Pathways between early-life adversity and adolescent self-harm: the mediating role of inflammation in the Avon Longitudinal Study of Parents and Children.
Pathways between early-life adversity and adolescent self-harm: the mediating role of inflammation in the Avon Longitudinal Study of Parents and Children.
复制标题
早期生活逆境与青少年自残之间的途径：雅芳父母和儿童纵向研究中炎症的中介作用。
DOI：
10.1111/jcpp.13100
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Russell AE
中科院分区：
文献类型：
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作者：
Russell AE
儿童期不良经历（ACE）如身体和情感虐待与自我伤害密切相关，但这种关系的机制尚不清楚。在先前的研究中，炎症与ACE和自我伤害或自杀的经历有关。这是第一个研究炎症标志物是否介导接触ACE和自我伤害之间的关联的研究。MethodsParticipants是来自雅芳父母和儿童纵向研究（ALSPAC）的4,308名年轻人，该研究是英国一项基于人口的出生队列研究。使用结构方程建模方法拟合调解模型与0至9岁（yo）之间经历的ACE数量，9.5 yo时测量的炎症标志物白细胞介素-6和C反应蛋白水平，以及16 yo.ResultsThe年轻人经历的ACE平均数量为1.41（SE0.03）。较高的ACE评分与16岁时自我伤害的风险增加相关（每增加ACE的直接效应相对风险（RR）为1.11，95% CI为1.05，1.18，p < 0.001）。我们没有发现ACE通过炎症对自我伤害产生间接影响的证据（RR 1.00，95%CI 1.00，1.01，p = 0.38）.ConclusionsYoung people who have been exposed to ACE are a group at high risk of self-harm. ACE和自我伤害之间的关联似乎不是由儿童时期的炎症过程介导的，这是由儿童时期测量的外周循环炎症标志物水平所指示的。需要进一步的研究来确定这种关系背后的其他心理和生物机制。
BackgroundAdverse childhood experiences (ACEs) such as physical and emotional abuse are strongly associated with self‐harm, but mechanisms underlying this relationship are unclear. Inflammation has been linked to both the experience of ACEs and self‐harm or suicide in prior research. This is the first study to examine whether inflammatory markers mediate the association between exposure to ACEs and self‐harm.MethodsParticipants were 4,308 young people from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population‐based birth cohort in the United Kingdom. A structural equation modelling approach was used to fit a mediation model with the number of ACEs experienced between ages 0 and 9 years old (yo), levels of the inflammatory markers interleukin‐6 and C‐reactive protein measured at 9.5 yo, and self‐harm reported at 16 yo.ResultsThe mean number of ACEs young people experienced was 1.41 (SE0.03). Higher ACE scores were associated with an increased risk of self‐harm at 16 yo (direct effect relative risk (RR) per additional ACE 1.11, 95% CI 1.05, 1.18,p< 0.001). We did not find evidence of an indirect effect of ACEs on self‐harm via inflammation (RR 1.00, 95% CI 1.00, 1.01,p= 0.38).ConclusionsYoung people who have been exposed to ACEs are a group at high risk of self‐harm. The association between ACEs and self‐harm does not appear to be mediated by an inflammatory process in childhood, as indexed by peripheral levels of circulating inflammatory markers measured in childhood. Further research is needed to identify alternative psychological and biological mechanisms underlying this relationship.