Association of Reports of Childhood Abuse and All-Cause Mortality Rates in Women
Association of Reports of Childhood Abuse and All-Cause Mortality Rates in Women
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DOI：
10.1001/jamapsychiatry.2016.1786
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发表时间：
2016-09-01
期刊：
影响因子：
25.8
通讯作者：
Miller, Gregory E.
中科院分区：
文献类型：
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作者：
Chen, Edith;Turiano, Nicholas A.;Miller, Gregory E.
重要性研究将儿童虐待与各种成人精神问题联系在一起，但对虐待儿童与成人死亡率之间的联系知之甚少。目的测试儿童时期身体和情感虐待的回顾报告与成年全原因死亡率的相关性。设计、设置和参与者从美国中年发展调查中抽取6285名成年人(基线年龄为25-74岁)作为全国样本。基线心理社会数据收集在1995年和1996年，随访死亡率数据收集到2015年10月。MAIN结果和测量参与者在基线完成关于儿童情绪虐待、中度身体虐待和严重身体虐待的自我报告的问卷调查。结果在纳入研究样本的6285名参与者中，男性2987人(48%)，白人5581人(91%)，平均年龄(SD)为46.9(12.95)岁。报告儿童期情感虐待(危险比，1.22；95%CI，1.01-1.49；P=.04)、中度身体虐待(HR，1.30；95%CI，1.05-1.60；P=.02)或严重身体虐待(HR，1.58；95%CI，1.20-2.08；P=.001)的女性在随访期内全因死亡的风险增加。报告的儿童期虐待类型越多，女性全因死亡的风险也越高(有虐待与无虐待，1.68；95%可信区间，1.24-2.30；P=.001；有虐待与无虐待，1.24；95%可信区间，1.01-1.52；P=.04)。这些影响不能用童年的社会经济地位、个性特征或成年后的抑郁来解释。在男性中没有观察到相关性。结论和相关性这些结果表明，除了既定的虐待精神后果外，报告童年虐待的女性在成年后也容易过早死亡。因此，报告的儿童期虐待可能会对妇女的健康和长寿产生长期影响。
IMPORTANCE Research has linked childhood abuse to a variety of adult psychiatric problems, but little is known about associations of child abuse with adult mortality.OBJECTIVE To test associations of retrospective reports of physical and emotional abuse in childhood with all-cause mortality rates in adulthood.DESIGN, SETTING, AND PARTICIPANTS National sample of 6285 adults (aged 25-74 years at baseline) from the survey of Midlife Development in the United States. Baseline psychosocial data were collected in 1995 and 1996, with follow-up mortality data collected through October 2015.MAIN OUTCOMES AND MEASURES Participants completed questionnaires at baseline about self-report of childhood emotional abuse, moderate physical abuse, and severe physical abuse. Mortality data during the next 20 years was tracked using the National Death Index.RESULTS Of the 6285 participants included in the study sample, 2987 were men (48%) and 5581 were white (91%), with a mean (SD) age of 46.9 (12.95) years. Women who reported childhood emotional abuse (hazard ratio [HR], 1.22; 95% CI, 1.01-1.49; P = .04), moderate physical abuse (HR, 1.30; 95% CI, 1.05-1.60; P = .02), or severe physical abuse (HR, 1.58; 95% CI, 1.20-2.08; P = .001) were at increased risk for all-cause mortality during the follow-up period. Reports of more types of childhood abuse were also associated with a greater risk of all-cause mortality in women (all vs none HR, 1.68; 95% CI, 1.24-2.30; P = .001; some vs none HR, 1.24; 95% CI, 1.01-1.52; P = .04). These effects could not be accounted for by childhood socioeconomic status, personality traits, or adult depression. No associations were observed in men.CONCLUSIONS AND RELEVANCE These results suggest that in addition to the established psychiatric consequences of abuse, women who report childhood abuse also remain vulnerable to premature mortality into adulthood. Thus, reported childhood abuse may have long-term ramifications for health and longevity in women.