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学龄前儿童抑郁症的风险因素:早期应激性生活事件的中介作用。

Risk factors for preschool depression: the mediating role of early stressful life events.

作者信息

Luby Joan L, Belden Andy C, Spitznagel Edward

机构信息

Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri 63110, USA.

出版信息

J Child Psychol Psychiatry. 2006 Dec;47(12):1292-8. doi: 10.1111/j.1469-7610.2006.01672.x.

Abstract

BACKGROUND

Family history of mood disorders and stressful life events are both established risk factors for childhood depression. However, the role of mediators in risk trajectories, which are potential targets for intervention, remains understudied. To date, there have been no investigations of mediating relationships between risk factors and very early onset depression, a developmental period during which intervention may be more effective. The current study used regression analyses to examine the relationships between family history of mood disorders and stressful life events as risk factors for depression in a preschool sample.

METHOD

Preschoolers 3.0 to 5.6 years of age participated in a comprehensive mental health assessment. Caregivers were interviewed about their children using a structured diagnostic measure to derive DSM-IV major depressive disorder (MDD) diagnoses and dimensional depression severity scores. Family history of psychiatric disorders and preschoolers' stressful life events was obtained.

RESULTS

Both family history and stressful life events predicted depression severity scores 6 months later. Analyses examining the influence of family history of mood disorders and stressful life events on preschoolers' depression severity demonstrated that stressful life events mediated the relationship between family history and preschoolers' depression.

CONCLUSIONS

Findings outline the key role of exposure to early stressful life events as a mediator of familial mood disorder risk in preschool onset depression. This finding in a preschool sample provides support for the hypothesis that psychosocial factors may have increased importance as mediators of risk in younger age groups. Findings suggest that psychosocial factors should be considered key targets for early intervention in depression.

摘要

背景

情绪障碍家族史和应激性生活事件都是儿童期抑郁症已确定的风险因素。然而,中介因素在风险轨迹中的作用,即潜在的干预目标,仍未得到充分研究。迄今为止,尚未有研究调查风险因素与极早发性抑郁症之间的中介关系,而极早发性抑郁症是一个干预可能更有效的发育阶段。本研究采用回归分析来检验情绪障碍家族史和应激性生活事件作为学龄前儿童样本中抑郁症风险因素之间的关系。

方法

3.0至5.6岁学龄前儿童参与了一项全面的心理健康评估。使用结构化诊断量表对照顾者进行访谈,以得出《精神疾病诊断与统计手册》第四版(DSM-IV)中重度抑郁症(MDD)的诊断结果和抑郁严重程度的维度评分。获取了精神疾病家族史和学龄前儿童的应激性生活事件。

结果

家族史和应激性生活事件均能预测6个月后的抑郁严重程度评分。对情绪障碍家族史和应激性生活事件对学龄前儿童抑郁严重程度的影响进行分析表明,应激性生活事件介导了家族史与学龄前儿童抑郁之间的关系。

结论

研究结果概述了早期应激性生活事件作为学龄前儿童抑郁症家族情绪障碍风险中介因素的关键作用。在学龄前儿童样本中的这一发现支持了以下假设:心理社会因素作为较年轻年龄组风险中介因素的重要性可能会增加。研究结果表明,心理社会因素应被视为抑郁症早期干预的关键目标。

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