Adverse Childhood Experiences and Mental Health, Chronic Medical Conditions, and Development in Young Children
Adverse Childhood Experiences and Mental Health, Chronic Medical Conditions, and Development in Young Children
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DOI：
10.1016/j.acap.2015.05.005
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发表时间：
2015-09-01
影响因子：
3.1
通讯作者：
Horwitz, Sarah McCue
中科院分区：
文献类型：
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作者：
Kerker, Bonnie D.;Zhang, Jinjin;Horwitz, Sarah McCue
目的：了解儿童福利系统中儿童不良童年经历（ace）与心理健康、慢性疾病和社会发展的关系。方法：本横断面研究使用了2008年至2009年儿童福利调查（全国儿童和青少年福祉调查II）中具有全国代表性的儿童样本。我们的分析包括对18 - 71个月未接受家庭外护理的儿童的看护人访谈和社工报告（n = 912）。我们通过双变量和多变量分析检验了ace与心理健康（通过儿童行为检查表[CBCL]测量）、报告的慢性医疗状况和社会发展（通过Vineland社会化量表测量）之间的关系。结果：几乎所有儿童（98.1%）在其一生中都有过ACE；平均得分为3.6次。每增加一例ACE， CBCL出现问题评分的几率增加32%（比值比[OR] 1.32, 95%可信区间[CI] 1.14, 1.53），出现慢性疾病的几率增加21%（比值比[OR] 1.21, 95%可信区间[CI] 1.05, 1.40）。在36 ~ 71个月的儿童中，每增加一个ACE，低Vineland社会化评分的几率增加77% （OR 1.77, 95% CI 1.12, 2.78）。结论：ace与儿童早期不良心理健康和慢性疾病有关，在3至5岁儿童中，与社会发展有关。需要努力研究是否为有多重压力源的家庭提供早期干预可以减轻ace对儿童预后的影响。
OBJECTIVE: To determine the relationships between adverse childhood experiences (ACEs) and mental health, chronic medical conditions, and social development among young children in the child welfare system.METHODS: This cross-sectional study used a nationally representative sample of children investigated by child welfare (National Survey of Child and Adolescent Well-Being II) from 2008 to 2009. Our analysis included caregiver interviews and caseworker reports about children aged 18 to 71 months who were not in out-of-home care (n = 912). We examined the associations between ACEs and mental health (measured by the Child Behavior Checklist [CBCL]), reported chronic medical conditions, and social development (measured by the Vineland Socialization Scale) in bivariate and multivariate analyses.RESULTS: Nearly all children (98.1%) were reported to have had an ACE in their lifetime; the average number of ACEs was 3.6. For every additional reported ACE, there was a 32% increased odds of having a problem score on the CBCL (odds ratio [OR] 1.32, 95% confidence interval [CI] 1.14, 1.53) and a 21% increased odds of having a chronic medical condition (OR 1.21, 95% CI 1.05, 1.40). Among children aged 36 to 71 months, for every additional reported ACE, there was a 77% increased odds of a low Vineland Socialization score (OR 1.77, 95% CI 1.12, 2.78).CONCLUSIONS: ACEs were associated with poor early childhood mental health and chronic medical conditions, and, among children aged 3 to 5, social development. Efforts are needed to examine whether providing early intervention to families with multiple stressors mitigates the impact of ACEs on children's outcomes.