Goodman Sherryl H, Broth Michelle R, Hall Christine M, Stowe Zachary N
Emory University.
Infant Ment Health J. 2008 Sep;29(5):492-513. doi: 10.1002/imhj.20188.
This study examined the quality of mother-infant interaction and levels of perceived stress and parenting efficacy in association with mothers' levels of depression among mothers with significant depressive symptoms during the postpartum period, who were followed prospectively during treatment, and their infants less than 6 months old. Mothers with postpartum depression (n = 19) were treated with medication, and the mothers were observed with their infants prior to treatment and 3 and 6 months later. A comparison group of nondepressed mothers (n = 25) was included to control for the normal developmental changes associated with the postpartum period. The depressed women experienced a significant reduction in depressive symptoms and did not differ significantly from well mothers 6 months after beginning treatment. Despite initial levels of parenting quality and depression, mothers' reduced levels of depression, after 12 weeks of treatment, were associated with improvements in the quality of their interactions with their infants and with improvements in their infants' quality of play. For both perceived stress and parenting efficacy beliefs, both depressed and well mothers showed a significant improvement from the initial to the 12-week visit, and there were no significant differences between depressed and well mothers' perceived stress or efficacy beliefs at the 12-week visit. Depression at the 12-week visit did not predict perceived stress or efficacy beliefs beyond the variance accounted for by initial levels of those variables and depression. The impact of reducing levels of maternal depression symptoms supports theoretical models of the role of parenting in the association between maternal depression and child functioning. Further, these findings support the benefits to infants of reducing depression in mothers.
本研究调查了产后有明显抑郁症状的母亲及其6个月以下婴儿的母婴互动质量、感知压力水平和育儿效能感，并将其与母亲的抑郁程度相关联。这些母亲在治疗期间接受前瞻性随访。产后抑郁症母亲（n = 19）接受药物治疗，并在治疗前、治疗后3个月和6个月观察她们与婴儿的互动情况。纳入了一组无抑郁症状的母亲作为对照组（n = 25），以控制与产后阶段相关的正常发育变化。抑郁的女性抑郁症状显著减轻，治疗6个月后与健康母亲无显著差异。尽管育儿质量和抑郁的初始水平不同，但治疗12周后母亲抑郁程度的降低与她们与婴儿互动质量的改善以及婴儿玩耍质量的提高相关。对于感知压力和育儿效能信念，抑郁母亲和健康母亲从初始到12周随访时均有显著改善，且在12周随访时，抑郁母亲和健康母亲的感知压力或效能信念无显著差异。12周随访时的抑郁程度并不能预测感知压力或效能信念，超出了这些变量和抑郁初始水平所解释的方差。母亲抑郁症状水平降低的影响支持了育儿在母亲抑郁与儿童功能关联中作用的理论模型。此外，这些发现支持了减轻母亲抑郁对婴儿有益的观点。
