Stein D, Williamson D E, Birmaher B, Brent D A, Kaufman J, Dahl R E, Perel J M, Ryan N D
Sackler School of Medicine, Tel Aviv University, Israel.
J Am Acad Child Adolesc Psychiatry. 2000 Nov;39(11):1387-95. doi: 10.1097/00004583-200011000-00013.
To evaluate parent-child bonding and familial functioning in depressed children, children at high risk for depression, and low-risk controls.
Diagnoses of children and their relatives were obtained via structured interviews with all available informants. Depressed children (n = 54) received a diagnosis of current major depressive disorder (MDD). The high-risk children (n = 21) had no lifetime diagnoses of mood disorders, but at least one first-degree relative with a lifetime history of depression. The low-risk controls (n = 23) had no lifetime psychiatric disorders and no first-degree relative with a lifetime history of mood disorders. Parent-child bonding was evaluated with the child's report on the Parental Bonding Instrument (PBI). Familial functioning was evaluated with each parent answering the Family Assessment Device (FAD).
Significant differences were found between the MDD and low-risk children on most parameters of the PBI and FAD. The children with MDD reported significantly elevated maternal overprotection, and their fathers scored significantly lower on the FAD scales of Behavioral Control and General Functioning, compared with the high-risk children. Mothers of high-risk children had significantly lower scores on the Roles and Affective Involvement dimensions of the FAD compared with mothers of low-risk children. Current maternal depression had a deleterious effect on the child's perception of maternal protection and paternal care, mother's report on all FAD scales, and father's report on most FAD scales, whether interacting with the child's depression or existing even if the child was not depressed.
Maternal depression and its interaction with the child's depression appear to have negative consequences for parent-child bonding and family functioning.
评估抑郁儿童、抑郁高危儿童和低风险对照组儿童的亲子关系及家庭功能。
通过对所有可获取信息提供者进行结构化访谈，获取儿童及其亲属的诊断信息。抑郁儿童（n = 54）被诊断为当前患有重度抑郁症（MDD）。高危儿童（n = 21）终生未被诊断出患有情绪障碍，但至少有一位一级亲属有抑郁病史。低风险对照组（n = 23）终生无精神疾病，且无一级亲属有情绪障碍病史。通过儿童对父母教养方式问卷（PBI）的报告来评估亲子关系。通过每位父母回答家庭功能评定量表（FAD）来评估家庭功能。
在PBI和FAD的大多数参数上，MDD儿童与低风险儿童之间存在显著差异。与高危儿童相比，患有MDD的儿童报告母亲过度保护显著增加，且他们的父亲在FAD的行为控制和总体功能量表上得分显著更低。与低风险儿童的母亲相比，高危儿童的母亲在FAD的角色和情感卷入维度上得分显著更低。当前母亲的抑郁对孩子对母亲保护和父亲关怀的认知、母亲在所有FAD量表上的报告以及父亲在大多数FAD量表上的报告都有有害影响，无论这种抑郁是与孩子的抑郁相互作用，还是即使孩子不抑郁也依然存在。
母亲的抑郁及其与孩子抑郁的相互作用似乎对亲子关系和家庭功能有负面影响。
