Association of Youth Age at Exposure to Household Dysfunction With Outcomes in Early Adulthood.
Association of Youth Age at Exposure to Household Dysfunction With Outcomes in Early Adulthood.
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DOI：
10.1001/jamanetworkopen.2020.32769
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发表时间：
2021-01-04
影响因子：
13.8
通讯作者：
Andersen SH
中科院分区：
文献类型：
--
作者：
Andersen SH
这项队列研究考察了儿童和青春期暴露于家庭功能障碍的年龄与成年早期结果之间的关系。在童年和青春期暴露于负面经历的年龄是否与随后的不良后果相关？在这项对来自丹麦19岁的605名 344人的数据的队列研究中，在青春期早期暴露于负面经历与后来的不良后果之间的关联比在儿童早期暴露更强。研究结果表明，针对童年时期接触负面经历的个人的政策干预应侧重于青春期接触负面经历的个人。目前对儿童早期的负面经历与后来的不良后果之间的联系的关注建立在有限的经验证据基础上。评估在儿童和青春期暴露于负面经历的年龄是否与成年早期的结果相关。这项队列研究使用了来自行政部门的所有丹麦人的人口数据，这些人出生于1987年至1995年，19岁时居住在丹麦。对2020年7月的数据进行了分析。按年龄组划分，从出生到17岁暴露于6项家庭功能障碍(HDI)。年龄组：0~2岁(儿童早期)、3~5岁(学龄前)、6~12岁(儿童中期)、13~17岁(青春期早期)。这6个项目分别是父母的失业、监禁、精神障碍、死亡和离婚以及孩子的寄养经历。精神障碍，低教育程度，与教育和劳动力市场脱节，以及刑事指控。固定效应模型被用来估计HDI暴露和整理的结果测量之间的剂量-反应和特定年龄的关联。研究样本包括从出生到19岁的605名 344人(平均出生年份，1991年[2.56]年；范围，1987-1995年；335名 725[55%]男性)。总体而言，278名 115人(45.94%)从出生到17岁接触过6种HDI中的1种或1种以上。接触最普遍的是1岁(曝光率，11.3%)，父母失业是最常见的人类发展指数(15.5%观察到在儿童中期)。经历这4种结果的风险与人类发展指数的数量单调相关。例如，在出生到17岁之间经历1次人类发展指数与经历不良结果的风险增加约1个百分点相关(β = 0.011；95%CI，0.010-0.012；P <； .001)。同样，经历不良后果的风险与暴露时的年龄有显著差异。青春期早期暴露与不良后果的相关性比儿童早期暴露更强(风险增加5.8%[β = 0.058；95%CI，0.052-0.063；P <； .001]vs1.0[β = 0.010；95%CI，0.004-0.015；P = .001])。在这项队列研究中，在青春期早期暴露于负面经历与后来的不良后果之间的关联比在童年时期的其他时间暴露更强。对于需要优先考虑针对弱势儿童和青年的资源的政策制定者来说，年龄相关的知识是重要的信息。
This cohort study examines the association between age at exposure to household dysfunction during childhood and adolescence and outcomes in early adulthood. Is age at exposure to negative experiences in childhood and adolescence associated with subsequent adverse outcomes? In this cohort study of data on 605 344 individuals aged 19 years from Denmark, exposure to negative experiences in early adolescence was more strongly associated with later adverse outcomes than was exposure in early childhood. The findings suggest that policy interventions targeting individuals exposed to negative experiences during childhood should focus on individuals exposed to negative experiences in adolescence. The current focus on the association of negative experiences in early childhood with adverse outcomes later in life is based on limited empirical evidence. To evaluate whether age at exposure to negative experiences in childhood and adolescence is associated with outcomes in early adulthood. This cohort study used population data from administrative sources for all Danish individuals born between 1987 and 1995 who were living in Denmark at 19 years of age. Data were analyzed in July 2020. Exposure to 6 household dysfunction items (HDIs) from birth to 17 years of age by age group. Age groups were as follows: 0 to 2 years (early childhood), 3 to 5 years (preschool), 6 to 12 years (mid-childhood), and 13 to 17 years (early adolescence). The 6 items were parents’ unemployment, incarceration, mental disorders, death, and divorce and the child’s foster care experiences. Mental disorders, low educational attainment, disconnection from education and the labor market, and criminal charges. A fixed-effects model was used to estimate the dose-response and age-specific associations between HDI exposure and the collated outcome measure. The study sample included 605 344 individuals observed from birth to 19 years of age (mean [SD] birth year, 1991 [2.56] years; range, 1987-1995; 335 725 [55%] male). Overall, 278 115 individuals (45.94%) were exposed to 1 or more of the 6 HDIs from birth to 17 years of age. Exposure was most prevalent at 1 year of age (exposure rate, 11.3%), and parental unemployment was the most common HDI (15.5% observed in mid-childhood). The risk of experiencing the 4 outcomes was monotonically associated with the number of HDIs. For example, experiencing 1 HDI between birth and 17 years of age was associated with an increased risk of experiencing an adverse outcome by approximately 1.0 percentage point (β = 0.011; 95% CI, 0.010-0.012; P < .001). Similarly, the risk of experiencing adverse outcomes varied significantly in association with age at exposure. Exposure during early adolescence was more strongly associated with adverse outcomes than was exposure during early childhood (increased risk of 5.8 percentage points [β = 0.058; 95% CI, 0.052-0.063; P < .001] vs 1.0 [β = 0.010; 95% CI, 0.004-0.015; P = .001]). In this cohort study, exposure to negative experiences in early adolescence was more strongly associated with later adverse outcomes than was exposure at other points in childhood. Knowledge of age-specific associations is important information for policy makers who need to prioritize resources targeting disadvantaged children and youths.
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影响因子：
4.4
作者：
Weber K;Rockstroh B;Borgelt J;Awiszus B;Popov T;Hoffmann K;Schonauer K;Watzl H;Pröpster K
通讯作者：
Pröpster K
影响因子：
8
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影响因子：
29.9
作者：
Caspi, Avshalom;Houts, Renate M.;Moffitt, Terrie E.
通讯作者：
Moffitt, Terrie E.
影响因子：
7.4
作者：
Dunn EC;McLaughlin KA;Slopen N;Rosand J;Smoller JW
通讯作者：
Smoller JW
DOI：
10.1037/cbs0000034
发表时间：
2016-01-01
影响因子：
2.5
作者：
Steele, Howard;Bate, Jordan;Murphy, Anne
通讯作者：
Murphy, Anne