Hassert Silva, Kurpius Sharon E Robinson, Tracey Terence J G
a Child & Family Psychiatry Department , Kaiser Permanente Oakland Medical Center , Oakland , California , USA.
Women Health. 2015;55(6):700-16. doi: 10.1080/03630242.2015.1039181. Epub 2015 Apr 24.
Postpartum depressive symptoms (PPDS) are likely to have a multifactorial etiology. The relationships among identified PPDS risk factors, however, remain inconclusive. A vulnerability-stress conceptualization of PPDS was tested with a sample of 144 U.S. mothers aged 18-46 years, who had given birth in the last 12 months. The Edinburgh Postnatal Depression Scale, Dysfunctional Attitude Scale Form A-17, Parenting Sense of Competence Scale, and Quality of Relationships Inventory were completed. The conceptual model and three alternative models were tested using structural equation modeling. A variation of the conceptual model yielded the best fit, χ(2) (98) = 133.541, p = .0099, Standardized Root Mean Residual (SRMR) = 0.071, Root Mean Square Error of Approximation (RMSEA) = 0.050 (90% CI = 0.026-0.070), Tucker Lewis Index (TLI) = 0.953, Comparative Fix Index (CFI) = 0.961. Dependency and partner conflict were positively related to PPDS, while maternal-efficacy was negatively related to PPDS. Dependency moderated the relationship between maternal-efficacy and PPDS, so that this relationship was stronger for mothers with higher dependency than for those with lower dependency. Dependency, partner conflict, and maternal-efficacy should be considered when building interventions that target the wellbeing of mothers in the first year after birth.
产后抑郁症状（PPDS）可能具有多因素病因。然而，已确定的PPDS风险因素之间的关系仍无定论。对144名年龄在18 - 46岁、在过去12个月内分娩的美国母亲进行了抽样测试，以验证PPDS的脆弱性 - 压力概念模型。完成了爱丁堡产后抑郁量表、功能失调态度量表A - 17版、育儿胜任感量表和人际关系质量量表。使用结构方程模型对概念模型和三个替代模型进行了测试。概念模型的一个变体拟合效果最佳，χ(2) (98) = 133.541，p = 0.0099，标准化根均残差（SRMR）= 0.071，近似误差均方根（RMSEA）= 0.050（90%置信区间 = 0.026 - 0.070），塔克 - 刘易斯指数（TLI）= 0.953，比较拟合指数（CFI）= 0.961。依赖性和伴侣冲突与PPDS呈正相关，而母亲效能感与PPDS呈负相关。依赖性调节了母亲效能感与PPDS之间的关系，因此对于依赖性较高的母亲，这种关系比依赖性较低的母亲更强。在制定针对产后第一年母亲幸福感的干预措施时，应考虑依赖性、伴侣冲突和母亲效能感。
