Kuh Diana, Hardy Rebecca, Rodgers Bryan, Wadsworth Michael E J
Medical Research Council National Survey of Health and Development, Department of Epidemiology and Public Health, Royal Free and University College Medical School, Gower Street Campus, 1-19 Torrington Place, London WC1E 6BT, UK.
Soc Sci Med. 2002 Dec;55(11):1957-73. doi: 10.1016/s0277-9536(01)00324-0.
Research on the causes of psychological distress in women in midlife has focused on current adversity and hormonal changes associated with menopause and paid less attention to possible risk factors across the life course. We examined the factors in childhood, adolescence and earlier adult life that show persisting effects on psychological symptoms reported annually over a 6 year period (47-52 years) using prospective data on a cohort of 1500 British women who have been followed since their birth in 1946. Even after taking into account the powerful effect of recent life stress, this study found that women with a high level of psychological distress had different life course trajectories than those with less distress. They were more likely to have scored highly on the neuroticism scale or exhibited antisocial behaviour when they were teenagers, and to have had prior experience of mental and physical health problems in adult life. Those whose parents had divorced reported more distress in midlife, particularly if they too had experienced marital breakdown. These factors accounted for the associations between some of the adult sources of risk, particularly those to do with interpersonal difficulties or poor adult socioeconomic circumstances, and psychological distress in midlife. There was no evidence that concurrent menopausal status had any effect on the level of psychological symptoms except for those women on hormone replacement therapy who had a small and independent additional risk. More attention to a long term temporal perspective is warranted in research on the causes of psychological distress in women at midlife.
对中年女性心理困扰成因的研究主要集中在当前的逆境以及与更年期相关的激素变化上，而对整个生命历程中可能的风险因素关注较少。我们利用对1500名自1946年出生起就开始跟踪的英国女性队列的前瞻性数据，研究了童年、青少年和成年早期对她们在6年期间（47 - 52岁）每年报告的心理症状持续产生影响的因素。即使考虑到近期生活压力的强大影响，本研究发现，心理困扰程度高的女性与困扰程度低的女性有着不同的生命历程轨迹。她们在青少年时期更有可能在神经质量表上得分高或表现出反社会行为，并且在成年后有过心理健康和身体健康问题的经历。父母离异的女性在中年时报告的困扰更多，特别是如果她们自己也经历过婚姻破裂。这些因素解释了一些成年风险源之间的关联，特别是那些与人际困难或成年后社会经济状况不佳有关的因素，以及中年时的心理困扰。没有证据表明同时期的更年期状态对心理症状水平有任何影响，除了那些接受激素替代疗法的女性有一个小的独立额外风险。在研究中年女性心理困扰的成因时，有必要更加关注长期的时间视角。
