母親的原生依附傾向、反思功能與對嬰兒哭泣的情緒反應之研究

研究背景與目的：照顧行為維繫人類的存續，但矛盾的是照顧者兒虐事件卻層出不窮。研究指出照顧者的原生依附與其對子代的照顧行為有關，而照顧者的反思功能(心智化)在其間扮演重要的角色。基於母親在嬰兒哭泣時的情緒反應是照顧行為裏重要的一環，本研究探究母親的原生依附傾向、反思功能及其對嬰兒哭泣的情緒反應之關係。研究方法：透過醫院、衛生所和社群網站等招募「20歲以上、已婚且育有0-2歲嬰兒的母親」，共獲得778位有效樣本。研究參與者根據孩子最近一次強烈的哭泣行為，填寫研究者自編的情緒反應量表，自評對嬰兒哭泣的情緒反應程度，並填寫「關係結構量表中文版(Relationships Structure Questionnaire-Chinese，Wang Neville, 2006)」、「家長反思功能量表(Parental Reflective Functioning Questionnaire，Luyten et al., 2017)」及基本資料表。以SPSS20進行探索性因素分析、描述統計、獨立樣本t檢定、單因子變異數分析、皮爾森積差相關及階層迴歸等分析，並以AMOS24進行驗證性因素分析。研究結果：第一，本研究自編之情緒反應量表經探索性及驗證性因素分析，發現照顧者對嬰兒哭泣之情緒反應可歸為「憂慮無助」和「憤怒反感」兩個因素，各有六題、五題。第二，母親的原生依附焦慮傾向愈高，可預測對嬰兒哭泣有愈強烈的「整體情緒反應」、「憂慮無助」和「憤怒反感」，但母親的原生依附逃避傾向不具有預測力。第三，母親在反思功能中的「前心智化」程度愈高，可預測對嬰兒哭泣有愈強烈的「整體情緒反應」、「憂慮無助」和「憤怒反感」；「對心智狀態的確定度」和「對心智狀態的興趣與好奇」愈高，則可預測愈緩和的「整體情緒反應」及「憤怒反感」。第四，母親的原生依附焦慮傾向愈高，可預測愈高的「前心智化」程度；母親的原生依附逃避傾向愈高，可預測愈高的「前心智化」程度，及愈低的「對心智狀態的確定度」與「對心智狀態的興趣與好奇」。第五、「前心智化」於「原生依附焦慮傾向」預測對嬰兒哭泣的「整體情緒反應」、「憂慮無助」和「憤怒反感」上，具有完全中介作用。結論：基於「前心智化」在母親之「原生依附焦慮」預測「對嬰兒哭泣的情緒反應」上具有完全中介角色，臨床工作者應致力於提升母親在育兒壓力下的心智化能力，以預防失功能之親職行為。再者，母親之原生依附逃避無法預測對嬰兒哭泣之負面情緒反應，推測此結果與依附逃避傾向愈強烈者，愈不易於自陳量表表露情緒有關，未來研究可增加生理反應之內隱測量。最後，本研究自編照顧者對嬰兒哭泣之情緒反應量表具有初步之信效度，未來研究可繼續探討其適用性，以對照顧者之情緒進行良好之評估。

關鍵字

原生依附；依附焦慮；依附逃避；反思功能；心智化；嬰兒哭泣；母親情緒；中介作用

並列摘要

Background and purpose: Caregiving behavior is related with the survival of human being, but it is paradoxical that the caregivers’ abuse or neglect of their children is not the new case. The research had indicated that the caregivers’ attachment representation of origin is related with their caregiving behavior toward their children, and parental reflective functioning (mentalization) plays an important role on facilitating this relatedness. Since mothers’ emotional response to infant crying has impact on their caregiving behavior, the study aims at the exploration of the relationship among mothers’ attachment, reflective functioning, and their emotional response to infant crying. Methods: From well-baby clinics, community, and the private social network, women who were above twenty years old, married, and with babies younger than 2 years old were invited. A sample of 778 participants were obtained. The instruments were “Emotional Response to Infant Crying Questionnaire” (constructed by this study), "Relationships Structure Questionnaire-Chinese version" (Wang Neville, 2006), "Parental Reflective Functioning Questionnaire" (Luyten et al., 2017) , and the background questionnaire. Data were analyzed by the SPSS 20 for exploratory factor analysis, descriptive statists, independent sample t-test, one-way ANOVA, Pearson’s product-moment correlation , and hierarchical regression analysis. The AMOS 24 was used for confirmatory factor analysis. Results: First, two factors on “Emotional Response to Infant Crying Questionnaire” were found, i.e. “Worry-Helplessness” (six items) and “Anger-Aversion” (five items). Second, the higher the mothers’ parental attachment anxiety, the more intense their general emotional response, “Worry-Helplessness” and “Anger-Aversion” to infant crying. However, the mothers’ parental attachment avoidance did not predict their emotional response. Third, the higher the pre-mentalizing mode of reflective functioning, the more intense their general emotional response, “Worry-Helplessness” and “Anger-Aversion” to infant crying. The higher the certainty about mental states as well as the interest and curiosity about mental states, the more relieved their general emotional response and “Anger-Aversion” toward infant crying. Fourth, the higher the mothers’ parental attachment anxiety, the higher their pre-mentalizing. Also, the higher the mothers’ parental attachment avoidance, the higher their pre-mentalizing, the lower their certainty about mental states, and the lower of interest and curiosity about mental states were noted. Finally, mothers’ pre-mentalizing was a total mediator in the prediction of attachment anxiety on emotional responses toward infant crying. Conslusions: Based on the mediating role of pre-mentalizing, clinical practitioners could address mothers’ mentalizing capacity under parenting stress to prevent any dysfunctional parenting. For future research, physiological instrument could be added in assessing the emotional responses of mothers with higher parental attachment avoidance. Finally, the preliminary satisfactory reliability and validity were noted on “Emotional Response to Infant Crying Questionnaire”, furthur investigation of its appropriateness in assessing caregivers’ emotions is needed.

並列關鍵字

attachment ； attachment anxiety ； attachment avoidance ； reflective functioning ； mentalization ； infant crying ； mothers’ emotions ； mediating effect