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母亲的抑郁病史和早年受虐经历对儿童健康相关生活质量的影响。

Effects of maternal history of depression and early life maltreatment on children's health-related quality of life.

作者信息

Dittrich Katja, Fuchs Anna, Bermpohl Felix, Meyer Justus, Führer Daniel, Reichl Corinna, Reck Corinna, Kluczniok Dorothea, Kaess Michael, Hindi Attar Catherine, Möhler Eva, Bierbaum Anna-Lena, Zietlow Anna-Lena, Jaite Charlotte, Winter Sibylle Maria, Herpertz Sabine C, Brunner Romuald, Bödeker Katja, Resch Franz

机构信息

Charité - Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Berlin, Germany.

University Hospital Heidelberg, Centre for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Heidelberg, Germany.

出版信息

J Affect Disord. 2018 Jan 1;225:280-288. doi: 10.1016/j.jad.2017.08.053. Epub 2017 Aug 18.

Abstract

BACKGROUND

There is a well-established link between maternal depression and child mental health. Similar effects have been found for maternal history of early life maltreatment (ELM). However, studies investigating the relationship of children's quality of life and maternal depression are scarce and none have been conducted for the association with maternal ELM. The aim of the present study was to investigate the effects of maternal history of ELM and depression on children's health-related quality of life and to identify mediating factors accounting for these effects.

METHODS

Our study involved 194 mothers with and without history of depression and/or ELM and their children between five and 12 years. Children's health-related quality of life was assessed by maternal proxy- and child self-ratings using the KIDSCREEN. We considered maternal sensitivity and maternal parenting stress as potential mediators.

RESULTS

We found an effect of maternal history of depression but not of maternal history of ELM on health-related quality of life. Maternal stress and sensitivity mediated the effects of maternal depression on child global health-related quality of life, as well as on the dimensions Autonomy & Parent Relation, School Environment (maternal and child rating), and Physical Wellbeing (child rating).

LIMITATION

Due to the cross-sectional design of the study, causal interpretations must be made with caution. Some scales yielded low internal consistency.

CONCLUSIONS

Maternal impairments in areas of parenting which possibly developed during acute depression persist even after remission of acute affective symptoms. Interventions should target parenting stress and sensitivity in parents with prior depression.

摘要

背景

母亲抑郁与儿童心理健康之间存在已被充分证实的联系。对于母亲早年受虐待(ELM)史也发现了类似影响。然而,研究儿童生活质量与母亲抑郁关系的研究很少,且尚无关于与母亲ELM关联的研究。本研究的目的是调查母亲ELM史和抑郁对儿童健康相关生活质量的影响,并确定解释这些影响的中介因素。

方法

我们的研究纳入了194名有或无抑郁和/或ELM史的母亲及其5至12岁的孩子。使用儿童生活质量量表(KIDSCREEN)通过母亲代理报告和儿童自评来评估儿童健康相关生活质量。我们将母亲的敏感性和母亲养育压力视为潜在中介因素。

结果

我们发现母亲抑郁史对健康相关生活质量有影响,而母亲ELM史则无此影响。母亲压力和敏感性介导了母亲抑郁对儿童总体健康相关生活质量的影响,以及对自主性与亲子关系、学校环境(母亲和儿童评分)和身体健康(儿童评分)等维度的影响。

局限性

由于本研究的横断面设计,因果解释必须谨慎。一些量表的内部一致性较低。

结论

母亲在养育方面的损害可能在急性抑郁期间形成,即使急性情感症状缓解后仍持续存在。干预措施应针对有既往抑郁史的父母的养育压力和敏感性。

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