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ETUDE PILOTE SUR LES FACTEURS DE RISQUE DE SURVENUE D’UN RETRAIT RELATIONNEL PRÉCOCE CHEZ LES ENFANTS DE MÈRES ADMISES EN UMB ET PRÉSENTANT DE GRAVES TROUBLES PSYCHIATRIQUES, ET LES LIENS AVEC LE DÉVELOPPEMENT PSYCHOLOGIQUE ULTÉRIEUR.
Introduction. Maternal mental pathology can potentially disrupt early interactions between a mother and her infant. Early relational withdrawal” (ERW) is considered a warning signal of infant psychic distress. To date, no study has explored early relational withdrawal in infants hospitalized jointly with their mothers in a mother-child unit (MCU). The objectives of our study are to explore in a population of infants hospitalized jointly with their mothers in the year following their birth: 1) the socio-demographic, economic, environmental, family and maternal mental health factors associated with RRP and 2) the links between RRP and childcare, schooling and psychic care between the ages of 2 and 5.
Methods. Thirty-four mothers and their children, who received standardized video recording of mother-child interactions during their care, were included in the study. SRW was assessed from cases recorded with the ADBB (alarm baby distress) scale. Associations between SRW and maternal sociodemographic, economic, environmental, family, and mental health factors, and then between childcare mode, psychic care, and type of schooling of the child between 2 and 5 years of age were explored by univariate analyses.
Results. In our population, the prevalence of SRW was 35%. The existence of a maternal psychiatric history tended to be associated with SRW Children with SRW at initial care were significantly more often psychologically followed up between 2 and 5 years of age than children without SRW..
Conclusion. SRW appears as a potentially sensitive indicator of the mental health of the “toddler”. Its presence can be considered as a marker of the need for regular developmental follow-up.
Expert’s note: The interest of this study is both the exploration of psychiatric disorders that can affect the mother/baby relationship apart from maternal depression and the longitudinal follow-up of children who presented a sustained relational withdrawal. Longitudinal studies are rare because they are difficult to implement and this is also the case for the notion of relational withdrawal. Therefore, the information provided by this research is all the more important because it corroborates the results of other longitudinal ADBB studies and in infant mental health in general. What is particularly interesting is the absence of correlation between sustained relational withdrawal and the various factors that were taken into account (poverty, family environment, etc.) other than maternal psychopathology, which shows, indirectly, that the quality of the parent-child bond is a protective factor against adversity and that this quality of bond depends on the mental health of the mothers. It is the accumulation of risk factors or risk factors associated with mental health difficulties in the parents that puts the baby in difficulty in its socio-emotional development.