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学龄前儿童抑郁和焦虑症状风险因素的多领域模型:共同和特定因素的证据。

Multi-domain models of risk factors for depression and anxiety symptoms in preschoolers: evidence for common and specific factors.

机构信息

Department of Psychology, Illinois Institute of Technology, 3105 South Dearborn, Chicago, IL 60616, USA.

出版信息

J Abnorm Child Psychol. 2013 Jul;41(5):705-22. doi: 10.1007/s10802-013-9723-2.

Abstract

Relatively few studies have examined multiple pathways by which risk factors from different domains are related to symptoms of anxiety and depression in young children; even fewer have assessed risks for these symptoms specifically, rather than for internalizing symptoms in general. We examined a theoretically- and empirically-based model of variables associated with these symptom types in a diverse community sample of 796 4-year-olds (391 boys, 405 girls) that included factors from the following domains: contextual (SES, stress and family conflict); parent characteristics (parental depression); parenting (support/engagement, hostility and scaffolding); and child characteristics including negative affect (NA) effortful control (EC) sensory regulation (SR), inhibitory control (IC) and attachment. We also compared the models to determine which variables contribute to a common correlates of symptoms of anxiety or depression, and which correlates differentiate between those symptom types. In the best-fitting model for these symptom types (a) SES, stress and conflict had indirect effects on both symptom types via long-chain paths; (b) caregiver depression had direct effects and indirect ones (mediated through parenting and child effortful control) on both symptom types; (c) parenting had direct and indirect effects (via temperament and SR); and temperament had direct effects on both symptom types. These data provide evidence of common risk factors, as well as indicate some specific pathways/mediators for the different symptom types. EC was related to anxiety, but not depression symptoms, suggesting that strategies to improve child EC may be particularly effective for treatment of anxiety symptoms in young children.

摘要

相对较少的研究检验了不同领域的风险因素通过哪些多种途径与幼儿的焦虑和抑郁症状相关;更少的研究评估了这些症状的风险,而不是一般的内化症状的风险。我们在一个由 796 名 4 岁儿童(391 名男孩,405 名女孩)组成的多样化社区样本中,检验了一个与这些症状类型相关的变量的理论和经验基础模型,该模型包括以下领域的因素:情境(SES、压力和家庭冲突);父母特征(父母抑郁);养育方式(支持/参与、敌意和支架);以及儿童特征,包括消极情绪(NA)、努力控制(EC)、感觉调节(SR)、抑制控制(IC)和依恋。我们还比较了这些模型,以确定哪些变量有助于焦虑或抑郁症状的共同相关因素,以及哪些相关因素区分了这些症状类型。在这些症状类型的最佳拟合模型中:(a)SES、压力和冲突通过长链途径对这两种症状类型有间接影响;(b)照顾者的抑郁有直接影响,也有间接影响(通过养育方式和儿童努力控制进行中介)对这两种症状类型都有影响;(c)养育方式有直接和间接影响(通过气质和 SR);气质对这两种症状类型都有直接影响。这些数据提供了共同风险因素的证据,也表明了不同症状类型的一些特定途径/中介。EC 与焦虑有关,但与抑郁症状无关,这表明改善儿童 EC 的策略可能对治疗幼儿的焦虑症状特别有效。

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