Childhood Sexual Abuse and Depression among American Indians in Adulthood
Childhood Sexual Abuse and Depression among American Indians in Adulthood
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DOI：
10.1093/hsw/hlz005
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发表时间：
2019-05-01
影响因子：
1.5
通讯作者：
Lee, Yeon-Shim
中科院分区：
文献类型：
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作者：
Easton, Scott D.;Roh, Soonhee;Lee, Yeon-Shim
本研究调查了479名美国印第安人（AI）成年人在中西部的样本中与抑郁症相关的远端和近端因素。远端因素包括儿童期性虐待（CSA）和其他儿童期逆境的历史。近端因素包括健康自我效能水平和酒精问题的治疗。该研究还研究了酒精问题治疗对CSA和抑郁症之间关系的调节作用。在模型1中，结果表明，在控制人口统计学和背景变量后，CSA与抑郁呈正相关。在模型2中，童年的逆境和酒精问题的治疗与AI成年人的抑郁症增加有关; CSA变得不显著。健康自我效能感水平作为保护性因素与抑郁呈负相关。在模型3中，酒精问题的治疗放大了CSA对抑郁症的影响。这些研究结果表明，早期创伤性经历可能对AI中的抑郁症产生持续的有害影响;一种加剧CSA对抑郁症影响的机制是治疗酒精问题。需要采取有针对性的干预措施，以减轻这一人群中儿童期创伤对健康的长期负面影响，并加强近端保护因素，如健康自我效能。
The present study investigated distal and proximal factors associated with depression among a sample of 479 American Indian (AI) adults in the Midwest. Distal factors included histories of childhood sexual abuse (CSA) and other childhood adversities. Proximal factors included levels of health self-efficacy and treatment for alcohol problems. The study also examined the moderating effect of treatment for alcohol problems on the relationship between CSA and depression. In model 1, results indicate that CSA was positively related to depression after controlling for demographic and background variables. In model 2, childhood adversities and treatment for alcohol problems were associated with increased depression in AI adults; CSA became nonsignificant. As a protective factor, level of health self-efficacy was negatively associated with depression. In model 3, treatment for alcohol problems magnified the effect of CSA on depression. These findings suggest that early traumatic experiences may have persistent, harmful effects on depression among AIs; one mechanism exacerbating the impact of CSA on depression is treatment for alcohol problems. Targeted interventions are needed to mitigate the long-term negative health effects of childhood trauma in this population and to strengthen proximal protective factors, such as health self-efficacy.