Implications of high-risk family studies for prevention of depression
Implications of high-risk family studies for prevention of depression
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DOI：
10.1016/j.amepre.2006.07.003
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发表时间：
2006-12-01
影响因子：
5.5
通讯作者：
Ries Merikangas, Kathleen
中科院分区：
文献类型：
--
作者：
Avenevoli, Shelli;Ries Merikangas, Kathleen
高风险家庭研究是一种强大的设计，有助于识别抑郁症的早期表达形式以及病前的脆弱性、风险和保护因素，这些因素对于确定预防目标和计划重点非常重要。本文 (1) 强调了高风险研究在为早期干预工作提供信息方面的优势； (2) 总结了抑郁症高风险对照研究的家族聚集性研究结果； (3) 简要回顾解释家庭风险的潜在中介因素（即早期表达形式、脆弱性因素）和增强或最小化家庭风险的调节因素（即互动风险和保护因素）的证据。耶鲁大学药物滥用和情感障碍共病高风险研究的新数据举例说明了确定父母患有药物和焦虑症的后代患抑郁症的特定家族途径的策略。同样，父母的抑郁症与后代的一系列情绪和行为问题有关，包括焦虑和行为障碍。这些非特异性影响，加上关于风险机制的新发现，支持早期干预工作，通过多管齐下的方法，针对一系列有抑郁风险的青少年，关注儿童和父母的个人特征、临床合并症以及更广泛的家庭和社会背景。
The high-risk family study is a powerful design that facilitates identification of early forms of expression of depression and premorbid vulnerability, risk, and protective factors that are important for defining prevention targets and program foci. This paper (1) highlights the strengths of high-risk studies for informing early intervention efforts; (2) summarizes findings of familial aggregation from controlled high-risk studies of depression; and (3) briefly reviews evidence for potential mediators (i.e., early forms of expression, vulnerability factors) that explain familial risk and for moderators (i.e., interactive risk and protective factors) that enhance or minimize familial risk. New data from the Yale High-Risk Study of Comorbidity of Substance Use and Affective Disorders are presented to exemplify strategies for identifying specific familial pathways to depression among offspring of parents with substance and anxiety disorders. Likewise, parental depression is associated with a range of emotional and behavioral problems, including anxiety and conduct disorder, in their offspring. These nonspecific effects, together with emerging findings on mechanisms of risk, support early intervention efforts that target a range of youth at risk for depression through multipronged approaches that attend to the individual characteristics of the child and parent, clinical comorbidity, and the broader family and social context.