School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia.
Murdoch Childrens Research Institute, Parkville, VIC, Australia.
J Abnorm Child Psychol. 2019 Jul;47(7):1165-1181. doi: 10.1007/s10802-018-0442-6.
The aim of this study was to explore how some temperamentally inhibited young children and not others in the general population develop anxiety disorders and broader clinical-level internalizing (anxious/depressive) problems, with a focus on the family. A brief screening tool for inhibition was universally distributed to parents of children in their year before starting school across eight socioeconomically diverse government areas in Melbourne, Australia (307 preschool services). Screening identified 11% of all children as inhibited. We invited all parents of inhibited children to participate in a longitudinal prevention study. Participants were 545 parents of inhibited pre-schoolers (78% uptake) of whom 498 (91%) completed assessment one year later and 469 (86%) two years later. Parents completed questionnaires to assess parenting practices, parent wellbeing, and child internalizing problems. Parents also engaged in structured diagnostic interviews to assess child anxiety disorders. During the follow up period close to half of the inhibited young children had anxiety disorders and one in seven had clinical-level internalizing problems, with girls perhaps at higher risk. The family variables significantly predicted inhibited children's anxiety disorders and broader internalizing problems. For child anxiety disorders, overinvolved/protective parenting was particularly important for girls and boys, and poorer parent wellbeing contributed. For child anxious/depressive problems, harsh discipline was a consistent predictor for girls and boys, and poorer parent wellbeing again contributed. These etiological findings support early intervention for temperamentally inhibited young children that focuses on the family environment to prevent the development of mental health problems.
本研究旨在探讨为何一般人群中有些天生抑制的幼儿会发展为焦虑障碍和更广泛的临床水平内化（焦虑/抑郁）问题，而其他幼儿则不会，研究重点是家庭。我们向澳大利亚墨尔本八个社会经济多样化的政府区域中即将上学的儿童的家长普遍发放了一种抑制情况的简短筛查工具（307 个学前服务），以识别所有儿童中有 11%为天生抑制。我们邀请了所有天生抑制儿童的家长参加一项纵向预防研究。参与者是 545 名天生抑制的学龄前儿童的家长（参与率为 78%），其中 498 名（91%）一年后完成评估，469 名（86%）两年后完成评估。家长完成了问卷，以评估育儿实践、家长的幸福感和孩子的内化问题。家长还参与了结构化的诊断访谈，以评估儿童的焦虑障碍。在随访期间，近一半的天生抑制幼儿患有焦虑障碍，七分之一的幼儿有临床水平的内化问题，女孩的风险可能更高。家庭变量显著预测了天生抑制儿童的焦虑障碍和更广泛的内化问题。对于儿童的焦虑障碍，过度参与/保护型育儿对男孩和女孩都很重要，而较差的家长幸福感也有影响。对于儿童的焦虑/抑郁问题，严厉的纪律对男孩和女孩都是一个一致的预测因素，而较差的家长幸福感再次有影响。这些病因学发现支持针对天生抑制的幼儿进行早期干预，重点是家庭环境，以预防心理健康问题的发展。
