Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway/615 N. Wolfe Street, Baltimore, MD, USA.
Arch Womens Ment Health. 2013 Jun;16(3):211-8. doi: 10.1007/s00737-013-0332-4. Epub 2013 Mar 2.
Perinatal depression prevention trials have rarely examined proximal outcomes that may be relevant for understanding long-term risk for depression. The Mothers and Babies (MB) Course is a cognitive-behavioral depression prevention intervention, which has been shown to prevent depressive symptoms among at-risk perinatal women of color. This study examined intervention impact on three proximal outcomes that are theoretically linked with the intervention's model of change and have been empirically linked with risk for depression: mood regulation expectancies, perceived social support, and coping. The study used data from a randomized intervention trial of the MB Course with 78 low-income, predominantly African-American perinatal women enrolled at one of four home visitation programs in Baltimore City. Mood regulation expectancies, perceived social support, and coping were assessed with self-report instruments at baseline, post-intervention, and 3- and 6-month follow-ups. The intervention group experienced 16 % greater growth in mood regulation from baseline to 6-month follow-up compared to the usual care group, suggesting a prevention effect. The pattern of findings was similar, although not statistically significant, for social support. Contrary to prediction, the control group experienced less growth in avoidant coping than the intervention group. Findings indicate the MB Course enhances mood regulation, which may facilitate prevention of depression over time. Assessment of intervention effects on proximal outcomes is beneficial for understanding how interventions may enhance protective factors relevant to successful long-term outcomes.
围产期抑郁预防试验很少检查可能与理解抑郁长期风险相关的近端结果。母亲和婴儿（MB）课程是一种认知行为抑郁预防干预措施，已被证明可以预防有色人种的高危围产期妇女的抑郁症状。本研究检验了干预对三个近端结果的影响，这些结果与干预的变化模型在理论上相关，并且与抑郁风险在经验上相关：情绪调节预期、感知社会支持和应对。该研究使用了来自巴尔的摩市四个家庭访视计划之一的 78 名低收入、主要是非裔美国的围产期妇女的随机干预试验数据。情绪调节预期、感知社会支持和应对能力通过自我报告工具在基线、干预后以及 3 个月和 6 个月的随访中进行评估。与常规护理组相比，干预组从基线到 6 个月随访时的情绪调节增长了 16%，表明存在预防效果。虽然没有统计学意义，但社会支持的发现模式相似。与预测相反，对照组在回避应对方面的增长低于干预组。研究结果表明，MB 课程增强了情绪调节能力，这可能有助于预防长期抑郁。评估干预对近端结果的影响有助于了解干预如何增强与成功的长期结果相关的保护因素。
