父母不良童年经历和童年威胁与剥夺对青少年抑郁和焦虑的影响:对澳大利亚儿童的纵向研究分析。

IF 6.1 2区 医学 Q1 PSYCHIATRY
Santosh Giri, Nancy Ross, Rachel Kornhaber, Kedir Y Ahmed, Subash Thapa
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引用次数: 0

摘要

目的:关于父母不良童年经历(ace)对青少年心理健康影响的证据仍然有限。本研究利用澳大利亚儿童纵向研究的数据,调查了父母的不良经历、儿童暴露于威胁和剥夺相关的不良经历以及青少年抑郁和焦虑之间的关系。方法:我们对澳大利亚儿童纵向研究(LSAC)进行了二次分析,这是一项基于人群的纵向队列研究。父母ace由照顾者回顾性报告。对4-17岁儿童的不良经历进行评估,并将其分为与威胁相关的不良经历(如欺凌、敌对父母、不安全社区、家庭暴力)或与剥夺相关的不良经历(如经济困难、父母滥用药物、父母心理困扰、家庭成员死亡、父母分居、父母法律问题)。抑郁和焦虑症状由12至17岁的青少年自我报告。使用修正泊松回归模型来检查父母ace和儿童威胁和剥夺相关ace(在12岁、14岁和16岁之前评估)与抑郁和焦虑结局的独立和联合关联,包括相互作用效应的测试。结果:共纳入12-13岁儿童3956例,14-15岁儿童3357例,16-17岁儿童3089例。男性占50.8-59.8%,女性占40.2-49.2%。到17岁时,30.4%和9.4%的青少年分别出现抑郁和焦虑。父母ace(≥2)与12 - 13岁(RR = 1.42; 95% CI: 1.10-1.84)和16-17岁(RR = 1.19; 95% CI: 1.02-1.39)抑郁风险增加相关。暴露于≥2次与剥夺相关的不良经历显著增加了所有年龄段的抑郁症风险,相对风险范围为1.31至2.18。高威胁相关ace(≥2)仅在12 ~ 13年时与抑郁风险增加相关(RR = 2.01; 95% CI: 1.28 ~ 3.17)。未观察到显著的相互作用。结论:研究结果强化了ace模型,表明在人口水平上,早期识别因金融危机或家庭逆境而面临早期生活剥夺的儿童,结合对儿童和父母的有针对性的干预措施以及支持性社会政策,可以降低长期的心理健康风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The effects of parental adverse childhood experiences (ACEs) and childhood threat and deprivation on adolescent depression and anxiety: an analysis of the longitudinal study of Australian children.

Aims: Evidence on the effects of parental Adverse Childhood Experiences (ACEs) on adolescent mental health remains limited. This study investigates the associations between parental ACEs, children's exposure to threat- and deprivation-related ACEs, and adolescent depression and anxiety using data from the Longitudinal Study of Australian Children.

Methods: We conducted a secondary analysis of the Longitudinal Study of Australian Children (LSAC), a population-based longitudinal cohort study. Parental ACEs were retrospectively reported by caregivers. Children's exposure to ACEs was assessed from ages 4-17 years and categorised as threat-related ACEs (e.g., bullying, hostile parenting, unsafe neighbourhoods, family violence) or deprivation-related ACEs (e.g., financial hardship, parental substance abuse, parental psychological distress, death of a family member, parental separation, parental legal problems). Depressive and anxiety symptoms were self-reported by adolescents at ages between 12 and 17 years. Modified Poisson regression models were used to examine the independent and combined associations of parental ACEs and children's threat- and deprivation-related ACEs (assessed before ages 12, 14, and 16 years) with depression and anxiety outcomes, including tests for interaction effects.

Results: The analysis included 3,956 children aged 12-13 years, 3,357 children aged 14-15 years, and 3,089 children aged 16-17 years. Males comprised 50.8-59.8% and females 40.2-49.2% across all ages. By the age of 17, 30.4% and 9.4% of the adolescents had depression and anxiety, respectively. Parental ACEs (≥2) were associated with increased depression risk at ages 12 to 13 years (RR = 1.42; 95% CI: 1.10-1.84) and at 16-17 years (RR = 1.19; 95% CI: 1.02-1.39). Exposure to ≥ 2 deprivation-related ACEs significantly increased the risk of depression across all ages, with relative risks ranging from 1.31 to 2.18. High threat-related ACEs (≥2) were associated with increased depression risk only at 12 to 13 years (RR = 2.01; 95% CI: 1.28-3.17). No significant interactions were observed.

Conclusions: The findings reinforce the ACEs model by showing that, at the population level, early identification of children exposed to early life deprivations rooted in financial crisis or familial adversities, combined with targeted interventions for both children and parents and supportive social policies, can reduce long-term mental health risks.

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来源期刊
CiteScore
7.80
自引率
1.20%
发文量
121
审稿时长
>12 weeks
期刊介绍: Epidemiology and Psychiatric Sciences is a prestigious international, peer-reviewed journal that has been publishing in Open Access format since 2020. Formerly known as Epidemiologia e Psichiatria Sociale and established in 1992 by Michele Tansella, the journal prioritizes highly relevant and innovative research articles and systematic reviews in the areas of public mental health and policy, mental health services and system research, as well as epidemiological and social psychiatry. Join us in advancing knowledge and understanding in these critical fields.
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