Fergusson David M, Boden Joseph M, Horwood L John
Christchurch Health and Development Study, University of Otago, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand.
Child Abuse Negl. 2008 Jun;32(6):607-19. doi: 10.1016/j.chiabu.2006.12.018. Epub 2008 Jun 18.
This research examined linkages between exposure to childhood sexual abuse (CSA) and childhood physical punishment/abuse (CPA) and mental health issues in early adulthood.
The investigation analyzed data from a birth cohort of over 1,000 New Zealand young adults studied to the age of 25.
Exposure to CSA and CPA was associated with increased risks of later mental disorders including depression, anxiety disorder, conduct/anti-social personality disorder, substance dependence, suicidal ideation, and suicide attempts at ages 16-25. Control for social, family, and individual factors reduced the associations between CPA and mental health outcomes to the point of statistical non-significance. However, there was a consistent finding for CSA to remain associated with increased risks of later mental health problems. After adjustment, those exposed to CSA including attempted or completed sexual penetration had rates of disorder that were 2.4 times higher than those not exposed to CSA. Those exposed to harsh or abusive physical punishment had rates of disorder that were 1.5 times higher than those exposed to no or occasional physical punishment. It was estimated that exposure to CSA accounted for approximately 13% of the mental health problems experienced by the cohort. Findings showed that exposure to CPA had only weak effects on later mental health. It was estimated that exposure to CPA accounted for approximately 5% of the mental health problems experienced by the cohort.
Exposure to CSA was associated with consistent increases in risks of later mental health problems. Exposure to CPA had weaker and less consistent effects on later mental health. These findings suggest that much of the association between CPA and later mental health reflects the general family context in which CPA occurs, whereas this is less the case for CSA.
本研究探讨童年期性虐待(CSA)和童年期身体惩罚/虐待(CPA)与成年早期心理健康问题之间的联系。
该调查分析了来自1000多名新西兰年轻人的出生队列数据,这些人被研究至25岁。
暴露于CSA和CPA与后期精神障碍风险增加有关,包括抑郁、焦虑症、品行/反社会人格障碍、物质依赖、自杀意念以及16 - 25岁时的自杀未遂。对社会、家庭和个人因素进行控制后,CPA与心理健康结果之间的关联降低至统计学上无显著意义。然而,有一个一致的发现是,CSA仍然与后期心理健康问题风险增加有关。调整后,那些遭受包括未遂或既遂性侵犯的CSA的人,其精神障碍发生率比未遭受CSA的人高2.4倍。那些遭受严厉或虐待性身体惩罚的人,其精神障碍发生率比未遭受或偶尔遭受身体惩罚的人高1.5倍。据估计,暴露于CSA占该队列所经历心理健康问题的约13%。研究结果表明,暴露于CPA对后期心理健康的影响较弱。据估计,暴露于CPA占该队列所经历心理健康问题的约5%。
暴露于CSA与后期心理健康问题风险持续增加有关。暴露于CPA对后期心理健康的影响较弱且不太一致。这些发现表明,CPA与后期心理健康之间的许多关联反映了CPA发生的一般家庭环境,而CSA的情况则并非如此。