Dittmann Denise, Reindl Vanessa, Herpertz-Dahlmann Beate, Dahmen Brigitte, Firk Christine, Borzikowsky Christoph, Konrad Kerstin
Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Aachen, Aachen, Germany.
Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, University Hospital Aachen, Aachen, Germany.
Psychopathology. 2023;56(1-2):75-89. doi: 10.1159/000525760. Epub 2022 Aug 2.
The current study explored the role of maternal depressive symptoms in the intergenerational transmission of childhood maltreatment and developmental psychopathology. Based on the sensitive window hypothesis, the effects of earlier versus later maternal depression symptoms on child development were analysed.
Ninety-nine mother-child dyads, 65% of which had high-risk teenage mothers, participated in a longitudinal study with three assessments in the first 18 months of the child's life (T1-T3) and a 4th reassessment (T4) at the child's preschool age. Using serial mediation analyses, we tested whether the relationship between the mother's own maltreatment history (Childhood Experience of Care and Abuse Questionnaire) and the child's psychopathological outcome at preschool age was mediated in a causal effect chain by maternal depression in the first 2 years of life, by current maternal depression (Beck Depression Inventory-II) and by current maternal child abuse potential (Child Abuse Potential Inventory). The children's emotional problems and externalizing symptoms were assessed at preschool age by parent or teacher Strengths and Difficulties Questionnaire ratings.
The results indicated that especially later maternal depression mediated the relationship between maternal childhood maltreatment and negative developmental outcomes in the next generation. The effects of maltreatment type on maternal depression were rather nonspecific. However, mental abuse affected existing risk factors more directly over time compared to physical and sexual abuse. Additionally, the impact of early life maltreatment and maternal depression on child psychopathology varied by rater. The pathway to externalizing symptoms was significant only in teacher ratings and for the pathway to emotional problems only in maternal ratings.
The present findings suggest that early maternal depression followed by ongoing maternal depression plays a mediating role in the intergenerational cycle of maltreatment. Therefore, in the future, interventions should be offered at an early stage, but also extend well beyond the first 2 years of a child's life, addressing maternal depression and trauma.
本研究探讨了母亲抑郁症状在儿童期虐待和发育性精神病理学代际传递中的作用。基于敏感窗口假说,分析了母亲抑郁症状出现的早晚对儿童发育的影响。
99对母婴参与了一项纵向研究,其中65%的母亲为高危青少年母亲。在孩子出生后的前18个月进行了三次评估(T1 - T3),并在孩子学龄前进行了第四次重新评估(T4)。我们使用系列中介分析来检验母亲自身的虐待史(儿童期照料与虐待经历问卷)与孩子学龄前心理病理结果之间的关系是否通过母亲在孩子出生后前两年的抑郁、当前母亲抑郁(贝克抑郁量表 - II)以及当前母亲虐待儿童的潜在可能性(儿童虐待潜在可能性量表)在因果效应链中起中介作用。孩子的情绪问题和外化症状在学龄前通过父母或教师的优势与困难问卷评分进行评估。
结果表明,尤其是母亲较晚出现的抑郁介导了母亲童年期虐待与下一代负面发育结果之间的关系。虐待类型对母亲抑郁的影响相当不具有特异性。然而,随着时间的推移,精神虐待比身体虐待和性虐待更直接地影响现有的风险因素。此外,早年虐待和母亲抑郁对儿童心理病理学的影响因评分者而异。外化症状的途径仅在教师评分中显著,而情绪问题的途径仅在母亲评分中显著。
目前的研究结果表明,早期母亲抑郁随后持续存在的母亲抑郁在虐待的代际循环中起中介作用。因此,未来应在早期提供干预措施,而且干预应远远超出孩子出生后的前两年,解决母亲的抑郁和创伤问题。