Centre for Psychiatry, Queen Mary University of London, Wolfson Institute of Preventive Medicine, United Kingdom.
Ann Epidemiol. 2010 May;20(5):385-94. doi: 10.1016/j.annepidem.2010.02.008.
Prospective evidence about whether the association of childhood adversity and psychopathology attenuates across the lifecourse and whether effects on mid-life psychopathology are mediated through adolescent and early adulthood psychopathology is limited.
Data were from the 1958 British Birth Cohort, a 45-year study of 98% of births in 1 week in 1958 in England, Scotland, and Wales. Outcomes included International Statistical Classification of Diseases (ICD-10) diagnoses for affective and anxiety disorders at 45 years and psychopathology at 16 years and 23 years. Multiple multi-informant measures of childhood adversity were available at 7, 11, and 16 years, with additional retrospective measures of parental sexual and physical abuse at 45 years. Analyses were determined on the basis of N = 9377; 59% of the surviving sample.
After adjustment for socioeconomic covariates, childhood adversities were associated with adolescent, early adulthood, and mid-life psychopathology: most associations did not attenuate with age. Mid-life associations were significantly fully or partially mediated by early adulthood psychopathology: cumulative adversity, illness, sexual abuse, and physical abuse remained significantly associated with mid-life psychopathology.
The findings confirm the importance of preventing exposure to adversity and suggest that effects of adversity on mid-life psychopathology may operate through psychopathology in early adulthood. Future research is needed to examine other intermediary factors which may explain these associations.
关于童年逆境与精神病理学之间的关联是否会随着生命历程而减弱,以及这种关联对中年精神病理学的影响是否通过青少年和成年早期的精神病理学来介导,目前还缺乏前瞻性证据。
数据来自于 1958 年英国出生队列研究,该研究对英格兰、苏格兰和威尔士在 1958 年一周内出生的 98%的婴儿进行了 45 年的随访。研究结局包括 45 岁时的 ICD-10 诊断为情感和焦虑障碍,以及 16 岁和 23 岁时的精神病理学。在 7、11 和 16 岁时可以获得多种多信息来源的儿童逆境测量指标,在 45 岁时可以获得父母性和身体虐待的额外回顾性测量指标。分析是基于 N=9377 名(存活样本的 59%)参与者进行的。
在校正了社会经济协变量后,儿童逆境与青少年、成年早期和中年精神病理学相关:大多数关联并未随着年龄的增长而减弱。中年的关联与成年早期的精神病理学显著地完全或部分中介相关:累积逆境、疾病、性虐待和身体虐待仍然与中年精神病理学显著相关。
这些发现证实了预防接触逆境的重要性,并表明逆境对中年精神病理学的影响可能通过成年早期的精神病理学来发挥作用。需要进一步的研究来探讨可能解释这些关联的其他中介因素。