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发育迟缓或有发育迟缓风险的幼儿主要照顾者抑郁症状的预测因素。

Predictors of depressive symptoms in primary caregivers of young children with or at risk for developmental delay.

作者信息

Feldman M, McDonald L, Serbin L, Stack D, Secco M L, Yu C T

机构信息

Department of Child and Youth Studies, Brock University, St Catherines, ON, Canada.

出版信息

J Intellect Disabil Res. 2007 Aug;51(Pt 8):606-19. doi: 10.1111/j.1365-2788.2006.00941.x.

Abstract

BACKGROUND

Despite extensive research with families raising children with or at risk for developmental delay (DD), it is not clear whether primary caregivers of these children are at increased risk for depressive symptoms. Discrepant findings in the literature may be owing to heterogeneity of child problems. More research is needed on child, parent and family variables that may increase risk for, or resilience to, caregiver depressive symptoms. Some studies have found that parental resources (e.g. social support and coping strategies) may buffer the effects of parental distress, while other studies have highlighted the role of parental self-efficacy.

METHODS

We examined Beck Depression Inventory (BDI) scores in 178 primary caregivers (mainly biological mothers) who had 2-year-old children with or at risk for DD owing to: (a) low birthweight, prematurity or multiple birth (n = 58), (b) other known reasons (e.g. Down syndrome, spina bifida) (n = 67), or (c) unknown reasons (n = 69).

RESULTS

We found that 20% (n = 35) of the caregivers scored above the BDI clinical cut-off for depression. Analysis of variance revealed that caregivers with elevated BDI scores had higher child behaviour problem and escape-avoidance coping scores, and lower social support and parent self-efficacy, compared with caregivers without depressive symptoms. Caregivers with children who had DD for unknown reasons had higher BDI scores than caregivers of the other two groups of children. Regression analyses showed that child behaviour problems, escape-avoidance coping strategies and social support predicted caregiver BDI scores, but caregiver self-efficacy only did so when entered independently of social support. Only social support mediated and (marginally) moderated the relationship between child behaviour problems and caregiver depressive symptoms.

CONCLUSIONS

These findings suggest that early intervention programmes should carefully consider the interaction of child characteristics (e.g. Diagnosis and behaviour problems), caregiver resources (e.g. coping strategies and social support), and parental mental health and mood when planning and tailoring services for families of children with or at risk for DD.

摘要

背景

尽管对抚养发育迟缓(DD)儿童或有发育迟缓风险儿童的家庭进行了广泛研究,但尚不清楚这些儿童的主要照料者出现抑郁症状的风险是否增加。文献中的不一致结果可能归因于儿童问题的异质性。需要对可能增加照料者抑郁症状风险或增强其恢复力的儿童、父母和家庭变量进行更多研究。一些研究发现,父母资源(如社会支持和应对策略)可能缓冲父母的痛苦影响,而其他研究则强调了父母自我效能感的作用。

方法

我们对178名主要照料者(主要是亲生母亲)的贝克抑郁量表(BDI)得分进行了检测,这些照料者的2岁孩子患有DD或有DD风险,原因如下:(a)低出生体重、早产或多胞胎(n = 58),(b)其他已知原因(如唐氏综合征、脊柱裂)(n = 67),或(c)不明原因(n = 69)。

结果

我们发现20%(n = 35)的照料者BDI得分高于抑郁症的临床临界值。方差分析显示,与没有抑郁症状的照料者相比,BDI得分升高的照料者有更高的儿童行为问题和逃避应对得分,以及更低的社会支持和父母自我效能感。孩子患有不明原因DD的照料者比其他两组孩子的照料者有更高的BDI得分。回归分析表明,儿童行为问题、逃避应对策略和社会支持可预测照料者的BDI得分,但照料者自我效能感只有在独立于社会支持进入模型时才具有预测作用。只有社会支持介导并(在一定程度上)调节了儿童行为问题与照料者抑郁症状之间的关系。

结论

这些发现表明,早期干预项目在为患有DD或有DD风险儿童的家庭规划和定制服务时,应仔细考虑儿童特征(如诊断和行为问题)、照料者资源(如应对策略和社会支持)以及父母心理健康和情绪之间的相互作用。

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