Reducing Depressive Symptoms in Low-Income Mothers

减少低收入母亲的抑郁症状

• 批准号: 6747724
• 负责人: LINDA BEEBER
• 金额: $ 65.15万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-06-01 至 2008-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6747724
• 关键词: behavioral /social science research tag; clinical research; coping; depression; female; human subject; human therapy evaluation; low socioeconomic status; mother child interaction; parents; patient oriented research; psychotherapy; self concept; social support network; stress; women' s health

DESCRIPTION (provided by applicant): Depressive symptoms are more prevalent, severe and persistent in low-income mothers as a function of complex life problems, lean resources and poor social support. In addition to limiting the mother's emotional availability to her infant/toddler, depressive symptoms block these mothers' escape from poverty by robbing their energy for school and job training, and diminishing their use of available enrichment programs for their child. This is especially insidious for the very youngest children - infants and toddlers - because they are the most developmentally vulnerable. Using a 2-group, repeated measures experimental design, this study will test a brief (5 month) intervention using a modification of Interpersonal Psychotherapy to help mothers effectively function in the presence of depressive symptoms, manage life issues, use social support and parent their infant or toddler. The study will take place in five Early Head Start child enrichment programs, 4 in North Carolina and 1 in New York. Mothers from these programs who have depressive symptoms (score 16 or greater on the Center for Epidemiological Studies Depression Scale (CES-D) and who have infants or toddlers between 6 weeks and 30 months old who are enrolled in Early Head Start will participate. The 226 mothers will be randomized to treatment and usual care/attention control groups and the effects will be measured over four collection points (baseline, 14 weeks, 22 and 26 weeks) using the Hamilton Rating Sale for Depression, Structured Clinical Interview for Depression (SCID), analysis of videotaped unstructured, in-home mother-infant/toddler interactions, Everyday Stressors Index, social support and use of EHS services. Three mediators (self-efficacy, proactive coping and social support seeking) and moderators (maternal characteristics [age, education, income], maternal health and maternal burden [number of children, child healthcare responsibilities, access to transportation, resource acquisition effort, job strain and debt]) will be analyzed for effect on the intervention outcomes. Few controlled interventions with high-risk mothers such as these have been done to date. The proposed study will address this gap by bringing an intervention specifically for depressive symptoms alongside of an already-existing early child intervention program. By helping these mothers better utilize Early Head Start resources, the positive benefits of the intervention can be maintained and thus result in lasting benefit for the child as well as the mother.

描述（由申请人提供）：由于复杂的生活问题、匮乏的资源和较差的社会支持，抑郁症状在低收入母亲中更为普遍、严重和持久。除了限制母亲对婴儿/幼儿的情感投入外，抑郁症状还剥夺了这些母亲上学和工作培训的精力，并减少了对孩子可用的丰富计划的使用，从而阻碍了她们摆脱贫困。这对于最小的儿童（婴儿和幼儿）来说尤其危险，因为他们在发育上最脆弱。本研究采用 2 组重复测量实验设计，将测试短暂（5 个月）的干预，使用人际心理治疗的修改，以帮助母亲在存在抑郁症状的情况下有效地发挥作用，管理生活问题，利用社会支持并养育她们的孩子。婴儿或幼儿。该研究将在五个早期启蒙儿童强化项目中进行，其中 4 个在北卡罗来纳州，1 个在纽约。来自这些项目的、有抑郁症状（流行病学研究中心抑郁量表 (CES-D) 得分为 16 分或以上，并且有 6 周至 30 个月大的婴儿或幼儿并参加早期启蒙计划）的母亲将参加。 226 名母亲将被随机分为治疗组和常规护理/注意对照组，并将使用汉密尔顿量表在四个收集点（基线、14 周、22 和 26 周）测量效果抑郁症评级出售、抑郁症结构化临床访谈 (SCID)、录像非结构化家庭母婴/幼儿互动分析、日常压力指数、社会支持和 EHS 服务的使用 三个中介（自我效能、积极应对）。和寻求社会支持）和调节因素（孕产妇特征[年龄、教育、收入]、孕产妇健康和孕产妇负担[儿童数量、儿童保健责任、交通便利性、资源获取努力、工作压力和债务]）将分析对干预结果的影响。迄今为止，很少有人对高危母亲实施此类控制干预措施。拟议的研究将通过在现有的早期儿童干预计划之外引入专门针对抑郁症状的干预措施来解决这一差距。通过帮助这些母亲更好地利用早期启蒙资源，可以保持干预措施的积极效益，从而为孩子和母亲带来持久的利益。