The Prevalence and Consequences of Adverse Childhood Experiences in the German Population.
The Prevalence and Consequences of Adverse Childhood Experiences in the German Population.
复制标题
德国人口中不良童年经历的普遍性和后果。
DOI：
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
J. Fegert
中科院分区：
文献类型：
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作者：
A. Witt;C. Sachser;P. Plener;E. Brähler;J. Fegert
背景
多项研究表明，儿童时期累积的不良经历与日后生活中的各种心理问题之间存在联系。到目前为止，还没有任何关于德国人口的相关代表性研究。本研究的目的是确定不良童年经历（ACE）的频率，在何种程度上，他们表现出自己的模式共同发生，以及他们可能的连接到德国人口的心理社会异常。
方法
通过患者健康问卷-4（PHQ-4）和关于攻击性和生活满意度的进一步问题，对2531名年龄在14岁及以上（平均[M] = 48.6岁，标准差[SD] = 18）的患者（55.4%女性）进行ACE和心理社会异常的回顾性研究。对ACE的发生频率及其累积发生率进行描述性分析。同时发生的ACE类型的模式进行了研究与潜在类分析。ACE和心理社会异常之间的关联进行了Logistic回归分析。
结果
43.7%的受访者报告至少有一个ACE; 8.9%报告四个或更多。最常见的报告是父母分居和离婚（19.4%），家庭酗酒和吸毒（16.7%），情感忽视（13.4%）和情感虐待（12.5%）。通过潜在类别分析确定了四种ACE模式：无/最小ACE、家庭功能障碍、儿童虐待和多重ACE。在累积模型中，有四种或四种以上ACE的高危组显示出抑郁（比值比[OR] = 7.8）、焦虑（OR = 7.1）、身体攻击性（OR = 10.5）和生活满意度受损（OR = 5.1）的风险显著升高。
结论
不良的童年经历是常见的，其累积与受影响的人的负面后遗症明显增加有关。需要采取的预防措施不仅限于虐待儿童的问题，还应解决父母家中的其他问题，如父母的精神疾病。自我报告的数据采集是本研究的局限性。
BACKGROUND
Multiple studies have shown a link between cumulative adverse experiences in childhood and a wide variety of psychosocial problems in later life. There have not been any pertinent representative studies of the German population until now. The goal of this study is to determine the frequency of adverse childhood experiences (ACE), the extent to which they manifest themselves in patterns of co-occurrence, and their possible connection to psychosocial abnormalities in the German population.
METHODS
2531 persons (55.4% female) aged 14 years and up (mean [M] = 48.6 years, standard deviation [SD] = 18) were retro- spectively studied for ACE and psychosocial abnormalities by means of the Patient Health Questionnaire-4 (PHQ-4) and further questions on aggressiveness and life satisfaction. The frequency of ACE and their cumulative occurrence were analyzed in de- scriptive terms. Patterns of simultaneously occurring types of ACE were studied with latent class analysis. Associations between ACE and psychosocial abnormalities were tested with logistic regression analyses.
RESULTS
43.7% of the respondents reported at least one ACE; 8.9% reported four or more. The most commonly reported ones were parental separation and divorce (19.4%), alcohol consumption and drug abuse in the family (16.7%), emotional neglect (13.4%), and emotional abuse (12.5%). Four ACE patterns were identified by latent class analysis: no/minimal ACE, household dysfunction, child maltreatment, and multiple ACE. In the cumulative model, the high-risk group with four or more ACE displayed a significantly elevated risk for depressiveness (odds ratio [OR] = 7.8), anxiety (OR = 7.1), physical aggressiveness (OR = 10.5), and impaired life satisfaction (OR = 5.1).
CONCLUSION
Adverse childhood experiences are common, and their cumulation is associated with markedly increased negative sequelae for the affected persons. Preventive approaches are needed that extend beyond the area of child maltreatment alone and address other problems in the parental home, such as mental illness in the parents. Data acquisition by self-reporting is a limitation of this study.