Adolescent Violence Perpetration: Associations With Multiple Types of Adverse Childhood Experiences
Adolescent Violence Perpetration: Associations With Multiple Types of Adverse Childhood Experiences
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DOI：
10.1542/peds.2009-0597
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发表时间：
2010-04-01
期刊：
影响因子：
8
通讯作者：
Borowsky, Iris W.
中科院分区：
文献类型：
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作者：
Duke, Naomi N.;Pettingell, Sandra L.;Borowsky, Iris W.
目的：不良童年经历与青春期和成年期的严重功能障碍和生命损失有关。本研究确定了多种不良事件与青少年暴力行为的不同类别之间的关系。方法：数据来自于136 549名6年级、9年级和12年级的学生，他们回答了2007年明尼苏达州学生调查，这是一项匿名的自我报告调查，调查了青少年的健康行为和认知、主要社交领域的特征和青少年参与。采用线性和Logistic回归模型分析6种不良经历，包括身体虐待、家庭和/或其他人的性虐待、目击虐待、家庭酗酒和/或吸毒导致的家庭功能障碍，在调整人口统计学变量后，是否与青少年实施暴力的风险显著相关。不良事件评分被输入到回归模型中，以测试事件评分和暴力结果之间的剂量-反应关系。所有分析均按性别分层。结果：超过1/4的青少年(28.9%)报告至少1次不良童年经历。最常见的不良经历是家庭成员酗酒造成的问题。每种类型的不良童年经历都与青少年的人际暴力行为(犯罪、欺凌、肢体打斗、约会暴力、在学校财产上携带武器)和自我定向暴力(自残行为、自杀意念和自杀企图)显著相关。青少年报告的每增加一种不良事件，暴力实施的风险增加35%至144%。结论：多种不良童年经历应被视为青春期与暴力相关的一系列后果的危险因素。提供者和倡导者应该意识到不良事件类型的相互关联性和累积影响。研究结果支持在考虑从虐待儿童到青少年实施犯罪和暴力后果的途径时，扩大目前关于不良事件类型的论述。儿科2010；125：e778-e786
OBJECTIVE: Adverse childhood experiences are associated with significant functional impairment and life lost in adolescence and adulthood. This study identified relationships between multiple types of adverse events and distinct categories of adolescent violence perpetration.METHODS: Data are from 136 549 students in the 6th, 9th, and 12th grades who responded to the 2007 Minnesota Student Survey, an anonymous, self-report survey examining youth health behaviors and perceptions, characteristics of primary socializing domains, and youth engagement. Linear and logistic regression models were used to determine if 6 types of adverse experiences including physical abuse, sexual abuse by family and/or other persons, witnessing abuse, and household dysfunction caused by family alcohol and/or drug use were significantly associated with risk of adolescent violence perpetration after adjustment for demographic covariates. An adverse-events score was entered into regression models to test for a dose-response relationship between the event score and violence outcomes. All analyses were stratified according to gender.RESULTS: More than 1 in 4 youth (28.9%) reported at least 1 adverse childhood experience. The most commonly reported adverse experience was alcohol abuse by a household family member that caused problems. Each type of adverse childhood experience was significantly associated with adolescent interpersonal violence perpetration (delinquency, bullying, physical fighting, dating violence, weapon-carrying on school property) and self-directed violence (self-mutilatory behavior, suicidal ideation, and suicide attempt). For each additional type of adverse event reported by youth, the risk of violence perpetration increased 35% to 144%.CONCLUSIONS: Multiple types of adverse childhood experiences should be considered as risk factors for a spectrum of violence-related outcomes during adolescence. Providers and advocates should be aware of the interrelatedness and cumulative impact of adverse-event types. Study findings support broadening the current discourse on types of adverse events when considering pathways from child maltreatment to adolescent perpetration of delinquent and violent outcomes. Pediatrics 2010; 125: e778-e786