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代际传递虐待和精神病理学:产前抑郁的作用。

Intergenerational transmission of maltreatment and psychopathology: the role of antenatal depression.

机构信息

Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK.

出版信息

Psychol Med. 2013 Mar;43(3):519-28. doi: 10.1017/S0033291712001298. Epub 2012 Jun 14.

Abstract

BACKGROUND

Maternal experience of childhood maltreatment and maternal antenatal depression are both associated with offspring childhood maltreatment and offspring adjustment problems. We have investigated the relative impact of maternal childhood maltreatment and exposure to depression in utero on offspring maltreatment and psychopathology.

METHOD

The sample included 125 families from the South London Child Development Study. A prospective longitudinal design was used. Data on maternal childhood maltreatment, maternal antenatal depression (36 weeks of pregnancy), offspring childhood maltreatment (age 11 years) and offspring adolescent antisocial behaviour and depression (ages 11 and 16 years) were obtained from parents and offspring through clinical interview.

RESULTS

Mothers who experienced childhood maltreatment were significantly more likely to be depressed during pregnancy [odds ratio (OR) 10.00]. Offspring of mothers who experienced only childhood maltreatment or only antenatal depression were no more at risk of being maltreated or having psychopathology; however, offspring of mothers who experienced both maternal childhood maltreatment and antenatal depression were exposed to significantly greater levels of childhood maltreatment and exhibited significantly higher levels of adolescent antisocial behaviour compared with offspring not so exposed. Furthermore, maternal childhood maltreatment accounted for a significant proportion of the variance in offspring childhood maltreatment in only those offspring exposed to depression in utero.

CONCLUSIONS

Maternal childhood maltreatment and maternal antenatal depression are highly associated. The co-occurrence of both insults significantly increases the risk of offspring adversity. The antenatal period is an optimum period to identify vulnerable women and to provide interventions.

摘要

背景

母亲在儿童期遭受虐待的经历和母亲产前抑郁都与子女在儿童期遭受虐待和子女适应问题有关。我们研究了母亲在儿童期遭受虐待和在子宫内暴露于抑郁对子女受虐待和精神病理学的相对影响。

方法

该样本包括来自伦敦南部儿童发展研究的 125 个家庭。采用前瞻性纵向设计。通过临床访谈从父母和子女那里获得了关于母亲在儿童期遭受的虐待、母亲产前抑郁(怀孕 36 周)、子女在儿童期遭受的虐待(11 岁)以及子女在青少年时期的反社会行为和抑郁(11 岁和 16 岁)的数据。

结果

经历过儿童期虐待的母亲在怀孕期间患抑郁症的可能性显著增加[优势比(OR)10.00]。仅经历过母亲在儿童期遭受虐待或仅在产前抑郁的子女受虐待或出现精神病理学的风险没有增加;然而,经历过母亲在儿童期遭受虐待和产前抑郁的子女比未暴露于这两种情况的子女更容易受到更严重的儿童期虐待,并且表现出更高水平的青少年反社会行为。此外,仅在那些暴露于产前抑郁的子女中,母亲在儿童期遭受的虐待在子女在儿童期遭受的虐待中解释了显著比例的方差。

结论

母亲在儿童期遭受的虐待和母亲产前抑郁高度相关。这两种创伤的同时发生显著增加了子女遭受逆境的风险。产前时期是识别脆弱妇女并提供干预措施的最佳时期。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c79/3558981/345bbbbf1b82/S0033291712001298_fig1.jpg

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