Ezpeleta Lourdes, Granero Roser, de la Osa Núria, Domènech Josep M
Unitat d'Epidemiologia i de Diagnòstic en Psicopatologia del Desenvolupament, Universitat Autònoma de Barcelona, Barcelona, Spain.
Soc Psychiatry Psychiatr Epidemiol. 2008 Jul;43(7):559-68. doi: 10.1007/s00127-008-0312-6. Epub 2008 Mar 22.
Data based on general population studies of exposure-to-risk factors is not adequate to describe the mental health of children living in the most extreme "high-risk" environments.
Data were collected in a longitudinal prospective study of two cohorts of 9 and 13 year-old socially at-risk children. Cluster analysis was used to classify youths based on the reports about potential areas of risk. The psychopathological structure of empirical clusters was compared through cross-sectional and longitudinal epidemiological indexes and through multiple regression and multivariate analysis of variance.
Cluster analysis provided eight binary high-low risk classifications. Exposure to risk was highly prevalent. In preadolescence, broken family, parenting style and contextual profiles were the highest risk factors for psychopathology. In adolescence, they were psychological variables, verbal comprehension, pre-peri-postnatal history, physical health and family characteristics. Cumulative risk followed a linear trend for psychopathology and functional impairment. The child's perception of low marital discord and good school achievement were protective factors.
Extreme socially at-risk populations have specific profiles of risk that can be identified through a person-centered approach and may be amenable to selective preventive interventions.
基于一般人群风险因素暴露研究的数据不足以描述生活在最极端“高风险”环境中的儿童的心理健康状况。
在一项对两组9岁和13岁社会风险儿童的纵向前瞻性研究中收集数据。聚类分析用于根据关于潜在风险领域的报告对青少年进行分类。通过横断面和纵向流行病学指标以及多元回归和多变量方差分析比较经验性聚类的心理病理结构。
聚类分析提供了八个二元高低风险分类。风险暴露非常普遍。在青春期前，家庭破裂、养育方式和背景概况是心理病理学的最高风险因素。在青春期，它们是心理变量、语言理解、产前-围产期-产后病史、身体健康和家庭特征。累积风险在心理病理学和功能损害方面呈线性趋势。儿童对低婚姻不和及良好学业成绩的认知是保护因素。
极端社会风险人群具有特定的风险特征，可通过以人为本的方法识别，并且可能适合选择性预防干预。
