How to Find Maternal Depression and Relationship Disorders between Mothers and Children Early in a Community

本研究的目的是为包括助产士、公共卫生护士、儿童精神病学家和临床心理学家在内的婴儿心理健康专业人员提供有用的基本信息，以便为生育中的母亲提供具体的支持。我们在日本北部某城市的一家综合医院招募了孕妇作为研究对象。我们对怀孕晚期、出生后1个月、出生后4个月和出生后1年的受试者进行了纵向心理健康调查。此外，我们还对出生后4个月和1年的被试进行了家访，包括录像，以评估母婴互动和母亲的情感可得性。家访调查的对象是63位母亲和她们的孩子。在家访调查中，我们参照《陌生情境》（Ainsworth， M. ... More）的程序，构建了母婴分离与团聚的场景。9名婴儿心理健康专家采用修正情绪可得性量表对母亲和婴儿的录像行为进行评价。最初的情绪可得性量表由Biringen， Z, Robison J.L.和Emde R.N.开发，我们对量表进行了修改以适应我们的研究。我们比较了持续抑郁组（CDG） （n=12）和非持续抑郁组（NCDG） （n=51）的母婴互动和母亲情绪可得性。CDG组的母亲在出生后1个月和4个月被判定患有抑郁症。因此，CDG母亲的情绪表达明显比NCDG母亲更消极和抑郁。CDG母亲对婴儿的说话量明显减少，沟通明显不顺畅。CDG患儿的情绪表达也明显比NCDG患儿更为消极和抑郁。CDG患儿复发频率明显高于NCDG患儿。从这些结果来看，持续抑郁的母亲在与孩子的互动和对孩子的情感可用性方面存在许多问题。少

The objective of the present study is to provide useful basic information for the infant mental health professionals including midwives, public health nurses, child psychiatrists and clinical psychologists trying to provide concrete supports to mothers in child bearing. We recruited the subjects of pregnant women in a general hospital in a city located in the northern area of Japan. We administered longitudinal mental health surveys to the subjects in third trimester of pregnancy, one month after birth, four months after birth and on year after birth. Furthermore, we conducted home visit survey including video-recording to the subjects four months and one year after birth to evaluate mother-infant interactions and maternal emotional availability. The subjects of the home visit surveys were 63 mothers and their children. In the home visit surveys, we structured the setting of separation and reunion of mothers and infants referring to the procedure of the Strange Situation (Ainsworth, M. … More ). The evaluation of the video-recorded behaviors of the mothers and infants was conducted by nine infant mental health professionals using the modified Emotional Availability Scale. The original version of the Emotional Availability Scale was developed by Biringen, Z, Robison J.L. and Emde R.N. We modified the scale to adapt our research.We compared the mother-infant interactions and maternal emotional availability between the continuously depressed group (CDG) (n=12) and the non continuously depressed group (NCDG) (n=51). The mothers of the CDG were judged to be depressed both one month and four months after birth. As a result, the emotional expression of the mothers of CDG was significantly more negative and depressed than that of the mothers of NCDG. The quantity of talking of the mothers of CDG to their infants was significantly less and the communication of them was significantly less smooth. The emotional expression of the infants of CDG was also significantly more negative and depressed than that of the infants of NCDG. The infants of CDG presented significantly more frequent recurving than the infants of NCDG. From these results, it was suggested that the continuously depressed mother had many problems of their interaction with their children and their emotional availability to their children. Less