Mothering From the Inside Out: Results of a second randomized clinical trial testing a mentalization-based intervention for mothers in addiction treatment.
Mothering From the Inside Out: Results of a second randomized clinical trial testing a mentalization-based intervention for mothers in addiction treatment.
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DOI：
10.1017/s0954579417000220
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发表时间：
2017-05
影响因子：
3.3
通讯作者：
Borelli J
中科院分区：
文献类型：
--
作者：
Suchman NE;DeCoste CL;McMahon TJ;Dalton R;Mayes LC;Borelli J
与没有药物滥用史的母亲相比，有酒精和药物成瘾史的母亲在养育幼儿方面表现出更大的困难。这项研究是第二项随机临床试验，测试从内到外的育儿（MIO）的有效性，这是一项为期12周的以心理为基础的个体治疗，旨在解决通常与慢性药物使用相关的心理缺陷，这些缺陷也干扰了养育幼儿的能力。87位照顾11至60个月大孩子的母亲被随机分配接受12次MIO和12次家长教育（PE）——一种心理教育的主动对照比较。在基线、治疗后和3个月的随访中，对母亲的反思功能、照顾表现、母子互动质量和儿童依恋进行了评估。在随访12个月时再次评估母子互动质量。与PE母亲相比，MIO母亲在治疗后和3个月的随访中表现出更高的反思功能和表征一致性能力。在12个月的随访中，与PE组相比，MIO母亲表现出更大的敏感性，她们的孩子表现出更大的参与度，MIO夫妇表现出更大的互惠性。随着成瘾严重程度的增加，MIO似乎也成为母亲反思功能、母子互动质量和儿童依恋状态的保护因素。结果表明，以心理为基础的干预措施与成瘾治疗同时提供给母亲和她们的幼儿是有希望的。
Mothers with histories of alcohol and drug addiction have shown greater difficulty parenting young children than mothers with no history of substance misuse. This study was the second randomized clinical trial testing the efficacy of Mothering from the Inside Out (MIO), a 12-week mentalization-based individual therapy designed to address psychological deficits commonly associated with chronic substance use that also interfere with the capacity to parent young children. Eighty-seven mothers caring for a child between 11 and 60 months of age were randomly assigned to receive 12 sessions of MIO versus 12 sessions of Parent Education (PE)—a psychoeducation active control comparison. Maternal reflective functioning, representations of caregiving, mother-child interaction quality, and child attachment were evaluated at baseline and post-treatment and 3-month follow up. Mother-child interaction quality was assessed again at 12-month follow up. In comparison with PE mothers, MIO mothers demonstrated a higher capacity for reflective functioning and representational coherence at post-treatment and 3-month follow up. At 12-month follow up, compared to PE cohorts, MIO mothers demonstrated greater sensitivity, their children showed greater involvement, and MIO dyads showed greater reciprocity. As addiction severity increased, MIO also appeared to serve as a protective factor for maternal reflective functioning, quality of mother-child interactions, and child attachment status. Results demonstrate the promise of mentalization-based interventions provided concomitant with addiction treatment for mothers and their young children.