Childhood adversity, pubertal timing and self-harm: a longitudinal cohort study.
Childhood adversity, pubertal timing and self-harm: a longitudinal cohort study.
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DOI：
10.1017/s0033291721000611
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发表时间：
2021-03-08
影响因子：
6.9
通讯作者：
Mars, Becky
中科院分区：
文献类型：
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作者：
Russell, Abigail Emma;Joinson, Carol;Roberts, Elystan;Heron, Jon;Ford, Tamsin;Gunnell, David;Moran, Paul;Relton, Caroline;Suderman, Matthew;Mars, Becky
儿童早期逆境的发生与后来的自我伤害密切相关，但人们对这种远端风险因素如何影响后来的行为知之甚少。一个可能的机制是，处于逆境中的儿童青春期提前，因为青春期提前与青少年自我伤害的风险增加有关。我们调查了青春期早期是否在童年逆境和后来的自我伤害之间起中介作用。参与者是来自英国基于人口的出生队列（ALSPAC）的6698名年轻人。我们测量了从0到9岁的9种逆境的暴露，以及16岁和21岁参与者的自我伤害。青春期的时间测量是高峰身高速度的年龄（aPHV -男性和女性）和初潮年龄（AAM）。我们使用广义结构方程模型进行分析。每增加一种逆境，参与者的自我伤害风险平均增加12-14%。当结局为自杀意图的自我伤害时，直接效应的相对风险（RR）估计值更强。没有证据表明较早的青春期时间介导了逆境和自我伤害之间的关联[aPHV的间接效应RR 1.00，95%置信区间（CI）1.00-1.00，AAM的RR 1.00，95% CI 1.00-1.01]。暴露于多种类型的逆境的累积措施并没有通过青春期早期的时间来增加自我伤害的风险，但是童年逆境和青春期早期都是后来自我伤害的风险因素。需要开展研究，查明儿童期逆境与后来自我伤害之间联系的潜在机制，以便为干预措施提供信息。
The occurrence of early childhood adversity is strongly linked to later self-harm, but there is poor understanding of how this distal risk factor might influence later behaviours. One possible mechanism is through an earlier onset of puberty in children exposed to adversity, since early puberty is associated with an increased risk of adolescent self-harm. We investigated whether early pubertal timing mediates the association between childhood adversity and later self-harm. Participants were 6698 young people from a UK population-based birth cohort (ALSPAC). We measured exposure to nine types of adversity from 0 to 9 years old, and self-harm when participants were aged 16 and 21 years. Pubertal timing measures were age at peak height velocity (aPHV – males and females) and age at menarche (AAM). We used generalised structural equation modelling for analyses. For every additional type of adversity; participants had an average 12–14% increased risk of self-harm by 16. Relative risk (RR) estimates were stronger for direct effects when outcomes were self-harm with suicidal intent. There was no evidence that earlier pubertal timing mediated the association between adversity and self-harm [indirect effect RR 1.00, 95% confidence interval (CI) 1.00–1.00 for aPHV and RR 1.00, 95% CI 1.00–1.01 for AAM]. A cumulative measure of exposure to multiple types of adversity does not confer an increased risk of self-harm via early pubertal timing, however both childhood adversity and early puberty are risk factors for later self-harm. Research identifying mechanisms underlying the link between childhood adversity and later self-harm is needed to inform interventions.