重新审视儿童不良经历筛查在医疗机构中的应用

IF 16.8 Q1 PSYCHOLOGY, MULTIDISCIPLINARY
Andrea Danese, Kirsten Asmussen, Jelena MacLeod, Alan Meehan, Jessica Sears, Natalie Slopen, Patrick Smith, Angela Sweeney
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引用次数: 0

摘要

童年的不良经历(ACE)是导致精神疾病的主要可改变风险因素。通过检测和减轻 ACE 来改善人群心理健康的潜力已引发了大量的公共卫生工作。然而,将 ACE 筛查作为公共心理健康决策的基础却暴露出了一些明显的挑战。在本综述中,我们将对这些挑战进行批判性的概述,重点关注 ACE 筛查措施的有效性、其对有不良心理健康后果风险的个体进行分类的准确性、其在促进提供有针对性的干预措施方面的实用性、受访者和访谈者对其的接受程度,以及这种筛查方法在财务上的整体可持续性。有明显的研究机会来应对这些挑战并改进当前的做法。例如,基础测量研究可以提高 ACE 测量的有效性和可接受性;可以采用个体风险建模方法来提高 ACE 筛查预测心理健康状况的准确性,并指导干预措施的选择;还可以对有前景的干预措施进行测试,以确保通过 ACE 筛查发现的弱势人群能够得到有效的支持。童年不良经历筛查可以通过对高危人群进行个性化治疗或在人群层面采取预防策略来改善心理健康结果。在本综述中,Danese 等人总结了这些筛查措施及相关分析方法所面临的挑战和机遇。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Revisiting the use of adverse childhood experience screening in healthcare settings

Revisiting the use of adverse childhood experience screening in healthcare settings
Adverse childhood experiences (ACEs) are key modifiable risk factors for mental illness. The potential to detect and mitigate ACEs to improve population mental health has led to large public health efforts. However, basing public mental health decisions on ACE screening has revealed several conspicuous challenges. In this Review, we provide a critical overview of these challenges, focusing on the validity of ACE screening measures, their accuracy in classifying individuals at risk for poor mental health outcomes, their utility in facilitating the delivery of targeted interventions, their acceptability by respondents and interviewers, and the overall financial sustainability of this screening approach. There are clear research opportunities to address these challenges and improve current practices. For example, basic measurement research could improve the validity and acceptability of ACE measures, individual risk modelling approaches could be adopted to improve the accuracy of ACE screening to predict mental health conditions and guide intervention selection, and promising interventions could be tested to ensure that vulnerable individuals detected through ACE screening receive effective support. Screening for adverse childhood experiences can improve mental health outcomes through personalized treatments in at-risk individuals or preventative strategies at the population level. In this Review, Danese et al. synthesize the challenges and opportunities of these screening measures and related analytical methods.
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