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从为人父母的过渡阶段看抑郁症状的感染:父母间的过程以及与伴侣相关的依恋的作用。

Depressive symptom contagion in the transition to parenthood: Interparental processes and the role of partner-related attachment.

机构信息

Department of Psychology.

Center for Developmental Processes and Gradients in Mental Health (PROMENTA).

出版信息

J Abnorm Psychol. 2019 Jul;128(5):397-403. doi: 10.1037/abn0000429. Epub 2019 Apr 15.

Abstract

How depressive symptoms unfold within a couple during the perinatal events of pregnancy, childbirth, and early parenthood is poorly understood. In this prospective study, we aim to investigate the reciprocal relation between maternal and paternal depressive symptomatology, specifically how symptoms in 1 partner relate to subsequent symptom level changes in the other partner throughout the perinatal period. Further, we aim to identify parents who are particularly vulnerable to the development of disruptive processes of negative mood states. Data were collected from 1,036 mothers and 878 fathers participating in the study from midpregnancy until 12 months postpartum. Depressive symptoms were assessed at 7 time points (4 prenatally) in both parents. Partner-related attachment was measured early in pregnancy. By using an autoregressive latent trajectory modeling approach, accounting for time invariant confounding, we found mothers' depressive symptoms late in pregnancy to predict elevated symptom levels in fathers 6 weeks after birth, with a small effect size. No other time-adjacent effects were observed among partners at other time points or with the opposite directionality. However, moderation analyses revealed that among parents characterized by insecure partner-attachment styles, additional cross-lagged pathways were evident during pregnancy and throughout the first year of parenthood. Clinicians need to be aware of fathers' vulnerability to symptom development in instances of maternal perinatal depressive states at the time around childbirth, and tailor preventive and treatment efforts to address both parents' needs. Further, particular attention should be directed to parents with heightened susceptibility to prolonged depression contagion processes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

摘要

在围产期怀孕、分娩和早期育儿期间,夫妻双方的抑郁症状是如何发展的,目前人们对此了解甚少。在这项前瞻性研究中,我们旨在调查母婴双方抑郁症状之间的相互关系,特别是一方伴侣的症状如何与另一方伴侣在围产期期间的后续症状水平变化相关。此外,我们旨在确定那些特别容易受到负面情绪状态破坏过程发展影响的父母。该研究的数据来自 1036 名母亲和 878 名父亲,他们参加了从妊娠中期到产后 12 个月的研究。在父母双方的 7 个时间点(4 个在孕期)评估了抑郁症状。在怀孕早期测量了伴侣相关的依恋。通过使用自回归潜变量轨迹建模方法,考虑时间不变的混杂因素,我们发现母亲在妊娠晚期的抑郁症状预测了父亲在出生后 6 周时的症状水平升高,且效应量较小。在其他时间点或相反方向,伴侣之间没有观察到其他时间相邻的影响。然而,调节分析显示,在具有不安全伴侣依恋风格的父母中,在怀孕期间和整个育儿的第一年,存在额外的交叉滞后途径。临床医生需要意识到,在母亲围产期抑郁状态时,父亲易出现症状发展,需要有针对性地开展预防和治疗工作,满足父母双方的需求。此外,应特别关注那些对延长的抑郁传染过程具有较高易感性的父母。(美国心理协会,2019,所有权利保留)。

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