Reflective functioning (RF) is a construct that has gained tremendous traction in the developmental psychology literature, demonstrating robust associations with parent–child attachment and ...interactional quality. Although theorists argue that RF should have meaningful links with relationship quality across the life span, to date this construct has not been applied to the study of adult romantic partnerships. The goal of the present investigation is to introduce the construct of Partner RF, the capacity to reflect on the thoughts and feelings of one’s partner and to consider their roles in guiding behavior in one’s partner and oneself. Next, we explore the degree to which Partner RF is associated with a range of theoretically related constructs—one’s partner’s Partner RF, as well as one’s own parental RF, attachment, relationship satisfaction, and coparenting—in first-time parents. In a longitudinal study of N = 107 primiparous couples, we found positive associations between mothers’ and fathers’ Partner RF and between mother’s Partner RF and their parental RF. Partner RF is higher among women who report lower prenatal attachment avoidance and demonstrate more prenatal positive communication with their partners. Counterintuitively, higher levels of maternal Partner RF predict greater decreases in couple and coparenting satisfaction across the transition to parenthood. Partner RF may be an important construct to measure and understand in terms of its role in couple relationship functioning and parental well-being.
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The capacity for reflective functioning (RF) or mentalizing of adoptive parents is hypothesized to play an important role in fostering socio-emotional development in adopted children. This paper ...reports on the development and preliminary validation of the Adoption Expectations Interview (AEI), a semi-structured interview to assess RF in prospective adoptive parents. The AEI was developed based on the Pregnancy Interview, Parent Development Interview, and Working Model of the Child Interview, three interviews that have been used to assess RF in biological parents, to capture RF before child arrival in prospective adoptive parents. In a sample of 96 prospective adoptive parents, the Reflective Functioning Scale, as applied to the AEI (AEI-RFS) showed good reliability, with strong correlations between the different demand items, high internal consistency, and good to excellent inter-rater reliability. A principal component analysis yielded one component, suggesting that the items measured a unidimensional factor. Preliminary evidence for the construct validity of the AEI-RFS was demonstrated by significant associations between the AEI-RFS and well-validated measures of mentalizing, attachment dimensions, and interpersonal functioning.
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The purpose of this explanatory sequential mixed methods study was to examine parenting outcomes and experiences over time among marginalized adolescent mothers enrolled in randomized clinical trials ...(RCT) between 2002 and 2016 testing Minding the Baby® (MTB), an early home visiting program. The quantitative phase examined associations between measures of maternal experiences and parenting outcomes from 71 participants 2-8 years since RCT completion. MTB mothers reported less hostile parenting and fewer child behavior problems. The sequential qualitative phase involved interviews with a subsample (n = 31) and revealed six themes about their personal and parenting maturation. Through integration of quantitative and qualitative data, we generated metainferences, revealing a nuanced understanding of participants' experiences. Integrated findings revealed the complex personal and parenting experiences among former adolescent mothers during their developmental phases of emerging and early adulthood. Findings inform clinical and research approaches to promote personal growth and positive parenting outcomes over time among women who began childbearing in adolescence.
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Exposure to early childhood adversity is associated with an increased risk for physiological disruption, including increased inflammation. Early interventions that support the mother-child ...relationship have been shown to potentially buffer negative psychosocial outcomes related to early adversity, but it is unclear whether these interventions have long-term biological effects. We evaluated whether prior participation in Minding the Baby® (MTB), an attachment-based home visiting intervention for young mother-infant dyads living in underserved communities, is associated with lower child salivary inflammatory biomarkers compared with controls at follow-up.
Ninety-seven maternal-child dyads (n = 43 intervention and n = 54 controls) enrolled in a follow-up study of the MTB randomized controlled trial, an average of 4.6 years after RCT completion. Children provided salivary specimens. We used adjusted linear regression to examine the relationship between MTB participation and child salivary inflammatory biomarkers (C-reactive protein CRP, interleukin IL-1β, IL-6, IL-8, and TNF-α).
Children were on average 6.6 years old, 48% female, and identified as non-Hispanic/Latino Black/African American (34%) and Hispanic/Latino (63%). Participation in MTB was associated with lower salivary CRP levels (β = -0.31, SE = 0.28, p = 0.003) compared with controls. Participation in MTB was not associated with salivary cytokine levels.
Participation in an intensive two-generation home visiting intervention such as MTB may reduce salivary inflammatory biomarkers associated with early childhood adversity. Replication and further research are needed to improve the understanding of the potential for early childhood interventions to buffer the biological embedding of early adversity.
Abstract
The infant health movement was launched nearly 50 years ago with the publication of the now classic paper,
Ghosts in the Nursery: A psychoanalytic approach to the problems of impaired ...infant‐mother relationships
, written by Selma Fraiberg, Edna Adelson, and Vivian Shapiro (1975). This paper offers us lessons for infant mental health practice that have been proven true time and again over the last 50 years. These lessons both underscore the factors essential to clinical progress across a range of interventions, and remind us of the significant challenges we face in these times of massive, global trauma and oppression, extreme economic hardship, and systemic racism. This commentary reviews the key lessons of Fraiberg and her colleagues’ classic paper, addresses some of the challenges inherent in retaining the breadth and substance of Fraiberg's model in contemporary practice, and proposes a model for conceptualizing infant and early childhood mental health practice that is geared toward building the relational foundations of reflection (Slade, 2023).
Resumen
Hace casi cincuenta años que el movimiento de salud infantil se inició con la publicación del ahora clásico ensayo Fantasmas en la guardería: Un acercamiento sicoanalítico a los problemas de relaciones infante‐madre deterioradas, escrito por Selma Fraiberg, Edna Adelson y Vivian Shapiro (1975). Fantasmas en la guardería nos ofrece lecciones para la práctica de la salud mental infantil cuya validez ha sido demostrada una y otra vez a lo largo de los últimos 50 años. Estas lecciones enfatizan los factores que son esenciales para el progreso clínico a lo largo de una gama de intervenciones. Ellos también nos recuerdan los retos significativos que enfrentamos en estos tiempos de trauma y opresión global masivas, adversidades económicas extremas y racismo sistémico. Este comentario revisa las lecciones claves del clásico ensayo de Freiberg y sus colegas, se ocupa de algunos de los desafíos inherentes para mantener la amplitud y sustancia del modelo de Freiberg en la práctica contemporánea y propone un modelo para la conceptualización de la práctica de salud mental infantil y la temprana niñez, el cual está dirigido a establecer los cimientos de la reflexión con base en la relación (Slade, 2023) en la práctica clínica.
Résumé
Le mouvement de la santé du nourrisson a été lancé il y a cinquante ans avec la publication d'un article désormais classique intitulé Fantômes dans la chambre d'enfants: Une approche psychanalytique des problèmes des relations enfants‐mères déficientes, écrit par Selma Fraibert, Edna Adelson et Vivian Shapiro (1975). Fantômes dans la chambre d'enfants nous offre des leçons pour la pratique de santé mentale du nourrisson qui se sont avérées vraies au fil des 50 dernières années. Ces leçons soulignent les facteurs essentiels au progrès clinique au travers d'une gamme d'interventions. Elles nous rappellent également les défis importants auxquels nous faisons face à cette époque de trauma et d'oppression massive globale, de difficultés économiques extrêmes et de racisme systémique. Ce commentaire passe en revue les leçons clés de l'article classique de Fraibert et ses collègues, en adressant certains des défis inhérents à la nécessité de retenir l'ampleur et la substance du modèle de Fraiberg dans la pratique contemporaine et en proposant un modèle pour la conceptualisation de la pratique de santé mentale du nourrisson et de la petite enfance qui soit axé sur la construction de fondations relationnelles sur la réflexion (Slade 2023) dans la pratique Clinique.
Zusammenfassung
Vor fast fünfzig Jahren wurde mit der Veröffentlichung des inzwischen zum Klassiker gewordenen Artikels „Ghosts in the Nursery: A psychoanalytic approach to the problems of impaired infant‐mother relationships“ von Selma Fraiberg, Edna Adelson und Vivian Shapiro (1975) die Bewegung für die Gesundheit von Säuglingen gestartet. „Ghosts in the Nursery“ (Geister im Kinderzimmer) bietet uns Lektionen für die Praxis der psychischen Gesundheit von Säuglingen, die sich in den letzten 50 Jahren immer wieder bewährt haben. Diese Lehren unterstreichen Faktoren, die bei einer Reihe von Interventionen für den klinischen Fortschritt wesentlich sind. Sie erinnern uns auch an die großen Herausforderungen, vor denen wir in diesen Zeiten massiver, globaler Traumata und Unterdrückung, extremer wirtschaftlicher Not und systemischen Rassismus stehen. Dieser Kommentar gibt einen Überblick über die wichtigsten Lehren aus dem Klassiker von Fraiberg und ihren Kolleginnen und adressiert einige der Herausforderungen, die mit der Beibehaltung des Umfangs und der Substanz von Fraibergs Modell in der heutigen Praxis verbunden sind. Außerdem wird ein Modell für die Konzeptualisierung der Praxis psychischer Gesundheit von Säuglingen und Kleinkindern vorgeschlagen, das darauf ausgerichtet ist, die relationalen Grundlagen der Reflexion (Slade, 2023) in der klinischen Praxis aufzubauen.
摘要
婴儿健康运动始于近五十年前, 当时 (1975年) Selma Fraiberg、Edna Adelson和Vivian Shapiro发表了一篇现已成为经典的论文《育儿幽灵:解决母婴关系受损问题的精神分析方法》。《育儿幽灵》为我们提供了婴儿心理健康实践的教训, 这些教训在过去的50年中一次又一次地被证明是正确的。这些经验教训强调了在各种干预措施中取得临床进展所必不可少的因素。它们也提醒我们, 在这个充满全球性创伤和压迫、极端经济困难和系统性种族主义的时代, 我们面临着重大挑战。这篇评论回顾了Fraiberg及其同事们的经典论文的主要教训, 讨论了在现代实践中保留Fraiberg模型的广度和实质内容所固有的一些挑战, 并提出了一种在临床实践中构建反思关系基础 (Slade, 2023) 的婴幼儿心理健康实践概念模型。
ملخص
انطلقت حركة صحة الرضع منذ ما يقرب من خمسين عاماً مع نشر الورقة البحثية الكلاسيكية “أشباح في الحضانة: منهج التحليل النفسي لمشاكل العلاقات المضطربة بين الرضيع والأم”، والتي كتبها الباحثون سلمى فرايبيرج، وإدنا أديلسون، وفيفيان شابيرو (1975).). تقدم لنا هذه الدراسة دروساً في ممارسة الصحة النفسية للأطفال الرضع والتي أثبتت صحتها مرارًا وتكرارًا على مدار الخمسين عامًا الماضية. تؤكد هذه الدروس على العوامل الأساسية للتقدم الاكلينيكي عبر مجموعة من التدخلات. كما أنها تذكرنا بالتحديات الكبيرة التي نواجهها في الأوقات التي تتسم بالصدمة والقمع والصعوبات الاقتصادية الشديدة، والعنصرية المنهجية. يستعرض هذا التعليق الدروس الرئيسية المستفادة من ورقة فرايبيرج وزملائها الكلاسيكية، ويتناول بعض التحديات الكامنة في الحفاظ على اتساع وجوهر نموذج فرايبيرج في الممارسة المعاصرة، ويقترح نموذجًا لوضع تصور لممارسة الصحة النفسية للرضع والطفولة المبكرة التي يتم توجيهها نحو بناء الأسس العلائقية للتأمل (سليد، 2023) في الممارسة الاكلينيكية.
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The infant health movement was launched nearly 50 years ago with the publication of the now classic paper, Ghosts in the Nursery: A psychoanalytic approach to the problems of impaired infant‐mother ...relationships, written by Selma Fraiberg, Edna Adelson, and Vivian Shapiro (1975). This paper offers us lessons for infant mental health practice that have been proven true time and again over the last 50 years. These lessons both underscore the factors essential to clinical progress across a range of interventions, and remind us of the significant challenges we face in these times of massive, global trauma and oppression, extreme economic hardship, and systemic racism. This commentary reviews the key lessons of Fraiberg and her colleagues’ classic paper, addresses some of the challenges inherent in retaining the breadth and substance of Fraiberg's model in contemporary practice, and proposes a model for conceptualizing infant and early childhood mental health practice that is geared toward building the relational foundations of reflection (Slade, 2023).
Full text
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Research is needed to better understand how childhood maltreatment history affects parental reflective capacities, and whether early childhood interventions help mitigate these effects. We examined ...associations between childhood maltreatment and current parenting (parental reflective functioning, parenting behaviors) among mothers who participated in a follow-up study (N = 97) of the Minding the Baby® (MTB) randomized control trial. MTB is a home visiting program that aims to help mothers understand their child’s mental states (feelings, intentions, needs) by promoting parental reflective functioning. Mothers retrospectively reported childhood maltreatment using the Childhood Trauma Questionnaire. Endorsing a higher number of childhood maltreatment subtypes was associated with less supportive/engaged parenting and higher pre-mentalizing modes, or difficulty with appropriately reflecting on the child’s mental states. These relationships were not moderated by participation in the MTB intervention. However, exploratory analyses of individual maltreatment subtypes revealed that participation in MTB may mitigate the harmful effects of childhood emotional abuse on pre-mentalizing modes, specifically. Further research is needed to understand the mechanisms through which early childhood interventions may prevent intergenerational cycles of maltreatment.
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Racism is a significant source of toxic stress and a root cause of health inequities. Emerging evidence suggests that exposure to vicarious racism (i.e., racism experienced by a caregiver) is ...associated with poor child health and development, but associations with biological indicators of toxic stress have not been well studied. It is also unknown whether two-generation interventions, such as early home visiting programs, may help to mitigate the harmful effects of vicarious racism.
The purpose of this study was to examine associations between maternal experiences of racial discrimination and child indicators of toxic stress and to test whether relationships are moderated by prior participation in Minding the Baby (MTB), an attachment-based early home visiting intervention.
Ninety-seven maternal-child dyads (n = 43 intervention dyads, n = 54 control dyads) enrolled in the MTB Early School Age follow-up study. Mothers reported on racial discrimination using the Experiences of Discrimination Scale. Child indicators of toxic stress included salivary biomarkers of inflammation (e.g., C-reactive protein, panel of pro-inflammatory cytokines), body mass index, and maternally reported child behavioral problems. We used linear regression to examine associations between maternal experiences of racial discrimination and child indicators of toxic stress and included an interaction term between experiences of discrimination and MTB group assignment (intervention vs. control) to test moderating effects of the MTB intervention.
Mothers identified as Black/African American (33%) and Hispanic/Latina (64%). In adjusted models, maternal experiences of racial discrimination were associated with elevated salivary interleukin-6 and tumor necrosis factor-α levels in children, but not child body mass index or behavior. Prior participation in the MTB intervention moderated the relationship between maternal experiences of discrimination and child interleukin-6 levels.
Results of this study suggest that racism may contribute to the biological embedding of early adversity through influences on inflammation, but additional research with serum markers is needed to better understand this relationship. Improved understanding of the relationships among vicarious racism, protective factors, and childhood toxic stress is necessary to inform family and systemic-level intervention.
Nancy Suchman is remembered as a pioneer whose mentalization‐based intervention—Mothering from the Inside Out (MIO)—transformed the treatment of parents struggling with substance use disorders. ...Specifically, Suchman's work highlighted the neural mechanisms underlying substance use disorders and identified the promotion of parental mentalizing as a key therapeutic focus in enhancing early parent‐child relationships. Her work transformed parenting support models for this population of parents. Several randomized controlled trials (RCT) show the effectiveness of MIO in promoting parental reflective functioning (PRF) and positive relational outcomes in parents with substance use disorders and their children. Suchman's MIO model has since been extended to parenting in many contexts. She is also remembered as a generous colleague, a gifted researcher and clinician, and an inspiration to generations of researchers and practitioners working with parents who aspire to raise healthy, secure children despite multiple challenges and adversities. This special issue compiles the work of researchers inspired by Suchman as they carry on her legacy in examining aspects of parental mentalization. Collectively, the research presented yields confirmation of MIO core assumptions, offers new insights into roles of positive sentiment and savoring in mentalization processes, and presents evaluations of MIO in multiple contexts and with new adaptations.
Resumen
A Nancy Suchman se le recuerda como una pionera cuya intervención basada en la mentalización—Cuidados Maternales de Dentro hacia Afuera (MIO)— transformó el tratamiento de progenitores luchando con trastornos de uso de sustancias. Específicamente, el trabajo de Suchman enfatizó los mecanismos neurales subyacentes en los trastornos de uso de sustancias e identificó el promover la mentalización del progenitor como un enfoque terapéutico clave para mejorar las tempranas relaciones progenitor‐niño. Su trabajo transformó los modelos de apoyo a la crianza para este grupo de progenitores. Varios ensayos controlados al azar muestran la eficacia del MIO en cuanto a promover el funcionamiento con reflexión del progenitor y los resultados de una positiva relación en progenitores con trastornos de uso de sustancias y sus niños. El modelo MIO de Suchman desde su creación ha sido expandido a la crianza en muchos contextos. A ella también se le recuerda como una colega generosa, una investigadora y profesional clínica talentosa y como una inspiración para generaciones de investigadores y practicantes profesionales que trabajan con progenitores que aspiran a criar niños saludables y seguros, a pesar de múltiples retos y circunstancias adversas. Este número especial recopila el trabajo de investigadores inspirados por Suchman a medida que ellos continúan el legado en cuanto a examinar aspectos de la mentalización del progenitor. Colectivamente, la investigación presentada aporta la confirmación de las suposiciones centrales del MIO, ofrece nuevas ideas acerca del papel del sentimiento positivo y el aprecio detenido en los procesos de mentalización, y presenta evaluaciones del MIO en contextos múltiples y con nuevas adaptaciones.
Résumé
Nous honorons et nous souvenons de Nancy Suchman en tant que pionnière dont l'intervention basée sur la mentalisation – le Maternage de l'Intérieur, en anglais Mothering from the Inside Out (MIO) – a transformé le traitement de parents aux prises avec la toxicomanie. Plus particulièrement le travail de Suchman a mis en lumière les mécanismes neuronaux sous‐jacents aux troubles lié à l'usage d'une substance et il a aussi identifié la promotion de la mentalisation parentale comme une cible thérapeutique clé pour l'amélioration des relations précoces parent‐enfant. Son travail a transformé les modèles de soutien parental pour cette population de parents. Plusieurs essais contrôlés randomisés montrent l'efficacité du MOI pour la promotion du fonctionnement de réflexion parental et des résultats relationnels positifs pour des parents ayant un trouble lié à l'usage d'une substance et leurs enfants. Le modèle MOI de Suchman a depuis été étendu au parentage dans de nombreux contextes. Nous nous souvenons aussi de Nancy Suchman comme étant une collègue généreuse, une chercheuse et une clinicienne talentueuse et une inspiration pour des générations de chercheurs et professionnels travaillant avec des parents qui aspirent à élever des enfants sécures, en bonne santé, malgré de grands défis et l'adversité à laquelle ils peuvent faire face. Ce numéro spécial compile le travail de chercheurs du monde entier, inspiré par Suchman, alors qu'ils perpétuent son héritage en examinant des aspects de la mentalisation parentale. Collectivement ces recherches compilées ici proposent la confirmation des hypothèses principales du MOI, offrent de nouvelles perspectives quant aux rôles du sentiment positif et du fait de savourer dans les processus de mentalisation et présentent des évaluations du MOI dans des contextes multiples et avec de nouvelles adaptations.
Zusammenfassung
Ein Mentalisierungsrahmen für das Verständnis suchtkranker Mütter: Die bahnbrechende Arbeit von Nancy E. Suchman
Nancy Suchman gilt als Pionierin, deren auf Mentalisierung basierende Intervention ‐ Mothering from the Inside Out (MIO) ‐ die Behandlung von Eltern, die mit Substanzkonsumstörungen kämpfen, verändert hat. Suchmans Arbeit beleuchtete insbesondere die neuronalen Mechanismen, die Substanzkonsumstörungen zugrunde liegen. Außerdem identifizierte sie die Förderung des elterlichen Mentalisierens als therapeutischen Schwerpunkt zur Verbesserung der frühen Eltern‐Kind‐Beziehung. Ihre Arbeit hat die Modelle zur Unterstützung von suchtkranken Elternpopulationen verändert. Mehrere randomisierte kontrollierte Studien belegen die Wirksamkeit von MIO bei der Förderung von elterlichem „Reflective Functioning“ und positiven Beziehungs‐Outcomes bei Eltern mit Substanzkonsumstörungen und ihren Kindern. Suchmans MIO‐Modell wurde seither auf Elternarbeit in vielen Kontexten ausgeweitet. Darüber hinaus bleibt sie als großzügige Kollegin, begabte Forscherin und Klinikerin sowie als Inspiration für Generationen von Forschenden und mit Eltern arbeitenden Praktiker:innen in Erinnerung. Ihr Ziel war es, trotz vielfältiger Herausforderungen und Widrigkeiten gesunde und sichere Kinder aufzuziehen. Diese Sonderausgabe stellt die Arbeiten von Forschenden zusammen, die von Suchman inspiriert wurden und ihr Vermächtnis bei der Untersuchung von Aspekten der elterlichen Mentalisierung weiterführen. Die vorgestellten Forschungsarbeiten bestätigen die Kernannahmen von MIO, bieten neue Einblicke in die Rolle positiver Gefühle sowie des Genießens in Mentalisierungsprozessen und stellen Evaluationen von MIO sowohl in verschiedenen Kontexten als auch mit neuen Anpassungen vor.
抄録
依存症の母親を理解するためにメンタライジングの枠組みを導入する。
ナンシー・E・サッチマンの先駆的な業績
Nancy Suchmanは、メンタライゼーションに基づく介入‐Mothering from the Inside Out(MIO 心の内側からの母親の子育て)により、物質使用障がいに苦しむ親の治療を一変させた先駆者として記憶されている。特に、Suchmanの研究は、物質使用障がいの根底にある神経メカニズムに注目し、人生早期の親‐子関係を促進する上で、親のメンタライゼーションの強化が治療の焦点となることを明らかにした。彼女の研究は、この集団の親に対する子育て支援モデルを一変させた。多数の無作為化比較試験の結果、MIOは、薬物使用障がいのある親とその子どもにおいて、親の内省機能を促進し、関係性を改善する導くことがわかっている。SuchmanのMIOモデルは、その後、様々な文脈の子育てに拡張されている。彼女はまた、寛大な同僚、才能ある研究者であり臨床家、そして、様々な課題や逆境にもかかわらず健康で安心できる子どもを育てたいと願う親と関わる多世代の研究者や実践者を鼓舞させる人として記憶されている。本特集は、Suchmanの遺志を継ぎ、親のメンタライゼーションの側面について探求している研究者の論文で構成されている。掲載論文は、MIOの中核的な仮定を確認し、メンタライゼーションのプロセスにおけるポジティブな感情や味わいの役割について新しい洞察をもたらし、複数の文脈や新しい適応を伴うMIOの評価を提示している。
摘要
Nancy Suchman作为一位先驱而被人们铭记, 她基于心智化的干预措施——“母爱由内而外” (MIO) ——改变了患有药物使用障碍的父母的治疗方法。具体而言, Suchman的工作突出了药物使用障碍背后的神经机制, 并将促进父母的心智化作为一项关键的治疗重点, 以增强早期亲子关系。她的工作改变了这群父母的育儿支持模式。多项随机对照试验表明, MIO在促进药物使用障碍患者的父母反思功能和积极关系方面颇有效果, 同时也使他们的孩子受益。自此以后, Suchman的MIO模型已扩展应用到许多情况下的育儿。她也被视为一位慷慨的同事、才华横溢的研究员和临床医生, 也是一代又一代研究人员和从业者的灵感来源, 他们与父母合作, 渴望在多重挑战和逆境中养育健康、安全的孩子。本期特刊汇集了世界各地受Suchman启发的研究人员的工作, 他们继承了Suchman在研究父母心智化方面的遗产。总的来说, 所呈现的研究证实了MIO的核心假设, 为积极情绪和品味在心智化过程中的作用提供了新的见解, 并在多个背景下对MIO进行了评估和新的调整。
ملخص
استدعاء إطار التركيز الذهني لفهم الأمهات المصابات بالإدمان: العمل الرائد لنانسي إي. سوشمان
تُذكر نانسي سوشمان كرائدة أدى تدخلها القائم على التركيز الذهني من خلال برنامج الأمومة من الداخل إلى الخارج (MIO) ‐ إلى إحداث نقلة في علاج الآباء والأمهات الذين يعانون من اضطرابات تعاطي المخدرات. على وجه التحديد ، سلط عمل سوشمان الضوء على الآليات العصبية الكامنة وراء اضطرابات تعاطي المخدرات وحدد تعزيز التركيز الذهني الوالدي باعتباره محورًا علاجيًا رئيسيًا في تعزيز العلاقات المبكرة بين الوالدين والطفل. غيّر عملها نماذج دعم الأبوة والأمومة لهذه الفئة من الآباء. تظهر العديد من التجارب المعشاة ذات الشواهد فعالية MIO في تعزيز الأداء التأملي الوالدي والنتائج العلائقية الإيجابية عند الآباء والأمهات الذين يعانون من اضطرابات تعاطي المخدرات وأطفالهم. منذ ذلك الحين ، امتد نموذج MIO الخاص بـسوشمان ليشمل الأبوة والأمومة في العديد من السياقات. يُذكر أيضًا أنها زميلة كريمة ، وباحثة وطبيبة موهوبة ، ومصدر إلهام لأجيال من الباحثين والممارسين الذين يعملون مع الآباء الذين يتطلعون إلى تربية أطفال أصحاء وآمنين في ضوء التحديات والمحن المتعددة. يضم هذا العدد الخاص عمل الباحثين حول العالم المستوحى من سوشمان وهم يواصلون إرثها في دراسة جوانب التركيز الذهني الوالدي. بشكل إجمالي ، تقدم الأبحاث في هذا العدد تأكيدًا لافتراضات MIO الأساسية ، كما تعرض رؤى جديدة حول أدوار المشاعر الإيجابية والتذوق في عمليات التركيز الذهني ، وتنشر تقييمات لـبرنامج MIO في سياقات متعددة ومع تعديلات جديدة.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Abstract
Background
Inequality in health can have profound effects on a child’s opportunities later in life. To prevent these downstream effects in families at increased risk of adversity, programs ...are needed to provide support and improve well-being across several domains. The present trial is aimed at assessing the effectiveness of the Minding the Baby® (MTB) home visiting intervention in improving the mother-child relationship, parental reflective functioning, well-being, and mental health, as well as child development and well-being in families at known risk of adverse health, relational, and developmental outcomes.
Methods
The study is a pragmatic, prospective, quasi-cluster-randomized controlled trial in which seven Danish municipalities were randomized to MTB training in either 2018 or 2019. A total of 250 pregnant women at increased risk of adversity will be recruited (75 care as usual families and 175 intervention families). Care as usual families will be recruited before and after the MTB training. The MTB intervention is an attachment-based, interdisciplinary home visiting intervention offered from the third trimester of pregnancy until the child is 2 years old. The participants are assessed at baseline, and when the infant is 3, 12, and 24 months old. The primary outcome is maternal sensitivity measured by the Coding Interactive Behavior scale applied to video recordings of mother-infant interactions. Secondary outcomes include parent-child interaction, parental reflective functioning, parental mental health, maternal satisfaction, parental stress, and child development and well-being. The treatment effect is estimated as a fixed effect using a binary indicator of MTB treatment, and cluster-robust standard errors based on wild bootstrap are used for inference.
Discussion
This is the first trial of MTB in a Scandinavian context and will include the largest sample yet in a trial of MTB. The trial is expected to contribute to knowledge about the effect of early support for pregnant women, their infants, and their families at increased risk of adversity.
Trial registration
ClinicalTrials.gov
NCT03495895
. The study was registered on April 12, 2018.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
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