Unpacking the impact of adverse childhood experiences on adult mental health.
Unpacking the impact of adverse childhood experiences on adult mental health.
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DOI：
10.1016/j.chiabu.2017.03.016
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发表时间：
2017-07
影响因子：
4.8
通讯作者：
Grogan-Kaylor A
中科院分区：
文献类型：
--
作者：
Merrick MT;Ports KA;Ford DC;Afifi TO;Gershoff ET;Grogan-Kaylor A
童年时期的逆境会影响成年后的心理健康，增加抑郁和自杀的风险。不良童年经历（ACE）和几个成年人的心理和行为健康结果之间的关联在文献中有很好的记录，建立了预防的必要性。目前的研究分析了扩展的ACE评分（包括儿童时期被打屁股）与成人心理健康结果之间的关系，方法是分别检查每个ACE，以确定每个ACE的贡献。数据来自CDC-Kaiser ACE研究的第二波，包括加州南部Kaiser Permanente的7465名成年成员。创建了对应于11个ACE类别的二分变量，ACE评分范围为0 - 11，对应于发生的ACE总数。多元逻辑回归模型被用来检查ACE和成人心理健康结果之间的关系，调整社会人口学协变量。结果表明，扩大的ACE评分与成年后中度至重度饮酒、吸毒、抑郁情绪和自杀企图的可能性之间存在分级剂量反应关系。在调整后的模型中，小时候被打屁股与所有自我报告的心理健康结果显著相关。超过80%的样本报告暴露于至少一种ACE，这意味着有可能捕获传统ACE指数以前没有考虑过的经验。研究结果强调了检查累积ACE评分和个体ACE对成人健康结果的重要性，以更好地了解未来预防工作的关键风险和保护因素。
Exposure to childhood adversity has an impact on adult mental health, increasing the risk for depression and suicide. Associations between Adverse Childhood Experiences (ACEs) and several adult mental and behavioral health outcomes are well documented in the literature, establishing the need for prevention. The current study analyzes the relationship between an expanded ACE score that includes being spanked as a child and adult mental health outcomes by examining each ACE separately to determine the contribution of each ACE. Data were drawn from Wave II of the CDC-Kaiser ACE Study, consisting of 7465 adult members of Kaiser Permanente in southern California. Dichotomous variables corresponding to each of the 11 ACE categories were created, with ACE score ranging from 0 to 11 corresponding to the total number of ACEs experienced. Multiple logistic regression modeling was used to examine the relationship between ACEs and adult mental health outcomes adjusting for sociodemographic covariates. Results indicated a graded dose-response relationship between the expanded ACE score and the likelihood of moderate to heavy drinking, drug use, depressed affect, and suicide attempts in adulthood. In the adjusted models, being spanked as a child was significantly associated with all self-reported mental health outcomes. Over 80% of the sample reported exposure to at least one ACE, signifying the potential to capture experiences not previously considered by traditional ACE indices. The findings highlight the importance of examining both cumulative ACE scores and individual ACEs on adult health outcomes to better understand key risk and protective factors for future prevention efforts.
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