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青少年心理病理症状、应对方式与儿童期反复遭受身体和情感虐待之间的相关性

[Correlation between psychopathological symptoms, coping style in adolescent and childhood repeated physical, emotional maltreatment].

作者信息

Tao Fang-biao, Huang Kun, Kim Soonduck, Ye Qing, Sun Ying, Zhang Cheng-ye, Zhou Yu-sheng, Su Pu-yu, Zhu Peng

机构信息

Department of Maternal and Child Health, School of Public Health, Anhui Medical University, Hefei 230032, China.

出版信息

Zhonghua Er Ke Za Zhi. 2006 Sep;44(9):688-93.

Abstract

OBJECTIVE

To study possible relationship between psychopathological symptoms, positive and negative coping styles in adolescents who experienced repeated serious childhood physical abuse (CPA), moderate CPA, and childhood emotional abuse (CEA).

METHODS

A total of 5453 students were recruited as subjects from 9 middle schools at grades 7, 8, 10, and 11. They provided informed consent and participated in the self-administered anonymous survey on their frequencies of serious or moderate physical abuse and emotional abuse by his/her parents or other caregivers about average times of experiencing maltreatment every year during primary school. The Symptoms Checklist 90 (SCL-90) was used to rate general mental problem and 9 special psychopathological symptoms. The trait positive and negative coping styles were assessed with the Trait Coping Style Questionnaire (TCSQ). Totally 5141 respondents substantially completed surveys. It was defined as repeating childhood maltreatment that the adolescent reported he/she had suffered 3 or more episodes of one or more forms of serious CPA, moderate CPA, and CEA. Multinomial logistic regression model was used to analyze the effect of the types and quantities of repeating childhood experiences on mental health when the positive, negative coping styles, and both of them entered the statistics model, taking the demographic variables as covariates.

RESULTS

Of respondents, 9.1 percent were rated as having general mental health problem. The rates of somatization, obsession, interpersonal susceptivity, depression, anxiety, phobia, paranoia, and psychotic symptoms were 1.3%, 3.6%, 3.6%, 2.8%, 2.2%, 4.0%, 2.1%, 2.8% and 1.6%, respectively. Dose-response trend existed between the number of items of repeating serious CPA, moderate CPA, CEA, and rates of general mental problems, 9 kinds of psychopathological symptoms, number of positive items of psychopathological symptoms. Compared with the respondents without serious CPA, moderate CPA or CEA, those with repeating childhood maltreatment had higher scores of negative coping styles. In the respondents with repeating childhood maltreatments, the prevalence of general mental problems and number of positive psychopathological symptoms increased with the rising of scores of negative coping styles. The results from multinomial logistic regression analysis showed that negative coping style decreased the odds ratio (OR) of repeating serious CPA, moderate CPA, and CEA with general mental health problems, but positive coping style did not.

CONCLUSIONS

The experiences of repeating childhood physical or emotional maltreatment are associated with a wide variety of psychopathological symptoms and general mental health problems. Negative coping strategies may moderate the links of childhood abusive experiences and mental problems.

摘要

目的

研究童年期遭受反复严重躯体虐待(CPA)、中度CPA以及童年期情感虐待(CEA)的青少年的心理病理症状与积极和消极应对方式之间的可能关系。

方法

从9所中学的7、8、10和11年级招募了5453名学生作为研究对象。他们签署了知情同意书,并参与了关于其遭受父母或其他照料者严重或中度躯体虐待及情感虐待频率的自填式匿名调查,调查内容为小学期间每年平均遭受虐待的次数。使用症状自评量表90(SCL - 90)对一般心理问题和9种特殊心理病理症状进行评分。采用特质应对方式问卷(TCSQ)评估特质积极和消极应对方式。共有5141名受访者完成了调查。若青少年报告其曾遭受3次或更多次一种或多种形式的严重CPA、中度CPA和CEA,则被定义为童年虐待经历重复。当积极、消极应对方式以及两者同时进入统计模型时,采用多项逻辑回归模型分析童年经历重复的类型和数量对心理健康的影响,并将人口统计学变量作为协变量。

结果

受访者中,9.1%被评定为存在一般心理健康问题。躯体化、强迫、人际敏感、抑郁、焦虑、恐惧、偏执和精神病性症状的发生率分别为1.3%、3.6%、3.6%、2.8%、2.2%、4.0%、2.1%、2.8%和1.6%。童年期重复严重CPA、中度CPA、CEA的项目数量与一般心理问题发生率、9种心理病理症状发生率、心理病理症状阳性项目数量之间存在剂量 - 反应趋势。与未遭受严重CPA、中度CPA或CEA的受访者相比,童年虐待经历重复的受访者消极应对方式得分更高。在童年虐待经历重复的受访者中,一般心理问题患病率和心理病理症状阳性项目数量随消极应对方式得分的升高而增加。多项逻辑回归分析结果显示,消极应对方式降低了童年虐待经历重复合并一般心理健康问题的严重CPA、中度CPA和CEA的比值比(OR),而积极应对方式则不然。

结论

童年期反复遭受躯体或情感虐待的经历与多种心理病理症状及一般心理健康问题相关。消极应对策略可能会缓和童年虐待经历与心理问题之间联系。

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