Childhood adversity and personality disorders: Results from a nationally representative population-based study
Childhood adversity and personality disorders: Results from a nationally representative population-based study
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DOI：
10.1016/j.jpsychires.2010.11.008
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发表时间：
2011-06-01
影响因子：
4.8
通讯作者：
Sareen, Jitender
中科院分区：
文献类型：
--
作者：
Afifi, Tracie O.;Mather, Amber;Sareen, Jitender
背景：虽然有大量基于人群的文献研究童年逆境与I轴精神障碍之间的关系，但关于童年逆境与II轴人格障碍（pd）之间关系的研究主要依赖于临床样本。当前研究的目的是在调整I轴精神障碍的同时，在全国代表性样本中检查一系列童年逆境与pd之间的关系。方法：数据来自全国酒精及相关疾病流行病学调查（NESARC; n = 34,653；数据收集于2004-2005年）；美国20岁及以上人口的全国代表性样本。结果：结果表明，在一般人群中，许多类型的童年逆境在pd患者中非常普遍，其中童年逆境与分裂型、反社会、边缘型和自恋型pd最为一致。在调整了所有其他类型的童年逆境、情绪障碍、焦虑障碍、物质使用障碍、其他PD类型和社会人口变量后，最可靠的童年逆境发现是A类和B类PD的虐待和忽视儿童（奇比从1.22到1.63）。在这些模型中，情绪障碍、焦虑障碍和物质使用障碍也与PD集群显著相关（比值比从1.26到2.38）。结论：有必要进一步研究以了解这种暴露是否与pd相关的因果作用。除了防止虐待儿童之外，重要的是要确定如何防止遭受逆境的儿童受损，因为这可能会减少pd的发展。(C) 2010 Elsevier Ltd.版权所有。
Background: Although, a large population-based literature exists on the relationship between childhood adversity and Axis I mental disorders, research on the link between childhood adversity and Axis II personality disorders (PDs) relies mainly on clinical samples. The purpose of the current study was to examine the relationship between a range of childhood adversities and PDs in a nationally representative sample while adjusting for Axis I mental disorders.Methods: Data were from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; n = 34,653; data collection 2004-2005); a nationally representative sample of the United States population aged 20 years and older.Results: The results indicated that many types of childhood adversity were highly prevalent among individuals with PDs in the general population and childhood adversity was most consistently associated with schizotypal, antisocial, borderline, and narcissistic PDs. The most robust childhood adversity findings were for child abuse and neglect with cluster A and cluster B PDs after adjusting for all other types of childhood adversity, mood disorders, anxiety disorders, substance use disorders, other PD clusters, and sociodemographic variables (Odd Ratios ranging from 1.22 to 1.63). In these models, mood disorders, anxiety disorders, and substance use disorders also remained significantly associated with PD clusters (Odds Ratios ranging from 1.26 to 2.38).Conclusions: Further research is necessary to understand whether such exposure has a causal role in the association with PDs. In addition to preventing child maltreatment, it is important to determine ways to prevent impairment among those exposed to adversity, as this may reduce the development of PDs. (C) 2010 Elsevier Ltd. All rights reserved.