School of Public Health and Health Systems, University of Waterloo, Canada.
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada.
Psychoneuroendocrinology. 2020 Apr;114:104613. doi: 10.1016/j.psyneuen.2020.104613. Epub 2020 Feb 7.
Parent and child mental health are strongly associated and this association may be transmitted via disruption to the hypothalamic-pituitary-adrenal axis in children. This study examined the potential mediating role of hair cortisol concentration (HCC) in the association between parent psychopathology and child mental disorder. Data come from 100 children diagnosed with a mental disorder [major depression (66 %), generalized anxiety (58 %), attention-deficit hyperactivity (33 %), oppositional defiant (35 %)] and their parents. Parent psychopathology was measured using the Center for Epidemiological Studies Depression Scale and State-Trait Anxiety Inventory. Child mental disorder was measured using the Mini International Neuropsychiatric Interview and hair samples were assayed using high-sensitivity ELISA for cortisol extraction. Sex-specific path models were specified to estimate mediating effects (αβ). Children were, on average, 14.4 (SD 2.3) years of age and 70 % were girls. Adjusting for child age, parent sex, and family income, HCC mediated the association between symptoms of parent psychopathology and major depression and attention-deficit hyperactivity in all children (αβ ranging -0.07 to 0.19; 38-46 % effect mediated). Mediating effects for generalized anxiety and opposition defiant were evident for boys only (αβ ranging -0.26 to 0.14; 31-38 % effect mediated). Evidence suggests HCC partially mediates the association between parent psychopathology and child mental disorder, and for generalized anxiety and oppositional defiant, this effect is specific to boys. Family inventions to reduce child stress may be effective in buffering the consequences of parent psychopathology. Further research that considers sex effects is needed to clarify how HCC conditions risk for mental disorder in children.
父母和子女的心理健康密切相关,这种关联可能通过儿童下丘脑-垂体-肾上腺轴的紊乱来传递。本研究探讨了皮质醇(HCC)在父母精神病理学与儿童精神障碍之间的潜在中介作用。数据来自 100 名被诊断患有精神障碍的儿童(重度抑郁症 66%,广泛性焦虑症 58%,注意缺陷多动障碍 33%,对立违抗性障碍 35%)及其父母。使用流行病学研究抑郁量表和状态-特质焦虑量表测量父母的精神病理学。使用 Mini 国际神经精神访谈评估儿童的精神障碍,使用高灵敏度 ELISA 测定头发样本中的皮质醇提取量。指定了特定于性别的路径模型来估计中介效应(αβ)。儿童的平均年龄为 14.4 岁(标准差 2.3),其中 70%为女孩。在调整儿童年龄、父母性别和家庭收入后,HCC 介导了父母精神病理学症状与所有儿童重度抑郁症和注意力缺陷多动障碍之间的关联(αβ 范围为-0.07 至 0.19;38%-46%的效应被中介)。对于男孩,广泛性焦虑症和对立违抗性障碍的中介效应也很明显(αβ 范围为-0.26 至 0.14;31%-38%的效应被中介)。有证据表明,HCC 部分介导了父母精神病理学与儿童精神障碍之间的关联,对于广泛性焦虑症和对立违抗性障碍,这种效应是针对男孩的。减少儿童压力的家庭干预措施可能对缓冲父母精神病理学的后果有效。需要进一步研究性别效应,以阐明 HCC 如何影响儿童的精神障碍风险。