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青春期母亲所生孩子的行为与发育:风险与三代同堂家庭

Behavior and development of preschool children born to adolescent mothers: risk and 3-generation households.

作者信息

Black Maureen M, Papas Mia A, Hussey Jon M, Hunter Wanda, Dubowitz Howard, Kotch Jonathan B, English Diana, Schneider Mary

机构信息

University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.

出版信息

Pediatrics. 2002 Apr;109(4):573-80. doi: 10.1542/peds.109.4.573.

Abstract

OBJECTIVE

To investigate whether living in a 3-generation household (grandmother-mother-child) is associated with fewer behavior problems and better cognitive development among preschool children of mothers who gave birth during adolescence and whether it protects children from the behavior and developmental problems associated with maltreatment and maternal depression.

DESIGN

Cohort study.

SETTING

Participants included low-income families recruited from 4 sites: East, Northwest, Midwest, and South, who are part of LONGSCAN, a longitudinal study of children's health, development, and maltreatment.

PARTICIPANTS

One hundred ninety-four mothers who were adolescents (less than age 19) at delivery. Data were gathered when children were 4 to 5 years of age. Twenty-six percent of the children lived in 3-generation households, 39% had a history of maltreatment, and 32% of the mothers had depression scores in the clinical range.

MAIN OUTCOME MEASURES

Child behavioral problems were measured with the Child Behavior Checklist, completed by the mother, and child developmental status was assessed with the Battelle Developmental Inventory Screening Test, administered by research assistants.

RESULTS

Multiple regression analyses revealed that children who had been reported for maltreatment and had mothers with depressive symptoms had more externalizing behavior problems, compared with children who experienced neither risk or only 1 risk. However, when residential status was considered, children with the greatest number of externalizing behavior problems were those who experienced both maltreatment and maternal depressive symptoms and lived in 3-generation households. Children who had been reported for maltreatment or had mothers with depressive symptoms were more likely to have internalizing problems, compared with children with neither risk. Residential status was not related to children's internalizing behavior problems or cognitive development.

CONCLUSIONS

Living in a 3-generation household did not protect preschool children from the behavior problems associated with maltreatment and depression. In contrast, living in a 3-generation household was associated with more behavior problems among the highest risk group of children--those who had been maltreated and had mothers with symptoms of depression. Although 3-generation families may provide an important source of support and stability for adolescent mothers and their infants early in the parenting process, it may not be advisable to rely on 3-generation households as young mothers enter adulthood, particularly among those with a history of maltreatment or depression. Children with the fewest number of behavior problems were living with their mothers in their own household (often with the father), had not been maltreated, and had mothers with few symptoms of depression.

摘要

目的

探讨生活在三代同堂家庭(祖母 - 母亲 - 孩子)是否与青春期生育母亲的学龄前儿童行为问题较少及认知发展较好相关,以及它是否能保护儿童免受与虐待和母亲抑郁相关的行为及发育问题的影响。

设计

队列研究。

背景

参与者包括从四个地点招募的低收入家庭:东部、西北部、中西部和南部,这些家庭是LONGSCAN的一部分,LONGSCAN是一项关于儿童健康、发展和虐待的纵向研究。

参与者

194名分娩时为青少年(小于19岁)的母亲。在孩子4至5岁时收集数据。26%的孩子生活在三代同堂家庭,39%有虐待史,32%的母亲抑郁得分处于临床范围。

主要结局指标

通过母亲填写的儿童行为检查表测量儿童行为问题,由研究助理实施的贝特尔发育量表筛查测试评估儿童发育状况。

结果

多元回归分析显示,与既无风险因素也仅有一个风险因素的儿童相比,有虐待报告且母亲有抑郁症状的儿童有更多的外化行为问题。然而,考虑居住状况时,外化行为问题最多的儿童是那些既经历过虐待又有母亲抑郁症状且生活在三代同堂家庭的儿童。与没有任何风险因素的儿童相比,有虐待报告或母亲有抑郁症状的儿童更可能有内化问题。居住状况与儿童的内化行为问题或认知发展无关。

结论

生活在三代同堂家庭并不能保护学龄前儿童免受与虐待和抑郁相关的行为问题的影响。相反,生活在三代同堂家庭与最高风险组儿童(即那些遭受过虐待且母亲有抑郁症状的儿童)中更多的行为问题相关。尽管三代同堂家庭可能在育儿过程早期为青春期母亲及其婴儿提供重要的支持和稳定来源,但随着年轻母亲步入成年,尤其是在那些有虐待或抑郁病史的母亲中,依赖三代同堂家庭可能并不可取。行为问题最少的儿童是与母亲住在自己家中(通常与父亲一起)、未遭受虐待且母亲抑郁症状较少的儿童。

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