Razi Journal of Medical Sciences

fa پیش بینی ایمنی دل‌بستگی و خود پنداره مادرانه بر مبنای بازنمایی‌های مادرانه پیش از تولد در مادران کودکان دارای اختلال طیف اتیسم شهر شیراز Prediction of Attachment Safety and Maternal Self-Concept Based on Maternal Representations before Birth in Mothers of Children with Autism Spectrum Disorder in Shiraz City روانشناسی بالینی Clinical Psychiatry پژوهشي Research <div style="text-align: justify;">زمینه و هدف: با توجه به تأثیر ویژگیهای کودک و بافت مراقبتی در هر مقطع تحولی کودکان دارای اختلال اتیسم، برای دستیابی به مسیر مشخص، تبیین تغییرات بازنمایی مادران دارای اختلال اتیسم ضرورت می یابد. بنابراین هدف از انجام این پژوهش تدوین مدل ساختاری ایمنی دلبستگی و خودپنداره مادرانه براساس بازنمایی های مادرانه پیش از تولد در مادران کودکان دارای اختلال طیف اتیسم شهر شیراز در سال 1401 بود. روش کار: روش مطالعه توصیفی و از نوع طرح های همبستگی مبتنی بر روش مدل یابی معادلات ساختاری بود که جامعه آماری آن شامل کلیه مادران دارای فرزند طیف اتیسم که فرزندشان را در مدارس استثنایی ثبت نام کرده و نیز در انجمن اوتیسم شهر شیراز پرونده داشتند، که تعداد آن‌ها در سال 1401 جمعا 987 نفر بود. با استفاده از روش نمونه گیری در دسترس، 360 نفر از مادران کودکان مبتلا انتخاب شدند که حاضر به شرکت در پژوهش بودند. ابزار پژوهش شامل پرسشنامه روابط میانی دلبستگی (KCAQ)- دلبستگی کودکان در دوره ی میانی هالپرن و کاپنبرگ (2006)، پرسشنامه خودپنداره را جرز(1983)، پرسشنامه رفتارهای دلبستگی مادر به جنین کارنلی (1981) بود. داده ها با استفاده از روش معادلات ساختاری و نرم ازفزار  AMOS تجزیه و تحلیل شدند. یافته‌ها: نتایج نشان دادند میان پذیرش نقش مادری ، دسترس‌پذیری ، تمایز بین خود و جنین و ازخودگذشتگی با ایمنی دل‌بستگی رابطه معنادار و افزایشی (مستقیم) برقرار است. به عبارتی می‌توان گفت بهبود و افزایش در متغیرهای مذکور منجر به افزایش ایمنی دل‌بستگی در مادران کودکان دارای اختلال اتیسم می‌شود. میان پذیرش نقش مادری، نسبت دادن خصوصیاتی به جنین ، تمایز بین خود و جنین و ازخودگذشتگی با خود پنداره مادرانه رابطه معنادار و افزایشی (مستقیم) وجود دارد. نتیجه‌گیری: مدل ساختاری ایمنی دلبستگی و خودپنداره مادرانه براساس بازنمایی های مادرانه پیش از تولد در مادران کودکان دارای اختلال طیف اتیسم از سطح سازگاری مطلوب برخوردار بود.</div> <div style="text-align: justify;">Background & Aims: Parents of children with autism suffer more problems than parents of normal children and even than parents of children with other developmental disorders. Perhaps the most important problem for mothers with autism is the disruption of maternal imaginations and dreams or maternal representations during pregnancy. Maternal representations refer to a process in which the mother has emotional, emotional experiences and a mutual relationship with her fetus and expands the maternal identity for herself. Attachment between mother and fetus is the first and most important relationship that is related to the way and quality of mother-child communication. There is evidence of the development of attachment between mother and fetus during pregnancy, which is reflected in mothers' behaviors. A mother who becomes attached to her fetus during pregnancy is ready to establish a pleasant relationship with the baby after delivery and allow him to develop a safe and healthy attachment. Some evidence shows that the emergence of the mother's attachment to the fetus is a predictor of the mother's attitude and performance after childbirth, the mother's interaction with the infant, and attachment patterns after the birth of the child. Considering the effect of the child's characteristics and the context of care in each stage of development of children with autism disorder, to achieve a specific path, it is necessary to explain the changes in the representation of mothers with autism disorder. Therefore, the purpose of this research was to develop a structural model of attachment safety and maternal self-concept based on maternal representations before birth in mothers of children with autism spectrum disorder in Shiraz city in 2022. Methods: The descriptive study method was based on the structural equation modeling method, and its statistical population included all mothers with children on the autism spectrum who enrolled their children in exceptional schools and also had a case in the Autism Association of Shiraz. Their number was 987 in 1401. Using available sampling method, 360 mothers of affected children were selected who were willing to participate in the research. The research tools included the Middle Attachment Relationships Questionnaire (KCAQ) - Children's Attachment in the Middle Period by Halpern and Kapenberg (2006), Self-Concept Questionnaire (1983), and Carnelly's Mother-Fetus Attachment Behavior Questionnaire (1981). Data were analyzed using structural equation method and AMOS software. Results: The results showed that there is a significant and increasing (direct) relationship between acceptance of the mother's role, accessibility, differentiation between self and fetus, and self-sacrifice with attachment safety. In other words, it can be said that the improvement and increase in the mentioned variables lead to an increase in attachment safety in mothers of children with autism disorder. There is a meaningful and increasing (direct) relationship between accepting the role of the mother, attributing characteristics to the fetus, distinguishing between self and fetus, and self-sacrifice with maternal self-concept. The results of the structural model in Table 6 indicate that acceptance of the maternal, accessibility, differentiation between self and fetus and selflessness have a significant and incremental (direct) relationship with attachment security. In other words, it can be said that the improvement and increase in the mentioned variables lead to an increase in attachment safety in mothers of children with autism. According to the path coefficients and based on the coefficient of determination index (R2), 3, 7, 2, and 9 percent of the changes in attachment safety are explained by acceptance of the maternal role, interaction with the fetus, differentiation between self and fetus, and self-sacrifice. Also, the intensity of the relationship between self-sacrifice and the safety of attachment was higher than in other relationships investigated. The results of the model in Figure 4 showed that there was no statistically significant relationship between attributing characteristics to the fetus and safety of attachment in the studied population (p<0.05). Conclusion: The structural model of attachment safety and maternal self-concept based on maternal representations before birth in mothers of children with autism spectrum disorder had a favorable level of adaptation. This breakthrough may be very challenging. The formation and consolidation of new skills such as expressing emotions, mutual interactions, regulating behaviors, and internalizing the mental representation of the caregiver's availability requires a new level of flexibility in the mother; Especially the mother of autistic children. A noteworthy point in the mothers investigated in this research, who had an autistic child, this caused a change in the mother's feedback about the relationship with the child, increased anxiety in coping with his needs, and created challenges in the daily interaction between the child and the caregiver; A problem that may lead to a change in the behavior based on the mother's sensitivity and consequently to the transformation of the child's internal working model. In fact, in this example, it is not the unsafe working models of the mother herself that is the main factor affecting the representation and sensitivity of the child, but rather the inconsistency and stability in the care system and, as a result, the desire for insecurity in children due to the inability of the caregiver. Accompanying the developmental characteristics of the child, accepting them, and aligning the current representations and caring behavior with these characteristics.  </div> ایمنی دلبستگی , خودپنداره مادرانه , بازنمایی های مادرانه پیش از تولد, اختلال طیف اتیسم Attachment Safety, Maternal Self-Concept, Prenatal Maternal Representations, Autism Spectrum Disorder 1 15 http://rjms.iums.ac.ir/browse.php?a_code=A-10-8145-1&slc_lang=fa&sid=1 Farzaneh Manzari Tavakoli فرزانه منظری توکلی 3900319475328460090216 0009-0004-2260-7425 No Ph.D. Student of General Psychology, Department of Psychology, Morovdasht Branch, Islamic Azad University, Morovdasht, Iran دانشجوی دکترا روانشناسی عمومی، گروه روانشناسی، واحد مرودشت، دانشگاه آزاد اسلامی، مرودشت، ایران Majid Barzegar مجید برزگر Mbarzegar55@gmail.com 3900319475328460090217 0009-0004-9354-2040 Yes Assistant Professor, Department of Psychology, Morovdasht Branch, Islamic Azad University, Morovdasht, Iran استادیار، گروه روانشناسی، واحد مرودشت، دانشگاه آزاد اسلامی، مرودشت، ایران Hossein Baghooli حسین بقولی bhossein@gmail.com 3900319475328460090218 0009-0005-0326-8912 No Assistant Professor, Department of Psychology, Morovdasht Branch, Islamic Azad University, Morovdasht, Iran استادیار، گروه روانشناسی، واحد مرودشت، دانشگاه آزاد اسلامی، مرودشت، ایران