Prevention for Infants of Low-Income Depressed Mothers

描述（由申请人提供）：本纵向调查将评估两种理论上知情的方法在预防低收入抑郁症母亲的年轻后代的适应不良，抑郁型发育组织和紧急精神病理方面的相对功效。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一生中没有精神障碍史。所有家庭都将处于或低于联邦贫困水平。抑郁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，随后8个月的注意力控制；2)IPT治疗4个月，随后进行亲子心理治疗（IPP）治疗8个月；3)加强社区标准（ECS）抑郁症治疗，包括促进社区标准干预措施的转诊。

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.