Adverse childhood experiences (ACEs) on mental disorders in young adulthood: Latent classes and community violence exposure
Adverse childhood experiences (ACEs) on mental disorders in young adulthood: Latent classes and community violence exposure
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DOI：
10.1016/j.ypmed.2020.106039
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发表时间：
2020-05-01
影响因子：
5.1
通讯作者：
Terry, Jasmine
中科院分区：
文献类型：
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作者：
Lee, Haenim;Kim, Youngmi;Terry, Jasmine
不良童年经历（ACE）对心理健康结果有显著影响。人们越来越关注将ACE的范围扩展到家庭环境之外。到目前为止，很少有研究探讨多维ACE与社区暴力。本研究旨在（1）确定潜在的ACE类别，包括暴露于社区暴力，（2）调查ACE类别与成年期精神障碍的关系：抑郁，焦虑和创伤后应激障碍（PTSD）。我们采用了潜在类别分析（LCA）和逻辑回归分析，使用的数据来自国家青少年和成人健康纵向研究（Add Health）。LCA将ACE分为四类：（1）儿童虐待（17.47%），（2）家庭功能障碍（14.39%），（3）社区暴力（5.36%）和（4）低逆境（62.79%）。Logistic回归分析结果显示，“儿童虐待”组与“低逆境”组相比，在成年期更容易报告抑郁（OR = 1.56，CI = 1.26-1.92）、焦虑（OR = 1.31，CI = 1.06-1.62）和创伤后应激障碍（OR = 1.97，CI = 1.35-2.87）。此外，“社区暴力”类更容易在成年后患PTSD（OR = 2.15，CI = 1.14-4.06），相比“低逆境”类。然而，“家庭功能障碍”类在所有三种精神障碍方面与“低逆境”类没有显著差异。研究结果支持不同类型的ACE暴露在年轻的成年人的精神障碍的差异。该研究强调了考虑ACE暴露类型对促进年轻人心理健康的重要性。
Adverse childhood experiences (ACEs) have significant impacts on mental health outcomes. There is a growing interest in expanding the scope of ACEs beyond household environments. To date, few studies examine multi-dimensional ACEs with community violence. This study aims to (1) identify underlying ACE classes including exposure to community violence, and (2) investigate the associations of ACE classes with mental disorders in adulthood: depression, anxiety, and Post-Traumatic Stress Disorder (PTSD). We employed Latent Class Analysis (LCA) and logistic regression analyses using the data from the National Longitudinal Study of Adolescent and Adult Health (Add Health). The LCA identified four heterogeneous ACE classes: (1) child maltreatment (17.47%), (2) household dysfunction (14.39%), (3) community violence (5.36%), and (4) low adversity (62.79%). Three logistic analyses showed that the "child maltreatment" class was more likely to report a depression (OR = 1.56, CI = 1.26-1.92), anxiety (OR = 1.31, CI = 1.06-1.62), and PTSD (OR = 1.97, CI = 1.35-2.87) in adulthood compared to the "low adversity" class. Also, the "community violence" class was more likely to have PTSD (OR = 2.15, CI = 1.14-4.06) in adulthood, compared to the "low adversity" class. However, the "household dysfunction" class was not significantly different in all three mental disorders from the "low adversity" class. Findings supported the differences in mental disorders in young adulthood by types of exposures to ACEs. The study highlights the importance of considering types of ACEs exposure for promoting mental health of young adults.