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从母亲抑郁到成年子女抑郁的途径:探索性纵向中介分析。

Pathways from maternal depression to young adult offspring depression: an exploratory longitudinal mediation analysis.

机构信息

Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

出版信息

Int J Methods Psychiatr Res. 2017 Jun;26(2). doi: 10.1002/mpr.1520. Epub 2016 Jul 29.

Abstract

Maternal depression in the peri-natal period is associated with increased risk for young adult depression in offspring. This study explored mediation of these links via trajectories of child conduct and emotional problems (Strengths and Difficulties Questionnaire) from ages 4-16 years old in data from the Avon Longitudinal Study of Parents and Children cohort (n = 13373). Through gender-specific structural equation models, a composite measure of exposure to early maternal depression (Edinburgh Postnatal Depression Scale), predicted young adult depression at age 18 (Revised Clinical Interview Schedule - distal outcome). Mediational effects were then estimated by testing which parts of joint piecewise latent trajectory models for child/adolescent conduct and emotional problems were associated with both exposure and distal outcome. For girls, only conduct problems in early childhood were consistently indicated to mediate effects of early maternal depression on risk of young adulthood depression. Some evidence for a pathway via changing levels of childhood and adolescent emotional difficulties was also suggested. For boys, by contrast, the differing models gave less consistent findings providing some evidence for a small time-specific indirect effect via early childhood conduct problems. In addition to its practice implications the current methodological application offers considerable potential in exploratory longitudinal developmental mediation studies. © 2016 The Authors International Journal of Methods in Psychiatric Research Published by John Wiley & Sons Ltd.

摘要

围产期产妇抑郁与后代青少年期抑郁风险增加有关。本研究通过年龄为 4 至 16 岁的儿童行为和情绪问题(长处和困难问卷)轨迹,探讨了这些联系的中介作用,该研究的数据来自雅芳纵向父母和儿童队列研究(n=13373)。通过性别特异性结构方程模型,早期产妇抑郁的综合测量(爱丁堡产后抑郁量表),预测了 18 岁时青少年的抑郁(修订后的临床访谈时间表-远端结局)。通过测试儿童/青少年行为和情绪问题的联合分段潜在轨迹模型中哪些部分与暴露和远端结局都相关,从而估计中介效应。对于女孩,只有幼儿时期的行为问题才被一致表明与早期产妇抑郁对青少年期抑郁风险的影响有关。也有一些证据表明,通过儿童和青少年情绪困难的变化水平存在一种途径。相比之下,对于男孩,不同的模型给出了不太一致的结果,为通过幼儿时期的行为问题存在较小的特定时间间接效应提供了一些证据。除了其对实践的意义外,当前的方法应用在探索性纵向发展中介研究中具有相当大的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf71/6877141/e4fac632f03b/MPR-26-e1520-g001.jpg

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