Dubowitz H, Black M M, Kerr M A, Hussey J M, Morrel T M, Everson M D, Starr R H
Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.
Pediatrics. 2001 Apr;107(4):728-35. doi: 10.1542/peds.107.4.728.
There is mounting concern about how mothers' own victimization experiences affect their children. This study examines the effects of mothers' victimization on their own mental health and parenting and on their children's behavior, development, and health. The effects of both timing and type of victimization are assessed. A related objective was to determine if there was a cumulative risk effect produced by victimization during both childhood and adulthood, or both physical and sexual.
Urban families in an eastern state and urban and rural families in a southern state.
A total of 419 mothers and their children 6 to 7 years old were identified from 2 sites. The eastern sample was recruited in the first 2 years of life from 3 pediatric clinics: 1 for children at high risk for human immunodeficiency virus disease, 1 for children with failure to thrive, and a third providing pediatric primary care. The southern sample was derived from a cohort of children at risk for adverse health or developmental outcomes, plus a systematic sampling of controls, recruited from area hospitals. At age 4, a random sample of children from the original cohort who had been maltreated along with a matched comparison group of nonmaltreated children were selected.
In general, mothers victimized during both childhood and adulthood had poorer outcomes than mothers victimized during either childhood/adolescence or adulthood who in turn had worse outcomes than mothers with no history of victimization. This manifested as more maternal depressive symptoms, harsher parenting, and more externalizing and internalizing behavior problems in their children. There were no significant differences in maternal functioning or child outcomes between those abused in childhood and those abused in adulthood. These findings were similar for type of victimization. Mothers' depression and harsh parenting were directly associated with their children's internalizing and externalizing behavior problems.
Maternal victimization appears to be a highly prevalent problem in high-risk samples and is associated with harmful implications for mental health and parenting, as well as for the offspring. Pediatricians need to consider past and current victimization of mothers. Routine screening for these problems, followed by appropriate evaluation and intervention may reduce maternal depression, improve parenting, and reduce the incidence of behavior problems in children.
母亲自身的受害经历如何影响其子女,这一问题引发了越来越多的关注。本研究考察母亲受害经历对其自身心理健康、养育方式以及子女行为、发育和健康的影响。同时评估受害经历的时间和类型所产生的影响。一个相关目标是确定童年期和成年期的受害经历,或身体虐待和性虐待是否会产生累积风险效应。
东部某州的城市家庭以及南部某州的城市和农村家庭。
从两个地点共确定了419名母亲及其6至7岁的子女。东部样本是在儿童生命的头两年从3家儿科诊所招募的:一家为感染人类免疫缺陷病毒疾病高危儿童服务,一家为发育不良儿童服务,第三家提供儿科初级保健。南部样本来自一组有不良健康或发育结局风险的儿童,以及从地区医院招募的对照组的系统抽样。在4岁时,从最初队列中随机抽取曾遭受虐待的儿童样本以及与之匹配的未受虐待儿童的对照组。
总体而言,童年期和成年期均受害的母亲比仅在童年/青春期或成年期受害的母亲结局更差,而后者又比无受害史的母亲结局更差。这表现为母亲更多的抑郁症状、更严厉的养育方式,以及子女更多的外化和内化行为问题。童年期受虐的母亲与成年期受虐的母亲在母亲功能或子女结局方面没有显著差异。对于受害类型,这些发现是相似的。母亲的抑郁和严厉养育方式与子女的内化和外化行为问题直接相关。
在高危样本中,母亲受害似乎是一个普遍存在的问题,并且与对心理健康、养育方式以及后代的有害影响相关。儿科医生需要考虑母亲过去和当前的受害情况。对这些问题进行常规筛查,随后进行适当的评估和干预,可能会减少母亲的抑郁,改善养育方式,并降低儿童行为问题的发生率。