A partir de 48 heures du post-partum, 78 mères ont répondu à l’autoquestionnaire MIBS ( Mother-to-Infant Bonding Scale ) traduit en français ainsi qu’à 3 autres questionnaires. Vingt-quatre heures plus tard, un entretien pédopsychiatrique permettait d’évaluer la relation mère-enfant. Les puéricultrices remplissaient le MIBS, en imaginant les réponses des mères. Le MIBS permettait un dépistage satisfaisant des difficultés du lien mère-enfant (sensibilité = 0,9 et spécificité = 0,8 pour un seuil supérieur ou égal à 2). Les scores MIBS étaient indépendants de l’humeur maternelle (EPDS) et du style d’attachement de la mère (AAQ). Par contre, il existait un lien avec les caractéristiques comportementales du bébé (MAIB). Les scores MIBS de la mère et de la puéricultrice étaient faiblement corrélés et les réponses rarement concordantes ; 100 % des puéricultrices estimaient que le MIBS aidait à l’évaluation du lien mère-enfant et 85 % des mères trouvaient un bénéfice à la passation du questionnaire.
The efficacy of parent-child psychotherapies is widely recognized today. There are, however, less data on predictive factors for outcome in infants and toddlers and their parents. The aim of this study was to highlight predictive factors for outcome after a brief psychotherapy in a population of 49 infants and toddlers aged 3-30 months presenting functional or behavioral disorders. Two assessments were performed, the first before treatment and the second a month after the end of the therapy. These assessments included an evaluation of the child's symptoms, and of depressive or anxiety symptoms in the parents. The assessments after therapy show complete or partial improvement in the child's symptoms for nearly three quarters, and a decrease in the number of anxious and depressive mothers, and also in the number of depressive fathers. Three independent factors appear as predictive of unfavorable outcome for the child: frequency and intensity of behavioral problems and fears, and the absence of the father at more than two-thirds of consultations. The outcome for the mother is associated solely with her anxiety score at the start of the therapy. This study underlines the particular difficulties involved in the treatment of infants and toddlers presenting behavioral disturbances and emotional difficulties, and the value of involving the father in treatment.
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