中国科学院心理健康重点实验室知识库

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。

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.

科技创新服务能力建设——基本科研业务费项目（19530050184）