THE IMPACT OF EXPOSURE TO INTERPERSONAL VIOLENCE ON GENDER DIFFERENCES IN ADOLESCENT-ONSET MAJOR DEPRESSION: RESULTS FROM THE NATIONAL COMORBIDITY SURVEY REPLICATION (NCS-R)
THE IMPACT OF EXPOSURE TO INTERPERSONAL VIOLENCE ON GENDER DIFFERENCES IN ADOLESCENT-ONSET MAJOR DEPRESSION: RESULTS FROM THE NATIONAL COMORBIDITY SURVEY REPLICATION (NCS-R)
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DOI：
10.1002/da.21916
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发表时间：
2012-05-01
影响因子：
7.4
通讯作者：
Molnar, Beth E.
中科院分区：
文献类型：
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作者：
Dunn, Erin C.;Gilman, Stephen E.;Molnar, Beth E.
背景：从青春期开始，女性患抑郁症的风险明显高于男性。尽管作出了巨大努力，但我们对这一差距的理解仍然存在差距。这项研究测试了青春期抑郁症的性别差异是否因为女性更容易接触暴力或对暴力更敏感。方法数据来自全国合并症调查复制的5692名参与者。训练有素的采访者使用改良版的综合国际诊断访谈收集了关于重度抑郁症和参与者暴露于四种类型的人际暴力（身体虐待、性侵犯、强奸和目睹暴力）的数据。我们使用离散时间生存分析来调查青少年抑郁发病风险的性别差异。在整个样本中，5.7%的人在18岁时符合DSM-IV抑郁症标准；5.8%的样本报告在18岁之前遭受过身体虐待，11.7%遭受过性侵犯，8.5%被强奸，13.2%目睹过暴力。到18岁时，女性患抑郁症的几率是男性的1.51倍。在过去的一年和接下来的几年里，接触各种类型的暴力都与抑郁的几率增加有关。对暴力暴露的调整部分减弱了性别与抑郁之间的关联，尤其是性侵犯（优势比[OR]减弱= 1.28;15.23%）和强奸（OR减弱= 1.32;12.59%）。没有证据表明女性比男性更容易受到暴力的影响。抑郁症的性别差异可以部分解释为女性更有可能经历人际暴力。因此，减少对性侵犯和强奸的暴露可以减轻抑郁症的性别差异。
Background Beginning in adolescence, females are at significantly higher risk for depression than males. Despite substantial efforts, gaps remain in our understanding of this disparity. This study tested whether gender differences in adolescent-onset depression arise because of female's greater exposure or sensitivity to violence. Methods Data came from 5,692 participants in the National Comorbidity Survey Replication. Trained interviewers collected data about major depression and participants exposure to four types of interpersonal violence (physical abuse, sexual assault, rape, and witnessing violence) using a modified version of the Composite International Diagnostic Interview. We used discrete time survival analysis to investigate gender differences in the risk of adolescent onset depression. Results Of the entire sample, 5.7% met DSM-IV criteria for depression by age 18; 5.8% of the sample reported being physically abused, 11.7% sexually assaulted, 8.5% raped, and 13.2% witnessed violence by age 18. Females had 1.51 times higher odds of depression by age 18 than males. Exposure to all types of violence was associated with an increased odds of depression in both the past year and the years following exposure. Adjusting for exposure to violence partially attenuated the association between gender and depression, especially for sexual assault (odds ratio [OR] attenuated = 1.28; 15.23%) and rape (OR attenuated = 1.32; 12.59%). There was no evidence that females were more vulnerable to the effects of violence than males. Discussion Gender differences in depression are partly explained by females higher likelihood of experiencing interpersonal violence. Reducing exposure to sexual assault and rape could therefore mitigate gender differences in depression.