Bar-Ilan University, Ramat Gan, Israel.
Baruch Ivcher School of Psychology, Interdisciplinary Center, Herzlia, Israel.
J Child Psychol Psychiatry. 2019 Jan;60(1):30-42. doi: 10.1111/jcpp.12880. Epub 2018 Feb 27.
While maternal depression is known to carry long-term negative consequences for offspring, very few studies followed children longitudinally to address markers of resilience in the context of maternal depression. We focused on oxytocin (OT) and mother-child synchrony - the biological and behavioral arms of the neurobiology of affiliation - as correlates of resilience among children of depressed mothers.
A community birth-cohort was recruited on the second postbirth day and repeatedly assessed for maternal depression across the first year. At 6 and 10 years, mothers and children underwent psychiatric diagnosis, mother-child interactions were coded for maternal sensitivity, child social engagement, and mother-child synchrony, children's OT assayed, and externalizing and internalizing problems reported.
Exposure to maternal depression markedly increased child propensity to develop Axis-I disorder at 6 and 10 years. Child OT showed main effects for both maternal depression and child psychiatric disorder at 6 and 10 years, with maternal or child psychopathology attenuating OT response. In contrast, maternal depression decreased synchrony at 6 years but by 10 years synchrony showed only child disorder effect, highlighting the shift from direct to indirect effects as children grow older. Path analysis linking maternal depression to child externalizing and internalizing problems at 10 years controlling for 6-year variables indicated that depression linked with decreased maternal sensitivity and child OT, which predicted reduced child engagement and synchrony, leading to higher externalizing and internalizing problems. OT and synchrony mediated the effects of maternal depression on child behavior problems and an alternative model without these resilience components provided less adequate fit.
Maternal depression continues to play a role in children's development beyond infancy. The mediating effects of OT and synchronous, mutually regulated interactions underscore the role of plasticity in resilience. Results emphasize the need to follow children of depressed mothers across middle childhood and construct interventions that bolster age-appropriate synchrony.
已知母亲抑郁会对后代产生长期的负面影响,但很少有研究对儿童进行纵向随访,以确定母亲抑郁背景下的适应力标志物。我们关注催产素 (OT) 和母婴同步——这是依恋神经生物学的生理和行为分支——作为抑郁母亲的孩子适应力的相关因素。
在出生后的第二天招募了一个社区出生队列,并在第一年中多次对母亲的抑郁情况进行评估。在 6 岁和 10 岁时,母亲和孩子接受了精神病诊断,对母婴互动进行了母亲敏感性、儿童社会参与度和母婴同步度的编码,对儿童的 OT 进行了检测,并报告了外化和内化问题。
暴露于母亲抑郁会显著增加儿童在 6 岁和 10 岁时发展为轴 I 障碍的倾向。儿童 OT 在 6 岁和 10 岁时均显示出母亲抑郁和儿童精神疾病的主要影响,母亲或儿童精神病理学减弱了 OT 反应。相比之下,母亲抑郁会降低 6 岁时的同步性,但到 10 岁时,同步性仅显示出儿童疾病的影响,这凸显了随着儿童年龄的增长,从直接影响到间接影响的转变。在控制 6 岁变量的情况下,将母婴抑郁与 10 岁儿童的外化和内化问题联系起来的路径分析表明,抑郁与母亲敏感性降低和儿童 OT 降低有关,这预测了儿童参与度和同步性降低,导致外化和内化问题增加。OT 和同步性介导了母亲抑郁对儿童行为问题的影响,而没有这些适应力成分的替代模型提供的拟合度较差。
母亲抑郁在婴儿期后仍继续对儿童的发展产生影响。OT 和同步、相互调节的相互作用的中介作用强调了可塑性在适应力中的作用。结果强调需要在整个儿童中期跟踪抑郁母亲的孩子,并构建增强适当年龄同步性的干预措施。