Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA.
Fam Process. 2023 Jun;62(2):737-753. doi: 10.1111/famp.12810. Epub 2022 Aug 25.
Bidirectional associations between maternal depression and child behavior problems have been reported in prior research, however, few studies examine these relations across varied family contexts. This study examined parenting stress and child diagnosis of autism spectrum disorder (ASD) as moderators of bidirectional associations between maternal depression and child behavior problems over time. Our sample included 86 mother-child dyads who reported maternal depressive symptoms, child behavior problems, and parenting stress at three time points over more than 1 year. Approximately half were mothers of children with ASD (n = 41) and half were mothers of neurotypical children (n = 45). We tested the bidirectional associations between maternal depressive symptoms and children's behavior problems and the potential moderating role of parental stress or child ASD diagnosis on these bidirectional associations using aggregated, lagged, and linear mixed models. Even after controlling for lagged maternal depressive symptoms, child behavior problems were associated with greater subsequent maternal depression at the between-person level, but not at the within-person level. The converse relation of prior maternal depressive symptoms on subsequent child behavior problems was not significant. Neither parenting stress nor child ASD diagnosis moderated bidirectional associations between maternal depressive symptoms and children's behavior problems. Child behavior predicted maternal depression, but the converse was not true, regardless of parenting stress levels or child's ASD diagnosis. For mothers experiencing elevated parenting stress and those with children with ASD, this may help alleviate elevated feelings of guilt related to their children's behavior problems.
先前的研究报告称，母亲的抑郁和孩子的行为问题之间存在双向关联，但很少有研究在不同的家庭环境中检验这些关系。本研究考察了育儿压力和儿童自闭症谱系障碍（ASD）诊断作为母亲抑郁和儿童行为问题之间随时间变化的双向关联的调节因素。我们的样本包括 86 对母子对，他们在超过 1 年的时间内分三个时间点报告了母亲的抑郁症状、孩子的行为问题和育儿压力。大约一半是自闭症儿童（n=41）的母亲，另一半是神经典型儿童（n=45）的母亲。我们使用聚合、滞后和线性混合模型测试了母亲抑郁症状与儿童行为问题之间的双向关联，以及父母压力或儿童 ASD 诊断对这些双向关联的潜在调节作用。即使在控制了滞后的母亲抑郁症状后，个体间水平上儿童的行为问题仍与随后的母亲抑郁呈正相关，但个体内水平上则无此关联。先前的母亲抑郁症状对随后儿童行为问题的反向关系不显著。育儿压力或儿童 ASD 诊断均不能调节母亲抑郁症状与儿童行为问题之间的双向关联。儿童行为预测了母亲的抑郁，但反之则不然，无论育儿压力水平或儿童的 ASD 诊断如何。对于那些经历育儿压力增加和孩子患有 ASD 的母亲来说，这可能有助于减轻她们因孩子的行为问题而产生的内疚感。
