Subscribe to RSS
DOI: 10.1055/a-1471-8017
Messinstrumente zur Erfassung von Bindungsaufbau während Schwangerschaft und nach der Geburt (Teil 3 einer Serie zur psychologischen Diagnostik im Peripartalzeitraum)
Questionnaires for the Assessment of Bonding During Pregnancy and after Birth (Part 3 of a series on psychological assessment during the peripartum period)![](https://www.thieme-connect.de/media/zgn/202106/lookinside/thumbnails/02-2021-0424_10-1055-a-1471-8017-1.jpg)
Zusammenfassung
Der Bindungsaufbau von (werdenden) Müttern und Vätern zu ihrem Kind hat große Bedeutung für das psychische Wohlbefinden der Eltern und des Kindes. Dies gilt insbesondere dann, wenn bei den Eltern bereits psychische Beschwerden wie Depressionen vorhanden sind. Darüber hinaus können frühkindliche Bindungserfahrungen sowohl die psychische Gesundheit des Kindes als auch spätere Beziehungen beeinflussen. Klassische Verfahren der Bindungsforschung wie der Fremde-Situations-Test zur standardisierten Erfassung des Bindungserlebens sind jedoch für den klinischen Alltag in Neonatologie und Geburtshilfe nicht praktikabel, zumal hier v. a. das Bindungsverhalten des Kindes im Fokus steht. Zudem kann die Bindung zum ungeborenen Kind so nicht erfasst werden. Daher bieten sich zur Erfassung des elterlichen Bindungserlebens v. a. Fragebögen an. Sowohl für die Zeit der Schwangerschaft, als auch für den Postpartalzeitraum sind geeignete Instrumente vorhanden, die jedoch überwiegend für Frauen entwickelt wurden. Allerdings besteht bei den meisten Fragebögen Bedarf zur methodischen Weiterentwicklung, da Cut-off Werte sowie Normwerte z. T. bisher nicht etabliert wurden. Solche Werte dürften allerdings insbesondere in der Regelversorgung von Bedeutung sein. Insgesamt scheint die Erfassung des Bindungserlebens sinnvoll zu sein, damit rechtzeitig Unterstützung beim Bindungsaufbau gegeben oder in unterstützende Angebote vermittelt werden kann.
Abstract
Bonding of (expectant) parents with their child is of great importance for the psychological well-being of both the parents and the child. This is especially true if parents suffer from mental health problems like depression. Furthermore, attachment experiences during early childhood can affect both the child’s mental health as well as later relationships. However, typical assessment methods like the Strange Situation Test are not very suitable in clinical practice in neonatology and obstetrics, especially since the focus here is primarily on the child's attachment behavior. In addition, bonding with the unborn child cannot be assessed in this way. Therefore, questionnaires represent a more feasible method for the assessment of parental bonding. Instruments have been developed for the time during pregnancy and after birth, but most of them were developed for women. Also, there is a need for further methodological development of these questionnaires. Cut-offs and norm values are highly relevant for clinical practice, but still need to be established in some cases. Assessment of parental bonding using questionnaires can potentially be beneficial and will most likely help to initiate timely supportive interventions.
Publication History
Received: 08 February 2021
Accepted after revision: 21 March 2021
Article published online:
31 May 2021
© 2021. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
Literatur
- 1 Loman MM, Gunnar MR, Early Experience S. et al. Early experience and the development of stress reactivity and regulation in children. Neurosci Biobehav Rev 2010; 34: 867-876
- 2 Barlow J, Bennett C, Midgley N. et al. Parent-infant psychotherapy for improving parental and infant mental health. Cochrane Database Syst Rev 2015; 1: CD010534
- 3 Barlow J, Bergman H, Kornor H. et al. Group-based parent training programmes for improving emotional and behavioural adjustment in young children. Cochrane Database Syst Rev 2016; 8: CD003680
- 4 Winston R, Chicot R. The importance of early bonding on the long-term mental health and resilience of children. London J Prim Care (Abingdon) 2016; 8: 12-14
- 5 Wittkowski A, Vatter S, Muhinyi A. et al. Measuring bonding or attachment in the parent-infant-relationship: A systematic review of parent-report assessment measures, their psychometric properties and clinical utility. Clin Psychol Rev 2020; 82: 101906
- 6 Ainsworth MDS, Blehar MC, Waters E. et al. Patterns of Attachment: A Psychological Study of the Strange Situation. Taylor & Francis; 2015
- 7 Tronick E, Als H, Adamson L. et al. The infant's response to entrapment between contradictory messages in face-to-face interaction. J Am Acad Child Psychiatry 1978; 17: 1-13
- 8 Mesman J, van Ijzendoorn MH, Bakermans-Kranenburg MJ. The many faces of the Still-Face Paradigm: A review and meta-analysis. Developmental Review 2009; 29: 120-162
- 9 Nagy E, Pilling K, Watt R. et al. Neonates’ responses to repeated exposure to a still face. PLoS One 2017; 12: e0181688
- 10 Stein A, Pearson RM, Goodman SH. et al. Effects of perinatal mental disorders on the fetus and child. Lancet 2014; 384: 1800-1819
- 11 Renner I, Hoffmann T, Paul M. Early Childhood Intervention for Children of Parents with Mental Health Issues – Results of the Research Program of the National Center for Early Prevention. Prax Kinderpsychol Kinderpsychiatr 2020; 69: 416-425
- 12 Dekel S, Thiel F, Dishy G. et al. Is childbirth-induced PTSD associated with low maternal attachment?. Arch Womens Ment Health 2019; 22: 119-122
- 13 Walsh J, Hepper EG, Bagge SR. et al. Maternal-fetal relationships and psychological health: emerging research directions. Journal of Reproductive and Infant Psychology 2013; 31: 490-499
- 14 Garthus-Niegel S, Horsch A, von Soest T. et al. Posttraumatic stress symptoms following childbirth: associations with prenatal attachment in subsequent pregnancies. Arch Womens Ment Health 2020; 23: 547-555
- 15 SH IJEH, Assis C. et al. Postpartum Bonding Difficulties and Adult Attachment Styles: The Mediating Role of Postpartum Depression and Childbirth-Related Ptsd. Infant Ment Health J 2018; 39: 198-208
- 16 Klier CM. Mother-infant bonding disorders in patients with postnatal depression: The Postpartum Bonding Questionnaire in clinical practice. Arch Womens Ment Health 2006; 9: 289-291
- 17 Schechter DS, Suardi F, Manini A. et al. How do maternal PTSD and alexithymia interact to impact maternal behavior?. Child Psychiatry Hum Dev 2015; 46: 406-417
- 18 Tichelman E, Westerneng M, Witteveen AB. et al. Correlates of prenatal and postnatal mother-to-infant bonding quality: A systematic review. PLoS One 2019; 14: e0222998
- 19 Cranley MS. Development of a tool for the measurement of maternal attachment during pregnancy. Nurs Res 1981; 30: 281-284
- 20 Doster A, Wallwiener S, Muller M. et al. Reliability and validity of the German version of the Maternal-Fetal Attachment Scale. Archives of gynecology and obstetrics 2018; 297: 1157-1167
- 21 Muller ME, Ferketich S. Factor analysis of the Maternal Fetal Attachment Scale. Nurs Res 1993; 42: 144-147
- 22 Sjoegren B, Edman G, Widström A. et al. Maternal foetal attachment and personality during first pregnancy. Journal of Reproductive and Infant Psychology 2004; 22: 57-69
- 23 Dubber S, Reck C, Muller M. et al. Postpartum bonding: the role of perinatal depression, anxiety and maternal-fetal bonding during pregnancy. Arch Womens Ment Health 2015; 18: 187-195
- 24 Condon JT. The assessment of antenatal emotional attachment: development of a questionnaire instrument. Br J Med Psychol 1993; 66: 167-183
- 25 Condon J, Corkindale C, Boyce P. et al. A longitudinal study of father-to-infant attachment: Antecedents and correlates. Journal of Reproductive and Infant Psychology 2013; 31: 15-30
- 26 Condon JT, Boyce P, Corkindale CJ. The First-Time Fathers Study: a prospective study of the mental health and wellbeing of men during the transition to parenthood. Aust N Z J Psychiatry 2004; 38: 56-64
- 27 Condon JT, Corkindale CJ, Boyce P. Assessment of postnatal paternal–infant attachment: development of a questionnaire instrument. Journal of Reproductive and Infant Psychology 2008; 26: 195-210
- 28 Gobel A, Barkmann C, Goletzke J. et al. Psychometric properties of 13-item versions of the maternal and paternal antenatal attachment scales in German. J Reprod Infant Psychol 2020; 38: 455-467
- 29 Brockington IF, Fraser C, Wilson D. The Postpartum Bonding Questionnaire: a validation. Arch Womens Ment Health 2006; 9: 233-242
- 30 Brockington IF, Oates J, George S. et al. A Screening Questionnaire for mother-infant bonding disorders. Archives of Women's Mental Health 2001; 3: 133-140
- 31 Reck C, Klier CM, Pabst K. et al. The German version of the Postpartum Bonding Instrument: psychometric properties and association with postpartum depression. Arch Womens Ment Health 2006; 9: 265-271
- 32 Edhborg M, Matthiesen AS, Lundh W. et al. Some early indicators for depressive symptoms and bonding 2 months postpartum – a study of new mothers and fathers. Arch Womens Ment Health 2005; 8: 221-231
- 33 Ionio C, Colombo C, Brazzoduro V. et al. Mothers and Fathers in NICU: The Impact of Preterm Birth on Parental Distress. Eur J Psychol 2016; 12: 604-621
- 34 Kerstis B, Aarts C, Tillman C. et al. Association between parental depressive symptoms and impaired bonding with the infant. Arch Womens Ment Health 2016; 19: 87-94
- 35 Fuchs A, Mohler E, Reck C. et al. The Early Mother-to-Child Bond and Its Unique Prospective Contribution to Child Behavior Evaluated by Mothers and Teachers. Psychopathology 2016; 49: 211-216
- 36 Moehler E, Brunner R, Wiebel A. et al. Maternal depressive symptoms in the postnatal period are associated with long-term impairment of mother-child bonding. Arch Womens Ment Health 2006; 9: 273-278
- 37 Muller M, Tronick E, Zietlow AL. et al. Effects of Maternal Anxiety Disorders on Infant Self-Comforting Behaviors: The Role of Maternal Bonding, Infant Gender and Age. Psychopathology 2016; 49: 295-304
- 38 Nonnenmacher N, Noe D, Ehrenthal JC. et al. Postpartum bonding: the impact of maternal depression and adult attachment style. Arch Womens Ment Health 2016; 19: 927-935
- 39 Reck C, Zietlow AL, Muller M. et al. Perceived parenting stress in the course of postpartum depression: the buffering effect of maternal bonding. Arch Womens Ment Health 2016; 19: 473-482
- 40 Moore ER, Bergman N, Anderson GC. et al. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev 2016; 11: CD003519
- 41 Korja R, Latva R, Lehtonen L. The effects of preterm birth on mother-infant interaction and attachment during the infant’s first two years. Acta Obstet Gynecol Scand 2012; 91: 164-173