A Paradoxical Role of Childbirth-Related Posttraumatic Stress Disorder (PTSD) Symptoms in the Association Between Personality Factors and Mother-Infant Bonding: A Cross-Sectional Study
A Paradoxical Role of Childbirth-Related Posttraumatic Stress Disorder (PTSD) Symptoms in the Association Between Personality Factors and Mother-Infant Bonding: A Cross-Sectional Study
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DOI：
10.1037/tra0000521
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发表时间：
2022-09-01
影响因子：
6.3
通讯作者：
Levy, Sigal
中科院分区：
文献类型：
--
作者：
Handelzalts, Jonathan E.;Hairston, Ilana S.;Levy, Sigal
临床影响陈述该结果强调了人格特征对了解产后精神病理症状的重要性，包括创伤后应激障碍(PTSD)、抑郁症和母婴结合困难。此外，产后创伤后应激障碍与分娩相关的一般症状和结合困难之间可能存在的负相关应进一步探讨，以更好地了解产后创伤后应激障碍相对于母婴结合的可能的衰弱和保护方面。这样的理解将有助于更好地治疗患有产后精神病理，特别是与分娩相关的创伤后应激障碍症状的妇女。目的：由于母婴结合困难对儿童发育具有潜在的不利影响，因此研究其病因和相关因素具有重要意义。只有少数研究集中在个性、产后抑郁和创伤后应激障碍(PTSD)在亲子关系困难的病因中所起的作用。本文试图确定脆弱(神经质)和韧性(性格乐观)与亲和力之间的联系，其中产后抑郁症和创伤后应激障碍症状可能是中介因素。方法：使用社交媒体对504名0-13个月婴儿的母亲进行横断面抽样调查。受访者完成了一项由以下问卷组成的在线调查：人口统计细节、神经质(大五大问卷子量表，BFI)、性格乐观(生活取向测试修订版)、产后创伤后应激障碍症状(城市出生创伤量表，BITS)、产后抑郁症状(爱丁堡产后抑郁量表，EPDS)和母婴关系困难(产后关系问卷，PBQ)。结果：路径分析发现5条显著的间接路径：倾向性乐观通过EPDS(beta=-0.04，p=0.010)和BITS一般症状(beta=-0.02，p=0.019)影响亲子关系，BFI神经质通过EPDS(beta=0.14，p=.001)，BITS出生相关症状(beta=-0.03，p=0.013)和BITS一般症状(beta=0.11，p=.001)影响亲子关系。结论：性格乐观和神经质都与亲子关系困难有关，产后抑郁和创伤后应激障碍是由产后抑郁和创伤后应激障碍引起的。当在单一模型中测量所有变量时，产后创伤后应激障碍与出生相关的症状预示着较少的结合困难，而一般的产后创伤后应激障碍症状与更多的结合困难相关。综上所述，这些结果可以促进对产后精神病理学和母婴纽带的更好理解，以便进行更好的治疗。
Clinical Impact Statement The results underscore the importance of personality traits to the understanding of postpartum psychopathological symptomatology, including posttraumatic stress disorder (PTSD), depression and mother-infant bonding difficulties. Further, the possible inverse association of postpartum PTSD childbirth-related and general symptoms with bonding difficulties should be further explored to better understand the possible debilitative as well as protective aspects of postpartum PTSD vis-a-vis mother-infant bonding. Such understanding would allow for better treatments offered to women suffering from postpartum psychopathology in general and childbirth-related PTSD symptoms in particular.Objective: As mother-infant bonding difficulties are potentially detrimental to child development, it is of importance to study its etiology and associated factors. Only a minority of studies have focused on the role of personality and postpartum depression and posttraumatic stress disorder (PTSD) in the etiology of bonding difficulties. The present article attempted to ascertain the association of vulnerability (Neuroticism) and resilience (Dispositional Optimism) with bonding, wherein postpartum depression and PTSD symptoms were possible mediators. Method: There were 504 mothers of infants, 0-13 months, who were sampled cross-sectionally using social media. Respondents completed an online survey consisting of the following questionnaires: demographic details, Neuroticism (subscale of the Big Five Inventory, BFI), Dispositional Optimism (Life Orientation Test-Revised), postpartum PTSD symptoms (City Birth Trauma Scale, BiTS), postpartum depression symptoms (Edinburgh Postpartum Depression Scale, EPDS), and mother-infant bonding difficulties (Postpartum Bonding Questionnaire, PBQ). Results: Path analysis revealed 5 significant indirect paths: Dispositional Optimism affected bonding through EPDS (beta = -0.04, p = .010) and through BiTS general symptoms (beta = -.02, p = .019), and BFI-Neuroticism affected bonding through EPDS (beta = 0.14, p = .001), BiTS birth-related symptoms (beta = -0.03, p = .013), and BiTS general symptoms (beta = 0.11, p = .001). Conclusions: Both Dispositional Optimism and Neuroticism correlated with bonding difficulties, mediated by postpartum depression and PTSD symptoms. When all variables were measured in a single model, postpartum PTSD birth-related symptoms predicted fewer bonding difficulties while general postpartum PTSD symptoms were associated with more bonding difficulties. Taken together, these results can promote better understanding of postpartum psychopathology and mother-infant bonding to allow for better treatments.