母亲抑郁和共病反社会行为：检验母亲敌意和温暖作为子女精神病理学风险的中介。
Maternal depression and co-occurring antisocial behaviour: testing maternal hostility and warmth as mediators of risk for offspring psychopathology.
机构信息
Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, Wales, UK.
出版信息
J Child Psychol Psychiatry. 2014;55(2):112-20. doi: 10.1111/jcpp.12111. Epub 2013 Jun 27.
BACKGROUND
Disruption in the parent-child relationship is a commonly hypothesized risk factor through which maternal depression may increase risk for offspring psychopathology. However, maternal depression is commonly accompanied by other psychopathology, including antisocial behaviour. Few studies have examined the role of co-occurring psychopathology in depressed mothers. Using a longitudinal study of offspring of mothers with recurrent depression, we aimed to test whether maternal warmth/hostility mediated links between maternal depression severity and child outcomes, and how far direct and indirect pathways were robust to controls for co-occurring maternal antisocial behaviour.
METHODS
Mothers with a history of recurrent major depressive disorder and their adolescent offspring (9-17 years at baseline) were assessed three times between 2007 and 2010. Mothers completed questionnaires assessing their own depression severity and antisocial behaviour at Time 1 (T1). The parent-child relationship was assessed using parent-rated questionnaire and interviewer-rated 5-min speech sample at Time 2 (T2). Offspring symptoms of depression and disruptive behaviours were assessed using the Child and Adolescent Psychiatric Assessment at Time 3 (T3).
RESULTS
Maternal hostility and warmth, respectively, mediated the association between maternal depression severity and risk for offspring psychopathology. However, the effects were attenuated when maternal antisocial behaviour was included in the analysis. In tests of the full theoretical model, maternal antisocial behaviour predicted both maternal hostility and low warmth, maternal hostility predicted offspring disruptive behaviour disorder symptoms, but not depression, and maternal warmth was not associated with either child outcome.
CONCLUSIONS
Parenting interventions aimed at reducing hostility may be beneficial for preventing or reducing adolescent disruptive behaviours in offspring of depressed mothers, especially when depressed mothers report co-occurring antisocial behaviour.
背景
亲子关系破裂是一种常见的假设风险因素，通过这种因素，母亲的抑郁可能会增加子女患精神病理学的风险。然而，母亲的抑郁通常伴随着其他精神病理学，包括反社会行为。很少有研究探讨抑郁母亲共病精神病理学的作用。本研究使用了一项对患有复发性抑郁症的母亲的后代进行的纵向研究，旨在检验母亲抑郁严重程度与儿童结果之间的关系是否通过母亲的温暖/敌意来介导，以及直接和间接途径在多大程度上可以通过控制共病母亲的反社会行为来稳健。
方法
在 2007 年至 2010 年间，我们对有反复发作性重度抑郁症病史的母亲及其青少年子女（基线时 9-17 岁）进行了三次评估。母亲在 T1 时完成了评估自身抑郁严重程度和反社会行为的问卷。在 T2 时，使用父母评定问卷和访谈者评定的 5 分钟演讲样本评估了亲子关系。在 T3 时，使用儿童和青少年精神病学评估评估了子女的抑郁和破坏性行为症状。
结果
母亲的敌意和温暖分别介导了母亲抑郁严重程度与子女患精神病理学风险之间的关联。然而，当分析中纳入母亲的反社会行为时，这种影响就减弱了。在全理论模型的检验中，母亲的反社会行为预测了母亲的敌意和低温暖，母亲的敌意预测了子女的破坏性行为障碍症状，但不预测抑郁，而母亲的温暖与任何一种儿童结果都没有关联。
结论
针对减少敌意的育儿干预措施可能对预防或减少抑郁母亲的子女中的青少年破坏性行为有益，尤其是当抑郁母亲报告存在共病的反社会行为时。
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