Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication II: associations with persistence of DSM-IV disorders.
Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication II: associations with persistence of DSM-IV disorders.
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DOI：
10.1001/archgenpsychiatry.2009.187
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发表时间：
2010-02
影响因子：
--
通讯作者：
Kessler, Ronald C.
中科院分区：
文献类型：
--
作者：
McLaughlin, Katie A.;Green, Jennifer Greif;Gruber, Michael J.;Sampson, Nancy A.;Zaslavsky, Alan M.;Kessler, Ronald C.
虽然显着协会的童年逆境（CA）与成人精神障碍已被广泛记录，协会的CA与发病和持续性的障碍尚未被区分。这一区别对于概念和实际目的都具有相当重要的意义。在全国科摩罗重复调查（NCS-R）中，研究12例回顾性报告的CA与成人DSM-IV疾病持续性的多变量相关性。横断面社区调查美国家庭人口中5，692名成年人的全国代表性样本。使用WHO复合国际诊断访谈（CIDI），在有这些疾病终身史的受访者中，分别评估了20种终生DSM-IV情绪、焦虑、破坏性行为和物质障碍的发作频率。使用后向复发生存模型对持续性的预测因素进行了检查，以预测自最近发作以来的时间，控制发病年龄和自发病以来的时间。CA涉及适应不良的家庭功能（MFF）（父母精神疾病，物质障碍，犯罪行为，家庭暴力，虐待，忽视），但不是其他CA显着，但适度相关的情绪，物质和焦虑症的持久性。MFF CA的数量具有统计学显著性，但同样具有实质性适度的亚加性关联，具有相同的结果。暴露于多种其他CA与情绪和焦虑障碍的持续性显着相关。在整个生命过程中，协会仍然具有统计学意义，尽管在没有CA的情况下，模拟显示最近一次发作时间的协会的实质性大小仅增加1.6%（从平均8.3年增加到平均8.4年）。CA与成人DSM-IV/CIDI疾病的总体统计学显著性关联主要是由于与发病而非持续性的组分关联，间接表明公共卫生对CA关注的最大焦点应针对一级预防而非二级预防。
Although significant associations of childhood adversities (CAs) with adult mental disorders have been widely documented, associations of CAs with onset and persistence of disorders have not been distinguished. This distinction is of considerable importance for both conceptual and practical purposes. To examine the multivariate associations of 12 retrospectively reported CAs with persistence of adult DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Cross-sectional community survey Nationally representative sample of 5,692 adults in the US household population. None Recency of episodes was assessed separately for each of 20 lifetime DSM-IV mood, anxiety, disruptive behavior, and substance disorders among respondents with a lifetime history of these disorders using the WHO Composite International Diagnostic Interview (CIDI). Predictors of persistence were examined using backward recurrence survival models to predict time-since-most-recent-episode controlling for age-of-onset and time-since-onset. CAs involving maladaptive family functioning (MFF) (parental mental illness, substance disorder, criminal behavior, family violence, abuse, neglect) but not other CAs were significantly but modestly related to persistence of mood, substance, and anxiety disorders. Number of MFF CAs had statistically significant, but again substantively modest, sub-additive associations with the same outcomes. Exposure to multiple other CAs was significantly associated with persistence of mood and anxiety disorders. Associations remained statistically significant throughout the life course, although the substantive size of associations indicated by simulations showing time to most recent episode would increase by only 1.6% (from a mean of 8.3 years to a mean of 8.4 years) in the absence of CAs. The overall statistically significant associations of CAs with adult DSM-IV/CIDI disorders are due largely to component associations with onsets rather than persistence, indirectly suggesting that the greatest focus of public health attention on CAs should be aimed at primary prevention rather than secondary prevention.
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影响因子：
17.7
作者：
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通讯作者：
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影响因子：
3.7
作者：
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通讯作者：
ALLISON, PD
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作者：
Arata, Catalina M.;Langhinrichsen-Rohling, Jennifer;O'Brien, Natalie
通讯作者：
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影响因子：
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作者：
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通讯作者：
MORAN, P
影响因子：
--
作者：
Green, Jennifer Greif;McLaughlin, Katie A.;Berglund, Patricia A.;Gruber, Michael J.;Sampson, Nancy A.;Zaslavsky, Alan M.;Kessler, Ronald C.
通讯作者：
Kessler, Ronald C.