Usui Yunosuke, Ono Miki, Nibuya Rintaro, Kikkawa Masayuki, Ito Shunichiro, Morishita Chihiro, Honyashiki Mina, Tamada Yu, Inoue Takeshi, Masuya Jiro
Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan.
Department of Psychiatry, Tokyo Medical University Hachioji Medical Center, Hachioji-shi, Tokyo, Japan.
Neuropsychiatr Dis Treat. 2024 Aug 13;20:1571-1581. doi: 10.2147/NDT.S469417. eCollection 2024.
Prior research has shown that inappropriate childhood nurturing experiences (low care and high overprotection), trait anxiety, and depressive rumination are risk factors for depression. However, no studies to date have analyzed the overall association between these factors and depressive symptoms. In the present study, we hypothesized that depressive rumination mediates the impacts of inappropriate childhood nurturing experiences on depressive symptoms, and that these mediating effects are moderated by trait anxiety, and tested these hypotheses in adult volunteers.
The subjects were adult volunteers who were investigated between April 2017 and April 2018. A self-report questionnaire on demographic data, childhood nurturing experiences, trait anxiety, depressive rumination, and depressive symptoms was distributed to conduct the survey, and written informed consent and valid responses were obtained from 585 subjects. Mediation and moderated-mediation analyses were performed by SPSS 28 and macro PROCESS 4.0 software. This study was approved by the Ethics Committee of Tokyo Medical University.
Parental care showed a significant negative indirect effect on depressive symptoms via its effect on depressive rumination ( < 0.01), whereas parental overprotection showed the opposite effect ( < 0.01). Furthermore, the mediation effect of depressive rumination on depressive symptoms was increased by trait anxiety ( < 0.05).
Our present study demonstrated that the main factor affecting depressive symptoms is inappropriate childhood nurturing experiences, which indirectly enhance depression by intensifying depressive rumination, and that depressive rumination and trait anxiety mutually reinforce each other to enhance depressive symptoms. These findings may be useful for the prevention of depressive symptoms. Large-scale prospective studies are needed to confirm the causal associations among these factors in the future.
先前的研究表明，童年时期不适当的养育经历（低关爱和高过度保护）、特质焦虑和抑郁性沉思是抑郁症的危险因素。然而，迄今为止尚无研究分析这些因素与抑郁症状之间的整体关联。在本研究中，我们假设抑郁性沉思介导了童年时期不适当养育经历对抑郁症状的影响，并且这些中介效应受特质焦虑的调节，并在成年志愿者中检验了这些假设。
研究对象为2017年4月至2018年4月期间接受调查的成年志愿者。发放了一份关于人口统计学数据、童年养育经历、特质焦虑、抑郁性沉思和抑郁症状的自填式问卷进行调查，共获得585名受试者的书面知情同意和有效回复。使用SPSS 28和宏程序PROCESS 4.0软件进行中介分析和调节中介分析。本研究经东京医科大学伦理委员会批准。
父母关爱通过对抑郁性沉思的影响对抑郁症状显示出显著的负向间接效应（<0.01），而父母过度保护则显示出相反的效应（<0.01）。此外，特质焦虑增强了抑郁性沉思对抑郁症状的中介效应（<0.05）。
我们目前的研究表明，影响抑郁症状的主要因素是童年时期不适当的养育经历，其通过加剧抑郁性沉思间接加重抑郁，并且抑郁性沉思和特质焦虑相互强化以加重抑郁症状。这些发现可能对预防抑郁症状有用。未来需要大规模的前瞻性研究来证实这些因素之间的因果关联。
