Trapolini T, McMahon C A, Ungerer J A
Department of Psychology, Macquarie University, Sydney, NSW 2109, Australia.
Child Care Health Dev. 2007 Nov;33(6):794-803. doi: 10.1111/j.1365-2214.2007.00739.x.
The present study aimed to clarify the circumstances under which maternal depression is associated with adverse outcomes in pre-school-aged children, and to explore the additional impact of the marital relationship in a socio-economically low-risk sample.
Ninety-two mothers recruited into a longitudinal study were assessed for symptoms of depression when their children were 4, 12 and 15 months, and later at 4 years of age. At 4 years of age, mothers were also asked to report on marital adjustment. Mothers, fathers and pre-school teachers were asked to report on children's internalizing and externalizing behaviour problems.
Children exposed to chronic maternal depression were rated by their parents as significantly more problematic on internalizing and externalizing behaviours. This association was not mediated or moderated by low marital satisfaction. No parent-reported effects were evident for children exposed to transient depression. Ten per cent of the children had internalizing scores in the clinical range, and 7% had externalizing scores in the clinical range. Almost all of the children with clinically elevated scores had been exposed to chronic maternal depression. Teacher reports of internalizing behaviours corroborated parent reports; however, teachers tended to report significantly lower levels of behaviour problems. Although there was a tendency for teachers to rate children exposed to any depression as more problematic on internalizing behaviours, the subgroup differences were not significant.
Findings confirm that depression chronicity is important in determining child behavioural outcomes, and that depression effects cannot be accounted for by low marital adjustment. Results are discussed with reference to transmission of risk models, and treatment implications are considered.
本研究旨在阐明母亲抑郁与学龄前儿童不良结局相关的情况,并在社会经济低风险样本中探讨婚姻关系的额外影响。
纳入一项纵向研究的92名母亲在其孩子4个月、12个月和15个月大时,以及后来4岁时接受了抑郁症状评估。在孩子4岁时,还要求母亲报告婚姻调适情况。母亲、父亲和学龄前教师被要求报告孩子的内化和外化行为问题。
父母将暴露于母亲慢性抑郁的孩子在内化和外化行为方面评定为问题明显更多。这种关联未被低婚姻满意度介导或调节。对于暴露于短暂抑郁的孩子,未发现父母报告的明显影响。10%的孩子内化得分在临床范围内,7%的孩子外化得分在临床范围内。几乎所有临床得分升高的孩子都暴露于母亲慢性抑郁。教师对内化行为的报告证实了父母的报告;然而,教师报告的行为问题水平往往明显更低。尽管教师倾向于将暴露于任何抑郁的孩子在内化行为方面评定为问题更多,但亚组差异不显著。
研究结果证实抑郁的慢性病程在决定儿童行为结局方面很重要,且抑郁的影响不能用低婚姻调适来解释。结合风险模型的传递对结果进行了讨论,并考虑了治疗意义。