Trajectories of maternal depressive symptoms predict child problem behaviour: The Generation R Study
Trajectories of maternal depressive symptoms predict child problem behaviour: The Generation R Study
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DOI：
10.1017/s0033291712000657
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发表时间：
2013-01-01
影响因子：
6.9
通讯作者：
Tiemeier, H.
中科院分区：
文献类型：
--
作者：
Cents, R. A. M.;Diamantopoulou, S.;Tiemeier, H.
背景目前还不清楚母亲抑郁症状的过程如何影响儿童发育。我们模拟了从怀孕中期到分娩后3年的母亲抑郁症状的轨迹，以更好地确定其与儿童问题行为的关联。母子二人组（n=4167）参加了荷兰的一项基于人群的前瞻性队列研究。抑郁症状进行了评估，在怀孕期间和产后2个月，6个月和36个月。当孩子们3岁时，问题行为进行了评估与儿童行为检查表完成的每一个家长。一组为基础的建模技术被用来模拟轨迹的母亲抑郁症状，并检查其与儿童的问题行为。轨迹建模的附加值是通过逐步线性回归确定的。我们确定了四个轨迹的母亲抑郁症状：“没有”（34%），“低”（54%），“中度”（11%）和“高”（1.5%）。儿童的问题行为不同的功能，母亲的轨迹成员。无论是由母亲还是父亲评定，被分配到较高轨迹的母亲的孩子比被分配到较低轨迹的母亲的孩子有更多的问题行为。该模型包括轨迹有附加的预测价值的模型只依赖于一个总结的重复测量的严重程度和一个预定义的慢性变量。根据其病程的不同，孕产妇抑郁症状对儿童问题行为有不同的影响。通过研究症状的轨迹可以获得更多的信息，而不仅仅是预先定义的严重程度和慢性程度的测量。此外，轨迹可以帮助确定临床抑郁的母亲谁是早期干预的可能候选人。
Background. It is unclear how the course of maternal depressive symptoms affects child development. We modelled trajectories of maternal depressive symptoms from mid-pregnancy to 3 years after childbirth to better determine their associations with child problem behaviour.Method. Mother-child dyads (n=4167) participated in a population-based prospective cohort in The Netherlands. Depressive symptoms were assessed with the Brief Symptom Inventory during pregnancy and at 2, 6 and 36 months postnatally. When children were 3 years old, problem behaviour was assessed with the Child Behaviour Checklist completed by each parent. A group-based modelling technique was used to model trajectories of maternal depressive symptoms and to examine their association with child problem behaviour. The added value of trajectory modelling was determined with successive linear regressions.Results. We identified four trajectories of maternal depressive symptoms; 'no' (34%), 'low' (54%), 'moderate' (11%) and 'high' (1.5%). Child problem behaviour varied as a function of maternal trajectory membership. Whether rated by mother or father, children of mothers assigned to higher trajectories had significantly more problem behaviours than children of mothers assigned to lower trajectories. The model including trajectories had additive predictive value over a model relying only on a summed repeated measure of severity and a predefined chronicity variable.Conclusions. Depending on their course, maternal depressive symptoms have different effects on child problem behaviour. More information is gained by studying trajectories of symptoms, than only predefined measures of severity and chronicity. Moreover, trajectories can help identifying clinically depressed mothers who are possible candidates for early interventions.