Prevention for Infants of Low-Income Depressed Mothers

低收入抑郁母亲的婴儿的预防

• 批准号: 6848040
• 负责人: Sheree Lynn Toth
• 金额: $ 96.85万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-02-01 至 2009-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6848040
• 关键词: child mental disorders; child psychology; child rearing; clinical research; disease /disorder prevention /control; family structure /dynamics; family therapy; female; functional ability; health care referral /consultation; human subject; human therapy evaluation; infant human (0-1 year); interview; longitudinal human study; low socioeconomic status; major depression; mental disorder diagnosis; mother child interaction; parents; patient oriented research; psychological adaptation; psychopathology; psychotherapy; questionnaires; role

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.

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在预防低收入抑郁母亲的年轻后代的适应不良、抑郁型发育组织和新兴精神病理学方面的相对功效。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 名人口统计相当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) 4 个月的人际心理治疗 (IPT)，随后进行 8 个月的注意力控制； 2）4个月的IPT，随后8个月的婴幼儿家长心理治疗（IPP）； 3) 抑郁症的强化社区标准（ECS）治疗，包括促进转介社区标准干预措施。 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 个月时进行重新评估。评估将衡量三个主要领域：1）母亲抑郁症状和重度抑郁症（MDD）诊断、社会角色功能、支持和家庭背景特征； 2）母子关系的质量和养育的情感特征； 3) 儿童功能、阶段性突出问题和压力反应。两个积极预防干预组（IPT 和 IPT/IPP）与 ECS 组和非疾病组的纵向比较将用于确定：1）IPT 和 IPT/IPP 是否能有效减少母亲抑郁症状和儿童 4 岁时 MDD 复发； 2）针对母亲抑郁症的治疗是否足以改变后代的发育过程； 3）是否有必要直接针对母子关系进行干预，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。