Kim-Cohen Julia, Caspi Avshalom, Rutter Michael, Tomás Mónica Polo, Moffitt Terrie E
Institute of Psychiatry, King's College London, UK.
Am J Psychiatry. 2006 Jun;163(6):1009-18. doi: 10.1176/ajp.2006.163.6.1009.
Many depressed women have a history of antisocial behavior, but research into maternal depression has not ascertained if this has implications for children of depressed mothers. This study compared the developmental outcomes in and caregiving environments provided to children by depressed mothers with or without an antisocial history.
In the Environmental Risk Longitudinal Twin Study, a nationally representative study of 1,106 families, mothers were administered the Diagnostic Interview Schedule for Major Depressive Disorder and interviewed about their lifetime history of antisocial personality disorder symptoms. Mothers and teachers provided information regarding the children's behavior problems at 5 and 7 years of age. The authors assessed the quality of the caregiving environment through maternal reports and interviewer observations.
Compared with children of mothers with depression only, the children of depressed and antisocial mothers had significantly higher levels of antisocial behavior and rates of DSM-IV conduct disorder, even after the authors controlled for numbers of symptoms and chronicity of maternal major depressive disorder. The children of depressed and antisocial mothers were at an elevated risk of experiencing multiple caregiving abuses, including physical maltreatment, high levels of maternal hostility, and exposure to domestic violence.
If one ignores the common co-occurrence of an antisocial history in depressed mothers, it may obscure the significantly elevated risks in children's development. Clinicians treating women's depression should be aware that children of depressed and antisocial mothers constitute a group at extremely high risk for early-onset psychopathology.
许多抑郁女性有反社会行为史,但针对母亲抑郁的研究尚未确定这是否会对抑郁母亲的子女产生影响。本研究比较了有或无反社会史的抑郁母亲所生子女的发育结果及养育环境。
在环境风险纵向双生子研究中,对1106个家庭进行了全国代表性研究,对母亲进行了《重性抑郁障碍诊断访谈量表》的测试,并询问她们反社会人格障碍症状的终生病史。母亲和教师提供了有关孩子在5岁和7岁时行为问题的信息。作者通过母亲报告和访谈者观察评估了养育环境的质量。
与仅患抑郁症母亲的子女相比,患抑郁症且有反社会行为母亲的子女,即使在作者控制了母亲重性抑郁障碍的症状数量和慢性程度之后,其反社会行为水平和DSM-IV品行障碍发生率仍显著更高。患抑郁症且有反社会行为母亲的子女遭受多种养育虐待的风险升高,包括身体虐待、母亲的高度敌意以及接触家庭暴力。
如果忽视抑郁母亲中常见的反社会史共病情况,可能会掩盖儿童发育中显著升高的风险。治疗女性抑郁症的临床医生应意识到,患抑郁症且有反社会行为母亲的子女是早发性精神病理学的极高风险群体。