Murphy Debra A, Greenwell Lisa, Mouttapa Michele, Brecht Mary-Lynn, Schuster Mark A
Health Risk Reduction Projects, Integrated Substance Abuse Programs, Department of Psychiatry, University of California at Los Angeles, Los Angeles, California 90025-7510, USA.
J Dev Behav Pediatr. 2006 Oct;27(5):386-95. doi: 10.1097/00004703-200610000-00004.
A longitudinal study was conducted on the psychological well-being of 81 young children (mean age = 8.8 years) living with mothers with AIDS or HIV-infected mothers with symptomatic disease. The relationship between mothers' physical health and children's psychological well-being was investigated. The children were assessed at seven time points over approximately 6 years. Individual growth models were estimated for children's depression, anxiety, and aggressiveness in relation to: mothers' viral load (medical records) and physical functioning, number of HIV-related physical symptoms, and medical visits due to illness (self-report). Results showed significant linear declines in children's depression, anxiety, and aggressiveness over time. Lower levels of physical functioning and more physical symptoms among mothers were associated with higher levels of children's depression, anxiety, and aggressiveness at baseline. Lower levels of physical functioning and more physical symptoms among mothers were associated with initially high but more rapidly decreasing levels of depression among children. However, mothers who began the study in better health appear to have changed in health more quickly than mothers who began the study in poorer health. Thus, stability in mothers' health appears to be associated with a more rapid improvement in children's mental health over time. Our findings suggest that the measures representing observable levels of, and changes in, mothers' health that are most likely to be directly experienced by themselves and their children are the measures that are most predictive of changes in children's mental health over time.
对81名与患有艾滋病的母亲或有症状疾病的感染艾滋病毒的母亲生活在一起的幼儿(平均年龄 = 8.8岁)的心理健康状况进行了一项纵向研究。调查了母亲的身体健康与孩子心理健康之间的关系。在大约6年的时间里,对这些孩子在七个时间点进行了评估。针对孩子的抑郁、焦虑和攻击性,估计了个体成长模型,这些模型与以下因素相关:母亲的病毒载量(病历)和身体机能、与艾滋病毒相关的身体症状数量以及因病就诊情况(自我报告)。结果显示,随着时间的推移,孩子的抑郁、焦虑和攻击性显著线性下降。母亲身体机能水平较低和身体症状较多,与孩子在基线时较高水平的抑郁、焦虑和攻击性相关。母亲身体机能水平较低和身体症状较多,与孩子最初较高但下降更快的抑郁水平相关。然而,开始研究时健康状况较好的母亲,其健康状况的变化似乎比开始研究时健康状况较差的母亲更快。因此,母亲健康状况的稳定性似乎与孩子心理健康随时间的更快改善相关。我们的研究结果表明,代表母亲健康的可观察水平及其变化的指标,最有可能是她们自己和孩子直接经历的,这些指标最能预测孩子心理健康随时间的变化。