Association of Childhood History of Parental Incarceration and Juvenile Justice Involvement With Mental Health in Early Adulthood
Association of Childhood History of Parental Incarceration and Juvenile Justice Involvement With Mental Health in Early Adulthood
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DOI：
10.1001/jamanetworkopen.2019.10465
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发表时间：
2019-09-01
影响因子：
13.8
通讯作者：
Davis, Matthew M.
中科院分区：
文献类型：
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作者：
Heard-Garris, Nia;Sacotte, Kaitlyn Ann;Davis, Matthew M.
重要性有父母监禁(PI)或少年司法介入(JJI)童年病史的年轻人比他们的同龄人更有可能有更差的心理健康结果。然而，心理健康与PI和JJI(PI+JJI)暴露之间的关系尚不清楚。目的确定PI+JJI暴露与青壮年心理健康结果的关联。设计、背景和参与者对美国全国青少年至成人健康纵向调查进行了横断面研究，以检验PI、JI和PI+JI与心理健康结果(即抑郁、焦虑、创伤后应激障碍、自杀意念和心理健康咨询)的关系。对13083名参与者进行了家庭访谈，排除了704名18岁后有精神障碍的参与者，12379名参与者构成了分析样本。受试者在1994至1995年间就读于7至12年级，在2008年的随访中年龄在24至32岁之间。2019年完成数据分析。在18岁之前接触父母监禁，JJI，或PI加JJI。主要结果和测量成年早期(24-32岁)的心理健康结果。分析包括多变量Logistic回归模型；考虑了个人、家庭和地理水平的因素；并产生了调整后的优势比。第1波平均年龄15.4岁(95%CI，15.2~15.7岁)，10499例(80.2%)无PI或JJI史，1247例(9.1%)有童年PI史，704例(5.2%)18岁以后有PI史，492例(4.5%)只有JJI史，141例(1.2%)PI+JJI史。社会人口学特征因暴露而异。与未接触PI和JJI的同龄人相比，暴露在PI和JJI中的人患抑郁症(调整后的优势比，2.80；95%CI，1.60-4.90)、焦虑(调整后的优势比，1.89；95%CI，1.08-3.31)和创伤后应激障碍(调整后的优势比，2.92；95%CI，1.09-7.82)的风险更高。除了单独接触PI或JJI外，接触PI和JJI与心理健康没有相加的关系。结论和相关性本研究表明，儿童时期接触刑事司法系统会使个人在成年早期面临心理健康状况不良的风险。以减少美国刑事司法系统对儿童的影响为重点的临床、宣传和政策努力，可能会在这些人成年后的心理健康方面产生实质性的改善。
IMPORTANCE Young adults with a childhood history of parental incarceration (PI) or juvenile justice involvement (JJI) are more likely to have worse mental health outcomes than their peers. However, the association between mental health and exposure to both PI and JJI (PI plus JJI) is unclear.OBJECTIVE To determine the association of PI plus JJI exposure with mental health outcomes in young adulthood.DESIGN, SETTING, AND PARTICIPANTS A cross-sectional study of the US National Longitudinal Survey of Adolescent to Adult Health was conducted to examine the associations between PI, JJI, and PI plus JJI and mental health outcomes (ie, depression, anxiety, posttraumatic stress disorder, suicidal ideation, and mental health counseling). In-home interviews were conducted of 13 083 participants; 704 participants with PI after age 18 years were excluded, and 12 379 participants formed the analysis sample. Participants were in grades 7 to 12 in 1994 to 1995 and were ages 24 to 32 years at follow-up in 2008. Data analysis was completed in 2019. EXPOSURES Parental incarceration, JJI, or PI plus JJI before age 18 years.MAIN OUTCOMES AND MEASURES Mental health outcomes in early adulthood (ages 24-32 years). The analysis included multivariable logistic regression models; accounted for individual, family, and geographic-level factors; and generated adjusted odds ratios.RESULTS Among 13 083 participants (6962 female; weighted proportion, 49.6%) with a mean age at wave 1 of 15.4 years (95% CI, 15.2-15.7 years), 10 499 (80.2%) did not have a history of PI or JJI, 1247 (9.1%) had childhood PI, 704 (5.2%) had PI after age 18 years, 492 (4.5%) had JJI only, and 141 (1.2%) had PI plus JJI. Sociodemographic characteristics varied by exposure. Exposure to both PI and JJI was associated with a greater risk of depression (adjusted odds ratio, 2.80; 95% CI, 1.60-4.90), anxiety (adjusted odds ratio, 1.89; 95% CI, 1.08-3.31), and posttraumatic stress disorder (adjusted odds ratio, 2.92; 95% CI, 1.09-7.82) compared with peers with neither exposure. Exposure to both PI and JJI did not have an additive association with mental health beyond PI or JJI alone.CONCLUSIONS AND RELEVANCE This study suggests that exposure to the criminal justice system during childhood places individuals at risk for poor mental health outcomes in early adulthood. Clinical, advocacy, and policy efforts that prioritize reducing the impact of the US criminal justice system on children may yield substantive improvements in the mentalwell-being of those individuals as adults.