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怀孕经历歧视与抑郁轨迹

Experiences of Discrimination and Depression Trajectories over Pregnancy.

机构信息

Department of Psychiatry, Center for Health and Community, Weill Neurosciences Institute, University of California, San Francisco, San Francisco, California; Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Department of Psychology, University of Denver, Denver, Colorado.

Department of Psychology, University of Denver, Denver, Colorado.

出版信息

Womens Health Issues. 2022 Mar-Apr;32(2):147-155. doi: 10.1016/j.whi.2021.10.002. Epub 2021 Nov 10.

Abstract

INTRODUCTION

Research on risk factors for prenatal depression is critical to improve the understanding, prevention, and treatment of women's psychopathology. The current study examines the relation between experiences of racial discrimination and trajectories of depression symptoms over the course of pregnancy.

METHOD

Participants completed standardized measures regarding symptoms of depression at four timepoints during pregnancy and reported on experiences of racial discrimination at one timepoint. Latent growth curve modeling was used to examine the relation between discrimination and initial levels (intercept) and trajectories (slope) of depression symptoms over pregnancy.

RESULTS

Participants were 129 pregnant individuals recruited from obstetric clinics and oversampled for elevated depression symptoms. Thirty-six percent of the participants were living at or below 200% of the federal poverty line. Fifty-four percent of the sample identified as non-Latinx White, 26% as Latinx, and 13% as non-Latinx Black. An unconditional latent growth curve modeling revealed a negative quadratic trajectory of depression symptoms during pregnancy. When women's report of discrimination was added as a predictor of depression trajectories, discrimination predicted the initial value (intercept) of depression symptoms, but not change over the course of pregnancy (slope). Specifically, higher levels of experiences of discrimination were associated with higher levels of depression symptoms. When sociodemographic and contextual covariates were included in the model, a low family income-to-needs ratio was also related to higher levels of depression symptoms.

CONCLUSIONS

These findings provide evidence that women's experiences of racial discrimination and family financial strain are risk factors for prenatal depression, with implications for screening, treatment, and policy.

摘要

简介

研究产前抑郁症的风险因素对于提高对女性精神病理学的理解、预防和治疗至关重要。本研究考察了种族歧视经历与孕期抑郁症状轨迹之间的关系。

方法

参与者在怀孕期间的四个时间点完成了关于抑郁症状的标准化测量,并在一个时间点报告了种族歧视经历。潜在增长曲线模型用于检验歧视与孕期抑郁症状的初始水平(截距)和轨迹(斜率)之间的关系。

结果

参与者是从妇产科诊所招募的 129 名孕妇,并且对抑郁症状升高进行了抽样。36%的参与者生活在联邦贫困线的 200%或以下。54%的样本认定为非拉丁裔白人,26%为拉丁裔,13%为非拉丁裔黑人。无条件潜在增长曲线模型显示,孕期抑郁症状呈负二次轨迹。当将歧视报告作为抑郁轨迹的预测因素添加到模型中时,歧视预测了抑郁症状的初始值(截距),但不能预测孕期的变化(斜率)。具体而言,较高水平的歧视经历与较高水平的抑郁症状相关。当将社会人口统计学和情境协变量纳入模型时,家庭收入需求比低也与较高水平的抑郁症状有关。

结论

这些发现提供了证据表明,女性的种族歧视经历和家庭经济压力是产前抑郁的风险因素,这对筛查、治疗和政策具有重要意义。

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