Acri Mary C, Bornheimer Lindsay, Hamovitch Emily, Lambert Kate
New York University Medical Center, The McSilver Institute for Poverty, Policy, and Research.
Child Youth Serv Rev. 2018 Oct;93:270-275. doi: 10.1016/j.childyouth.2018.08.004. Epub 2018 Aug 8.
Maternal depression is a common, chronic set of disorders associated with significant burden to caregivers, children and families. Some evidence suggests that depression is associated with perceptions of barriers to child mental health treatment and premature termination from services. However, this relationship has not yet been examined among a predominantly low-income sample, which is at disproportionately high risk of depression, child mental health problems, and treatment drop out. Accordingly, the purpose of this study is to examine the relationships between caregiver depression and perceived barriers to treatment.
Three hundred twenty (n=320) children between the ages of 7 to 11 and their caregivers were assigned to either the 4 Rs and 2Ss for Strengthening Families, which is a multiple family group intervention, or services as usual (SAU) consisting of typical outpatient mental health services. Caregiver depression was measured by the Center for Epidemiologic Depression Scale; perceived barriers to treatment were assessed via the Kazdin Barriers to Treatment Scale.
Clinically significant levels of depressive symptoms at baseline were significantly associated with greater scores in all four barriers to treatment subscales (stressors and obstacles competing with treatment, treatment demands and issues, perceived relevance, relationship with therapist) at post-test.
Addressing maternal mental health, and attending to stressors that impede poverty-impacted families from child services is critical for the health and functioning of caregivers, and to ensure that children with mental health problems receive treatment.
孕产妇抑郁症是一组常见的慢性疾病,给照顾者、儿童和家庭带来了沉重负担。一些证据表明,抑郁症与儿童心理健康治疗的障碍认知以及服务的过早终止有关。然而,这种关系尚未在以低收入为主的样本中进行研究,而该样本患抑郁症、儿童心理健康问题和治疗中断的风险极高。因此,本研究的目的是探讨照顾者抑郁症与感知到的治疗障碍之间的关系。
320名7至11岁的儿童及其照顾者被分配到“加强家庭的4R和2S”(一种多家庭团体干预)或常规服务(SAU,包括典型的门诊心理健康服务)中。照顾者的抑郁程度通过流行病学抑郁量表中心进行测量;治疗障碍的感知通过卡兹丁治疗障碍量表进行评估。
基线时具有临床意义的抑郁症状水平与测试后治疗障碍所有四个子量表(与治疗竞争的压力源和障碍、治疗需求和问题、感知相关性、与治疗师的关系)的更高得分显著相关。
解决孕产妇心理健康问题,并关注阻碍受贫困影响家庭获得儿童服务的压力源,对于照顾者的健康和功能以及确保有心理健康问题的儿童接受治疗至关重要。