Brown David W, Anda Robert F, Edwards Valerie J, Felitti Vincent J, Dube Shanta R, Giles Wayne H
Centers for Disease Control and Prevention, Atlanta, GA, USA.
Child Abuse Negl. 2007 Sep;31(9):961-9. doi: 10.1016/j.chiabu.2007.02.011. Epub 2007 Sep 14.
To examine relationships between childhood autobiographical memory disturbance (CAMD) and adverse childhood experiences (ACEs) which are defined as common forms of child maltreatment and related traumatic stressors.
We use the ACE score (an integer count of eight different categories of ACEs) as a measure of cumulative exposure to traumatic stress during childhood. In a cross sectional analysis we assess the relationship of the ACE score to the prevalence of CAMD in a sample of 9,460 relatively healthy adults evaluated for wellness care at a southern California health maintenance organization between August 1995 and March 1996. In addition, we examined possible secular influences by examining association among each of four birth cohorts. Logistic regression was used to obtain the adjusted relative odds of CAMD associated with increasing ACE score.
Overall, the age-standardized prevalence of CAMD was 18% (men: 15%; women: 19%). As the ACE score increased, the prevalence of CAMD increased in a graded fashion for both men and women (p for trend <.0001). After adjustment for age, sex, race/ethnicity, and education, adults with an ACE score >or=6 were 5.9 (95% CI, 4.4-7.9) times more likely to have CAMD compared to adults with an ACE score of 0. The prevalence of CAMD increased with each successive birth cohort, and graded relationships between the ACE score and CAMD were observed among each of the four birth cohorts though no statistical difference in the association was found across birth cohorts.
The accumulation of ACEs across several domains is associated CAMD among men and women and in each of four birth cohorts. Further research is needed that describes the prevalence of CAMD in population-based samples and that examines whether impaired memory is a marker for persons neurobiologically affected by multiple forms of child maltreatment and related traumatic stressors.
探讨童年自传体记忆障碍(CAMD)与童年不良经历(ACEs)之间的关系,童年不良经历被定义为儿童虐待的常见形式及相关创伤性应激源。
我们使用ACE评分(对八种不同类型ACEs的整数计数)作为童年期累积创伤性应激暴露的衡量指标。在一项横断面分析中,我们评估了在1995年8月至1996年3月期间于南加州一家健康维护组织接受健康评估的9460名相对健康成年人样本中,ACE评分与CAMD患病率之间的关系。此外,我们通过检查四个出生队列中每一个队列之间的关联来研究可能的长期影响。采用逻辑回归分析以获得与ACE评分增加相关的CAMD调整后相对比值。
总体而言,CAMD的年龄标准化患病率为18%(男性:15%;女性:19%)。随着ACE评分的增加,男性和女性的CAMD患病率均呈分级上升趋势(趋势p<.0001)。在对年龄、性别、种族/民族和教育程度进行调整后,ACE评分≥6的成年人患CAMD的可能性是ACE评分为0的成年人的5.9倍(95%CI,4.4 - 7.9)。CAMD患病率随连续出生队列的增加而上升,并且在四个出生队列中的每一个队列中均观察到ACE评分与CAMD之间的分级关系,尽管各出生队列之间的关联无统计学差异。
多个领域ACEs的累积与男性和女性以及四个出生队列中的每一个队列中的CAMD相关。需要进一步的研究来描述基于人群样本中CAMD的患病率,并研究记忆受损是否是受多种形式儿童虐待及相关创伤性应激源神经生物学影响的人群的一个标志。