Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents: Results from the adverse childhood experiences study
Relationship between multiple forms of childhood maltreatment and adult mental health in community respondents: Results from the adverse childhood experiences study
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DOI：
10.1176/appi.ajp.160.8.1453
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发表时间：
2003-08-01
影响因子：
17.7
通讯作者：
Anda, RF
中科院分区：
文献类型：
--
作者：
Edwards, VJ;Holden, GW;Anda, RF
目的：研究儿童虐待类型组合(身体虐待、性虐待和目睹母亲虐待)在健康维护组织(HMO)成年成员中的患病率，并探讨儿童家庭环境中儿童虐待类型和情感虐待类型组合与成人心理健康的关系。方法：共有8,667名HMO成年成员完成了儿童暴露于家庭功能障碍的测量，包括身体和性虐待、目睹母亲虐待和儿童家庭环境中的情感虐待。结果：单独考虑虐待类型时，性虐待、身体虐待和目睹母亲暴力的发生率分别为21.6%、20.6%和14.0%。在报告任何一种虐待类型的受访者中，34.6%报告了不止一种类型的虐待。较低的心理健康得分与较多的虐待类别相关(对于没有、一种、两种和三种虐待类型的受访者，平均得分分别为78.5、75.5、72.8和69.9)。情感虐待的家庭环境和情感虐待家庭环境与各种虐待类型的交互作用都对心理健康得分有显著影响。结论：儿童时期的身体虐待和性虐待，以及目睹母亲虐待，在本研究中的HMO成年成员中是常见的。在那些报告任何虐待的人中，超过三分之一的人经历过一种以上的虐待。在报告的虐待类型数量和心理健康得分之间发现了剂量-反应关系。此外，情感虐待的家庭环境加剧了心理健康得分的下降。未来关于儿童期虐待对成年人心理健康影响的研究应该包括对各种虐待经历的评估，以及这些虐待发生的家庭氛围。
Objective: This study examined the prevalence of a history of various combinations of childhood maltreatment types (physical abuse, sexual abuse, and witnessing of maternal battering) among adult members of a health maintenance organization (HMO) and explored the relationship with adult mental health of the combinations of types of childhood maltreatment and emotional abuse in the childhood family environment.Method: A total of 8,667 adult members of an HMO completed measures of childhood exposure to family dysfunction, which included items on physical and sexual abuse, witnessing of maternal battering, and emotional abuse in the childhood family environment. The adults' current mental health was assessed by using the mental health scale of the Medical Outcomes Study 36-item Short-Form Health Survey.Results: The prevalences of sexual abuse, physical abuse, and witnessing of maternal violence were 21.6%, 20.6%, and 14.0%, respectively, when the maltreatment types were considered separately. Among respondents reporting any of the maltreatment types, 34.6% reported more than one type of maltreatment. Lower mean mental health scores were associated with higher numbers of abuse categories (mean=78.5, 75.5, 72.8, and 69.9 for respondents with no, one, two, and three abuse types, respectively). Both an emotionally abusive family environment and the interaction of an emotionally abusive family environment with the various maltreatment types had a significant effect on mental health scores.Conclusions: Childhood physical and sexual abuse, as well as witnessing of maternal battering, were common among the adult members of an HMO in this study. Among those reporting any maltreatment, more than one-third had experienced more than one type of maltreatment. A dose-response relation was found between the number of types of maltreatment reported and mental health scores. in addition, an emotionally abusive family environment accentuated the decrements in mental health scores. Future research examining the effects of childhood maltreatment on adult mental health should include assessments of a wide range of abusive experiences, as well as the family atmosphere in which they occur.