Weeks Murray, Cairney John, Wild T Cameron, Ploubidis George B, Naicker Kiyuri, Colman Ian
Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada.
Depress Anxiety. 2014 Jul;31(7):608-16. doi: 10.1002/da.22235. Epub 2014 Jan 14.
Previous research examining the development of anxious and depressive symptoms (i.e., internalizing symptoms) from childhood to adolescence has often assumed that trajectories of these symptoms do not vary across individuals. The purpose of this study was to identify distinct trajectories of internalizing symptoms from childhood to adolescence, and to identify risk factors for membership in these trajectory groups. In particular, we sought to identify risk factors associated with early appearing (i.e., child onset) symptoms versus symptoms that increase in adolescence (i.e., adolescent onset).
Drawing on longitudinal data from the National Longitudinal Survey of Children and Youth, latent class growth modeling (LCGM) was used to identify distinct trajectories of internalizing symptoms for 6,337 individuals, from age 4-5 to 14-15. Multinomial regression was used to examine potential early-life risk factors for membership in a particular trajectory group.
Five trajectories were identified as follows: "low stable" (68%; reference group), "adolescent onset" (10%), "moderate stable" (12%), "high childhood" (6%), and "high stable" (4%). Membership in the "adolescent onset" group was predicted by child gender (greater odds for girls), stressful life events, hostile parenting, aggression, and hyperactivity. Membership in the "high stable" and "high childhood" trajectory groups (i.e., child-onset) was additionally predicted by maternal depression, family dysfunction, and difficult temperament. Also, several significant gender interactions were observed.
Causal mechanisms for child and adolescent depression and anxiety may differ according to time of onset, as well as child gender. Some early factors may put girls at greater risk for internalizing problems than boys.
以往关于儿童到青少年期焦虑和抑郁症状(即内化症状)发展的研究通常假定这些症状的轨迹在个体间没有差异。本研究的目的是确定从儿童期到青少年期内化症状的不同轨迹,并确定这些轨迹组的成员风险因素。特别是,我们试图确定与早期出现(即儿童期起病)症状以及青春期增加(即青少年期起病)症状相关的风险因素。
利用全国儿童和青少年纵向调查的纵向数据,采用潜在类别增长模型(LCGM)确定6337名个体从4至5岁到14至15岁内化症状的不同轨迹。使用多项回归来检验特定轨迹组成员的潜在早期生活风险因素。
确定了五条轨迹如下:“低稳定”(68%;参照组)、“青少年期起病”(10%)、“中度稳定”(12%)、“儿童期高症状”(6%)和“高稳定”(4%)。“青少年期起病”组的成员由儿童性别(女孩几率更高)、应激性生活事件、敌意型养育方式、攻击行为和多动行为预测。“高稳定”和“儿童期高症状”轨迹组(即儿童期起病)的成员还由母亲抑郁、家庭功能障碍和困难气质预测。此外,还观察到一些显著的性别交互作用。
儿童和青少年抑郁及焦虑的因果机制可能因起病时间以及儿童性别而异。一些早期因素可能使女孩比男孩面临更大的内化问题风险。