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父母虐待与成年期同居伴侣关系:成年慢性抑郁症的生命历程研究——4

Parental maltreatment and adulthood cohabiting partnerships: a life-course study of adult chronic depression--4.

作者信息

Brown George W, Craig Tom K J, Harris Tirril O, Handley Rachel V

机构信息

Department of Health and Population Research, King's College London, St. Thomas' Hospital Campus, London, UK.

出版信息

J Affect Disord. 2008 Sep;110(1-2):115-25. doi: 10.1016/j.jad.2008.01.015. Epub 2008 Mar 4.

Abstract

BACKGROUND

This fourth paper of a series of five concerning depression in women considers: i. why parental maltreatment increases risk of highly aversive ('very poor') partnerships, and ii. how far these relationships explain the link of such maltreatment with adult chronic depression.

METHODS

Data was collected retrospectively by semi-structured interviews and only women living at some point with a partner included.

RESULTS

Parental maltreatment was indirectly linked to chronic depression via highly aversive partnerships. This was partly mediated by childhood conduct problems. However, a broader range of behaviour in late adolescence and early adulthood such as early risky sexual behaviour among those without conduct problems was also involved. In addition parental maltreatment was directly linked to chronic depression, judged by a substantial remaining association when other risk factors were controlled. Highly aversive partnerships were less common by the late 20s while this was matched by an increase of 'very poor' circumstances among those no longer living with a partner. This increase often involved lone motherhood, an established risk factor for chronic depression.

LIMITATIONS

These findings should be seen as tentative given the retrospective nature of many of the measures (But see the second paper in the present series [Brown, G.W., Craig, T.K.J., Harris, T.O., Handley, R.V., & Harvey, A.L. (2007b). Validity of retrospective measures of early maltreatment and depressive episodes using CECA (Childhood Experience of Care & Abuse)--A life-course study of adult chronic depression--2. J. Affect. Disord., 103, 217-224]. Only women were studied.

CONCLUSIONS

Parental maltreatment relates indirectly to adult chronic episodes of depression with highly aversive partnerships playing an important mediating role. Parental maltreatment also has a direct link. While these results are broadly consistent with earlier research a more complete understanding of the mechanisms acting across the life-course requires an assessment of a wider range of factors around the time of an onset of depression. This is the task of our next and final paper.

摘要

背景

这是关于女性抑郁症的系列五篇论文中的第四篇,探讨了:i. 为何父母虐待会增加建立高度厌恶型(“非常糟糕”)伴侣关系的风险;ii. 这些关系在多大程度上解释了此类虐待与成人慢性抑郁症之间的联系。

方法

通过半结构化访谈进行回顾性数据收集,仅纳入曾在某个阶段与伴侣共同生活的女性。

结果

父母虐待通过高度厌恶型伴侣关系与慢性抑郁症存在间接联系。这部分是由童年期行为问题介导的。然而,青少年晚期和成年早期更广泛的行为,如无行为问题者的早期危险性行为也有涉及。此外,在控制其他风险因素后,父母虐待与慢性抑郁症仍存在显著的剩余关联,表明两者有直接联系。到20多岁后期,高度厌恶型伴侣关系变得不那么常见,而不再与伴侣共同生活者中“非常糟糕”情况的增加与之相匹配。这种增加往往涉及单亲母亲身份,这是慢性抑郁症的一个既定风险因素。

局限性

鉴于许多测量方法具有回顾性,这些发现应被视为初步的(但见本系列第二篇论文[布朗,G.W.,克雷格,T.K.J.,哈里斯,T.O.,汉德利,R.V.,& 哈维,A.L.(2007b)。使用CECA(儿童照料与虐待经历)对早期虐待和抑郁发作进行回顾性测量的有效性——成人慢性抑郁症的生命历程研究——2。《情感障碍杂志》,103,217 - 224])。仅研究了女性。

结论

父母虐待与成人慢性抑郁发作存在间接关联,高度厌恶型伴侣关系起重要中介作用。父母虐待也有直接联系。虽然这些结果与早期研究大致一致,但要更全面地理解贯穿生命历程的作用机制,需要评估抑郁症发作时更广泛的因素。这是我们下一篇也是最后一篇论文的任务。

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