Childhood abuse and neglect: Specificity of effects on adolescent and young adult depression and suicidality
Childhood abuse and neglect: Specificity of effects on adolescent and young adult depression and suicidality
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DOI：
10.1097/00004583-199912000-00009
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发表时间：
1999-12-01
影响因子：
13.3
通讯作者：
Smailes, EM
中科院分区：
文献类型：
--
作者：
Brown, J;Cohen, P;Smailes, EM
目的：探讨童年忽视、身体虐待和性虐待对青少年和成人抑郁和自杀行为的影响程度和独立性。方法：在1975年、1983年、1986年和1992年的17年间，随机抽取776名平均年龄为5岁至成年的儿童作为研究对象。评估包括一系列儿童、家庭和环境风险以及精神疾病。639名青少年的虐待史由官方虐待记录和成年早期的回顾性自我报告确定。自1983年以来，流失率一直低于5%。结果：儿童期有虐待史的青少年抑郁或自杀的可能性是无虐待史者的3倍（p < 0.01）。不利的环境因素。包括家庭环境、父母和孩子的特征在内，青春期抑郁障碍和自杀企图的风险增加占很大比例，但成年期没有（p < 0.01）。儿童期性虐待的影响最大，且与相关因素最无关。有性虐待史的青少年再次自杀的风险是有性虐待史青少年的8倍（优势比= 8.40,p < 0.01）。结论：有性虐待史的个体在青春期和青年期抑郁或自杀的风险更大。对于那些可能反复尝试自杀的青少年来说，青春期是最脆弱的时期。相比之下，忽视的许多明显影响可能归因于一系列背景因素，这表明在这些情况下需要更广泛的干预重点。
Objective: To investigate the magnitude and independence of the effects of childhood neglect, physical abuse, and sexual abuse on adolescent and adult depression and suicidal behavior. Method: A cohort of 776 randomly selected children was studied from a mean age of 5 years to adulthood in 1975, 1983, 1986, and 1992 during a 17-year period. Assessments included a range of child, family, and environmental risks and psychiatric disorders. A history of abuse was determined by official abuse records and by retrospective self-report in early adulthood on 639 youths. Attrition rate since 1983 has been less than 5%. Results: Adolescents and young adults with a history of childhood maltreatment were 3 times more likely to become depressed or suicidal compared with individuals without such a history (p < .01). Adverse contextual factors. including family environment, parent and child characteristics, accounted for much of the increased risk for depressive disorders and suicide attempts in adolescence but not in adulthood (p < .01). The effects of childhood sexual abuse were largest and most independent of associated factors. Risk of repeated suicide attempts was 8 times greater for youths with a sexual abuse history (odds ratio = 8.40, p < .01). Conclusions: Individuals with a history of sexual abuse are at greater risk of becoming depressed or suicidal during adolescence and young adulthood. Adolescence is the most vulnerable period for those youths who may attempt suicide repeatedly. Many of the apparent effects of neglect, in contrast, may be attributable to a range of contextual factors, suggesting broader focus for intervention in these cases.