The impact of cumulative childhood adversity on young adult mental health: Measures, models, and interpretations
The impact of cumulative childhood adversity on young adult mental health: Measures, models, and interpretations
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DOI：
10.1016/j.socscimed.2007.11.023
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发表时间：
2008-03-01
影响因子：
5.4
通讯作者：
Gore, Susan
中科院分区：
文献类型：
--
作者：
Schilling, Elizabeth A.;Aseltine, Robert H.;Gore, Susan
近年来，调查童年累积逆境对成年心理健康影响的研究激增。一般来说，很少有人注意到累积逆境的可操作性，大多数研究将其作为所经历的不同事件发生次数的简单总和。此外，累积的童年逆境与某些心理健康维度的数学关系可能比基本的线性关联更复杂，这种可能性往往没有被考虑。本研究探讨了这些问题，从经济和种族多样性的样本过渡到成年在波士顿，马萨诸塞州，美国的2波数据。在高中时报告了各种各样的童年逆境，2年后在向成年过渡期间报告了3种心理健康结果-抑郁情绪，吸毒和反社会行为。我们的研究结果表明，操作化和统计建模都是重要的和相互关联的，因此，它们有可能影响对累积的童年逆境对成人心理健康影响的实质性解释。在我们的数据中，总的累积童年逆境与抑郁症状，药物使用和反社会行为以正曲线的方式相关，随着逆境的积累，影响逐渐增加，但进一步的分析表明，这种曲线效应是高累积逆境分数与更严重事件经历的混淆。因此，具有较高累积逆境的受访者的心理健康状况不成比例地较差，因为他们所面临的逆境的严重程度，而不是经历的不同类型逆境的累积数量。这些结果表明，针对预防儿童期逆境的公共卫生工作最好针对最严重的逆境，以便对青年期的心理健康产生最大的益处。(C)2007爱思唯尔有限公司版权所有。
Research studies investigating the impact of childhood cumulative adversity on adult mental health have proliferated in recent years. In general, little attention has been paid to the operationalization of cumulative adversity, with most studies operationalizing this as the simple sum of the number of occurrences of distinct events experienced. In addition, the possibility that the mathematical relationship of cumulative childhood adversity to some mental health dimensions may be more complex than a basic linear association has not often been considered. This study explores these issues with 2 waves of data drawn from an economically and racially diverse sample transitioning to adulthood in Boston, Massachusetts, USA. A diverse set of childhood adversities were reported in high school and 3 mental health outcomes-depressed mood, drug use, and antisocial behavior-were reported 2 years later during the transition to adulthood.Our results suggest that both operationalization and statistical modeling are important and interrelated and, as such, they have the potential to influence substantive interpretation of the effect of cumulative childhood adversity on adult mental health. In our data, total cumulative childhood adversity was related to depressive symptoms, drug use, and antisocial behavior in a positive curvilinear manner with incremental impact increasing as adversities accumulate, but further analysis revealed that this curvilinear effect was an artifact of the confounding of high cumulative adversity scores with the experience of more severe events. Thus, respondents with higher cumulative adversity had disproportionately poorer mental health because of the severity of the adversities they were exposed to, not the cumulative number of different types of adversities experienced. These results indicate that public health efforts targeting prevention of childhood adversities would best be aimed at the most severe adversities in order to have greatest benefit to mental health in young adulthood. (C) 2007 Elsevier Ltd. All rights reserved.