论著

累积生态风险与产后抑郁:不安全依恋内部工作模式的中介作用

  • 马福云 ,
  • 张宇航 ,
  • 阚佳琦 ,
  • 韩红 ,
  • 陈楚侨 ,
  • 王争艳 ,
  • 程南华
展开
  • 1首都师范大学心理学院, 北京市“学习与认知”重点实验室,北京 100048;
    2中国科学院心理研究所心理健康重点实验室,北京 100101
马福云,2018年毕业于北京中医药大学,获医学博士学位,2018年进入首都师范大学心理学院博士后流动站,跟随王争艳教授进行0~3岁婴幼儿心理学方面的研究工作。张宇航,2021年毕业于首都师范大学心理学院,获得教育学硕士学位。主要研究方向为儿童的情绪发展及其神经机制。#作者有同等贡献。
*程南华, 6777@cnu.edu.cn

网络出版日期: 2024-10-16

基金资助

科技创新服务能力建设——基本科研业务费项目(19530050184)

Cumulative Ecological Risk and Postpartum Depression: The Mediating Role of Internal Working Model of Insecurity Attachment

  • MA Fuyun ,
  • ZHANG Yuhang ,
  • KAN Jiaqi ,
  • HAN Hong ,
  • Raymond C. K. CHAN ,
  • WANG Zhengyan ,
  • CHENG Nanhua
Expand
  • 1Beijing Key Laboratory of Learning and Cognition and Department of Psychology, Capital Normal University, Beijing 100048, China;
    2Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101
#Equal Contribute.
*CHENG Nanhua, 6777@cnu.edu.cn

Online published: 2024-10-16

摘要

目的:考察累积生态风险对产后抑郁(postpartum depression, PPD)的影响及不安全依恋在其中的中介作用。
方法:采用问卷调查的方式,从2017年3月至2017年6月,使用基本信息表、爱丁堡产后抑郁量表、儿童期创伤经历问卷和成人依恋经历调查问卷,对北京市三家妇幼保健医院754例平均年龄(标准差)为32.0(3.4)岁的产妇进行调查研究。采用结构方程模型检验累积生态风险对产妇PPD的直接作用以及不安全依恋的中介作用。
结果:66.4%的产妇为初次生产,产妇的爱丁堡产后抑郁量表平均分(标准差)为7.3(4.4),产妇儿童期不安全依恋得分为2.2(0.8)。产妇的年龄、住房情况、主客观社会经济地位和儿童期创伤经历与其产后抑郁存在相关性;产妇抑郁平均水平尚未达到临床诊断标准,累积生态风险和不安全依恋对产后抑郁具有正向预测作用;累积生态风险可部分通过产妇的不安全依恋预测产后抑郁。
结论:累积生态风险对产后抑郁具有重要的影响,且这种影响可能通过产妇内部的依恋工作模式来实现。研究结果提示,从干预的角度减少产妇产后抑郁的生态风险时,应该考虑家庭和个体心理等不同领域的风险和累积风险。

本文引用格式

马福云 , 张宇航 , 阚佳琦 , 韩红 , 陈楚侨 , 王争艳 , 程南华 . 累积生态风险与产后抑郁:不安全依恋内部工作模式的中介作用[J]. 心理学通讯, 2021 , 4(2) : 87 -95 . DOI: 10.12100/j.issn.2096-5494.220088

Abstract

Objective: To investigate the effect of cumulative ecological risk on postpartum depression and the mediating role of insecure attachment.
Methods: From March 2017 to June 2017, 754 postpartum women (age: 32.0±3.4 years) in 3 Beijing maternal and child health hospitals were recruited to complete a set of questionnaires including the basic information questionnaire, the Edinburgh Postpartum Depression Scale, the Childhood Trauma Questionnaire, and the Adult Attachment Experience Questionnaire. Structural equation modeling was used to test the direct effect of cumulative ecological risk on postpartum depression and the mediating effect of insecure attachment.
Results: There were 66.4% of the postpartum women that gave birth for the first time; and the average score of the Edinburgh Postpartum Depression Scale was 7.3 (4.4) and the score of insecure attachment in the childhood of postpartum women was 2.2 (0.8). Maternal age, housing status, subjective and objective economic status, and childhood traumatic experience were associated significantly with postpartum depression. Postpartum women’s average depression level had not met the clinical criteria, and the cumulative ecological risk and insecure attachment both had a significant positive predictive effect on postpartum depression. Cumulative ecological risk could partly predict postpartum depression through postpartum women’s insecure attachment.
Conclusions: Cumulative ecological risk has an important effect on postpartum depression, and this effect may be achieved through the postpartum women’s internal attachment work pattern. Therefore, this study reminds us that from the perspective of intervention, when reducing the ecological risk of maternal postpartum depression, we should consider the cumulative risks and risks in different fields such as family and individual psychology.

参考文献

[1] 傅文青, 姚树桥, 于宏华, 赵幸福, 李茹, 李英, 张艳青. (2005). 儿童期创伤问卷在中国高校大学生中应用的信效度研究. 中国临床心理学杂志,13(1), 40-42.
[2] 甘宇, 史战明, 胡华. (2017). 童年虐待与抑郁发生的机制研究. 四川精神卫生,30(6), 580-584.
[3] 顾玮, 汤月芬, 黄咏梅, 施慎逊. (2004). 产后抑郁症的发生率及其影响因素分析. 上海医学, 27(10), 756-758.
[4] 靳宇倡, 丁美月. (2017). 产后抑郁症的预测因素及神经生理机制. 心理科学进展,25(7), 1145-1161. doi: 10.3724/SP.J.1042.2017.01145
[5] 李董平, 周月月, 赵力燕, 王艳辉, 孙文强. (2016). 累积生态风险与青少年网络成瘾:心理需要满足和积极结果预期的中介作用. 心理学报, 48(12), 1519-1537. doi: 10.3724/SP.J.1041.2016.01519
[6] 李玉红, 傅苏林, 谢伦芳, 胡海利, 钱小静, 叶冬青. (2009). 产褥期产妇及其配偶的抑郁现况调查. 安徽医科大学学报,44(4), 506-508.
[7] 彭建铁, 黄晓文. (2015). 产后抑郁症与5-羟色胺转运体基因连锁多态区多态性及社会环境因素相关性分析. 中国妇产科临床杂志, 16(6), 547-550. doi: 10.13390/j.issn.1672-1861.2015.06.021.
[8] 陶建青, 龚冀荣, 陆锦滢. (2018). 我国产后抑郁症患病率的Meta分析. 中国健康心理学杂志,26(2), 171-174. doi: 10.13342/j.cnki.cjhp.2018.02.003
[9] 谢芳, 李金容, 张彩霞. (2020). 产后抑郁症影响因素的多元Logistic回归分析.中国计划生育和妇产科,12(7), 93-96. doi: 10.3969/j.issn.1674-4020.2020.07.24
[10] 王争艳, 刘迎泽, 杨叶. (2005). 依恋内部工作模式的研究概述及探讨. 心理科学进展,13(5), 629-639.
[11] 王宇琛. (2012). 母亲敏感性、将心比心对婴儿依恋的预测:社会经济地位效应(硕士学位论文). 首都师范大学, 北京.
[12] 王朝, 肖晶, 王争艳, 吴东红. (2012). 成人对父母的依恋经历调查问卷的编制. 中国心理卫生杂志,26(8), 626-630.
[13] 王蕾蕾, 宋崇升, 石超, 卞清涛. (2019). 童年期创伤与抑郁症的关系. 中华行为医学与脑科学杂志, 28(5), 476-480.
[14] 姚微, 谈小雪. (2014). 初产妇母乳喂养自我效能影响因素及与产后抑郁症的相关性分析. 中国护理管理,14(1), 89-91.
[15] 张春雨, 张进辅, 张静秋, 张苹平. (2011). 述情障碍成因的认知及社会机制. 心理科学进展,19(3), 398-409.
[16] Abdollahi F., Rezai Abhari F., & Zarghami M. (2017). Post-partum depression effect on child health and development.Acta Med Iran, 55(2), 109-114.
[17] Abramson L. Y., Metalsky G. I., & Alloy L. B. (1989). Hopelessness depression: A theory-based subtype of depression.Psychol Rev, 96(2), 358-372.
[18] American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders: DSM-5™ (5th ed.). Arlington, VA: American Psychiatric Publishing.
[19] Appleyard K., Egeland B., van Dulmen M.H., & Alan Sroufe L. (2005). When more is not better: The role of cumulative risk in child behavior outcomes. J Child Psychol Psychiatry, 46(3), 235-245. doi: 10.1111/j.1469-7610.2004.00351.x
[20] Bernstein, D. P., & Fink, L. (1998). Childhood trauma questionnaire: A retrospective self-report manual. San Antonio, TX: The Psychological Corporation, Harcourt Brace.
[21] Blum, L. D. (2007). Psychodynamics of postpartum depression.Psychoanal Psychol, 24(1), 45-62. doi: 10.1037/0736-9735.24.1.45
[22] Bowlby, J. (1977). The making and breaking of affectional bonds.Br J Psychiatry, 130(3), 201-210. doi: 10.1192/bjp.130.3.201
[23] Bronfenbrenner, U., & Morris, P. A. (1998). The Ecology of Developmental Processes. In W. Damon, & R. M. Lerner (Orgs.), Handbook of Child Psychology, Vol. 1: Theoretical Models of Human Development. New York, NY: John Wiley.
[24] Cox J. L., Holden J. M., & Sagovsky R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale.Br J Psychiatry, 150, 782-786. doi: 10.1192/bjp.150.6.782
[25] Duman, N. B., & Kocak, C. (2013). The effect of social support on state anxiety levels during pregnancy.Social Behavior & Personality: An International Journal, 41(7), 1153-1163. doi: 10.2224/sbp.2013.41.7.1153
[26] Doan S. N., Fuller-Rowell T. E., & Evans G. W. (2012). Cumulative risk and adolescent’s s internalizing and externalizing problems: The mediating roles of maternal responsiveness and self-regulation.Dev Psychol, 48(6), 1529-1539. doi: 10.1037/a0027815
[27] Evans G. W., Li D., & Whipple S. S. (2013). Cumulative risk and child development.Psychol Bull, 139(6), 1342-1396. doi: 10.1037/a00318 08
[28] Figueiredo F. P., Parada A. P., de Araujo L. F., Silva W. A., Jr., & Del-Ben C. M. (2015). The influence of genetic factors on peripartum depression: A systematic review.J Affect Disord, 172, 265-273. doi: 10.1016/j.jad.2014.10.016
[29] Giddens, A., & Bowlby, J. (1970). Attachment and Loss, Volume I: Attachment.Bri J Sociol, 21(1), 111-112. doi: 10.2307/588279
[30] Gelman P. L., Flores-Ramos M., López-Martínez M., Fuentes C. C., & Grajeda, J. P. R. (2015). Hypothalamic-pituitary-adrenal axis function during perinatal depression.Neurosci Bull, 31(3), 338-350. doi: 10.1007/s12264-014-1508-2
[31] Gerard, J. M., & Buehler, C. (2004). Cumulative environmental risk and youth problem behavior.J Marriage Fam, 66(3), 702-720. doi: 10.1111/j.0022-2445.2004.00048.x
[32] Ikeda M., Hayashi M., & Kamibeppu K. (2014) The relationship between attachment style and postpartum depression.Attach Hum Dev, 16(6), 557-572. doi: 10.1080/14616734.2014.941884
[33] Liu, Y. L. (2006). Paternal/maternal attachment, peer support, social expectations of peer interaction, and depressive symptoms.Adolescence, 41(164), 705-721.
[34] Martí M., Bonillo A., Jané M. C., Fisher E. M., & Duch H. (2016). Cumulative risk, the mother-child relationship, and social-emotional competence in Latino head start children. Early Educ Dev, 27(5), 590-622. doi: 10.1080/10409289.2016.1106202
[35] Pietromonaco P. R., DeBuse C. J., & Powers S. I. (2013). Does attachment get under the skin? Adult romantic attachment and cortisol responses to stress.Curr Dir Psychol Sci, 22(1), 63-68. doi: 10.1177/0963721412463229
[36] Podsakoff P. M., MacKenzie S. B., Lee J. Y., & Podsakoff N. P. (2003). Common method biases in behavioral research: A critical review of the literature and recommended remedies.J Appl Psychol, 88(5), 879-903. doi: 10.1037/0021-9010.88.5.879
[37] Roland, M. (1950). A clinical observation of postpartum depression and its treatment.West J Surg Obstet Gynecol, 58(7), 391-393.
[38] Roberts R. E., Roberts C. R., & Xing Y. (2010). One-year incidence of suicide attempts and associated risk and protective factors among adolescents.Arch Suicide Res, 14(1), 66-78. doi: 10.1080/13811110 903479078
[39] Robertson E., Grace S., Wallington T., & Stewart D. E. (2004). Antenatal risk factors for postpartum depression: A synthesis of recent literature.Gen Hosp Psychiatry, 26(4), 289-295. doi: 10.1016/j.gen hosppsych.2004.02.006
[40] Shiakou, M. (2012). Representations of attachment patterns in the family drawings of maltreated and non‐maltreated children.Child Abus Rev, 21(3), 203-218. doi:10.1002/car.1184
[41] Sit D., Luther J., Buysse D., Dills J. L., Eng H., Okun M.,.. Wisner K. L. (2015). Suicidal ideation in depressed postpartum women: Associations with childhood trauma, sleep disturbance and anxiety.J Psychiatr Res, 66-67, 95-104. doi: 10.1016/j.jpsychires.2015.04.021
[42] Wade M., Moore C., Astington J. W., Frampton K., & Jenkins J. M. (2015). Cumulative contextual risk, maternal responsivity, and social cognition at 18 months.Dev Psychopathol, 27(1), 189-203. doi: 10.1017/S0954579414000674
[43] Watts T. W., Duncan G. J., Clements D. H., & Sarama J. (2018). What is the long‐run impact of learning mathematics during preschool?Child Dev, 89(2), 539-555. doi: 10.1111/cdev.12713
[44] Wright, M. O., & Masten, A. S. (2005). Resilience processes in development: Four waves of research on positive adaptation in the context of adversity. In S. Goldstein & R. B. Brooks (Eds.), Handbook of resilience in children. Boston, MA: Springer.
文章导航

/

〈 〉