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产妇产后抑郁症状的病因:儿童期情感虐待、夫妻关系满意度和基因。

The etiology of maternal postpartum depressive symptoms: Childhood emotional maltreatment, couple relationship satisfaction, and genes.

机构信息

Institute of Early Childhood Education.

Department of Educational Psychology and School Counseling.

出版信息

J Fam Psychol. 2021 Feb;35(1):44-56. doi: 10.1037/fam0000722. Epub 2020 May 28.

Abstract

There is a call for integrative studies examining the roles of biological and psychosocial factors and their interrelations in shaping maternal postpartum psychopathology. Using longitudinal data from 198 primiparous mothers, we tested a biopsychosocial model for the etiology of maternal postpartum depressive symptoms that integrated childhood emotional maltreatment, couple relationship satisfaction, and oxytocin and dopamine D4 receptor genes (i.e., OXTR rs53576 and DRD4). Results indicate (a) two indirect effects from childhood emotional maltreatment and DRD4 to depressive symptoms at 1 year postpartum through couple relationship satisfaction at 6 months postpartum; (b) an interactive effect between DRD4 and couple relationship satisfaction at 6 months postpartum in predicting depressive symptoms at 1 year postpartum, which is in concert with the differential susceptibility hypotheses; and (c) no mediating effects or moderating effects (after adjusting for multiple testing with Bonferroni correction) involving OXTR rs53576. Notably, all associations were identified after controlling for several key covariates (e.g., maternal prenatal depressive symptoms). Last, robustness of the currently identified interactive effect involving DRD4 was demonstrated by an extensive set of additional analyses considering the effects of rGE, G × Covariates, and/or E × Covariates. Taken altogether, this study represents one of the initial efforts for a more sophisticated portrayal of how nature and nurture forces may work in conjunction with each other to shape new mothers' psychopathology. Yet given the current modest sample size and candidate gene approach, our findings are preliminary, should be cautiously interpreted, and need to be replicated with more rigorous designs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

摘要

有一种呼吁,要求进行综合性研究,以检验生物和心理社会因素的作用及其相互关系在塑造产妇产后精神病理学中的作用。本研究使用 198 名初产妇的纵向数据,检验了一个关于产妇产后抑郁症状病因的生物心理社会模型,该模型整合了儿童期情感虐待、夫妻关系满意度以及催产素和多巴胺 D4 受体基因(即 OXTR rs53576 和 DRD4)。结果表明:(a)儿童期情感虐待和 DRD4 通过 6 个月时的夫妻关系满意度对产后 1 年时的抑郁症状产生了两个间接影响;(b)DRD4 和夫妻关系满意度在 6 个月时的交互作用预测了产后 1 年时的抑郁症状,这与差异易感性假设一致;(c)在进行 Bonferroni 校正以调整多重测试后,OXTR rs53576 没有中介作用或调节作用。值得注意的是,在控制了几个关键协变量(例如,产妇产前抑郁症状)后,所有关联都被识别出来。最后,通过考虑 rGE、G×协变量和/或 E×协变量的影响,对涉及 DRD4 的当前识别出的交互作用进行了广泛的额外分析,证明了该交互作用的稳健性。总的来说,这项研究是首次努力更复杂地描绘自然和养育力量如何相互作用,共同塑造新妈妈的精神病理学。然而,鉴于目前样本量较小和候选基因方法,我们的发现是初步的,应该谨慎解释,需要用更严格的设计进行复制。(PsycInfo 数据库记录(c)2021 APA,保留所有权利)。

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