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极低出生体重儿幸存者中过度保护型养育方式与精神病理学的关联

Exposure to overprotective parenting and psychopathology in extremely low birth weight survivors.

作者信息

Day K L, Dobson K G, Schmidt L A, Ferro M A, Saigal S, Boyle M H, Van Lieshout R J

机构信息

Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada.

Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada.

出版信息

Child Care Health Dev. 2018 Mar;44(2):234-239. doi: 10.1111/cch.12498. Epub 2017 Aug 4.

Abstract

BACKGROUND

Extremely low birth weight (ELBW; <1,000 g) infants are the most vulnerable babies and are at higher risk for experiencing overprotective (i.e., controlling and intrusive) parenting, which is hypothesized to contribute to the risk for mental disorders. Despite the increased risk for anxiety disorders and decreased risk for alcohol or substance use disorders seen in ELBW survivors, no research has examined the impact of parenting. This study investigated if overprotective parenting mediates links between ELBW birth status and psychiatric disorders in adulthood.

STUDY DESIGN

Participants included ELBW survivors born in 1977-1982 and matched normal birth weight (≥2,500 g) control participants (ELBW n = 81; normal birth weight n = 87) prospectively followed in Ontario, Canada. These individuals retrospectively reported on whether either of their parents was overprotective using the Parental Bonding Instrument. Presence of a current anxiety disorder and of current alcohol or substance use disorders was assessed using the Mini International Neuropsychiatric Interview at age 29-36 years.

RESULTS

Path analysis showed that overprotective parenting was a significant mediator of the association between ELBW status and risk for an anxiety disorder in adulthood and the risk for an alcohol or substance use disorder in adulthood in ELBW survivors. Overprotective parenting accounted for 53% of the association between ELBW status and the risk for an anxiety disorder in adulthood and 26% of the association between ELBW status and alcohol or substance use disorders.

CONCLUSIONS

Overprotective parenting accounted for a substantial proportion of the increased risk for anxiety and alcohol or substance use disorders in adulthood in ELBW survivors. Despite their perceived vulnerabilities, it is important that the parents of ELBW survivors be supported in their attempts to facilitate their children's pursuit of independence during childhood and beyond.

摘要

背景

极低出生体重(ELBW;<1000克)婴儿是最脆弱的群体,经历过度保护(即控制和侵扰性)养育方式的风险更高,据推测这种养育方式会增加患精神障碍的风险。尽管ELBW幸存者患焦虑症的风险增加,患酒精或物质使用障碍的风险降低,但尚无研究探讨养育方式的影响。本研究调查了过度保护的养育方式是否介导了ELBW出生状态与成年期精神障碍之间的联系。

研究设计

参与者包括1977年至1982年出生的ELBW幸存者以及匹配的正常出生体重(≥2500克)对照参与者(ELBW组n = 81;正常出生体重组n = 87),他们在加拿大安大略省接受前瞻性随访。这些个体使用父母教养方式问卷回顾性报告其父母一方是否过度保护。在29至36岁时使用迷你国际神经精神病学访谈评估当前焦虑症以及当前酒精或物质使用障碍的存在情况。

结果

路径分析表明,过度保护的养育方式是ELBW状态与成年期焦虑症风险以及ELBW幸存者成年期酒精或物质使用障碍风险之间关联的重要中介因素。过度保护型养育方式占ELBW状态与成年期焦虑症风险之间关联的53%,以及ELBW状态与酒精或物质使用障碍之间关联的26%。

结论

过度保护型养育方式在ELBW幸存者成年期焦虑症以及酒精或物质使用障碍风险增加中占很大比例。尽管ELBW幸存者被认为较为脆弱,但重要的是要支持ELBW幸存者的父母在童年及以后帮助孩子追求独立方面所做的努力。

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