When more is not better: the role of cumulative risk in child behavior outcomes
When more is not better: the role of cumulative risk in child behavior outcomes
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DOI：
10.1111/j.1469-7610.2004.00351.x
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发表时间：
2005-03-01
影响因子：
7.6
通讯作者：
Sroufe, LA
中科院分区：
文献类型：
--
作者：
Appleyard, K;Egeland, B;Sroufe, LA
背景：累积风险研究已经确定了共同发生的危险因素对儿童行为结果的有害影响。然而，现存的文献并没有解决潜在的差异效应的累积风险在不同的发展点，并留下了开放的问题，是否阈值模型或线性风险模型更好地描述了累积风险对行为结果的影响。目前的研究检查了累积风险因素的影响（即，儿童虐待、父母间暴力、家庭破裂、社会经济地位低和父母压力大）对青少年期儿童行为结果的影响。研究方法：使用正在进行的风险城市儿童（N = 171）纵向研究的数据，这五个风险因素在儿童早期和中期的累积影响进行了调查。结果：研究结果支持累积风险假设，即儿童早期的风险数量预测青春期的行为问题。有证据表明，累积风险呈线性，但不是阈值模型;存在的风险越多，儿童结局越差。此外，在幼儿期存在多种风险继续解释预测青少年行为结果的变化，即使包括在童年中期的风险的影响。结论：研究结果表明，有必要对高危儿童进行全面预防和早期干预，这样似乎就不会有一个点，超过这个点，为儿童提供的服务就毫无希望，而且我们可以减少的每一个风险因素都很重要。
Background: Cumulative risk research has established the deleterious effects of co-occurring risk factors on child behavior outcomes. However, extant literature has not addressed potential differential effects of cumulative risk at different points in development and has left open questions about whether a threshold model or a linear risk model better describes the impact of cumulative risk on behavior outcomes. The current study examined the impact of cumulative risk factors (i.e., child maltreatment, inter-parental violence, family disruption, low socioeconomic status, and high parental stress) in early and middle childhood on child behavior outcomes in adolescence. Methods: Using data from an ongoing longitudinal study of at-risk urban children (N = 171), the cumulative effects of these five risk factors across early and middle childhood were investigated. Results: The findings support the cumulative risk hypothesis that the number of risks in early childhood predicts behavior problems in adolescence. Evidence for a linear but not a threshold model of cumulative risk was found; the more risks present, the worse the child outcome. Moreover, the presence of multiple risks in early childhood continues to explain variations in predicting adolescent behavior outcomes even after including the effects of risk in middle childhood. Conclusions: The results support the need for comprehensive prevention and early intervention efforts with high-risk children, such that there does not appear to be a point beyond which services for children are hopeless, and that every risk factor we can reduce matters.