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患有抑郁症的儿童以及未来患抑郁症风险高和低的儿童的母婴互动。

Mother-child interactions in depressed children and children at high risk and low risk for future depression.

作者信息

Dietz Laura J, Birmaher Boris, Williamson Douglas E, Silk Jennifer S, Dahl Ronald E, Axelson David A, Ehmann Mary, Ryan Neal D

机构信息

Drs. Dietz, Birmaher, Silk, Dahl, Axelson, and Ryan and Ms. Ehmann are with the Department of Psychiatry at the University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic; Dr. Williamson is with the Department of Psychiatry at the University of Texas Health Science Center at San Antonio..

Drs. Dietz, Birmaher, Silk, Dahl, Axelson, and Ryan and Ms. Ehmann are with the Department of Psychiatry at the University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic; Dr. Williamson is with the Department of Psychiatry at the University of Texas Health Science Center at San Antonio.

出版信息

J Am Acad Child Adolesc Psychiatry. 2008 May;47(5):574-582. doi: 10.1097/CHI.0b013e3181676595.

Abstract

OBJECTIVE

To compare mother-child interactions and parenting styles in families of children with major depressive disorder, youths at high risk for depression, and healthy controls.

METHOD

Currently depressed (n = 43), high-risk (n = 28), and healthy control (n = 41) youths and their mothers engaged in a standardized videotaped problem-solving interaction. Measures of affect and behavior for both mothers and children were obtained, in addition to global measures of parenting.

RESULTS

Depressed children demonstrated more negativity and less positivity in dyadic interactions than did children at high risk and control children. Mothers of depressed children were more disengaged than control mothers. Exploratory repeated-measures analyses in a subgroup of depressed children (n = 16) suggested mother-child interactions do not significantly change when children recover from depression. Children at high risk demonstrated less positivity in dyadic interactions than did controls. Mothers with a history of major depressive disorder and mothers with higher current depressive symptoms demonstrated patterns of disengagement and low control in interactions with children.

CONCLUSIONS

Mother-child interactions in depressed youths are marked by maternal disengagement and low child positivity that may not improve when children recover. The bidirectional effects of maternal disengagement and low levels of child positivity may precede onset of major depressive disorder in children and serve as risk factors for recurrent depression in youths.

摘要

目的

比较患有重度抑郁症的儿童家庭、有抑郁症高风险的青少年家庭以及健康对照组家庭中的母婴互动及养育方式。

方法

目前患有抑郁症的青少年(n = 43)、高风险青少年(n = 28)以及健康对照青少年(n = 41)及其母亲参与了一次标准化的录像问题解决互动。除了整体养育方式测量外,还获取了母亲和孩子的情感及行为测量数据。

结果

与高风险儿童和对照儿童相比,患有抑郁症的儿童在二元互动中表现出更多消极情绪和更少积极情绪。患有抑郁症儿童的母亲比对照母亲参与度更低。对一组患有抑郁症的儿童(n = 16)进行的探索性重复测量分析表明,当儿童从抑郁症中康复时,母婴互动没有显著变化。有抑郁症高风险的儿童在二元互动中表现出的积极情绪比对照儿童少。有重度抑郁症病史的母亲以及当前抑郁症状较严重的母亲在与孩子互动时表现出参与度低和控制不足的模式。

结论

患有抑郁症的青少年的母婴互动特点是母亲参与度低且孩子积极情绪少,孩子康复时这种情况可能不会改善。母亲参与度低和孩子积极情绪水平低的双向影响可能在儿童重度抑郁症发病之前出现,并成为青少年复发性抑郁症的风险因素。

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