Daundasekara Sajeevika S, Schuler Brittany R, Beauchamp Jennifer E S, Hernandez Daphne C
Department of Research, Cizik School of Nursing, University of Texas Health Science Center, 6901 Bertner Avenue, 591, Houston, TX 77030, United States.
School of Social Work, Temple University, 1301 Cecil B. Moore Ave. Ritter Annex 549, Philadelphia, PA 19122.
J Affect Disord. 2021 Jul 1;290:31-39. doi: 10.1016/j.jad.2021.04.058. Epub 2021 May 1.
Household material hardships could have a negative impact on maternal mental health. Understanding mechanisms by which material hardship trajectories affect maternal depression and anxiety could aid health care professionals and researchers to design better interventions to improve mental health outcomes among mothers.
The study identified family-level mechanisms by which material hardship trajectories affect maternal depression and anxiety using Fragile Families and Child Wellbeing Study data (n = 1,645). Latent growth mixture modelling was used to identify latent classes of material hardship trajectories at Years-1, -3, and -5. Parenting stress and couple relationship quality was measured at Year-9. The outcome measures included maternal depression and generalized anxiety disorder (GAD) at Year-15 based on the Composite International Diagnostic Interview - Short Form.
Parenting stress mediated the association between low-increasing hardship (b = 0.020, 95% confidence interval (CI):0.003, 0.043) and maternal depression. Parenting stress also mediated the association between high-increasing hardship (b = 0.043, 95% CI:0.004, 0.092), high decreasing hardship (b = 0.034, 95% CI=0.001, 0.072), and low-increasing (b = 0.034, 95% CI:0.007, 0.066) and maternal GAD. In all models, current material hardship was directly related to maternal depression (b = 0.188, 95% CI:0.134, 0.242) and GAD (b = 0.174, 95% CI:0.091, 0.239).
Study results need to be interpreted with caution as the FFCWS oversampled non-marital births as part of the original study design.
While current material hardship appears to be more related to maternal mental health, prior material hardship experiences contribute to greater parenting stress which places mothers at risk for experiencing depression and GAD later on.
家庭物质困难可能对母亲的心理健康产生负面影响。了解物质困难轨迹影响母亲抑郁和焦虑的机制，有助于医护人员和研究人员设计更好的干预措施，以改善母亲的心理健康状况。
本研究利用脆弱家庭与儿童福利研究数据（n = 1645），确定了物质困难轨迹影响母亲抑郁和焦虑的家庭层面机制。使用潜在增长混合模型来识别第1年、第3年和第5年物质困难轨迹的潜在类别。在第9年测量育儿压力和夫妻关系质量。基于综合国际诊断访谈简表，第15年的结果测量包括母亲抑郁和广泛性焦虑障碍（GAD）。
育儿压力介导了低增长困难（b = 0.020，95%置信区间（CI）：0.003，0.043）与母亲抑郁之间的关联。育儿压力还介导了高增长困难（b = 0.043，95% CI：0.004，0.092）、高下降困难（b = 0.034，95% CI = 0.001，0.072）以及低增长困难（b = 0.034，95% CI：0.007，0.066）与母亲广泛性焦虑障碍之间的关联。在所有模型中，当前物质困难与母亲抑郁（b = 0.188，95% CI：0.134，0.242）和广泛性焦虑障碍（b = 0.174，95% CI：0.091，0.239）直接相关。
由于脆弱家庭与儿童福利研究在原始研究设计中对非婚生育进行了过度抽样，研究结果需谨慎解读。
虽然当前物质困难似乎与母亲心理健康的关系更为密切，但先前的物质困难经历会导致更大的育儿压力，这使母亲日后有患抑郁症和广泛性焦虑障碍的风险。
