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青少年吸烟对成年早期焦虑症状的影响,以及婴儿期焦虑脆弱因素与成年早期焦虑症状之间的关系:TOPP 研究。

The impact of smoking in adolescence on early adult anxiety symptoms and the relationship between infant vulnerability factors for anxiety and early adult anxiety symptoms: the TOPP Study.

机构信息

School of Medicine, Deakin University, Geelong, Victoria, Australia.

出版信息

PLoS One. 2013 May 16;8(5):e63252. doi: 10.1371/journal.pone.0063252. Print 2013.

Abstract

Cigarette smoking is increased in people with trait anxiety and anxiety disorders, however no longitudinal data exist illuminating whether smoking in adolescence can influence the developmental trajectory of anxiety symptoms from early vulnerability in infancy to adult anxiety expression. Using The Tracing Opportunities and Problems in Childhood and Adolescence (TOPP) Study, a community-based cohort of children and adolescents from Norway who were observed from the age of 18 months to age 18-19 years, we explored the relationship between adolescent smoking, early vulnerability for anxiety in infancy (e.g. shyness, internalizing behaviors, emotional temperaments) and reported early adult anxiety. Structural equation modeling demonstrated that adolescent active smoking was positively associated with increased early adulthood anxiety (β = 0.17, p<0.05), after controlling for maternal education (proxy for socioeconomic status). Adolescent anxiety did not predict early adult smoking. Adolescent active smoking was a significant effect modifier in the relationship between some infant vulnerability factors and later anxiety; smoking during adolescence moderated the relationship between infant internalizing behaviors (total sample: active smokers: β = 0.85, p<0.01, non-active smokers: ns) and highly emotional temperament (total sample: active smokers: β = 0.55, p<0.01,non-active smokers: ns), but not shyness, and anxiety in early adulthood. The results support a model where smoking acts as an exogenous risk factor in the development of anxiety, and smoking may alter the developmental trajectory of anxiety from infant vulnerability to early adult anxiety symptom expression. Although alternative non-mutually exclusive models may explain these findings, the results suggest that adolescent smoking may be a risk factor for adult anxiety, potentially by influencing anxiety developmental trajectories. Given the known adverse health effects of cigarette smoking and significant health burden imposed by anxiety disorders, this study supports the importance of smoking prevention and cessation programs targeting children and adolescence.

摘要

吸烟在具有特质焦虑和焦虑障碍的人群中更为常见,然而,目前尚无纵向数据表明青少年时期的吸烟是否会影响从婴儿期早期易感性到成年期焦虑表现的焦虑症状发展轨迹。使用挪威基于社区的儿童和青少年队列研究——儿童期和青少年期机会与问题追踪研究(TOPP),该研究对从 18 个月大到 18-19 岁的儿童和青少年进行了观察,我们探讨了青少年吸烟、婴儿期早期焦虑易感性(例如害羞、内化行为、情绪气质)与报告的成年早期焦虑之间的关系。结构方程模型表明,在控制母亲教育(代表社会经济地位)后,青少年主动吸烟与成年早期焦虑增加呈正相关(β=0.17,p<0.05)。青少年焦虑并不能预测成年早期吸烟。青少年主动吸烟是婴儿期某些脆弱因素与后期焦虑之间关系的显著效应修饰剂;青少年时期吸烟会调节婴儿期内化行为(总体样本:主动吸烟者:β=0.85,p<0.01,非主动吸烟者:无显著差异,ns)和高度情绪化气质(总体样本:主动吸烟者:β=0.55,p<0.01,非主动吸烟者:无显著差异,ns)与成年早期焦虑之间的关系,但与害羞无关。研究结果支持了这样一种模式,即吸烟是焦虑发展的外源性风险因素,吸烟可能会改变从婴儿期脆弱性到成年早期焦虑症状表达的焦虑发展轨迹。尽管可能存在其他非互斥的解释模型,但研究结果表明,青少年吸烟可能是成年焦虑的一个风险因素,这可能是通过影响焦虑发展轨迹来实现的。鉴于吸烟对健康的已知不良影响以及焦虑障碍带来的重大健康负担,这项研究支持了针对儿童和青少年的吸烟预防和戒烟计划的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d31d/3655993/d9d81b8a854e/pone.0063252.g001.jpg

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