Alley Jenna, Tsomokos Dimitris I, Mengelkoch Summer, Slavich George M
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles.
Department of Psychology and Human Development, UCL Institute of Education, University College London, London, United Kingdom.
JAMA Psychiatry. 2025 May 28. doi: 10.1001/jamapsychiatry.2025.0815.
Although early maternal warmth strongly predicts adolescent health, questions remain about the biopsychosocial mechanisms underlying this association.
To understand how maternal warmth at 3 years of age shapes adolescent social safety schemas at 14 years of age and physical and mental health at 17 years of age.
DESIGN, SETTING, AND PARTICIPANTS: The Millennium Cohort Study tracks approximately 19 200 children born from late 2000 to early 2002 in the UK. Participants were assessed from ages 3 to 17 years.
Low maternal warmth (eg, lack of praise, negative tone of voice when speaking to the child) and maternal harshness (eg, using physical restraint, grabbing the child) were independently coded during a home visit (age 3 years).
Social safety (age 14 years) was measured by children's responses to 3 items (eg, "I have family and friends who help me feel safe, secure and happy"). Physical health was self-reported on a scale ranging from 1 (excellent) to 5 (poor) (age 17 years). Psychological distress (age 17 years) was assessed using the 6-item Kessler Psychological Distress Scale. Psychiatric problems (age 17 years) was a latent variable composed of self-disclosed clinical diagnosis of depression/anxiety, self-harm, and suicidal behaviors.
The present sample included 8540 youths (52% female; 3.0% Black or Black British, 2.8% Indian, 6.7% Pakistani and Bangladeshi, 2.8% Mixed, 83% White, and 1.6% other). Data were analyzed from March 2024 to September 2024 using structural equation modeling. In models controlling for sex, ethnicity, income, neighborhood disadvantage, maternal mental health, and early cognitive ability, the paths from childhood maternal warmth (but not harshness) to social safety schemas at 14 years of age (b = 0.03; P < .001) and physical health at 17 years of age (b = 0.05; P = .02) were significant, suggesting that early maternal warmth enhances subsequent perceived social safety and physical health. Additionally, the paths from negative social safety schemas at 14 years of age to poorer physical health (b = 0.50; P < .001), psychological distress (b = 5.37; P < .001), and psychiatric problems (b = 0.21; P < .001) at 17 years of age were significant, suggesting that greater perceived social safety prospectively predicts better health. Social safety at 14 years of age mediated 20% to 100% of the effect of early maternal warmth on physical health, psychological distress, and psychiatric problems at 17 years of age (b = 0.01-0.15; P < .001 for all).
These results show that early-life maternal warmth affected adolescent health by influencing perceptions of social safety. Improving parent-child relationships and enhancing youths' perceptions of social safety may thus improve adolescent health.
尽管早期母亲的温暖关爱能有力地预测青少年的健康状况，但这种关联背后的生物心理社会机制仍存在疑问。
了解3岁时母亲的温暖关爱如何塑造14岁青少年的社会安全模式以及17岁时的身心健康。
设计、背景和参与者：千禧队列研究追踪了英国2000年末至2002年初出生的约19200名儿童。参与者从3岁到17岁接受评估。
在一次家访（3岁时）中，对母亲的低温暖关爱（如缺乏赞扬、与孩子说话时语气消极）和母亲的严厉（如使用身体约束、抓住孩子）进行独立编码。
社会安全感（14岁时）通过儿童对3个项目的回答来衡量（如“我有家人和朋友帮助我感到安全、安心和快乐”）。身体健康状况由自我报告，范围从1（优秀）到5（差）（17岁时）。心理困扰（17岁时）使用6项凯斯勒心理困扰量表进行评估。精神问题（17岁时）是一个潜在变量，由自我披露的抑郁/焦虑临床诊断、自我伤害和自杀行为组成。
本样本包括8540名青少年（52%为女性；3.0%为黑人或英籍黑人，2.8%为印度人，6.7%为巴基斯坦和孟加拉国人，2.8%为混血，83%为白人，1.6%为其他）。2024年3月至2024年9月使用结构方程模型对数据进行分析。在控制了性别、种族、收入、邻里劣势、母亲心理健康和早期认知能力的模型中，从童年时期母亲的温暖关爱（而非严厉）到14岁时的社会安全模式（b = 0.03；P < .001）以及17岁时的身体健康（b = 0.05；P = .02）的路径是显著的，这表明早期母亲的温暖关爱能增强随后感知到的社会安全感和身体健康。此外，从14岁时消极的社会安全模式到17岁时较差的身体健康（b = 0.50；P < .001）、心理困扰（b = 5.37；P < .001）和精神问题（b = 0.21；P < .001）的路径是显著的，这表明更高的社会安全感预期能预测更好的健康状况。14岁时的社会安全感介导了早期母亲的温暖关爱对17岁时身体健康、心理困扰和精神问题影响的20%至100%（b = 0.01 - 0.15；所有P < .001）。
这些结果表明，早年母亲的温暖关爱通过影响社会安全感的认知来影响青少年的健康。因此，改善亲子关系和增强青少年对社会安全感的认知可能会改善青少年的健康状况。
