Dipietro Janet A, Costigan Kathleen A, Sipsma Heather L
John Hopkins University, Baltimore, MD, USA.
J Psychosom Obstet Gynaecol. 2008 Jun;29(2):115-24. doi: 10.1080/01674820701701546.
This study examined stability and change in maternal anxiety, stress and depression both during the second half of pregnancy and from pregnancy to six weeks and two years postpartum. Self-report measures included those designed to measure mood and state as well as more persistent attributes. Longitudinal data were collected from 137 women during pregnancy, 120 at six weeks, and 97 at two years. There was significant individual stability in scores on specific measures during pregnancy (range in Pearson rs=0.30-0.86) and from pregnancy through two years postpartum (rs=0.30-0.74). Comparable levels of convergence among measures of different constructs both within pregnancy and over time were also demonstrated, suggesting lack of precision in measurement instruments designed for specific constructs. Despite intra-individual stability, changes in mean levels were also observed over time with somewhat different patters for each variable. However, maternal parity was an important contributor to both level and trajectory. A summary composite score showed an elevated level of psychological distress during pregnancy in multiparous women, followed by a decline through two years postpartum; primiparous women displayed a gradual increase in distress [main effect F (1,87)=3.97, p < 0.05; time interaction F (2,174)= 7.15, p < 0.001] to multiparous levels by two years. Results are discussed in terms of a "motherhood" effect on psychological distress.
本研究考察了孕期后半段以及从孕期到产后六周和两年期间,母亲焦虑、压力和抑郁情绪的稳定性及变化情况。自我报告测量方法包括用于测量情绪和状态以及更持久特质的方法。纵向数据收集自137名女性孕期的数据、120名产后六周的数据以及97名产后两年的数据。在孕期特定测量指标得分上存在显著的个体稳定性(皮尔逊相关系数范围为rs = 0.30 - 0.86),从孕期到产后两年也是如此(rs = 0.30 - 0.74)。不同构念的测量指标在孕期内以及随时间推移也表现出相当程度的一致性,这表明针对特定构念设计的测量工具缺乏精确性。尽管存在个体内部稳定性,但随着时间推移,平均水平也发生了变化,每个变量的变化模式略有不同。然而,母亲的胎次对水平和轨迹都有重要影响。一个综合得分显示,经产妇在孕期心理困扰水平较高,随后在产后两年逐渐下降;初产妇的困扰程度则逐渐上升[主效应F(1,87)=3.97,p < 0.05;时间交互效应F(2,174)=7.15,p < 0.001],到产后两年达到经产妇的水平。研究结果从“母亲身份”对心理困扰的影响方面进行了讨论。