Table_3_From Early Micro-Temporal Interaction Patterns to Child Cortisol Levels: Toward the Role of Interactive Reparation and Infant Attachment in a Longitudinal Study.pdf

Parental mental disorders increase the risk for insecure attachment in children. However, the quality of caregiver–infant interaction plays a key role in the development of infant attachment. Dyadic interaction is frequently investigated via global scales which are too rough to uncover micro-temporal mechanisms. Prior research found that the latency to reparation of uncoordinated dyadic states is associated with infant behavioral and neuroendocrine regulation. We investigated the hypothesis that this interactive mechanism is critical in predicting secure vs. insecure attachment quality in infancy. We also assessed the predictive quality of infant attachment regarding neuroendocrine reactivity later in childhood. A subsample of N = 58 dyads (n = 22 mothers with anxiety disorders, n = 36 controls) from a larger study were analyzed. At 3–8 months postpartum, maternal anxiety disorders were diagnosed via a structured clinical interview as well as dyadic interaction during the Face-to-Face-Still-Face (FFSF) was observed and coded on a micro-temporal scale. Infant attachment quality was assessed with the strange situation paradigm at 12–24 months of age. In an overlapping subsample of N = 39 (n = 13 mothers with anxiety disorder; n = 26 controls), we assessed child cortisol reactivity at 5 to 6 years of age. Generalized linear modeling revealed that longer latencies to interactive reparation during the reunion episode of the FFSF as well as maternal diagnosis at 3–8 months of age predict insecure attachment in children aged 12–24 months. Cox regressions demonstrated that dyads with infants who developed insecure attachment at 12–24 months of age were 48% less likely to achieve an interactive reparation at 3–8 months of age. Mixed models revealed that compared to securely attached children, children who had developed an insecure attachment at 12–24 months of age had an increased cortisol reactivity at 5 to 6 years of age during free play. The results confirm the hypothesis that the development of attachment is affected by experienced micro-temporal interactive patterns besides diagnostic categories. They also showed that infants of mothers with postpartum anxiety disorders have a more than fivefold increased risk of developing an insecure attachment than the infants of the control group. Moreover, results imply that these patterns may influence neurohormonal regulation even in preschool aged children.

父母精神障碍会提升儿童出现不安全依恋的风险。然而，照料者-婴儿互动质量对婴儿依恋的发展起着关键作用。二元互动常通过整体量表进行研究，但这类量表过于粗糙，无法揭示微时间层面的作用机制。既往研究发现，二元互动不协调状态的修复潜伏期与婴儿的行为及神经内分泌调节存在关联。本研究旨在验证如下假说：该互动机制对婴儿期安全/不安全依恋质量的预测具有关键作用。同时，本研究还评估了婴儿依恋质量对儿童后期神经内分泌反应性的预测效能。本研究从一项大型研究中选取了N=58个母婴二元组（其中n=22名为焦虑障碍母亲组，n=36名为对照组）进行分析。在产后3至8个月时，研究人员通过结构化临床访谈确诊母亲的焦虑障碍状况，并对面对面静止脸范式（Face-to-Face-Still-Face, FFSF）中的二元互动进行观察，同时以微时间编码量表进行编码。研究人员于婴儿12至24月龄时，采用陌生情境范式（Strange Situation Paradigm）评估其依恋质量。在重叠子样本（N=39，其中n=13名焦虑障碍母亲组，n=26名对照组）中，研究人员对5至6岁儿童的皮质醇反应性进行了评估。广义线性模型分析结果显示，在FFSF范式的重逢阶段，二元互动修复的潜伏期越长，加上母亲在产后3至8个月的焦虑障碍诊断结果，均可预测12至24月龄儿童的不安全依恋状况。Cox回归分析表明，在12至24月龄时出现不安全依恋的婴儿所属的母婴二元组，其在产后3至8个月时完成互动修复的概率要低48%。混合效应模型分析显示，相较于安全依恋儿童，在12至24月龄时形成不安全依恋的儿童，其在5至6岁自由游戏阶段的皮质醇反应性显著升高。研究结果验证了假说：除了诊断分类之外，个体所经历的微时间互动模式同样会影响依恋的发展。同时，研究结果还显示，产后焦虑障碍母亲所生婴儿出现不安全依恋的风险是对照组婴儿的5倍以上。此外，研究结果表明，这类互动模式甚至会对学龄前儿童的神经激素调节产生影响。