MAOA基因rs6323多态性与母亲支持性教养对青少年抑郁的交互作用：素质-压力假说与不同易感性假说的检验

抑郁的遗传与环境交互作用(G×E)机制已成为富有挑战性的前沿课题之一。然而,既有G×E研究大多关注遗传基因与不利环境的交互作用,相对忽视了积极环境的影响。本研究以1025名青少年为被试,运用问卷法与 DNA分型技术,采用间隔3年的追踪设计(T1小学六年级—T2初中三年级),考察 MAOA基因rs6323多态性与母亲支持性教养对青少年抑郁的交互作用以及性别在其中的调节作用,并同时采用新兴的探索性与验证性方法检验G×E交互作用的素质–压力假说与不同易感性假说。结果显示, MAOA基因rs6323多态性与母亲支持性教养行为交互作用于女青少年的抑郁,母亲支持性教养显著负向预测 GG 基因型女青少年的抑郁,但对 TT基因型女青少年抑郁的预测作用并不显著,该交互作用符合不同易感性假说。MAOA基因 rs6323多态性与母亲支持性教养对男青少年的抑郁无显著交互作用。本研究发现推进了抑郁遗传机制的研究,并为不同易感性假说提供新的研究证据。     

Maternal mind-mindedness: stability over time and consistency across relationships

Maternal mind-mindedness has been described both as a cognitive-behavioural trait and as a relational construct. This study assessed stability over time and consistency across relationships of maternal mind-mindedness in relation to preschool and primary school siblings and compared representational and interactional mind-mindedness. Mothers with two children between 2½ and 10 years were assessed twice, nine months apart (N = 32 at Time 1; N = 30 at Time 2). Representational mind-mindedness for a partner/friend was also assessed twice. Mothers’ representational mind-mindedness showed temporal stability but was inconsistent across relationships with two children and a partner/friend. Conversely, mothers’ interactional mind-mindedness was stable and highly consistent across relationships with two children. This supports the possibility that mothers’ interactional mind-mindedness is trait-like, while findings are equivocal for representational mind-mindedness. Representational mind-mindedness and interactional mind-mindedness were unrelated in this preliminary study, suggesting that these measures of maternal mind-mindedness were not equivalent for this age group.     

Maternal representation and care of infant sleep

Maternal reports about infant sleep care and ideas about the causes of awakening were obtained from telephone interviews with 104 middle class primiparae when their infants were 1 month and 1 year old. These reports were compared with their expectations about infant sleep before the birth of their child. It was found that most of the mothers were willing to ‘help’ their infants fall asleep, with 19 different kinds of techniques being spontaneously mentioned. Most of the techniques involved physical contact. The changes in technique from before birth to the end of the first year of life mainly concerned a decrease in the use of techniques involving holding the infant in the arms. From 1 month to 1 year, there was a decrease in rocking techniques, while at 1 year the use of a (bottle) feeding technique and taking the child into the parents' bed became apparent. The reasons mothers gave for infant awakenings varied from 1 month to 1 year. At 1 year, the most frequent reason was that the infant has ‘sufficient sleep’. Mothers' representations before the infant birth did not overlap with representations and reports of sleep handling after birth. Mothers were willing to apply and use a great variety of caring techniques that they perceived to be adjusted to the individual needs of their child. © 1998 John Wiley & Sons, Ltd.     

Predictors of maternal reactions to excessive crying of newborns. Findings from a prospective study in a naturalistic situation

The prospective study examines which factors assessed in pregnancy predispose mothers to seeing their newborn crying more as a problem and to more mental health problems in response to excessive baby crying. A total of 2140 pregnant women participated in the study, of which 1798 delivered a living singleton. Data was collected by means of a series of written questionnaires. The duration of the baby crying as well as the maternal reactions to the crying were assessed at a mean time of 1–2 months following delivery. The maternal reactions were related to several variables assessed at the end of the first trimester of pregnancy. Data was analysed by means of the method of stepwise multiple regression. Four factors were found to be associated with the reactions of mothers to newborn crying. These are: the duration of the crying, a first-born baby, a relatively high maternal age, and a relatively high score on ‘neuroticism’ in mothers. It was concluded that it is possible to indicate to a certain degree which mothers of excessive crying babies are prone to report more impact of the crying or more mental health symptomatology. It might be worthwhile to offer those mothers some extra support in order to try to prevent the situation from becoming worse. © 1998 John Wiley & Sons, Ltd.     

Like mother,like child? Maternal determinants of children's early social-emotional development

Social-Emotional competencies evolve early in life. For example, early emotion regulation is learned primarily in the context of mother–child interaction, which may allow for maternal influences to shape children's social-emotional development. The aim of the current study was to longitudinally examine maternal determinants of children's early social-emotional development in a community-based sample of first-time mothers (N = 61, aged 22–39 years). Specifically, we used structural equation modeling to examine how maternal emotion regulation difficulties and subclinical depression directly and indirectly, through sensitivity and postnatal bonding, assessed at 6 to 8 months predicted child outcomes at 12 to 16 months. We found that mothers’ sensitivity predicted fewer social-emotional and behavioral problems and that stronger bonding predicted fewer problems and more social-emotional competencies. Emotion regulation difficulties were significantly associated with depressive symptoms; yet, when accounting for shared variances, both factors differentially predicted less positive child outcomes such that more difficulties indirectly, through poorer bonding, predicted greater delay in competencies, and more symptoms indirectly, through less sensitivity, predicted more problems. Current findings underline the significance of maternal factors impacting the quality of mother–child interaction for children's positive development. Potential implications for early prevention programs to support children who are otherwise at risk for negative emotional outcomes due to mothers’ emotional state postpartum are discussed.     

Antidepressant Medication: Is It a Viable and Valuable Adjunct to Cognitive-Behavioral Therapy for School Refusal?

Cognitive-behavioral therapy (CBT) is an evidence-based treatment for school refusal. However, some youth do not respond to CBT. The serious risks associated with school nonattendance call for novel approaches to help those who do not respond to CBT. Because school refusal is commonly associated with anxiety disorders, and the combination of CBT and antidepressant medication enhances outcomes in the treatment of anxiety disorders, combined treatment may be effective for school refusal. This narrative review evaluates the current evidence base for adding antidepressant treatment to CBT for school refusal. Six randomized controlled trials (RCTs), two open trials, six case studies/series, and one observational study were identified and reviewed. There is support for combined CBT and imipramine, but this medication is not typically used due to the risk of concerning side effects. Two recent RCTs failed to provide evidence for the superiority of combined CBT and fluoxetine. Further research in this area is required because the extant studies have a number of methodological limitations. Recommendations are provided for clinicians who consider prescribing antidepressant medication or referring for adjunctive antidepressant treatment for school refusal.     

Impact of maternal adverse childhood experiences on child socioemotional function in rural Kenya: Mediating role of maternal mental health

Mothers in low‐ and middle‐income countries (LMIC) suffer heightened vulnerability for adverse childhood experiences (ACEs), which is exacerbated by the multitude of risk factors associated with poverty and may lead to increased risk of psychiatric disorder. The constellation of complex, co‐occurring biological, environmental, social, economic and psychological risk factors are in turn transmitted to her child, conferring vulnerability for adverse development. This study examines the association between maternal intra‐ and extra‐familial ACEs, maternal education and the mental health of her child, mediated by maternal mental health. Mother‐child dyads (n = 121) in Machakos, Kenya were examined cross‐sectionally using self‐report measures of ACEs, maternal mental health and child internalizing and externalizing mental health problems. The four models proposed to examine the relationship between intra‐ and extra‐familial maternal ACEs and child internalizing and externalizing problems demonstrated indirect pathways through maternal mental health. These effects were found to be conditional on levels of maternal education, which served as a protective factor at lower levels of maternal ACEs. These models demonstrate how the impact of ACEs persists across the lifespan resulting in a negative impact on maternal mental health and conferring further risk to subsequent generations. Elucidating the association between ACEs and subsequent intergenerational sequelae, especially in LMIC where risk is heightened, may improve targeted caregiver mental health programs for prevention and intervention.