MATERNAL DEPRESSION IN CONTEXT--INFANTS AT RISK

拟议的项目将审查产妇、环境和 婴儿因素（例如，社会支持、婴儿气质），这些因素联合收割机 母亲抑郁症会使婴儿面临社会问题的风险， 情绪功能 我建议对600名女性进行抑郁症筛查 在怀孕的第二个三个月，以确定60临床 抑郁的母亲和60名非抑郁的母亲。 符合标准的母亲 DSM-III-R抑郁症筛查工具和匹配的 将对很少有抑郁症状的母亲进行抽样 在产后两个月进行一次结构化的精神病访谈。 母亲 根据访谈，符合DSM-III-R重度抑郁症标准的患者 信息和那些没有抑郁症史的人将被随访 与他们的婴儿进行短期纵向研究。 母婴 将在产后4个月和14个月时对两对婴儿进行评价。 我预计 至少50例抑郁症和50例非抑郁症母婴的最终样本 14个月随访时的二分体。 本研究的具体目的是：1） 比较抑郁和非抑郁的母亲在以下方面：a）社会 支持;和B）养育的维度; 2）比较婴儿的 抑郁和非抑郁的母亲在以下方面：a）情感 显示; B）社会反应; c）气质;和d）依恋 模式; 3）解决抑郁母亲的个体差异 通过检查母亲的特征， 精神病理学、整体精神病理学的严重程度、社会支持，以及 父母教养方式对婴儿依恋安全性的预测差异 产后14个月;以及4）检查怀孕期间的母体因素， 产后4个月时，结合婴儿气质的测量 在4个月时预测婴儿的依恋安全性和母亲 产后14个月时的敏感性。 一个独特的方面的建议 研究是仔细描述婴儿的行为特征， 这被认为会影响婴儿的参与能力 在与其护理者的相互交互中（例如，情感 反应性、社会性）。虽然目前可用的治疗方法 将有可能补救母亲抑郁症的症状，更多的数据 制定预防战略，将风险降至最低 抑郁母亲的后代。 识别那些抑郁的母亲 他们在养育子女方面面临最大的困难， 谁是在影响监管问题的风险最大，应告知 制定具体的预防措施。

The proposed project will examine the role of maternal, environmental and infant factors (e.g., social support, infant temperament) which combine with maternal depression to place infants at risk for problems in social- emotional functioning. I am proposing to screen 600 women for depression in the second trimester of pregnancy in order to ascertain 60 clinically depressed mothers and 60 nondepressed mothers. Mothers who meet criteria for DSM-III-R major depression on the screening instrument and a matched sample of mothers with very few depressive symptoms will be administered a structured psychiatric interview at two months post partum. Mothers who meet DSM-III-R criteria for major depression based on the interview information and those who have no history of depression will be followed with their infants in a short-term longitudinal study. Mother-infant pairs will be evaluated at 4 and 14 months post partum. I anticipate a final sample of at least 50 depressed and 50 nondepressed mother-infant dyads at the 14 month follow-up. The specific aims of the study are: 1) to compare depressed and nondepressed mothers with respect to: a) social supports; and b) dimensions of parenting; 2) to compare infants of depressed and nondepressed mothers with respect to: a) affective displays; b) social responsivity; c) temperament; and d) attachment patterns; 3) to address individual differences within depressed mothers by examining whether maternal characteristics such as concomitant psychopathology, severity of global psychopathology, social supports, and parenting styles differentially predict infant security of attachment at 14 months postpartum; and 4) to examine maternal factors in pregnancy and at 4 months postpartum in combination with measures of infant temperament at 4 months to predict infant security of attachment and maternal sensitivity at 14 months postpartum. A unique aspect of the proposed study is the careful characterization of the infant in terms of behaviors which are hypothesized to influence the infant's ability to participate in a reciprocal interaction with their caregiver (e.g., emotional reactivity, sociability). While treatments are currently available which will potentially remediate the symptoms of maternal depression, more data are required to develop prevention strategies which will minimize risk to offspring of depressed mothers. Identifying those depressed mothers who are at greatest risk for difficulties in parenting and those infants who are at greatest risk for problems in affect regulation should inform the development of specific preventive interventions.