目的：以Kagan的實驗室行為觀察法測量4個月嬰兒的活動量與14個月幼兒的行為抑制，探討單純憂鬱、單純焦慮、混合焦慮與憂鬱母親之幼兒在活動量與行為抑制類型上的的分布差異。
方法：「產後憂鬱症之前因後果」研究所蒐集4個月寶寶活動量與14個月小孩行為抑制實驗情境觀察的錄影帶，依據Kagan的評分方法評估其活動量與行為抑制分類。將所有媽媽經CMSADS-L診斷後分為單純憂鬱組、單純焦慮組、混合焦慮與憂鬱組及正常組，以χ2檢驗四組媽媽與其幼兒在活動量與行為抑制類型上的差異。
結果：４個月幼兒活動量各類型在全部樣本中的人數比例為哭多動多型(High reactivity，以下簡稱煩躁型)有12.6%，哭多動少型(Distressed type，以下簡稱易哭型)有12.2%，哭少動多型(Aroused type，以下簡稱過動型)有23.7%，哭少動少型(Low reactivity，以下簡稱安穩型)有51.5%﹔其中煩躁型在混合焦慮與憂鬱組中的比例最高，顯著高於正常組，而易哭型在單純憂鬱組中的比例最高，顯著高於混合焦慮與憂鬱組。14個月行為抑制的分類與母親四組診斷間並無差異。
討論：本研究為行為抑制東方人樣本中的先趨研究，呈現出華人嬰兒活動量的各類型比例，其中煩躁型在混合焦慮與憂鬱組中的比例最高，顯示混合焦慮與憂鬱在病因上可能與單純憂鬱、單純焦慮有所不同﹔而易哭型在單純憂鬱組中的比例最高，推論此活動量類型可將單純憂鬱從混合憂鬱焦慮症中區分出來，且視為單純憂鬱症的早期脆弱因子。未來的研究除了加大樣本之外，宜進一步追蹤幼兒未來的發展，探討幼兒活動量與行為抑制與其往後憂鬱與焦慮發展。

柯慧貞(1996)，產後憂鬱症致病機轉之前瞻性研究Ⅲ。行政院國科會專題計畫成果報告，編號NSC-85-2331-13-006-108Y。
Anderson JC, Williams S, McGee R, Silva PA (1987), DSM-III disorders in preadolescent children: Prevalence in a large sample from the general population. Archives of General Psychiatry, 44: 69-76
Arnold AD and Cheek JM (1986), Shyness, self-preoccupation, and the Stroop Color Word Test. Personality and individual differences, 7: 1-3
Bakish D (1999), The patient with comorbid depression and anxiety: the unmet need. Journal of Clinical Psychiatry, 60: 20-24
Ballenger JC (1999), Clinical guidelines for establishing remission in patients with depression and anxiety. Journal of Clinical Psychiatry, 60: 29-34.
Battaglia M, Bajo S, Strambi L, Brambilla F, Castronovo C, Vanni G, Bellodi L (1997), Physiological and behavioral responses to minor stressors in offspring of parents with panic disorder. Journal of Psychiatry, 31: 365-376
Bayley, N. (1969), Manual for the Bayley Scales of Infant Development. New York: Psychological Corp
Biederman J, Rosenbaum JF, Hirshfeld DR, Faraone SV, Bolduc EA, Gersten M, Meminger SR, Kagan J, Snidman N, Reznick JS (1990), Psychiatric correlates of behavioral inhibition in young children of parents with and without psychiatric disorders. Archives of General Psychiatry, 47: 21-26
Biederman J, Rosenbaum JF, Bolduc EA, Faraone SV, Hirshfeld DR (1991), A high risk study of young children of parents with panic disorder and agoraphobia with and without comorbid major depression. Psychiatry Research, 37: 333-48.
Biederman J, Rosenbaum JF, Bolduc-Murphy EA, Faraone SV, Chaloff J, Hirshfeld DR, Kagan J (1993), A 3-Year Follow-up of Children with and without Behavioral Inhibition. Journal of the American Academy of Child & Adolescent Psychiatry, 32: 814-821
Biederman J, Hirshfeld DR, Rosenbaum JF, Herot C, Friedman D, Snidman N, Kagan J, Faraone SV (2001), Further Evidence of Association Between Behavioral Inhibition and Social Anxiety in Children. American Journal of Psychiatry, 158: 1673-1679
Bird HR, Canino G, Rubin-Stipec M, Gould MS, Ribera J, Sesman M, Woodbury M, Huertas-Goldman S, Pagan A, Sanchez-Lacay A, Moscoso M (1988), Estimates of the prevalence of childhood maladjustment in a community survey in Puerto Rico. Archives of General Psychiatry, 45: 1120-1126
Boyd JH, Rae DS, Thompson JW, Burns BJ, Bourdon K, Locke BZ, Regier DA (1990), Phobia: prevalence and risk factors. Soc Psychiatry Psychiatr Epidemiol, 25:314-323.
Calkins SD, Fox NA (1992), The relations among infant temperament, security of attachment, and behavioral inhibition at twenty-four months. Child Development, 63: 1456-1472
Cameron OG, Thyer BA, Nesse RM, Curtis GC (1986), Symptom profiles of patients with DSM-III anxiety disorders. American Journal of Psychiatry, 143:1132-1137.
Carter, A.S., Garrity-Rokous, F.E., Chazan-Cohen, R., Little, C., & Briggs-Gowan, M. (2001). Maternal Depression And Comorbidity: Predicting Early Parenting, Attachment Security, and Toddler Social-Emotional Problems and Competencies. Journal of the American Academy of Child and Adolescent Psychiatry, 40: 18-26.
Caudill W. and Weinstein H. (1969). Maternal care and infant behavior in Japan and America. Psychiatry, 32: 12-43.
Chen X, Hastings PD, Rubin KH, Chen H, Cen G, Stewart SL (1998), Child-rearing attitudes and behavioral inhibition in Chinese and Canadian toddlers: a cross-cultural study. Developmental Psychology, 34: 677-686.
Clark LA, Watson D, Mineka S (1994), Temperament, Personality, and the Mood and Anxiety Disorders. Journal of Abnormal Psychology, 103: 103-116
Dantchev N and Widlocher DJ (1998), The measurement of retardation in depression. Journal of Clinical Psychiatry, 59:19-25.
Deborah C. Beidel and Samuel M. Turner (1998), Shy Children, Phobic Adults.
DeLanerolle NC, Lang FF (1988), Functional neural pathway for vocalization in the domestic cat. In: Newman JD, ed. The physiological control of mammalian vocalization. New York, NY: Plenum; 21-42
Endicott J, Spitxer RL (1978), A diagnostic interview: the Schedule for Affective Disorders and Schizophrenia. Archives of General Psychiatry, 35: 837-844
Eric J, Mash & Russell A. Barkley (1996), Child Psychopathology.
Farooq S, Gahir MS, Okyere E, Sheikh AJ, Oyebode F (1995), Somatization: a transcultural study. Journal of Psychosomatic Research, 39:883-888
Fava M, Rankin MA, Wright EC, Alpert JE, Nierenberg AA, Pava J, Rosenbaum JF (2000), Anxiety disorders in major depression. Comprehensive Psychiatry, 41: 97-102.
Feske U, Frank E, Kupfer DJ, Shear MK, Weaver E (1998), Anxiety as a predictor of response to interpersonal psychotherapy for recurrent major depression: an exploratory investigation. Depression & Anxiety, 8: 135-141.
Freedman DG, Freedman M (1969), Behavioral differences between Chinese-American and American newborns. Nature, 224: 1227
Garcia-Coll C, Kagan J, Reznick JS (1984), Behavioral inhibition in young children. Child Development, 55: 1005-1019
Gest SD (1997), Behavioral inhibition: stability and associations with adaptation from childhood to early adulthood. Journal of Personality & Social Psychology, 72: 467-475.
Harmon-Jones E, Allen JJ (1997), Behavioral activation sensitivity and resting frontal EEG asymmetry: covariation of putative indicators related to risk for mood disorders. Journal of Abnormal Psychology, 106: 159-163.
Hirshfeld DR, Rosenbaum JF, Biederman J, Bolduc EA, Faraone SV, Snidman N, Reznick JS, Kagan J (1992), Stable behavioral inhibition and its association with anxiety disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 31: 103-111.
Hirshfeld DR, Biederman J, Brody L, Faraone SV, Rosenbaum JF (1997a), Associations between expressed emotion and child behavioral inhibition and psychopathology: a pilot study. Journal of the American Academy of Child & Adolescent Psychiatry, 36: 205-213.
Hirshfeld DR, Biederman J, Brody L, Faraone SV, Rosenbaum JF (1997b), Expressed emotion toward children with behavioral inhibition: associations with maternal anxiety disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 36: 910-917.
Hsu LK, Folstein MF (1997), Somatoform disorders in Caucasian and Chinese Americans. Journal of Nervous & Mental Disease, 185: 382-7.
Jack D, Maser, Cloninger (1990), Comorbidity of mood and anxiety disorder
Johnson MR and Lydiard RB (1998), comorbidity of major depression and panic disorder. Journal of Clinical Psychology, 54: 201-210
Jurgens U (1982), Amygdalar vocalization pathways in the squirrel monkey. Brain Research, 241: 181-196
Kagan J, Kearsley KB, Zelazo PR (1978), Infancy: Its place in human development. Cambridge, MA: Harvard University Press.
Kagan J, Reznick JS, Clarke C, Snidman N, Garcia-Coll C (1984), Behavioral inhibition to the unfamiliar. Child Development, 55: 2212-2225
Kagan J, Reznick JS, Snidman N (1987), The physiology and psychology of behavioral inhibition in children. Child Development, 58: 1459-1473.
Kagan J, Reznick JS, Gibbons J (1989), Inhibited and Uninhibited Types of Children. Child Development, 60: 838-845
Kagan J, Snidman N (1991a), Infant Predictors of Inhibited and Uninhibited Profiles. Psychological Science, 2: 40-44
Kagan J, Snidman N (1991b), Temperamental Factors in Human Development. American Psychologist, 46: 856-862
Kagan J (1992), Behavior, Biology, and the Meanings of Temperamental Constructs. Pediatrics, 90: 510-513
Kagan J, Arcus D, Snidman N, Wang YF, Hendler J, Greene S (1994), Reactivity in infants: a cross-national comparison. Developmental Psychology, 30(3): 342-345
Kagan J (1994), Galen's Prophecy. New York: Basic Books
Kagan J, Zentner M (1996), Early Childhood predictors of Adult Psychopathology. Harvard Review of Psychiatry, 3: 341-350
Kagan J (1997), Temperament and the Reactions to Unfamiliarity. Child Development, 68: 139-143
Kagan J, Snidman N, Zentner M, Peterson E (1999a), Infant Temperament and Anxiety Symptoms in School Age Children. Development and Psychopathology, 11: 209-224
Kagan J, Snidman N (1999b), Early Childhood Predictors of Adult Anxiety Disorders. Biological Psychiatry, 46: 1536-1541.
Kashani JH, Orvaschel H (1988), Anxiety disorders in mid-adolescece: A community sample. American Journal of Psychiatry, 145: 960-964
Kendler KS, Neale MC, Kessler RC, Heath AC, Eaves LJ (1992), The genetic epidemiology of phobias in women. The interrelationship of agoraphobia, social phobia, situational phobia, and simple phobia. Archives of General Psychiatry, 49: 273-281.
Kenneth H, Rubin & Shannon L, Stewart (1996), Social Withdrawal
Kochanska G (1991), Patterns of inhibition to the unfamiliar in children of normal and affectively ill mothers. Child Development, 62: 250-263
Koukopoulos A and Koukopoulos A (1999), Agitated depression as a mixed state and the problem of melancholia. Psychiatry Clinics North America, 22:547-564.
Kovacs M (1990), Comorbidity anxiety disorders in childhood-onset depression. In: Master JD. Cloninger CR. eds. Comorbidity of Mood and Anxiety Disorders. Washington DC: American Psychiatric Press. pp. 271-282
Kupfer DJ, Carpenter LL (1990), Clinical evidence of comorbidity: A critique of treated samples and longitudinal studies. In: Master JD. Cloninger CR. eds. Comorbidity of Mood and Anxiety Disorders. Washington DC: American Psychiatric Press. pp. 231-238
LaGasse L, Gruber C, Lipsitt LP (1989), The infantile expression of avidity in relation to later assessments. In: Reznick JS, ed. Perspectives on behavioral inhibition. Chicago, IL: University of Chicago Press. 159-176
Lemke MR (1999), Motor signs of depression. Nervenarzt, 70:600-612
Lewis M. (1989). Culture and biology: The role of temperament. In P. R. Zelazo & R. G. Bzarr (Eds), Challenges to development paradigm: Implications for theory assessment and treatment (pp.203-223). Hillsdale, NJ: Erlbaum.
Lydiard RB, Brawman-Mintzer O (1998), Anxious depression. Journal of Clinical Psychiatry, 59: 10-17.
Magee WJ, Eaton WW, Wittchen HU, McGonagle KA, Kessler RC (1996), Agoraphobia, simple phobia, and social phobia in the National Comorbidity Survey. Archives of General Psychiatry, 53:159-168.
Maier W, Falkai P (1999), The epidemiology of comorbidity between depression, anxiety disorders and somatic diseases. International Clinical Psychopharmacology, 14: S1-6.
Manassis K, Bradley S, Goldberg S, Hood J, Swinson R (1995), Behavioral inhibition, attachment and anxiety in children of mothers with anxiety disorders. Canadian Journal of Psychiatry, 40: 87-92
Marshall PJ, Stevenson-Hinde J (1998), Behavioral inhibition, heart period, and respiratory sinus arrhythmia in young children. Developmental Psychobiology, 33: 283-292.
Masi G, Favilla L, Mucci M, Millepiedi S (2000), Depressive comorbidity in children and adolescents with generalized anxiety disorder. Child Psychiatry & Human Development, 30: 205-215.
Master JD, Cloninger CR (1990), Comorbidity of anxiety and mood disorders: Introduction and Overview. In: Master JD. Cloninger CR. eds. Comorbidity of Mood and Anxiety Disorders. Washington DC: American Psychiatric Press. pp. 869
Matheny AP Jr. (1989), Children's behavioral inhibition over age and across situations: genetic similarity for a trait during change. Journal of Personality, 57: 215-235.
McGee R, Williams S, Silva PH (1985), Factor structure and correlates of ratings of inattention, hyperactivity, and antisocial behavior in a large sample of 9-year old children from the general population. Journal of Consulting and Clinical Psychology, 53: 480-490
McNally RJ (1992), Cognitive processing of trauma cues in rape victims with posttraumatic stress disorder. Cognitive therapy and research, 16: 283-295
Merikangas KR, Stevens DE, Fenton B, Stolar M, O’malley S, Woods SW, Risch N (1998), Co-morbidity and familial aggression of alcoholism and anxiety disorders. Psychological Medicine, 28: 773-788
Mick MA, Telch MJ (1998), Social anxiety and history of behavioral inhibition in young adults. Journal of Anxiety Disorders, 12: 1-20.
Mishkin M, Aggelton J (1981), Multiple functional contributions of the amygdale in the monkey. In: Ben-Ari Y, ed. The amygdale complex. Amsterdam, the Netherlands: Elsevier North-Holland Biomedical Press. 409-420. INSERM Symposium 20.
Nachmias M, Gunnar M, Mangelsdorf S, Parritz RH, Buss K (1996), Behavioral inhibition and stress reactivity: the moderating role of attachment security. Child Development, 67: 508-522.
Parker G, Cheah YC, Roy K (2001), Do the Chinese somatize depression? A cross-cultural study. Social Psychiatry Epidemiology, 36:287-93
Parker G, Gladstone G, Chee KT (2001), Depression in the planet's largest ethnic group: the Chinese. American Journal of Psychiatry, 158: 857-864.
Puig-Antich J, Robinovich H (1986), Relationship between affective and anxiety disorders in childhood. In: Gittelman R. ed. Anxiety disorders of childhood. New York: Guilford Press. pp.136-156
Regier DA, Boyd JH, Burke JD, Rae DS, Myers JK, Kramer M, Robins LN, George LK, Karno M, Locke BZ (1988), One-month prevalence of mental disorders in the United States. Archives of General Psychiatry, 45: 977-986
Regier DA, Burke JD, Burke KC (1990), Evidence for comorbidity: Population-based studies. In: Master JD. Cloninger CR. eds. Comorbidity of Mood and Anxiety Disorders. Washington DC: American Psychiatric Press. pp. 113-122
Regier DA, Rae DS, Narrow WE, Kaelber CT, Schatzberg AF (1998), Prevalence of anxiety disorders and their comorbidity with mood and addictive disorders. British Journal of Psychiatry, Supplement 24-28
Reznick JS, Kagan J, Snidman N, Gersten M, Baak K, Rosenberg A (1986), Inhibited and Uninhibited Children: A Follow-up Study. Child Development, 57: 660-680
Reznick JS, Hegeman JM, Kaufman ER, Woods SW, Jacobs M (1992), Retrospective and Concurrent Self-Report of Behavioral inhibition and Their Relation to Adult Mental Health. Development and Psychopathology, 4: 301-321
Ronald M. Rapee & William C. Sanderson (1997), Social Phobia
Rosenbaum JF, Biederman J, Gersten M, Hirshfeld DR, Meminger SR, Herman JB, Kagan J, Reznick JS, Snidman N (1988), Behavioral inhibition in children of parents with panic disorder and agoraphobia. A controlled study. Archives of General Psychiatry, 45: 463-470.
Rosenbaum JF, Biederman J, Hirshfeld DR, Bolduc EA, Faraone SV, Kagan J, Snidman N, Reznick JS (1991a), Further evidence of an association between behavioral inhibition and anxiety disorders: results from a family study of children from a non-clinical sample. Journal of Psychiatric Research, 25: 49-65.
Rosenbaum JF, Biederman J, Hirshfeld DR, Bolduc EA, Chaloff J (1991b), Behavioral inhibition in children: a possible precursor to panic disorder or social phobia. Journal of Clinical Psychiatry, 52: 5-9.
Rosenbaum JF, Biederman J, Bolduc EA, Hirshfeld DR, Faraone SV, Kagan J (1992), Comorbidity of parental anxiety disorders as risk for childhood-onset anxiety in inhibited children. American Journal of Psychiatry, 149: 475-481.
Rosenbaum JF, Biederman J, Bolduc-Murphy EA, Faraone SV, Chaloff J, Hirshfeld DR, Kagan J (1993), Behavioral inhibition in childhood: a risk factor for anxiety disorders. Harvard Review of Psychiatry, 1: 2-16.
Rosenbaum JF, Biederman J, Hirshfeld DR, Kagan J, Snidman N, Friedman D, Nineberg A, Gallery DJ, Faraone SV (2000), A Controlled Study of Behavioral Inhibition of Parents With panic Disorder and Depression. American Journal of Psychiatry, 157: 2002-2010
Rosenberg A, Kagan J (1987), Iris pigmentation and behavioral inhibition. Developmental Psychobiology, 20: 377-392.
Rosenberg A, Kagan J (1989), Physical and physiological correlates of behavioral inhibition. Developmental Psychobiology, 22: 753-770.
Rothbart MK (1988), Temperament and the development of inhibited approach. Child Development, 59: 1241-1250.
Rubin KH, Hastings PD, Stewart SL, Henderson HA, Chen X (1997), The consistency and concomitants of inhibition: some of the children, all of the time. Child Development, 68: 467-483.
Sabbe B, Hulstijn W, Van Hoof J, Zitman F (1996), Fine motor retardation and depression. Journal of Psychiatric Reseach, 30:295-306.
Sabbe B, Hulstijn W, van Hoof J, Tuynman-Qua HG, Zitman F (1999), Retardation in depression: assessment by means of simple motor tasks. Journal of Affect Disorder, 55:39-44.
Schelde JT (1998), Major depression: behavioral markers of depression and recovery. Journal of Nerv Ment Dis, 186:133-140
Schwartz CE, Snidman N, Kagan J (1999), Adolescent Social Anxiety as an Outcome of Inhibited Temperament in Childhood. Journal of the American Academy of Child & Adolescent Psychiatry, 38: 1008-1015
Sobin C, Mayer L, Endicott J (1998), The motor agitation and retardation scale: a scale for the assessment of motor abnormalities in depressed patients. Journal of Neuropsychiatry Clinical Neuroscience, 10:85-92.
Spitzer RL, Endicott J (1979), Schedule for Affective Disorders and Schizophrenia-Lifetime Version (3rd ed.). Reasearch Assessment and Training Unit, New York State Psychiatric Institute, New York, New York.
Stern H, Arcus D, Kagan J, Robin DB, Snidman N (1994), Statistical Choices in infant temperament research. Behaviormetrika, 21: 1-17
Stevenson-Hinde J, Marshall PJ (1999), Behavioral inhibition, heart period, and respiratory sinus arrhythmia: an attachment perspective. Child Development, 70: 805-816.
Strelau J, Angleitner A (1991), Explorations in temperament: international perspectives on theory and measurement.
Van den Boom DC (1989), Neonatal irritability and the development of attachment. In: Kohnstamm GA, Bates JE, Rothbart MK, eds. Temperament in childhood. New York, NY: Wiley, 229-318
Van Hoof JJ, Hulstijn W, van Mier H, Pagen M (1993), Figure drawing and psychomotor retardation: preliminary report. J Affect Disord, 29: 263-266.
Warren SL, Schmitz S, Emde RN (1999), Behavioral genetic analyses of self-reported anxiety at 7 years of age. Journal of the American Academy of Child & Adolescent Psychiatry, 38: 1403-1408
Weisz JR, Suwanlert S, Chaiyasit W, Weiss B, Achenban TM, Walter BA (1987), Epidemiology of behavioral and emotional problems among Thai and American children: Parent reports for ages 6-11. Journal of the American Academy of Child & Adolescent Psychiatry, 26: 890-898.
Weisz JR, Suwanlert S, Chaiyasit W, Weiss B, Walter BA, Anderson WW (1988), Thai and American perspectives on over-and undercontrolled child behavior problems. Journal of Consulting and Clinical Psychology, 56: 601-609
Wittchen HU and Essau CA (1993), Comorbidity and mixed anxiety-deppressive disorders: is there epidemiologic? Journal of Clinical Psychiatry, 54: 9-15