Modeling life course pathways from to adult mental health adverse childhood experiences
Modeling life course pathways from to adult mental health adverse childhood experiences
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DOI：
10.1016/j.chiabu.2018.03.005
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发表时间：
2018-06-01
影响因子：
4.8
通讯作者：
Fleming, Christopher M.
中科院分区：
文献类型：
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作者：
Jones, Tiffany M.;Nurius, Paula;Fleming, Christopher M.
虽然不良童年经历（ACE）和成人心理健康之间的关联正在得到很好的确立，但人们对ACE发挥影响的复杂和多种途径知之甚少。越来越多的证据表明，生命早期的逆境不仅传达了早期的影响，而且还增加了与压力相关的生命过程级联的风险，这些级联继续破坏健康。本研究的目的是测试途径的压力增殖和压力体现过程中连接ACE到成年期的心理健康损害。数据来自2011年行为风险因素监测调查，这是华盛顿州18岁及以上成年人的代表性样本（N = 14，001）。结构方程模型允许测试ACE的直接和间接影响，虽然低收入状况，在成年逆境的经验，和社会支持。该模型表明，成人低收入，社会支持和成人逆境实际上是渠道，通过ACE发挥其影响力的心理健康损害在成年期。通过这些变量的显着间接途径支持的假设，ACE的影响是通过这些变量进行。这是第一个展示多种与压力相关的生命历程途径的模型之一，通过这些途径，早期生活逆境会损害成年人的心理健康。讨论阐述了多种服务系统的干预机会，在早期和后期的生活中断ACE效应的直接和间接途径。
Although the association between adverse childhood experiences (ACEs) and adult mental health is becoming well established, less is known about the complex and multiple pathways through which ACEs exert their influence. Growing evidence suggests that adversity early in life conveys not only early impacts, but also augments risk of stress-related life course cascades that continue to undermine health. The present study aims to test pathways of stress proliferation and stress embodiment processes linking ACEs to mental health impairment in adulthood. Data are from the 2011 Behavioral Risk Factor Surveillance Survey, a representative sample of Washington State adults ages 18 and over (N = 14,001). Structural equation modeling allowed for testing of direct and indirect effects from ACEs though low income status, experiences of adversity in adulthood, and social support. The model demonstrated that adult low income, social support and adult adversity are in fact conduits through which ACEs exert their influence on mental health impairment in adulthood. Significant indirect pathways through these variables supported hypotheses that the effect of ACEs is carried through these variables. This is among the first models that demonstrates multiple stress-related life course pathways through which early life adversity compromises adult mental health. Discussion elaborates multiple service system opportunities for intervention in early and later life to interrupt direct and indirect pathways of ACE effects.