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产后母亲的抑郁和焦虑及其与儿童两岁时情绪消极和行为问题的关联。

Maternal postnatal depression and anxiety and their association with child emotional negativity and behavior problems at two years.

作者信息

Prenoveau Jason M, Craske Michelle G, West Valerie, Giannakakis Andreas, Zioga Maria, Lehtonen Annukka, Davies Beverley, Netsi Elena, Cardy Jessica, Cooper Peter, Murray Lynne, Stein Alan

机构信息

Department of Psychology, Loyola University Maryland.

Department of Psychology, University of California, Los Angeles.

出版信息

Dev Psychol. 2017 Jan;53(1):50-62. doi: 10.1037/dev0000221.

Abstract

Postnatal maternal depression is associated with poorer child emotional and behavioral functioning, but it is unclear whether this occurs following brief episodes or only with persistent depression. Little research has examined the relation between postnatal anxiety and child outcomes. The present study examined the role of postnatal major depressive disorder (MDD) and generalized anxiety disorder (GAD) symptom chronicity on children's emotional and behavioral functioning at 24 months. Following postnatal screening mothers (n = 296) were identified as having MDD, GAD, MDD and GAD, or no disorder at 3 months postnatal; the average age was 32.3 (SD = 5.0), 91.9% self-identified as Caucasian, and 62.2% were married. Maternal disorder symptom severity was assessed by questionnaires and structured interview at 3, 6, 10, 14, and 24 months postpartum. At 24 months, child emotional negativity and behavior were assessed using questionnaires and by direct observation. Latent trait-state-occasion modeling was used to represent maternal disorder symptom chronicity; both stable trait and time-specific occasion portions of maternal symptomatology were examined in relation to child outcomes. Only the stable trait portion of maternal MDD and GAD symptom severity were related to maternal report of child behavior problems and higher levels of emotional negativity. Persistent maternal MDD, but not GAD, symptom severity was related to higher levels of child emotional negativity as measured observationally. These data suggest that children's behavior problems and emotional negativity are adversely affected by persistent maternal depression, and possibly anxiety. This has implications for interventions to prevent negative effects of postnatal psychopathology on children. (PsycINFO Database Record

摘要

产后母亲抑郁与儿童较差的情绪和行为功能有关,但尚不清楚这种情况是发生在短暂发作之后,还是仅与持续性抑郁有关。很少有研究探讨产后焦虑与儿童结局之间的关系。本研究考察了产后重度抑郁症(MDD)和广泛性焦虑症(GAD)症状的慢性程度对儿童24个月时情绪和行为功能的影响。在产后筛查后,确定母亲(n = 296)在产后3个月时患有MDD、GAD、MDD和GAD或无疾病;平均年龄为32.3岁(标准差 = 5.0),91.9%的人自我认定为白种人,62.2%已婚。在产后3、6、10、14和24个月,通过问卷和结构化访谈评估母亲疾病症状的严重程度。在24个月时,使用问卷和直接观察评估儿童的情绪消极性和行为。采用潜在特质-状态-情境模型来表示母亲疾病症状的慢性程度;考察了母亲症状学的稳定特质和特定时间情境部分与儿童结局的关系。只有母亲MDD和GAD症状严重程度的稳定特质部分与母亲报告的儿童行为问题以及更高水平的情绪消极性有关。从观察测量来看,母亲持续性MDD而非GAD的症状严重程度与儿童更高水平的情绪消极性有关。这些数据表明,儿童的行为问题和情绪消极性受到母亲持续性抑郁以及可能的焦虑的不利影响。这对预防产后精神病理学对儿童的负面影响的干预措施具有启示意义。(PsycINFO数据库记录

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e612/5191902/a869d24b7df2/dev_53_1_50_fig1a.jpg

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