Mother-child Relationship Disturbances
Conditions
Keywords
MIP, RCT, postnatal depression, Mother-child relationship
Brief summary
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.
Detailed description
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). Assessment of the general functioning of the child : Children's Global Assessment Scale (Shaffer et al 1983). Assessment of the child's cognitive functioning: Wechsler Preschool and Primary Scale of Intelligence (WPPSI, Wechsler, 2005). Assessment of the child's social and emotional functioning: Story Stem Attachment Profile (SSAP, Hodges et al., 2003). Machover Draw-a-Person Test (Blomberg & Cleve, 1997)
Interventions
BEHAVIORALMother-Infant Psychoanalytic tmt
Psychoanalytic sessions with mother and infant, at a median of 23 sessions 2 times weekly.
BEHAVIORALChild Health Centre care
Nurse calls at Child Health Centres (CHC), with regular paediatric checkups. The nurse was encouraged to promote attachment and to detect postnatal depressions. Appointments with a psychiatrist or therapist or child psychiatric psychologist was initiated in 1/3 of the cases. This was registered at the end-point interview.
Sponsors
Karolinska Institutet
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
54 Months to 54 Months
Healthy volunteers
No
Inclusion criteria
* 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.
Exclusion criteria
* Maternal psychosis according to DSM-IV, to an extent precluding collaboration. * Substance dependence according to DSM-IV, to an extent precluding collaboration.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Child functioning: Children's Global Assessment Scale | At followup interview |
| Maternal depression: Edinburgh Postnatal Depression Scale | At followup interview |
Secondary
| Measure | Time frame |
|---|---|
| Child functioning: Ages and Stages Questionnaire:Social Emotional | At followup interview |
| Child functioning: Strengths and Difficulties Questionnaire | At followup interview |
| Maternal distress: Symptom Check List - 90 | 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 |
| Child cognitive functioning: Wechsler's Preschool and Primary Scales of Intelligence | At followup interview |
| Maternal stress: Swedish Parental Stress Questionnaire | At followup interview |
Countries
Sweden
Contacts
Primary ContactPer-Anders Rydelius, Professor
Outcome results
None listed