Depressive Symptoms and Compromised Parenting in Low-Income Mothers of Infants and Toddlers: Distal and Proximal Risks
Depressive Symptoms and Compromised Parenting in Low-Income Mothers of Infants and Toddlers: Distal and Proximal Risks
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DOI：
10.1002/nur.21604
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发表时间：
2014-08-01
影响因子：
2
通讯作者：
Lewis, Virginia S.
中科院分区：
文献类型：
--
作者：
Beeber, Linda S.;Schwartz, Todd A.;Lewis, Virginia S.
低收入母亲出现抑郁症状的比例高于一般人群，这增加了经济困难给她们的婴幼儿带来的现有风险。强调几个关键的干预目标，这种方法尤其适用于抑郁症状影响母亲精力和注意力的母亲，可以改善对面临逆境的人群的干预。本研究的目的是确定对抑郁症状有显著影响的环境风险因素，这些因素与抑郁症状结合在一起，与不良的养育方式有关。使用来自美国东北部和东南部六个早期开端项目的251名不同种族的母亲的基线数据，这些母亲被招募参加家庭干预的临床试验，Belsky的远端到近端影响水平的生态框架被用于在分层回归模型中组织抑郁症状的风险因素。在压力下，幼儿的母亲报告的抑郁症状比婴儿的母亲更严重，这支持了对产后抑郁症状筛查和监测的必要性。多元模型揭示了干预目标可以集中在抑郁症的预防和干预工作上，包括帮助母亲减少慢性日常压力源和与重要他人的冲突，以及有效处理具有挑战性的幼儿行为，特别是在面对区域纪律规范时。同居伴侣的存在与更有效的养育子女有关，无论参与者的抑郁症状严重程度如何。(C) 2014 Wiley期刊公司
Low-income mothers develop depressive symptoms at higher rates than the general population, adding to the existing risk that economic hardship places on their infants and toddlers. Emphasizing a few key intervention targets, an approach that is especially relevant to mothers when depressive symptoms compromise their energy and concentration, can improve interventions with populations facing adversity. The goal of this study was to identify contextual risk factors that significantly contributed to depressive symptoms and that, in combination with depressive symptoms, were associated with compromised parenting. Using baseline data from 251 ethnically diverse mothers from six Early Head Start programs in the Northeastern and Southeastern US, who were recruited for a clinical trial of an in-home intervention, Belsky's ecological framework of distal to proximal levels of influence was used to organize risk factors for depressive symptoms in hierarchical regression models. Under stress, mothers of toddlers reported more severe depressive symptoms than mothers of infants, supporting the need for depressive symptom screening and monitoring past the immediate postpartum period. Multivariate models revealed intervention targets that can focus depression prevention and intervention efforts, including helping mothers reduce chronic day-to-day stressors and conflicts with significant others, and to effectively handle challenging toddler behaviors, especially in the face of regional disciplinary norms. Presence of a live-in partner was linked to more effective parenting, regardless of participants' depressive symptom severity. (C) 2014 Wiley Periodicals, Inc.