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情绪调节障碍的代际传递:第一部分。孕妇的精神病理学、自我伤害和副交感神经反应性。

Intergenerational transmission of emotion dysregulation: Part I. Psychopathology, self-injury, and parasympathetic responsivity among pregnant women.

机构信息

Department of Psychology,University at Albany, State University of New York,Albany, NY,USA.

Department of Psychology,University of Utah,Salt Lake City, UT,USA.

出版信息

Dev Psychopathol. 2019 Aug;31(3):817-831. doi: 10.1017/S0954579419000336. Epub 2019 May 8.

Abstract

The World Health Organization recently reported that maternal mental health is a major public health concern. As many as one in four women suffer from psychiatric disorders at some point during pregnancy or the first postpartum year. Furthermore, self-injurious thoughts and behaviors (SITBs) represent one of the leading causes of death among women during this time. Thus, efforts to identify women at risk for serious forms of psychopathology and especially for SITBs are of utmost importance. Despite this urgency, current single-diagnostic approaches fail to recognize a significant subset of women who are vulnerable to perinatal stress and distress. The current study was among the first to investigate emotion dysregulation-a multilevel, transdiagnostic risk factor for psychopathology-and its associations with stress, distress, and SITBs in a sample of pregnant women (26-40 weeks gestation) recruited to reflect a range of emotion dysregulation. Both self-reported emotion dysregulation and respiratory sinus arrhythmia, a biomarker of emotion dysregulation, demonstrated expected associations with measures of mental health, including depression, anxiety, borderline personality pathology, and SITBs. In addition, self-reported emotion dysregulation was associated with blunted respiratory sinus arrhythmia responsivity to an ecologically valid infant cry task. Findings add to the literature considering transdiagnostic risk during pregnancy using a multiple-levels-of-analysis approach.

摘要

世界卫生组织最近报告称,孕产妇心理健康是一个主要的公共卫生关注点。多达四分之一的女性在怀孕期间或产后第一年的某个时候患有精神疾病。此外,自我伤害的想法和行为(SITBs)是这段时间女性死亡的主要原因之一。因此,努力识别有严重精神病理学风险的女性,尤其是有 SITBs 风险的女性,是至关重要的。尽管如此紧迫,目前的单一诊断方法未能识别出很大一部分容易受到围产期压力和痛苦影响的女性。本研究是首批调查情绪失调的研究之一——一种多水平、跨诊断的精神病理学风险因素——及其与压力、痛苦和 SITBs 在一组孕妇(26-40 孕周)中的关联,这些孕妇的招募反映了一系列情绪失调。自我报告的情绪失调和呼吸窦性心律失常(情绪失调的生物标志物)都与心理健康的衡量标准表现出预期的关联,包括抑郁、焦虑、边缘型人格病理和 SITBs。此外,自我报告的情绪失调与对生态有效婴儿哭泣任务的呼吸窦性心律失常反应迟钝有关。这些发现增加了使用多水平分析方法考虑怀孕期间跨诊断风险的文献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4138/6790982/dabf63ebf1d1/nihms-1053978-f0001.jpg

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