Sensitive periods for the effect of childhood interpersonal violence on psychiatric disorder onset among adolescents
Sensitive periods for the effect of childhood interpersonal violence on psychiatric disorder onset among adolescents
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DOI：
10.1192/bjp.bp.117.208397
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发表时间：
2017-12-01
影响因子：
10.5
通讯作者：
Susser, Ezra S.
中科院分区：
文献类型：
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作者：
Dunn, Erin C.;Wang, Yan;Susser, Ezra S.
尽管童年期的逆境是精神病理学的一个强有力的决定因素，但是否存在第一次逆境发作最有害的“敏感期”仍不清楚。（18岁以下）与精神病理学的风险有关。我们研究了第一次接触四种人际暴力的年龄之间的关系，（父母的身体虐待，他人的身体虐待，强奸和性侵犯/骚扰）和四类DSM-IV疾病的发作（痛苦、恐惧、行为、药物使用）（n=9984）。暴露的年龄被定义为：幼儿期（0-5岁），儿童中期（6-10岁）和青春期（11-18岁）。结果暴露于人际暴力在任何年龄段的精神疾病的风险增加了一倍（优势比（OR）=1.51-2.52）。然而，根据首次暴露的时间，观察到的风险差异很小。在进行了20次相关性测试后，根据暴露时间，只观察到三个显著的风险差异;这些结果表明，在青春期首次接触任何类型的人际暴力的青年中，行为障碍的风险增加（OR=2.37，95%CI 1.69-3.34），尤其是被他人殴打（OR=2.44; 95%CI 1.57-3.79），在青春期被人殴打的青少年中，物质使用障碍的风险增加（OR=2.77，95%01194 -396）。结论人际暴力暴露的儿童精神障碍的风险增加。然而，第一次暴露的年龄在很大程度上与精神病理学风险无关。
BackgroundAlthough childhood adversity is a strong determinant of psychopathology, it remains unclear whether there are 'sensitive periods' when a first episode of adversity is most harmful.AimsTo examine whether variation in the developmental timing of a first episode of interpersonal violence (up to age 18) associates with risk for psychopathology.MethodUsing cross-sectional data, we examined the association between age at first exposure to four types of interpersonal violence (physical abuse by parents, physical abuse by others, rape, and sexual assault/molestation) and onset of four classes of DSM-IV disorders (distress, fear, behaviour, substance use) (n=9984). Age at exposure was defined as: early childhood (ages 0-5), middle childhood (ages 6-10) and adolescence (ages 11-18).ResultsExposure to interpersonal violence at any age period about doubled the risk of a psychiatric disorder (odds ratios (ORs)=1.51-2.52). However, few differences in risk were observed based on the timing of first exposure. After conducting 20 tests of association, only three significant differences in risk were observed based on the timing of exposure; these results suggested an elevated risk of behaviour disorder among youth first exposed to any type of interpersonal violence during adolescence (OR=2.37, 95% Cl 1.69-3.34), especially being beaten by another person (OR=2.44; 95% CI 1.57-3.79), and an elevated risk of substance use disorder among youth beaten by someone during adolescence (OR=2.77, 95% 01 194-396).ConclusionsChildren exposed to interpersonal violence had an elevated risk of psychiatric disorder. However, age at first episode of exposure was largely unassociated with psychopathology risk.