Background Disorganised attachment in childhood has been considered an important early marker for the development of socio-emotional and mental health problems. This review critically examines the current evidence and methodology employed to assess the influence of perinatal maternal mental health on disorganised attachment in infancy. Methods A search revealed 1 149 articles reporting studies examining predictors of disorganised attachment. An additional 564 grey literature articles were identified via bibliographic searches. After screening for inclusion of maternal mental health measures and use of the Strange Situation Procedure, 28 articles met inclusion criteria. Results Few studies robustly examined clinical levels of maternal mental health over time and the potential effects on infant disorganised attachment. Still, the bulk of current evidence does not support a strong positive association between disorganised attachment and low to moderate levels of maternal depression. The relationship between disorganised attachment and chronic and/or severe maternal depression is unclear given the dearth of research into the area. Limited research has examined other mental health disorders, with one study suggesting borderline personality disorder is associated with disorganised attachment. A level of bias in the literature was evident, with many studies recruiting non-clinical samples and excluding those with significant mental health concerns. Conclusions Most non-significant findings were reported in non-clinical samples, while most positive findings were reported in clinical samples, suggesting that severity of mental disorder may be a critical factor. Further research on the relationship between disorganised attachment and chronic and severe maternal depression, psychotic, trauma, bipolar, and personality disorders is required.

中文翻译：

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围产期孕产妇心理健康和无序依恋：一项批判性的系统评价

背景 童年时期的无组织依恋被认为是社会情绪和心理健康问题发展的重要早期标志。本综述批判性地审查了当前用于评估围产期母亲心理健康对婴儿期无组织依恋的影响的证据和方法。方法 一项搜索揭示了 1149 篇文章，这些文章报告研究了无组织依恋的预测因素。通过书目搜索确定了另外 564 篇灰色文献文章。在筛选纳入孕产妇心理健康措施并使用陌生情境程序后，28 篇文章符合纳入标准。结果 很少有研究有力地检验了随着时间的推移母亲心理健康的临床水平以及对婴儿杂乱无章依恋的潜在影响。仍然，目前的大部分证据并不支持无序依恋与低至中度孕产妇抑郁症之间存在强烈的正相关。鉴于对该领域缺乏研究，混乱的依恋与慢性和/或严重的孕产妇抑郁症之间的关系尚不清楚。有限的研究检查了其他精神健康障碍，一项研究表明边缘型人格障碍与无组织的依恋有关。文献中明显存在一定程度的偏见，许多研究招募了非临床样本，并排除了那些有严重心理健康问题的样本。结论 大多数非临床样本报告了不显着的结果，而临床样本报告了大多数阳性结果，表明精神障碍的严重程度可能是一个关键因素。