Papousek M, von Hofacker N
Institute for Social Paediatrics and Youth Medicine, University of Munich, Germany.
Child Care Health Dev. 1998 Sep;24(5):395-424. doi: 10.1046/j.1365-2214.2002.00091.x.
Infants between 1 and 6 months of age (mean age 3.6 months) who were referred to the Munich Interdisciplinary Research and Intervention Programme because of persistent crying and their mothers were examined and compared with an age-matched community-based control sample with no current cry problem. Three groups, referred extreme criers, referred moderate criers, and controls, were compared with regard to measures of psychosocial and organic risks, the mothers' perception of her own psychological state and infant temperament, the quality of mother-infant relationship, and intuitive parenting in mother-infant face-to-face interactions. In comparison with general-community samples of infants with persistent crying, the present clinical sample represents a biased group with particularly high levels of infant distress for long periods of time, with problems of sleep-wake organization, neuromotor immaturity, and difficult temperament. Moreover, extreme crying was associated with a cumulation of organic and psychosocial risks, including high rates of prenatal stress and anxiety, maternal psychopathology and partnership conflicts. Mothers in both referred groups scored similarly low on feelings of self-efficacy, and high on depression, anxiety, exhaustion, anger, adverse childhood memories, and marital distress. Mother-infant relationships were more often distressed or disturbed among referred dyads than among controls, and 40% as compared with 19% showed dysregulatory patterns of interactional failures in face-to-face contexts. The findings suggest that factors related to parental care did not cause persistent crying, but functioned as maintaining or exacerbating factors. Dynamic interactions between persistent crying, difficult temperament, and parenting factors which compromise maternal resources and intuitive parenting may put such families at long-term risk for both relationship and behaviour problems.
因持续哭闹而被转介至慕尼黑跨学科研究与干预项目的1至6个月大婴儿（平均年龄3.6个月）及其母亲接受了检查，并与年龄匹配、目前无哭闹问题的社区对照样本进行了比较。将三组，即转介的极度哭闹婴儿组、转介的中度哭闹婴儿组和对照组，在心理社会和器质性风险指标、母亲对自身心理状态和婴儿气质的认知、母婴关系质量以及母婴面对面互动中的直观育儿方式等方面进行了比较。与持续哭闹婴儿的一般社区样本相比，本临床样本代表了一个有偏差的群体，这些婴儿长期处于特别高水平的痛苦之中，存在睡眠-觉醒组织问题、神经运动发育不成熟和气质困难等问题。此外，极度哭闹与器质性和心理社会风险的累积有关，包括高比例的产前压力和焦虑、母亲精神病理学以及伴侣冲突。两个转介组的母亲在自我效能感方面得分同样较低，而在抑郁、焦虑、疲惫、愤怒、不良童年记忆和婚姻困扰方面得分较高。与对照组相比，转介的母婴二元组中母婴关系出现困扰或紊乱的情况更为常见，面对面情境中互动失败的失调模式分别为40%和19%。研究结果表明，与父母照料相关的因素并非导致持续哭闹的原因，而是起到维持或加剧的作用。持续哭闹、困难气质以及损害母亲资源和直观育儿方式的育儿因素之间的动态相互作用，可能使这类家庭面临关系和行为问题的长期风险。
