无医学指征剖宫产的影响因素及对策

无医学指征剖宫产是造成高剖宫产率的一个重要原因,也是公共卫生和全世界医疗机构关注的问题。事实上,许多潜在因素包括社会人口学、传统文化、家庭、法理及医源因素在无医学指征剖宫产形成中发挥了重要作用,并加剧了无医学指征剖宫产这一现象出现。更重要的是,通过构建和谐医疗环境、提高无痛分娩率、加强妊娠期健康宣教、规范产科管理、优化分娩环境和增加人文关怀等合理干预可有效降低无医学指征剖宫产。期望为卫生政策制定、临床指南和促进该领域未来的临床实践提供有意义的参考。

     

Maternal Sensitivity: Evidence of Stability across Time,Contexts, and Measurement Instruments

Although maternal sensitivity is widely understood as having a direct impact on the quality of the mother–child relationship, empirical evidence supporting this has been inconsistent, possibly because of varied definitions of the construct and limitations of measurements. The Maternal Behavior Q‐Set (MBQS) appears to be a promising measure of sensitivity, showing associations with attachment security (r = .60) higher than those reported (r = .24) in a highly‐regarded meta‐analysis of other sensitivity measures. The present study aimed to further establish the validity and utility of the MBQS by exploring its consistency with a contingency‐based measure of sensitivity, while also seeking evidence of stability across contexts and times. Seventy‐two mothers and their 10‐month‐olds participated in a procedure that included two episodes of Floor Play and Reunions following maternal differential treatment. Mothers were scored on contingent responsivity and warmth. At 12 months, the dyads underwent the Strange Situation Procedure where sensitivity was assessed using a 72‐item version of the MBQS. The findings revealed the stability of maternal sensitivity across times, contexts, and measures. However, linkages applied only to 10‐month scores from reunion, not play, episodes, supporting Pederson and Moran's (1995) assertion that high‐demand circumstances reveal more meaningful differences in maternal sensitivity. Copyright © 2012 John Wiley & Sons, Ltd.     

Empathy,Perspective Taking and Prosocial Behaviour: The Importance of Parenting Practices

The current study analyzed the relationships among maternal empathy (emotional and cognitive), parenting that encourages the child to take the perspective of others, child cognitive empathy and child prosocial behaviour. Participants were 72 typically developing children (66 Caucasian, six Asian) aged between 47 and 76 months (M = 61.5 months, SD = 8.3 months). Results support the facilitative effect of parenting that encourages the child to take the perspective of others. Thus, the role played by parents in the development of prosocial behaviour extends beyond warm/sensitive/responsive parenting in infancy. Together these forms of parenting are key factors that facilitate the development of prosocial behaviour. Copyright © 2011 John Wiley & Sons, Ltd.     

‘I think motherhood for me was a bit like a double‐edged sword’: the narratives of older mothers

It is assumed in Western society that women want to become mothers. This desire is situated within the ideology of the ‘perfect mother’. However, feminists have highlighted contradictions between this ideology and the reality of mothering. A trend towards later motherhood has recently been identified. Delayed motherhood has been associated with a number of advantages such as a sense of psychological readiness, however this may mask some of its negative aspects. The aim of the study reported here was to explore the transition to, and lived experience of, delayed motherhood. Five women who were over 30 prior to the birth of their first child were interviewed. A narrative analysis at the personal, interpersonal and societal levels was conducted. At the personal level, diverse stories which contained both problems in adapting to motherhood and also progressive aspects of positive experiences and integration of maternal identities were told. At the interpersonal level, the prominence of the ‘double‐edged’ tone conveyed maternal ambivalence. At the societal level, dominant ideologies of the ‘good mother’ and normative development were identified. Though the women actively constructed their stories and attempted to resist dominant representations, this analysis emphasises the need for more realistic portrayals of delayed motherhood. Copyright © 2006 John Wiley & Sons, Ltd.     

AD/HD Symptoms and Conduct Problems: Similarities and Differences in Maternal Perceptions

Several theories attempt to explain the high co-occurrence of Attention Deficit/ Hyperactivity Disorder (AD/HD) and Conduct Problems (CP). A strong possibility is that AD/HD behaviours lead to the development of CP, due to family coercive interaction patterns, maintained through parental false beliefs regarding child problem behaviour. We compared maternal perceptions about AD/HD behaviors and CP, and the possible reactions elicited by such behaviours. The sample consisted of 317 mothers of boys and girls aged 4–6. Four versions of The Parental Account of the Causes of Childhood Problems Questionnaire were used, in which a vignette was ascribed to either a boy or a girl displaying some of the major AD/HD behaviours or CP. The results showed that CP were perceived as significantly more severe than AD/HD behaviours. Moreover, AD/HD behaviours were attributed to biological causes more often than CP, and less strict rearing practices were chosen for AD/HD symptoms. Our findings provide evidence that mothers usually perceive AD/HD behaviours and CP as separate entities and may behave accordingly with their children.     

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.     

父亲参与教养对小学生攻击行为的影响:母亲育儿压力的部分中介效应

本研究旨在考察父亲参与教养对小学生攻击行为的影响以及母亲育儿压力在二者之间的中介作用,采用同伴提名法和问卷法对604名1~6年级小学生及其家长进行调查。潜变量结构方程模型拟合检验结果显示：父亲参与教养（互动性、可及性、责任性）对小学生攻击行为（身体攻击、关系攻击）具有显著的负向预测作用;在父亲参与教养与小学生关系攻击之间,母亲的育儿愁苦和亲子互动失调具有显著的部分中介作用;在父亲参与教养与小学生身体攻击之间,只有母亲的育儿愁苦具有显著的部分中介作用。上述结果表明,父亲参与教养可以通过减少母亲的育儿愁苦来降低儿童的关系攻击和身体攻击,还能通过减少母子互动失调来降低儿童的关系攻击。     

Infanticide and maternal aggression: Synchrony of male and female reproductive strategies in mice

Thirty-six percent of male mice from three strains attacked newborn pups sired by another male. No male attacked its own offspring. Females did not show differential aggression toward males likely (strangers) or unlikely (sires) to attack their pups. Both forms of aggression were unaffected by housing in rooms which did or did not contain the aggression targets. The three strains differed in strength of maternal aggression but not in the incidence of infanticide. Females showed more aggression when mated with males of the same, rather than a different, strain but no differences with intruders of the same or a different strain. Infanticide by males is best viewed as a postcopulatory, intermale-competition strategy, and maternal aggression as a counter strategy.     

The impact of mothers' trait anxiety on their expectations of approach‐avoidance behaviour in anxious and non‐anxious children

This study investigated estimates of approach and avoidance behaviour in clinically anxious and non‐anxious children, and whether mothers' expectations of their children's avoidance differed as a function of high trait anxiety (HTA) versus low trait anxiety (LTA). Participants were 62 clinically anxious and 60 non‐anxious children aged 7–12 years and their mothers. Estimates of avoidance were obtained using an analogue task in which children and mothers were given threat and pleasant information about two novel animals and were asked to estimate children's avoidance of the threat animal's habitat when the threat animal was present (threat condition) and absent (safe condition) from the habitat and when its presence was uncertain (ambiguous condition). Contrary to expectation, anxious children did not differ from controls in estimates of avoidance in any condition. However, relative to HTA mothers of anxious children and LTA mothers of non‐anxious children, HTA mothers estimated greater approach behaviour by their non‐anxious children in the threat condition. Findings suggest that mothers' expectations of children's approach‐avoidance behaviour is influenced by both maternal and child factors.     

青少年心理行为问题与专业心理求助态度：父母知晓的中介作用

摘 要 对831名中学生施测青少年自评量表、父母知晓量表、专业心理求助态度问卷,考察青少年心理行为问题、父亲知晓、母亲知晓与专业心理求助态度的关系。结果发现：（1）青少年的专业心理求助态度与心理行为问题、父母知晓呈显著相关。（2）父亲知晓在青少年心理行为问题与专业心理求助态度的关系中起部分中介作用,母亲知晓的中介作用不显著。研究结果对青少年专业心理求助的干预有着重要意义。