Prevention for Infants of Low-Income Depressed Mothers

描述（由申请人提供）：这项纵向调查将评估两种理论上知情的方法，以防止适应不良，抑郁症型的发展组织，并在低收入抑郁症母亲的年轻后代出现精神病理学的相对疗效。研究参与者将包括260名母亲及其婴儿; 195名母亲目前患有重度抑郁症，65名人口统计学上可比较的母亲没有精神障碍的终身病史。所有家庭都将处于或低于联邦贫困线。抑郁的母亲及其婴儿将被随机分配到3种治疗条件中的一种：1）人际心理治疗（IPT）4个月，然后是注意力控制8个月; 2）IPT 4个月，然后是婴儿-父母心理治疗（IPP）8个月; 3）增强社区标准（ECS）治疗抑郁症，包括促进社区标准干预措施的转诊。 基线评估将在婴儿12个月大时进行，随后在婴儿14、16、24、36和48个月大时进行重新评估。评估将测量三个主要方面：1）母亲抑郁症和重度抑郁症（MDD）诊断，社会角色功能，支持和家庭环境特征; 2）母子关系的质量和父母的情感特征; 3）儿童功能，阶段突出问题和压力反应。两个积极预防干预组的纵向比较（IPT和IPT/IPP）将用于确定：1）IPT和IPT/IPP是否有效地减少母亲抑郁症和MDD复发，直到孩子4岁; 2）针对母亲抑郁症的治疗是否足以改变后代的发育过程;以及3）是否有必要直接关注母子关系的干预，以促进积极的结果，并降低抑郁母亲的年轻后代适应不良和精神病理学的风险。

DESCRIPTION (provided by applicant): This longitudinal investigation will evaluate the relative efficacy of two theoretically-informed approaches to preventing maladaptation, a depressotypic developmental organization, and emergent psychopathology in young offspring of low-income depressed mothers. Research participants will include 260 mothers and their infants; 195 mothers will have a current major depressive disorder and 65 demographically comparable mothers will have no lifetime history of mental disorder. All families will be at or below the federal poverty level. Depressed mothers and their infants will be randomly assigned to 1 of 3 treatment conditions: 1) Interpersonal Psychotherapy (IPT) for 4 months followed by an attention control for 8 months; 2)IPT for 4 months followed by Infant-Parent Psychotherapy (IPP) for 8 months; and 3) Enhanced Community Standard (ECS) treatment for depression, involving facilitated referrals for standard interventions in the community. Baseline assessments will be conducted when infants are 12 months old, with subsequent re-assessments when infants are 14, 16, 24, 36, and 48 months of age. Assessments will measure three major areas: 1) Maternal depressive symptomatology and Major Depressive Disorder (MDD) diagnosis, social role functioning, support, and home contextual features; 2) the quality of the mother-child relationship and affective features of parenting; and 3) child functioning, stage-salient issues, and stress-reactivity. Longitudinal comparisons of the two active preventive intervention groups (IPT and IPT/IPP) with the ECS and nondisordered groups will be used to determine: 1) whether IPT and IPT/IPP are efficacious in reducing maternal depressive symptomatology and MDD relapse through the child's age of four; 2) whether treatment targeted on maternal depression is sufficient to alter the developmental course in offspring; and 3) whether intervention directly focused on the mother-child relationship also is necessary to promote positive outcomes and reduce risk for maladaptation and psychopathology in young offspring of depressed mothers.