Center for Adolescent Nursing, School of Nursing, Division of Academic General Pediatrics, Department of Pediatrics, University of Minnesota, 5-140 Weaver-Densford Hall, 308 Harvard St SE, Minneapolis, MN 55455, USA.
Pediatrics. 2010 Apr;125(4):e778-86. doi: 10.1542/peds.2009-0597. Epub 2010 Mar 15.
Adverse childhood experiences are associated with significant functional impairment and life lost in adolescence and adulthood. This study identified relationships between multiple types of adverse events and distinct categories of adolescent violence perpetration.
Data are from 136 549 students in the 6th, 9th, and 12th grades who responded to the 2007 Minnesota Student Survey, an anonymous, self-report survey examining youth health behaviors and perceptions, characteristics of primary socializing domains, and youth engagement. Linear and logistic regression models were used to determine if 6 types of adverse experiences including physical abuse, sexual abuse by family and/or other persons, witnessing abuse, and household dysfunction caused by family alcohol and/or drug use were significantly associated with risk of adolescent violence perpetration after adjustment for demographic covariates. An adverse-events score was entered into regression models to test for a dose-response relationship between the event score and violence outcomes. All analyses were stratified according to gender.
More than 1 in 4 youth (28.9%) reported at least 1 adverse childhood experience. The most commonly reported adverse experience was alcohol abuse by a household family member that caused problems. Each type of adverse childhood experience was significantly associated with adolescent interpersonal violence perpetration (delinquency, bullying, physical fighting, dating violence, weapon-carrying on school property) and self-directed violence (self-mutilatory behavior, suicidal ideation, and suicide attempt). For each additional type of adverse event reported by youth, the risk of violence perpetration increased 35% to 144%.
Multiple types of adverse childhood experiences should be considered as risk factors for a spectrum of violence-related outcomes during adolescence. Providers and advocates should be aware of the interrelatedness and cumulative impact of adverse-event types. Study findings support broadening the current discourse on types of adverse events when considering pathways from child maltreatment to adolescent perpetration of delinquent and violent outcomes.
不良的童年经历与青少年和成年期的严重功能障碍和生命损失有关。本研究确定了多种类型的不良事件与青少年暴力行为的不同类别之间的关系。
数据来自于 136549 名 6、9 和 12 年级的学生,他们对 2007 年明尼苏达州学生调查做出了回应,这是一项匿名的、自我报告的调查,旨在检查青少年的健康行为和观念、主要社交领域的特征以及青年的参与情况。线性和逻辑回归模型用于确定 6 种不良经历(包括身体虐待、家庭和/或其他人的性虐待、目睹虐待以及家庭酒精和/或药物使用导致的家庭功能障碍)是否与调整人口统计学协变量后青少年暴力行为的风险显著相关。将不良事件评分输入回归模型,以检验事件评分与暴力结果之间的剂量反应关系。所有分析均根据性别分层。
超过 1/4 的青少年(28.9%)报告至少有一种不良童年经历。最常见的不良经历是家庭中成员酗酒导致问题。每一种不良童年经历都与青少年人际暴力行为(犯罪、欺凌、身体打斗、约会暴力、携带武器进入学校财产)和自我导向的暴力行为(自残行为、自杀意念和自杀企图)显著相关。每增加一种青少年报告的不良事件,暴力行为的风险就会增加 35%至 144%。
应将多种类型的不良童年经历视为青少年时期与暴力相关结果相关的一系列风险因素。提供者和倡导者应意识到不良事件类型的相互关系和累积影响。研究结果支持在考虑从儿童虐待到青少年犯罪和暴力行为的发生途径时,扩大当前关于不良事件类型的讨论。