Brown Monique J, Perera Robert A, Masho Saba W, Mezuk Briana, Cohen Steven A
College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA.
Department of Biostatistics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
Soc Sci Med. 2015 Apr;131:48-57. doi: 10.1016/j.socscimed.2015.02.044. Epub 2015 Mar 2.
Six in ten people in the general population have been exposed to adverse childhood experiences (ACEs). Intimate partner violence (IPV) is a major public health problem in the US. The main objective of this study was to assess sex differences in the role of posttraumatic stress disorder (PTSD), substance abuse, and depression as mediators in the association between ACEs and intimate partner aggression. Data were obtained from Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Structural equation modeling was used to determine the mediational role of PTSD, substance abuse and depression in the association between ACE constructs (neglect, physical/psychological abuse, sexual abuse, parental violence, and parental incarceration/psychopathology) and intimate partner aggression. Among men, PTSD mediated the relationship between sexual abuse and intimate partner aggression. However, among men and women, substance abuse mediated the relationship between physical and psychological abuse and intimate partner aggression. IPV programs geared towards aggressors should address abuse (sexual, physical and psychological), which occurred during childhood and recent substance abuse and PTSD. These programs should be implemented for men and women. Programs aimed at preventing abuse of children may help to reduce rates of depression and PTSD in adulthood, and subsequent intimate partner aggression.
一般人群中有十分之六的人曾经历过童年不良经历（ACEs）。亲密伴侣暴力（IPV）是美国一个主要的公共卫生问题。本研究的主要目的是评估创伤后应激障碍（PTSD）、药物滥用和抑郁在ACEs与亲密伴侣攻击行为之间的关联中作为中介因素的性别差异。数据来自全国酒精及相关疾病流行病学调查的第二轮（2004 - 2005年）。采用结构方程模型来确定PTSD、药物滥用和抑郁在ACEs构成因素（忽视、身体/心理虐待、性虐待、父母暴力以及父母监禁/精神病理学）与亲密伴侣攻击行为之间关联中的中介作用。在男性中，PTSD介导了性虐待与亲密伴侣攻击行为之间的关系。然而，在男性和女性中，药物滥用介导了身体和心理虐待与亲密伴侣攻击行为之间的关系。针对攻击者的IPV项目应解决童年时期发生的虐待（性、身体和心理方面）以及近期的药物滥用和PTSD问题。这些项目应针对男性和女性实施。旨在预防儿童虐待的项目可能有助于降低成年期的抑郁和PTSD发生率，以及随后的亲密伴侣攻击行为发生率。
