Psychosocial resilience in adolescent offspring of mothers with depression: testing causal mechanisms

青少年的情绪和行为问题越来越普遍。一个关键的优先事项是确定因果风险和保护机制，以告知政策和预防战略，特别是在高风险群体中。一个常见的促成因素是母亲患抑郁症，这可能对儿童的发育、健康和福祉产生重大影响，特别是当母亲的抑郁症是慢性或复发性的时候。问题往往在青少年时期出现，包括抑郁、反社会行为以及在家庭和学校的困难。然而，母亲抑郁症以不同的方式影响孩子。许多母亲患有抑郁症的年轻人不会出现行为或情绪问题，而是保持良好的适应能力。这项研究测试了年轻人自己，他们的家人和朋友在促进对母亲抑郁症作为风险影响的弹性适应方面所发挥的作用。当父母的抑郁症不影响有效的养育时，或者当和谐的家庭关系得到维持时，恢复力更有可能吗？儿童自身的资源是否重要，例如是否有有效的应对策略？与朋友的积极关系能弥补家庭中的困难吗？了解什么最能帮助父母抑郁的年轻人在成长过程中保持积极的心理健康是很重要的，因为这将有助于确定有效的干预目标。然而，至关重要的是要表明，恢复力促进因素与持续的保护作用，考虑他们是否也预测福祉的变化（如从早期的问题恢复），以测试的影响方向，从而澄清'因果'机制参与恢复力。要找出其中的因果关系，就需要很好地理解年轻人的韧性是如何随着时间的推移而发展的。该项目利用了两个非常有价值的纵向数据集和分析。第一个是从出生到青春期研究的父母和孩子的大型人口队列。第二个样本是复发性临床抑郁症的父母。这两项研究都跟踪了父母和他们的孩子长大后的情况。这意味着，分析可以开始通过模拟青年人心理健康的变化如何与促进复原力的因素的变化相关联（反之亦然），来解开潜在的因果过程。这项研究还将探讨其他一些重要问题。我们将确保可能形成干预目标的儿童、家庭和同伴关系因素不仅仅是相关逆境的标志。我们将测试哪些保护因素在母亲抑郁症的背景下特别重要。这项研究将探讨不同的因素对男孩和女孩是否重要，因为这将有助于以后适当调整干预措施。最后，我们将测试在一般人群中受慢性孕产妇抑郁症状影响的年轻人的弹性的解释是否与患有复发性抑郁症的母亲受影响更严重的青少年样本相同。

Adolescent emotional and behavioural problems have become increasingly common. A key priority is to identify causal risk and protective mechanisms to inform policies and prevention strategies, especially in high-risk groups. A common contributory factor is exposure to maternal depression that can have a major impact on the development, health and wellbeing of children, especially when a mother's depression is chronic or recurrent. Problems often develop during adolescence and include depression, antisocial behaviour and difficulties at home and at school. However, maternal depression affects children in different ways. Many young people with a depressed mother do not develop behavioural or emotional problems and instead remain well-adjusted. This study tests the role that young people themselves, their families and friends play in promoting resilient adaptation to maternal depression as a risk influence. Is resilience more likely when a parent's depression does not interfere with effective parenting or when harmonious family relationships are maintained? Are children's own resources important, for example having effective coping strategies? Can positive relationships with friends compensate for difficulties at home? Understanding what best helps young people with depressed parents maintain positive psychosocial wellbeing as they grow up is important as this will facilitate identification of effective intervention targets. However, it is crucial to show that resilience promoting factors are associated with sustained protective effects, to consider whether they also predict change in well-being (e.g. recovery from earlier problems), to test the direction of effects thereby clarifying 'causal' mechanisms involved in resilience. To find out the causal pathways involved requires good understanding of how resilience in young people develops over time. This project makes use of two extremely valuable longitudinal datasets and analyses. The first is a large population cohort of parents and children studied from birth into adolescence. The second is a sample of parents with recurrent clinical depression. Both studies have followed parents and their children as they grow older. This means that analyses can begin to disentangle underlying causal processes by modelling how change in young people's mental health is related to change in the factors that promote resilience (and vice versa). The study will also address a number of other important issues. We will make sure that child, family and peer relationship factors that might form the targets for intervention are not just markers for correlated adversity. We will test which protective factors are specifically important in the context of maternal depression. The study will address whether different factors are important for boys and for girls, because this will later help tailor interventions appropriately. Finally, we will test whether explanations for resilience in young people affected by chronic maternal depressive symptoms in the general population are the same as for a sample of adolescents with more severely affected mothers with recurrent depressive disorder.