Eisenhower Abbey Severance, Baker Bruce L, Blacher Jan
Department of Psychology, University of California, Los Angeles, CA 90091-1580, USA.
Soc Sci Med. 2009 Jan;68(1):89-99. doi: 10.1016/j.socscimed.2008.09.033. Epub 2008 Nov 3.
Mothers of children with developmental delays may experience poorer psychological well-being than other mothers; however, little research has examined how delayed development in children might predict mothers' perceived physical well-being. Children with delayed development manifest heightened behavior problems, which may negatively affect maternal well-being. We examined the associations between developmental delay and behavior problems at child age 3 and mothers' self-perceived physical health at child ages 3, 4, and 5, in families of 218 children with and without developmental delays. The study sample comprised 218 families from central Pennsylvania and Southern California, USA who were recruited through community agencies that provide diagnostic and intervention services for individuals with development difficulties. We found that mothers of children with delayed development at age 3 reported poorer concurrent and later physical health than mothers of children with typical development. Broadening the analyses to include not only child development status (delayed development versus typical development) but also child behavior problems at age 3, only child behavior problems and the interaction of development status and behavior problems, but not development status itself, predicted maternal health. Early child behavior problems contributed to later maternal health above and beyond early maternal health, suggesting a possible causal association between child behavior problems and mothers' physical health. The relation between child behavior problems and maternal health was moderated by mothers' parenting stress and mediated by depressive symptoms. Mothers of children with both delayed development and high behavior problems are a particular risk group that may be especially in need of early intervention. Further research should examine the behavioral and biological pathways by which these child-related stressors influence mothers' physical health.
发育迟缓儿童的母亲可能比其他母亲的心理健康状况更差；然而，很少有研究探讨儿童发育迟缓如何预测母亲感知到的身体健康状况。发育迟缓的儿童表现出更多的行为问题，这可能会对母亲的幸福感产生负面影响。我们研究了218名有或没有发育迟缓儿童的家庭中，孩子3岁时的发育迟缓与行为问题之间的关联，以及孩子3岁、4岁和5岁时母亲自我感知的身体健康状况。研究样本包括来自美国宾夕法尼亚州中部和南加州的218个家庭，这些家庭是通过为有发育困难的个人提供诊断和干预服务的社区机构招募的。我们发现，3岁时发育迟缓儿童的母亲报告的当前和后期身体健康状况比发育正常儿童的母亲更差。扩大分析范围，不仅包括儿童发育状况（发育迟缓与发育正常），还包括3岁时的儿童行为问题、仅儿童行为问题以及发育状况与行为问题的相互作用，而不是发育状况本身，可以预测母亲的健康状况。儿童早期行为问题对后期母亲健康的影响超过了早期母亲健康状况的影响，这表明儿童行为问题与母亲身体健康之间可能存在因果关系。儿童行为问题与母亲健康之间的关系受到母亲育儿压力的调节，并由抑郁症状介导。发育迟缓和行为问题都严重的儿童的母亲是一个特别危险的群体，可能特别需要早期干预。进一步的研究应该探讨这些与儿童相关的压力源影响母亲身体健康的行为和生物学途径。
