Shanok A F, Miller L
Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY 10027, USA.
Arch Womens Ment Health. 2007;10(5):199-210. doi: 10.1007/s00737-007-0194-8. Epub 2007 Aug 10.
Between a quarter and half of pregnant adolescents are estimated to be depressed (Beardslee et al. 1988). Two recent open clinical trials found significant drops in depression levels among pregnant and newly parenting inner city teenagers after 12 weeks of Interpersonal Psychotherapy modified for pregnant teenagers (Miller et al. submitted). The current study addresses the nature of and contributors to participants' depression, and the active ingredients in their healing.
Qualitative analyses of therapy sessions, clinical notes and post hoc interviews of clinicians were integrated with questionnaire data.
The most common symptoms of participant depression (n = 80) were anger/irritability and sadness and the cluster of depressive symptoms with the greatest variance was characterized by shame and guilt. Participants attributed symptoms of depression to feeling trapped or wronged, when family members were sad or rejecting and when the symptoms functioned to help participants meet their needs. Experiences associated with symptom relief were validation of pregnancies, successful use of self-advocacy and boundary setting skills and recognition of passage through important transitions. Support from participants' mothers was instrumental.
Interpersonal contexts may be pivotal in contributing, maintaining and/or alleviating depression among poor urban pregnant and newly parenting adolescents.
据估计，四分之一至一半的怀孕青少年患有抑郁症（Beardslee等人，1988年）。最近的两项开放临床试验发现，针对怀孕青少年进行改良的人际心理治疗12周后，城市中心区怀孕及刚成为母亲的青少年的抑郁水平显著下降（Miller等人，待发表）。本研究探讨了参与者抑郁的本质、成因以及康复过程中的有效因素。
将治疗过程记录、临床笔记以及临床医生的事后访谈的定性分析与问卷调查数据相结合。
参与者抑郁（n = 80）最常见的症状是愤怒/易怒和悲伤，差异最大的一组抑郁症状以羞耻和内疚为特征。参与者将抑郁症状归因于感到被困或受委屈，归因于家庭成员悲伤或排斥自己，以及这些症状有助于满足自身需求的时候。与症状缓解相关的经历包括怀孕得到确认、成功运用自我主张和设定界限的技巧以及认识到度过重要的转变期。参与者母亲的支持起到了重要作用。
人际环境在贫困城市地区怀孕及刚成为母亲的青少年抑郁的产生、维持和/或缓解过程中可能起着关键作用。
