Breslau N, Prabucki K
Department of Psychiatry, Case Western Reserve University, Cleveland.
Arch Gen Psychiatry. 1987 Dec;44(12):1040-6. doi: 10.1001/archpsyc.1987.01800240014003.
We examined the effects of chronic stress in families of severely disabled children on psychopathology in siblings. We present findings from a five-year follow-up of 192 siblings of disabled children and a geographically based probability sample of 284 children (controls), who were 6 to 18 years old at initial assessment (time 1) and 11 to 23 years old at follow-up (time 2). Data on the Psychiatric Screening Inventory were obtained from mothers at times 1 and 2. Additionally, at time 2 the Diagnostic Interview Schedule for Children was administered to the children themselves. At follow-up, the siblings' picture according to mothers' assessment appears worse than it did initially: In addition to the excess in aggressive symptoms seen at time 1, they manifested an excess in depressive affect and social isolation. The time 2 interviews with the children themselves show that the siblings scored significantly higher than controls on depressive symptoms, although the rate of DSM-III major depression was not significantly different. An excess in depressive symptoms was observed also in mothers of disabled children, who, like the siblings, were not at increased risk for major depression.
我们研究了重度残疾儿童家庭中的慢性压力对其兄弟姐妹精神病理学的影响。我们呈现了对192名残疾儿童兄弟姐妹进行的为期五年随访的结果，以及从284名儿童（对照组）中基于地理位置抽取的概率样本的结果，这些儿童在初次评估时（时间1）年龄为6至18岁，随访时（时间2）年龄为11至23岁。在时间1和时间2从母亲那里获取了关于《精神科筛查量表》的数据。此外，在时间2对儿童本人实施了《儿童诊断访谈量表》。随访时，根据母亲的评估，这些兄弟姐妹的情况比最初看起来更糟：除了在时间1时出现的攻击症状过多外，他们还表现出抑郁情绪和社交孤立过多。在时间2对儿童本人的访谈显示，这些兄弟姐妹在抑郁症状方面的得分显著高于对照组，尽管《精神疾病诊断与统计手册》第三版（DSM - III）中重度抑郁症的发生率没有显著差异。在残疾儿童的母亲中也观察到抑郁症状过多，她们和这些兄弟姐妹一样，患重度抑郁症的风险并未增加。
