Cohen Patricia, Chen Henian, Gordon Kathy, Johnson Jeffrey, Brook Judith, Kasen Stephanie
Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA.
Dev Psychopathol. 2008 Spring;20(2):633-50. doi: 10.1017/S095457940800031X.
Low socioeconomic status (SES) background has been identified as a risk for several mental disorders. However evidence regarding SES and the developmental course of personality disorder (PD) has not been addressed. Nor is it clear whether an SES relationship to PD symptom course may be attributable to known associated risks. Further, specificity of such relationships to a particular PD diagnostic pattern independent of comorbidity with other PD or with depression has not been investigated. Data are from a general population studied longitudinally between ages 10 and 36 in four assessment waves. Effects of SES-associated risks on the level of symptoms of schizotypal and borderline disorders are estimated and compared to effects on depressive symptoms. Low family SES had robust modest independent effects on both PDs over the entire age span despite substantial cumulative effects of trauma history, stressful recent life events, IQ, poor parenting, and comorbid symptoms. SES effects on depressive symptoms were generally absent, but a small "protective" effect of low SES appeared when comorbidity with PD symptoms was taken into account. Cumulatively, these risks account for developmental failures of substantial magnitude and consequence, marking the importance of understanding the remaining mechanisms of SES effects and programmatic implications for minimizing associated risk.
社会经济地位低下已被确认为多种精神障碍的一个风险因素。然而,关于社会经济地位与人格障碍(PD)发展过程的证据尚未得到探讨。社会经济地位与人格障碍症状过程之间的关系是否可归因于已知的相关风险也不清楚。此外,这种关系与特定人格障碍诊断模式的特异性,独立于与其他人格障碍或抑郁症的共病情况,尚未得到研究。数据来自于在10至36岁之间进行了四次评估的纵向研究的普通人群。估计社会经济地位相关风险对分裂样和边缘性障碍症状水平的影响,并与对抑郁症状的影响进行比较。尽管创伤史、近期应激性生活事件、智商、不良养育方式和共病症状有大量累积影响,但低家庭社会经济地位在整个年龄跨度内对这两种人格障碍都有稳健适度的独立影响。社会经济地位对抑郁症状的影响通常不存在,但在考虑与人格障碍症状共病时,低社会经济地位会出现一个小的“保护”作用。累积起来,这些风险导致了相当严重程度和后果的发展失败,这凸显了理解社会经济地位影响的剩余机制以及将相关风险降至最低的方案意义的重要性。