A Follow-up Study of a Randomized Controlled Trial of Mother-Infant Psychoanalytic Treatment and Treatment As Usual at Child Health Centres
试验速览
- 阶段
- 1 期
- 入组人数
- 71
- 试验地点
- 1
- 主要终点
- Child functioning: Children's Global Assessment Scale
研究概览
简要总结
An RCT comparing mother-infant psychoanalytic treatment (MIP) with Child Health Centre care in cases of mother-infant relationship disturbances was performed on 80 cases in Stockholm 2005-2008. The infants were < 18 months at interview #1. At 6 months follow-ups, significant effects were shown in favour of MIP on maternal sensitivity (EAS), depression (EPDS), and relationship qualities PIR-GAS). This study will evaluate effects at a child age of 4½ years; to evaluate the longterm effects of MIP and CHild Health Centre care, and to better validate results on children who now have reached an age where they can participate more actively in evaluations.
详细描述
DESIGN
The 71 dyads remaining from the MIPPS-01 study will be interviewed when the children have reached 4½ years, in order to evaluate the long-term intervention effects of MIP treatments delivered by psychoanalysts at the Infant Reception Service of the Swedish Psychoanalytic Society and of the usual treatments of infants and children in Sweden implying contact with nurses at Child Health Centres.
INSTRUMENTS
Mother-report questionnaires; the Ages and Stages Questionnaire:Social-Emotional (ASQ:SE; Squires et al., 2002), the Edinburgh Postnatal Depression Scale (EPDS; Cox et al., 1987), the Swedish Parental Questionnaire (SPSQ; Östberg et al., 1997) and the Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997).
Independently rated video-taped mother-child interactions: the Emotional Availability Scale (EAS; Biringen, 1998).
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 54 Months 至 54 Months（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •The mother expressed significant concerns about one or more of the following domains: herself as a mother, her infant's well-being, or the mother-baby relationship (this was operationalized as a score < 80 ("perturbed relation") on the PIR-GAS or, alternatively, > 2.5 on the SPSQ).
- •Infant of any gender, age below 18 months.
- •Duration of worries exceeding two weeks.
- •Domicile in Stockholm.
- •Reasonable mastery of Swedish.
排除标准
- •Maternal psychosis according to DSM-IV, to an extent precluding collaboration.
- •Substance dependence according to DSM-IV, to an extent precluding collaboration.
研究组 & 干预措施
Child Health Centre care
TAU involved scheduled health visitor calls at the local Child Health Centre (CHC), with paediatric checkups at 2 and 6 months of age. The health visitor is encouraged to promote attachment and to detect postnatal depressions. Mothers may be offered parental groups, infant massage or guidance promoting interaction, as well as appointments with a paediatrician or a child psychiatric psychologist. Additional treatment was initiated in 1/3 of the cases. This was registered at the end-point interview.
干预措施: Child Health Centre care (Behavioral)
Mother-Infant Psychoanalytic tmt
MIP (Norman, 2001; 2004) is a psychoanalytic method adapted to the requirements of the infant as analysand in the presence of his mother. The analyst strives to recruit the baby for an emotional interchange, though this does not imply any belief that the infant understands verbal communication. The analyst addresses the baby to help him liberate emotions consolidated in symptoms such as screaming, avoiding maternal eye contact, and breast refusal. The analyst takes great care in enrolling the participant mother. This is to enhance her understanding of the baby's predicament and the nature of their relation, as well as giving her all space needed to vent her own frustration, depression and anxiety.
干预措施: Mother-Infant Psychoanalytic tmt (Behavioral)
结局指标
主要结局
Child functioning: Children's Global Assessment Scale
时间窗: At followup interview
Maternal depression: Edinburgh Postnatal Depression Scale
时间窗: At followup interview
次要结局
- Maternal distress: Symptom Check List - 90(At followup interview)
- Maternal stress: Swedish Parental Stress Questionnaire(At followup interview)
- Child functioning: Ages and Stages Questionnaire:Social Emotional(At followup interview)
- Child functioning: Strengths and Difficulties Questionnaire(At followup interview)
- Child cognitive functioning: Wechsler's Preschool and Primary Scales of Intelligence(At followup interview)
- Child's social and emotional functioning: Story Stem Attachment Profile(At followup interview)
- Child's social and emotional functioning: Machover Draw-a-Person test(At followup interview)