effect differs across individuals and across development, and whether they can be modified by early intervention. Eventually, with increasing age, developing skills, and diversity of experience, infants develop individualized regulatory styles. That process, and how it is affected by the mother's physical and emotional unavailability, also requires further investigation.
总之，情绪调节障碍可能源于与母亲的短暂或长期分离，以及母亲情感上无法给予支持所带来的更令人不安的影响，比如母亲抑郁时的情况。在因母亲住院或出差导致与母亲分离的研究中，观察到了与母亲或主要照顾者（母亲身体无法陪伴时的协调）的和谐互动。这些分离影响了婴儿的玩耍行为和睡眠模式。然而，住院和出差情况的比较表明，住院对婴儿行为的负面影响比出差更大。这可能与住院是因为另一个婴儿出生有关——新兄弟姐妹出生后，婴儿不再与母亲有特殊、专属的关系。这一发现凸显了情感陪伴的至关重要性。母亲从医院回来后，虽然她不再身体无法陪伴，但现在她在情感上却无法给予支持。通过比较两种实验室情境，即静止脸范式和短暂离开，以急性形式研究了情感上无法给予支持的情况。静止脸对婴儿互动行为的负面影响比身体分离更大。情感上无法给予支持的最极端形式，即母亲抑郁，产生的负面影响最大。在这种情况下，混乱或情绪调节障碍会持续更长时间。生理方面（心率、迷走神经张力和皮质醇水平）、玩耍行为、情感、活动水平、睡眠组织以及其他调节功能（如饮食和如厕）的变化，甚至免疫系统的变化，在母亲抑郁期间都会持续存在。我和我的同事认为，这些变化的发生是因为婴儿长期被剥夺了一个重要的外部刺激调节者（母亲），因此未能发展出情绪调节能力或有组织的行为和生理节律。最后，讨论了个体差异，包括与成熟度（如早产）和气质/性格（如无抑制/抑制或外化/内化）相关的差异，以及源于母婴不匹配程度的差异，如不同的气质。需要进一步研究来确定这种早期调节障碍的影响会持续多久，它们如何影响婴儿的长期发展，它们在个体和发展过程中的影响有何不同，以及它们是否可以通过早期干预得到改善。最终，随着年龄增长、技能发展和经验多样化，婴儿会形成个性化的调节方式。这个过程以及它如何受到母亲身体和情感无法陪伴的影响，也需要进一步研究。
