Department of Psychology, University of Southern California, Los Angeles, CA 90089-1061, USA.
J Adolesc Health. 2010 Aug;47(2):198-205. doi: 10.1016/j.jadohealth.2010.01.020.
To examine dose-response effects of cumulative violence exposure including parent-to-youth aggression, marital physical aggression, and community violence, and to explore whether separate interpersonal domains of exposure differentially influence adverse outcomes.
The present study uses parent-reports and child-reports of youth violence exposure from the first three waves of a prospective, longitudinal study of 103 community-based families. Outcomes were criterion levels (T score >or= 60) of somatic complaints, depressive symptoms, anxiety, over-arousal, aggression, delinquent behaviors, and presence versus absence of academic failure.
After controlling for initial symptoms, income and parents' psychopathology, adjusted relative risks showed that marital aggression contributed uniquely to anxiety, and parent-to-youth aggression contributed uniquely to somatic complaints and aggression. All three domains significantly contributed to academic failure. With each one-point increase on the cumulative violence exposure index that summed across interpersonal domains and across time, there was an increased risk of more than 50% for meeting criterion levels of depressive symptoms and anxiety, and a 10%-25% increased risk for somatic complaints, delinquent behaviors, and academic failure. Significant curvilinear effects showed high cumulative violence increased risk of comorbid symptoms; 76% of youth with higher cumulative violence met thresholds on 3+ adverse outcomes, compared to 36% and 7% for youth with moderate and low violence exposure.
These data highlight the importance of assessing violence exposure across multiple interpersonal domains and across time. Awareness of the contributions of violence exposure to common symptoms and particularly comorbid symptoms can inform interventions for wide-ranging adolescent problems.
考察累积暴力暴露（包括父母对子女的攻击、婚姻身体攻击和社区暴力）的剂量反应效应，并探讨不同的人际领域暴露是否会对不良后果产生不同影响。
本研究使用前瞻性纵向研究中 103 个基于社区的家庭的前三个波次中父母报告和儿童报告的青少年暴力暴露数据。结果是躯体抱怨、抑郁症状、焦虑、过度唤醒、攻击、犯罪行为以及是否存在学业失败的标准水平（T 分数≥60）。
在控制初始症状、收入和父母精神病理学后，调整后的相对风险显示，婚姻攻击对焦虑有独特贡献，父母对子女的攻击对躯体抱怨和攻击有独特贡献。所有三个领域都显著导致学业失败。在人际领域和时间上累积暴力暴露指数每增加 1 分，出现抑郁症状和焦虑标准水平的风险增加超过 50%，躯体抱怨、犯罪行为和学业失败的风险增加 10%-25%。显著的曲线效应表明，高累积暴力增加了共病症状的风险；与中度和低度暴力暴露的青少年相比，76%的高累积暴力青少年符合 3 种以上不良结果的阈值，而中度和低度暴力暴露的青少年分别为 36%和 7%。
这些数据强调了评估多个人际领域和跨越时间的暴力暴露的重要性。了解暴力暴露对常见症状特别是共病症状的贡献，可以为广泛的青少年问题干预提供信息。
