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代际传递中的儿童虐待及其后果中的孕产妇抑郁:纵向出生队列中产后效应的检验。

Maternal depression in the intergenerational transmission of childhood maltreatment and its sequelae: Testing postpartum effects in a longitudinal birth cohort.

机构信息

Duke University.

King's College London.

出版信息

Dev Psychopathol. 2019 Feb;31(1):143-156. doi: 10.1017/S0954579418000032. Epub 2018 Mar 22.

Abstract

Mothers who have experienced childhood maltreatment are more likely to have children also exposed to maltreatment, a phenomenon known as intergenerational transmission. Factors in the perinatal period may contribute uniquely to this transmission, but timing effects have not been ascertained. Using structural equation modeling with 1,016 mothers and their 2,032 children in the Environmental Risk Longitudinal Twin Study, we tested the mediating role of postpartum depression between maternal childhood maltreatment and a cascade of negative child outcomes, specifically child exposure to maltreatment, internalizing symptoms, and externalizing symptoms: (a) adjusting for later maternal depression, (b) comparing across sex differences, and (c) examining the relative role of maltreatment subtypes. Mothers who had been maltreated as children, especially those who had experienced emotional or sexual abuse, were at increased risk for postpartum depression. In turn, postpartum depression predicted children's exposure to maltreatment, followed by emotional and behavioral problems. Indirect effects from maternal childhood maltreatment to child outcomes were robust across child sex and supported significant mediation through postpartum depression; however, this appeared to be carried by mothers' depression beyond the postpartum period. Identifying and treating postpartum depression, and preventing its recurrence, may help interrupt the intergenerational transmission of maltreatment and its sequelae.

摘要

经历过儿童期虐待的母亲更有可能让自己的孩子也遭受虐待,这种现象被称为代际传递。围产期的因素可能对这种传递有独特的贡献,但时间效应尚未确定。我们使用环境风险纵向双胞胎研究中的 1016 名母亲及其 2032 名子女的结构方程模型,检验了产后抑郁在母亲儿童期虐待与一系列负面儿童结果(即儿童遭受虐待、内化症状和外化症状)之间的中介作用:(a)调整后期的母亲抑郁情况,(b)比较性别差异,(c)检查虐待亚型的相对作用。曾遭受过儿童期虐待的母亲,尤其是那些经历过情感或性虐待的母亲,患产后抑郁的风险增加。反过来,产后抑郁又预示着孩子会遭受虐待,随后会出现情绪和行为问题。从母亲儿童期虐待到儿童结果的间接效应在儿童性别之间是稳健的,并通过产后抑郁得到了显著的中介;然而,这似乎是由母亲产后时期的抑郁所导致的。识别和治疗产后抑郁,并防止其复发,可能有助于中断虐待及其后果的代际传递。

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