TOP‐DOWN AND BOTTOM‐UP: THE ROLE OF SOCIAL INFORMATION PROCESSING AND MINDFULNESS AS PREDICTORS IN MATERNAL–INFANT INTERACTION

The cross‐generational transmission of attachment appears to reflect a complex interplay of factors, which have been challenging to identify. The current longitudinal study explored the maternal cognitive model of relationships through language use, maternal mindfulness, and attachment style assessed prenatally, as predictors of maternal response to distress and infant behavior at 6 months’ postpartum. Infant behavior to the mother also was examined to provide an understanding of the evolving relationship. Thirty‐two females were interviewed prenatally regarding social and family experiences. At 6 months’ postpartum, each mother participated in a video‐recorded session where she was asked to teach her infant a developmentally appropriate task. Videos were analyzed using the NCAST Teaching Protocol. Language use prenatally as well as the mindfulness facets (acting with awareness and describing) predicted the mothers’ ability to respond to infant distress, indicating greater attunement. Infant's response to mother and clarity of cues also were predicted by maternal pronoun use. The study highlights the role of internal working models reflective of interpersonal beliefs, cognitive models, and current‐moment awareness in maternal behavior. The effect of maternal language on infant behavior arguably indicates the infant's integration of maternal internal working models.     

新生儿疼痛管理方法与培训现状

总结了目前新生儿疼痛管理方法与培训现状.疼痛管理方法包括非药物性止痛方法如口服蔗糖水、非营养性吸吮、襁褓包裹及袋鼠式护理等,药物镇痛如瑞芬太尼与丙泊酚用于小儿气管插管及其他;培训现状包括权威教科书上缺少关于新生儿疼痛管理知识、缺乏特异性调查问卷、缺乏专业师资及培训机构.认为在新生儿的治疗护理中医护人员要坚持科学的认识论,把握医学伦理学的要求,在日常的治疗护理中体现对新生儿的人文关怀,才能进一步提高医疗护理质量,达到医院与患者的双赢.     

Infant Emotion Regulation Strategy Moderates Relations between Self‐Reported Maternal Depressive Symptoms and Infant HPA Activity

Children of mothers with depressive symptoms often have high cortisol levels. Research shows that various child characteristics (e.g., attachment pattern, internalizing behaviours, and temperament) moderate this association. We suggest that these characteristics share common variance with emotion regulation strategy. Therefore, we examine infant emotion regulation strategy as a moderator of the association between maternal depressive symptoms and infant hypothalamic–pituitary–adrenal (HPA) function. We hypothesize that infants who utilize more independent emotion regulation strategies and have mothers who report higher depressive symptoms will exhibit elevated cortisol levels. Participants were 193 mothers and infants (15 months old) recruited from the community. Self‐reported maternal depressive symptoms were assessed. Infant independent regulatory behaviours (withdrawal, wandering away, distraction, scanning, orienting to another object) were coded in the context of a Toy Frustration Task. Infant cortisol was collected via saliva samples at baseline, +20, and +40 minutes. Results indicate that infant emotion regulation strategy moderates the relation between mothers' self‐reported depressive symptoms and infant total cortisol output (AUC_G) and cortisol reactivity (AUC_I). Infants who employed more independent regulatory behaviours and have mothers with higher depressive symptoms experience greater cortisol secretion. We discuss the findings in relation to parent‐infant interactions and the adaptive nature of emotion regulation strategies, as they relate to HPA regulatory capacities. Copyright © 2015 John Wiley & Sons, Ltd.     

Perceived mother‐infant relationship difficulties in postnatal depression

Postnatal depression has been associated with mother–infant relationship difficulties, but there has been less research in clinical populations. This study aims to identify characteristics of reported mother–infant relationship difficulties in mothers with postnatal depression who had been referred to a tertiary Mother and Baby Service. Forty‐one mothers with postnatal depression completed self‐report and interview measures with regards to their mental state, social adversity, and perceptions on their relationship with their infants. Almost one‐third of mothers (31.7%) reported severe difficulties, including rejection of the infant and maternal pathological anger. A low birth weight and maternal dissatisfaction towards their social role were found to be significantly related to perceived mother–infant interaction difficulties. Self‐reports correlated satisfactorily with interview schedules. A significant proportion of mothers reported difficulties in relating to their infants which can be reliably identified by means of the self‐report measures used. Copyright © 2004 John Wiley & Sons, Ltd.     

七氟醚与氯胺酮做基础麻醉在婴幼儿先天性唇腭裂手术中的应用比较

为了寻找婴幼儿先天性唇腭裂手术比较理想的基础麻醉方式,将该类手术患儿60例随机均分为氯胺酮肌肉注射基础麻醉组（K组）和高浓度七氟醚吸入基础麻醉组（S组）。患儿入手术室后常规监测生命体征,记录其哭闹时间、睫毛反射消失时间和疼痛反射消失时间,观察基础麻醉期间患儿的合作情况和有无并发症的发生。术后随访并发症的发生情况。S组与K组患儿相比,哭闹时间、睫毛反射时间、疼痛反射消失时间均显著缩短。K组患儿基础麻醉期间发生的并发症明显多于S组,且．术后呕吐的发生率亦显著高于S组。因此,高浓度七氟醚吸入做基础麻醉是婴幼儿先天性唇腭裂手术时较为理想的基础麻醉方式。     

The effect of mother-infant skin-to-skin contact on plasma cortisol and β-endorphin concentrations in preterm newborns

The aim of this study was to assess the effect of mother-infant skin-to-skin contact on plasma β- endorphin and cortisol concentrations in stable, preterm infants on a newborn intensive care unit. Blood samples were obtained before and at the end of a 20-min period of skin-to-skin contact. Similarly paired samples, obtained at the same times and after the same interval, without skin-to- skin contact, were obtained on another day and served as controls. Both cortisol and β-endorphin concentrations fell significantly after the skin-to-skin session (cortisol: geometric mean change 66%, p=0.008; β-endorphin: geometric mean change 74%, p=0.002). There was also a significant fall in cortisol levels during the control session (geometric mean change 78%, p=0.02), in contrast to β-endorphin levels, in which there was no significant change. Analysis of variance showed that the fall in β-endorphin, but not the fall in cortisol, during the skin-to-skin session was significant when compared with the control session. These results emphasize the hormonal responsiveness of the preterm newborn to relatively minor interventions. We conclude that maternal skin-to-skin contact results in a significant reduction in circulating β-endorphin in the newborn; there was no evidence of any adverse effect.     

Discrimination of pitch contours by neonates

With the high-amplitude sucking procedure, newborns were presented with two lists of phonetically varied Japanese words differing in pitch contour. Discrimination of the lists was found, thus indicating that newborns are able to extract pitch contour information at the word level.     

Young infants' perception of unity and form in occlusion displays

Young infants have been reported to perceive the unity of a center-occluded object when the visible ends of the object are aligned and undergo common motion but not when the edges of the object are misaligned (Johnson & Aslin, 1996). Using a recognition-based paradigm, the authors investigated the possibility that past research failed to provide sufficiently sensitive assessments of infants' perception of the unity of misaligned edges in partial occlusion displays. Positive evidence was obtained in 4-month-olds for veridical perception of the motion and location of a hidden region but not its orientation, whereas 7-month-olds, in contrast to the younger infants, appeared to respond to the orientation of the hidden region. Overall, the results suggest that habituation designs tapping recognition processes may be particularly efficacious in revealing infants' perceptual organization. In addition, the findings provide corroborative evidence for the importance of both motion and orientation in young infants' object segregation and for the difficulty in achieving percepts of the global form of a partly occluded object.     

Development of category formation for faces differing by age in 9‐ to 12‐month‐olds: An effect of experience with infant faces

We examined category formation for faces differing in age in 9‐ and 12‐month‐olds, and the influence of exposure to infant faces on such ability. Infants were familiarized with adult or infant faces, and then tested with a novel exemplar from the familiarized category paired with a novel exemplar from a novel category (Experiment 1). Both age groups formed discrete categories of adult and infant faces, but exposure to infant faces in everyday life did not modulate performance. The same task was conducted with child versus infant faces (Experiment 2). Whereas 9‐month‐olds preferred infant faces after familiarization with child faces, but not child faces after familiarization with infant faces, 12‐month‐olds formed discrete categories of child and infant faces. Moreover, more exposure to infant faces correlated with higher novel category preference scores when infants were familiarized with infant faces in 12‐month‐olds, but not 9‐month‐olds. The 9‐month‐old asymmetry did not reflect spontaneous preference for infant over child faces (Experiment 3). These findings indicate that 9‐ and 12‐month‐olds can form age‐based categories of faces. The ability of 12‐month‐olds to form separate child and infant categories suggests that they have a more exclusive representation of face age, one that may be influenced by prior experience with infant faces.