Collishaw Stephan, Pickles Andrew, Messer Julie, Rutter Michael, Shearer Christina, Maughan Barbara
King's College London, MRC Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, London, UK.
Child Abuse Negl. 2007 Mar;31(3):211-29. doi: 10.1016/j.chiabu.2007.02.004. Epub 2007 Mar 30.
Child abuse is an important risk for adult psychiatric morbidity. However, not all maltreated children experience mental health problems as adults. The aims of the present study were to address the extent of resilience to adult psychopathology in a representative community sample, and to explore predictors of a good prognosis.
Data are drawn from a follow-up of the Isle of Wight study, an epidemiological sample assessed in adolescence and at midlife. Ratings of psychiatric disorder, peer relationships and family functioning were made in adolescence; adult assessments included a lifetime psychiatric history, personality and social functioning assessments, and retrospective reports of childhood sexual and physical abuse.
Ten percent of individuals reported repeated or severe physical or sexual abuse in childhood. Prospective measures revealed increased rates of adolescent psychiatric disorders in this group. Rates of adult psychopathology were also high. A substantial minority of abused individuals reported no mental health problems in adult life. Resilience of this kind was related to perceived parental care, adolescent peer relationships, the quality of adult love relationships, and personality style.
Good quality relationships across childhood, adolescence and adulthood appear especially important for adult psychological well being in the context of childhood abuse.
儿童期受虐是成年期出现精神疾病的一项重要风险因素。然而,并非所有受虐儿童成年后都会出现心理健康问题。本研究的目的在于探讨在一个具有代表性的社区样本中成年精神病理学的恢复力程度,并探究预后良好的预测因素。
数据取自怀特岛研究的随访,这是一个在青春期和中年期进行评估的流行病学样本。在青春期对精神障碍、同伴关系和家庭功能进行评分;成年期评估包括终生精神病史、人格和社会功能评估,以及童年期性虐待和身体虐待的回顾性报告。
10%的个体报告在童年期遭受过反复或严重的身体或性虐待。前瞻性测量显示该组青少年精神障碍发生率增加。成年期精神病理学发生率也很高。相当一部分受虐个体报告成年后没有心理健康问题。这种恢复力与感知到的父母关爱、青少年同伴关系、成年恋爱关系质量和人格类型有关。
在童年期受虐的背景下,童年、青少年和成年期的高质量关系对成年后的心理健康似乎尤为重要。