Nomura Yoko, Chemtob Claude M
Department of Psychiatry, Mount Sinai School of Medicine, 1 Gustave L. Levy Pl, Box 1230, New York, NY 10029, USA.
Arch Pediatr Adolesc Med. 2009 Jun;163(6):531-9. doi: 10.1001/archpediatrics.2009.51.
To examine whether the number of maternal psychopathologies is associated with increased clinically significant behavioral problems in preschool children exposed to disaster, using child behavior ratings from multiple informants.
Cross-sectional study.
Lower Manhattan, New York, New York.
One hundred two preschool child-mother dyads directly exposed to the World Trade Center attacks.
Maternal disorders: 2 (posttraumatic stress disorder [PTSD] and depression), 1 (depression or PTSD), or none.
Maternal depression and PTSD were self-reported. Child behavioral problems were rated by mothers and teachers using a standardized behavioral checklist. For each informant, we created separate dichotomous variables that indicated whether the child's behavioral problems were severe enough to be clinically significant. We then used an analytic technique (generalized estimating equations) that integrates the child behavioral problem ratings by the mother and teachers to derive a more reliable indicator of clinically significant child behavioral problems.
The rate of clinically significant child behavioral problems increased linearly relative to the number of maternal psychopathologies. The number of maternal psychopathologies was associated with a linear increase in functional impairment. Compared with children of mothers without psychopathologies, children of mothers with depression and PTSD were at greater risk for several clinically significant problems, notably, aggressive behavior (relative risk, 13.0), emotionally reactive behavior (11.2), and somatic complaints (10.5). Boys were more likely to have clinically significant behavior problems than were girls.
Concurrent maternal depression and PTSD was associated with dramatic increases in the rate of clinically significant behavioral problems in preschool children, particularly boys, 3 years after the World Trade Center attacks.
通过多渠道信息提供者对儿童行为的评定，研究母亲精神病理学症状的数量是否与遭受灾难的学龄前儿童临床上显著的行为问题增加有关。
横断面研究。
纽约州纽约市曼哈顿下城。
102对直接暴露于世贸中心袭击事件的学龄前儿童-母亲二元组。
母亲疾病：2种（创伤后应激障碍[PTSD]和抑郁症）、1种（抑郁症或PTSD）或无。
母亲的抑郁症和PTSD通过自我报告获得。儿童行为问题由母亲和教师使用标准化行为清单进行评定。对于每个信息提供者，我们创建了单独的二分变量，以表明儿童的行为问题是否严重到具有临床意义。然后，我们使用一种分析技术（广义估计方程），整合母亲和教师对儿童行为问题的评定，以得出更可靠的具有临床意义的儿童行为问题指标。
具有临床意义的儿童行为问题发生率相对于母亲精神病理学症状的数量呈线性增加。母亲精神病理学症状的数量与功能损害的线性增加有关。与没有精神病理学症状的母亲的孩子相比，患有抑郁症和PTSD的母亲的孩子出现几种具有临床意义问题的风险更高，尤其是攻击性行为（相对风险，13.0）、情绪反应性行为（11.2）和躯体不适（10.5）。男孩比女孩更有可能出现具有临床意义的行为问题。
在世贸中心袭击事件发生3年后，母亲同时患有抑郁症和PTSD与学龄前儿童，尤其是男孩临床上显著的行为问题发生率急剧增加有关。
