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）：这项纵向研究将评估两种理论上明智的方法预防疾病的相对疗效，一个压抑型发育组织以及新兴的心理病理学对低收入抑郁母亲的年轻后代。研究参与者将包括260位母亲及其婴儿； 195个母亲将患有当前重度抑郁症，65个人口统计学上可比的母亲将没有终身的精神障碍史。所有家庭将处于联邦贫困层面或之下。抑郁的母亲及其婴儿将随机分配到3种治疗条件中的1个：1）人际心理治疗（IPT）4个月，然后进行8个月的注意力控制； 2）IPT 4个月，然后是婴儿父母心理治疗（IPP）8个月； 3）增强了抑郁症的社区标准（ECS）治疗，涉及社区中标准干预措施的促进推荐。 婴儿将在婴儿12个月大时进行基线评估，随后在婴儿为14、16、24、36和48个月大的时候进行重新评估。评估将衡量三个主要领域：1）母体抑郁症状学和重大抑郁症（MDD）诊断，社会角色功能，支持和家庭背景特征； 2）母子关系的质量和育儿的情感特征； 3）儿童功能，阶段降低问题和压力反应性。将使用两个主动预防干预组（IPT和IPP/IPP）与ECS和非序列组的纵向比较来确定：1）IPT和IPT/IPP是否有效减少母体抑郁症状学和MDD复发。 2）针对孕产妇抑郁症的治疗是否足以改变后代的发育过程； 3）干预措施是否直接关注母子关系也是促进积极结果并降低沮丧母亲年轻后代的不良适应和心理病理学风险的必要条件。