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抑郁症和童年创伤对接受家访母亲的影响。

Impact of Depression and Childhood Trauma in Mothers Receiving Home Visitation.

作者信息

Ammerman Robert T, Shenk Chad E, Teeters Angelique R, Noll Jennie G, Putnam Frank W, Van Ginkel Judith B

机构信息

Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH 45229.

出版信息

J Child Fam Stud. 2012 Aug;21(4):612-625. doi: 10.1007/s10826-011-9513-9.

Abstract

Research has documented the deleterious effects of maternal depression and childhood trauma on parenting and child development. There are high rates of both depression and childhood trauma in new mothers participating in home visitation programs, a prevention approach designed to optimize mother and child outcomes. Little is known about the impacts of maternal depression and childhood trauma on parenting in the context of home visitation. This study contrasted depressed and non-depressed mothers enrolled in the first year of a home visitation program on parenting stress, quality of home environment, social network, and psychiatric symptoms. Mothers were young, low income, and predominantly unmarried. Results indicated that depressed mothers displayed impairments in parenting, smaller and less robust social networks, and increased psychiatric symptoms relative to their non-depressed counterparts. Path analyses for the full sample revealed a path linking childhood trauma, depression, and parenting stress. Path analyses by group revealed several differential relationships between dimensions of social network and parenting. Number of embedded networks, namely the number of different domains in which the mother is actively interacting with others, was associated with lowered parenting stress among non-depressed mothers and increased parenting stress in their depressed counterparts with childhood trauma histories. In depressed mothers, social network size was associated with lower levels of parenting stress but decreased quality of the home environment, whereas number of embedded networks was positively related to quality of the home environment. Implications of findings for home visitation programs are discussed.

摘要

研究记录了母亲抑郁和童年创伤对养育子女及儿童发展的有害影响。参与家访项目(一种旨在优化母婴结局的预防方法)的新妈妈中,抑郁和童年创伤的发生率都很高。关于在家访背景下母亲抑郁和童年创伤对养育子女的影响,人们知之甚少。本研究对比了家访项目第一年中登记在册的抑郁和非抑郁母亲在养育压力、家庭环境质量、社交网络及精神症状方面的情况。这些母亲年轻、低收入且大多未婚。结果表明,与非抑郁母亲相比,抑郁母亲在养育子女方面存在缺陷,社交网络更小且更不稳定,精神症状也有所增加。对全样本的路径分析揭示了一条连接童年创伤、抑郁和养育压力的路径。按组进行的路径分析揭示了社交网络维度与养育子女之间的几种差异关系。嵌入网络的数量,即母亲与他人积极互动的不同领域的数量,与非抑郁母亲养育压力的降低相关,而对于有童年创伤史的抑郁母亲,其养育压力则会增加。在抑郁母亲中,社交网络规模与较低水平的养育压力相关,但家庭环境质量下降,而嵌入网络的数量与家庭环境质量呈正相关。本文讨论了研究结果对家访项目的启示。

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