Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Massachusetts, USA.
J Adolesc Health. 2011 Aug;49(2):187-92. doi: 10.1016/j.jadohealth.2010.12.003. Epub 2011 Mar 23.
The objectives of this study were (1) to examine whether the association between childhood family conflict and the risk of substance use disorders (SUDs) in adolescence differs by gender, and (2) to determine whether anxious/depressive symptoms and conduct problems explain this association among adolescent males and females.
Data were obtained from 1,421 children aged 10-16 years at the time of enrollment in the Project on Human Development in Chicago Neighborhoods. We assessed gender differences in the association between childhood family conflict and adolescent SUDs by fitting a logistic regression model that included the interaction of gender and family conflict. We also investigated whether conduct problems and anxious/depressive symptoms explained the association between family conflict and SUDs differently for males and females through gender-specific mediation analyses.
The association between childhood family conflict and SUDs in adolescence differed by gender (p = .04). Family conflict was significantly associated with SUDs among females (OR: 1.61; CI: 1.20-2.15), but not among males (OR: 1.00; CI: .76-1.32). The elevated risk of SUDs among females exposed to family conflict was partly explained by girls' conduct problems, but not by anxious/depressive symptoms.
Females living in families with elevated levels of conflict were more likely to engage in acting out behaviors, which was associated with the development of SUDs. Future epidemiologic research is needed to help determine when this exposure is most problematic with respect to subsequent mental health outcomes and the most crucial time to intervene.
本研究旨在:(1) 检验童年期家庭冲突与青少年期物质使用障碍(SUD)风险之间的关联是否因性别而异;(2) 确定焦虑/抑郁症状和品行问题是否能解释青少年男性和女性中这种关联。
数据来自于参加芝加哥社区人类发展项目的 1421 名 10-16 岁的儿童。我们通过拟合一个包含性别和家庭冲突交互作用的逻辑回归模型,来评估童年期家庭冲突与青少年 SUD 之间关联的性别差异。我们还通过性别特异性中介分析,考察品行问题和焦虑/抑郁症状是否以不同的方式解释了家庭冲突与 SUD 之间的关联。
童年期家庭冲突与青春期 SUD 之间的关联存在性别差异(p =.04)。家庭冲突与女性 SUD 显著相关(OR:1.61;CI:1.20-2.15),但与男性无关(OR:1.00;CI:.76-1.32)。在家庭冲突下,女性发生 SUD 的风险增加部分是由于女孩的品行问题所致,而不是焦虑/抑郁症状。
生活在冲突水平较高家庭中的女性更有可能表现出行为问题,这与 SUD 的发展有关。未来需要开展流行病学研究,以帮助确定这种暴露在哪些方面对随后的心理健康结果最成问题,以及干预的最关键时期。