接受胎儿酒精谱系障碍筛查的平原印第安人母亲的心理困扰。
Psychological distress among Plains Indian mothers with children referred to screening for Fetal Alcohol Spectrum Disorders.
机构信息
Department of Family and Community Medicine, University of New Mexico School of Medicine, MSC09 5040, 1 University of New Mexico, Albuquerque, New Mexico, USA.
出版信息
Subst Abuse Treat Prev Policy. 2010 Sep 6;5:22. doi: 10.1186/1747-597X-5-22.
BACKGROUND
Psychological distress (PD) includes symptoms of depression and anxiety and is associated with considerable emotional suffering, social dysfunction and, often, with problematic alcohol use. The rate of current PD among American Indian women is approximately 2.5 times higher than that of U.S. women in general. Our study aims to fill the current knowledge gap about the prevalence and characteristics of PD and its association with self-reported current drinking problems among American Indian mothers whose children were referred to screening for fetal alcohol spectrum disorders (FASD).
METHODS
Secondary analysis of cross-sectional data was conducted from maternal interviews of referred American Indian mothers (n = 152) and a comparison group of mothers (n = 33) from the same Plains culture tribes who participated in an NIAAA-funded epidemiology study of FASD. Referred women were from one of six Plains Indian reservation communities and one urban area who bore children suspected of having an FASD. A 6-item PD scale (PD-6, Cronbach's alpha = .86) was constructed with a summed score range of 0-12 and a cut-point of 7 indicating serious PD. Multiple statistical tests were used to examine the characteristics of PD and its association with self-reported current drinking problems.
RESULTS
Referred and comparison mothers had an average age of 31.3 years but differed (respectively) on: education (<high school: 47.4%, 9.1%), PD-6 mean scores (3.57, 1.48), current prevalence of serious PD (19.1%, 0.0%), and a current drinking problem (31.6%, 12.1%). Among referred mothers, those with a current drinking problem had a significantly higher mean PD-6 score. Having PD, serious PD, and 2 specific scale items significantly increased the odds that a referred mother would have a current drinking problem.
CONCLUSIONS
Psychological distress among referred mothers is significantly associated with having a self-reported drinking problem. FASD prevention requires multi-level prevention efforts that provide real opportunities for educational attainment and screening and monitoring of PD and alcohol use during the childbearing years. Mixed methods studies are needed to illuminate the social and cultural determinants at the base of the experience of PD and to identify the strengths and protective factors of unaffected peers who reside within the same communities.
背景
心理困扰（PD）包括抑郁和焦虑症状，与巨大的情绪痛苦、社交功能障碍以及经常出现的问题性饮酒行为有关。美国印第安妇女目前 PD 的发生率大约比美国普通妇女高 2.5 倍。我们的研究旨在填补目前关于 PD 的流行率和特征及其与自我报告的当前饮酒问题之间的关系的知识空白，这些妇女是其子女被推荐进行胎儿酒精谱系障碍（FASD）筛查的美国印第安母亲。
方法
对来自被推荐的美国印第安母亲（n = 152）和来自同一平原文化部落并参与由国家酒精滥用与酒精中毒研究所资助的 FASD 流行病学研究的母亲（n = 33）的母亲访谈进行了横断面数据的二次分析。被推荐的女性来自六个平原印第安人保留地社区和一个城市地区，她们生育的子女疑似患有 FASD。构建了一个 6 项 PD 量表（PD-6，Cronbach's alpha =.86），得分范围为 0-12，得分 7 表示严重 PD。使用多种统计检验来检查 PD 的特征及其与自我报告的当前饮酒问题之间的关联。
结果
被推荐和对照组母亲的平均年龄为 31.3 岁，但在以下方面存在差异：教育程度（<高中：47.4%，9.1%）、PD-6 平均得分（3.57，1.48）、当前严重 PD 的流行率（19.1%，0.0%）和当前饮酒问题（31.6%，12.1%）。在被推荐的母亲中，有当前饮酒问题的母亲 PD-6 得分显著更高。存在 PD、严重 PD 和 2 个特定量表项目显著增加了被推荐母亲出现当前饮酒问题的可能性。
结论
被推荐母亲的心理困扰与自我报告的饮酒问题显著相关。FASD 预防需要多层面的预防措施，为教育程度的提高以及在生育期间 PD 和酒精使用的筛查和监测提供真正的机会。需要进行混合方法研究，以阐明 PD 体验的社会和文化决定因素，并确定在同一社区内居住的未受影响的同伴的优势和保护因素。
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