Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA.
Health Psychol. 2012 Jul;31(4):413-22. doi: 10.1037/a0027300. Epub 2012 Feb 13.
Identifying interrelationships among childhood social disadvantage, emotional functioning and adult health may help illustrate how health disparities may become embedded early in life, yet few have considered how these factors are associated. We examined whether the association of child emotional functioning and adult health risk was modified by child socioeconomic status (CSES), or whether child emotional functioning mediated the association of CSES and adult health risk.
We studied 430 adult offspring (mean age 42 years) of Collaborative Perinatal Project participants, a cohort of pregnant women enrolled in 1959-1966 (Broman, Nichols, & Kennedy, 1975; Niswander & Gordon, 1972). Child emotional functioning was assessed by psychologist ratings at age 7 and included inappropriate self regulation (ISR) and distress proneness. CSES measures included parental education, household income, and parental occupation. Adult health risk was measured by the inflammatory marker C-reactive protein (CRP). Hypotheses were tested with multiple linear regression. Effect modification was evaluated via interaction terms and stratification of fully adjusted models by CSES. Mediation by child emotional functioning was evaluated via coefficient changes.
There was no evidence that child emotional functioning mediated the association of CSES and CRP. Significant interactions were observed for ISR and low income (b = 1.67, SE = 0.70, p < .05), and distress proneness and low (b = 3.14, SE = 1.47, p < .05) and middle (b = 3.52, SE = 1.46, p < .05) income. Stratified models indicated that associations of child emotion with CRP varied significantly by level of parental education, household income and occupation.
The highest levels of adult inflammation were observed among those with childhood emotional problems who were also exposed to low socioeconomic status as children. This study suggests adulthood disparities in CRP may have developmental origins in childhood adversity.
识别儿童社会劣势、情绪功能与成人健康之间的相互关系,有助于说明健康差距是如何在生命早期形成的,但很少有人考虑这些因素是如何相关的。我们研究了儿童情绪功能与成人健康风险之间的关联是否受到儿童社会经济地位(CSES)的影响,或者儿童情绪功能是否调节了 CSES 和成人健康风险之间的关联。
我们研究了共 430 名 Collaborative Perinatal Project 参与者的成年后代(平均年龄 42 岁),这是一个 1959-1966 年期间招募的孕妇队列(Broman、Nichols 和 Kennedy,1975;Niswander 和 Gordon,1972)。儿童情绪功能通过 7 岁时的心理学家评分进行评估,包括不当自我调节(ISR)和易激惹倾向。CSES 测量包括父母教育程度、家庭收入和父母职业。成人健康风险通过炎症标志物 C 反应蛋白(CRP)来衡量。通过多线性回归测试假设,通过交互项和完全调整模型的分层来评估效应修饰,通过系数变化来评估儿童情绪功能的中介作用。
没有证据表明儿童情绪功能调节了 CSES 和 CRP 之间的关系。对于 ISR 和低收入(b=1.67,SE=0.70,p<.05)以及易激惹倾向和低收入(b=3.14,SE=1.47,p<.05)和中等收入(b=3.52,SE=1.46,p<.05),观察到了显著的交互作用。分层模型表明,儿童情绪与 CRP 的关联因父母教育程度、家庭收入和职业水平而异。
在儿童时期存在情绪问题且同时面临低社会经济地位的人群中,观察到最高水平的成人炎症。本研究表明,CRP 方面的成年差异可能具有儿童逆境的发展起源。