School of Psychiatry,University of New South Wales,Sydney,Australia.
School of Health Sciences,Canterbury University,Christchurch,New Zealand.
Epidemiol Psychiatr Sci. 2017 Dec;26(6):612-623. doi: 10.1017/S204579601600055X. Epub 2016 Aug 4.
Childhood maltreatment and a family history of a schizophrenia spectrum disorder (SSD) are each associated with social-emotional dysfunction in childhood. Both are also strong risk factors for adult SSDs, and social-emotional dysfunction in childhood may be an antecedent of these disorders. We used data from a large Australian population cohort to determine the independent and moderating effects of maltreatment and parental SSDs on early childhood social-emotional functioning.
The New South Wales Child Development Study combines intergenerational multi-agency data using record linkage methods. Multiple measures of social-emotional functioning (social competency, prosocial/helping behaviour, anxious/fearful behaviour; aggressive behaviour, and hyperactivity/inattention) on 69 116 kindergarten children (age ~5 years) were linked with government records of child maltreatment and parental presentations to health services for SSD. Multivariable analyses investigated the association between maltreatment and social-emotional functioning, adjusting for demographic variables and parental SSD history, in the population sample and in sub-cohorts exposed and not exposed to parental SSD history. We also examined the association of parental SSD history and social-emotional functioning, adjusting for demographic variables and maltreatment.
Medium-sized associations were identified between maltreatment and poor social competency, aggressive behaviour and hyperactivity/inattention; small associations were revealed between maltreatment and poor prosocial/helping and anxious/fearful behaviours. These associations did not differ greatly when adjusted for parental SSD, and were greater in magnitude among children with no history of parental SSD. Small associations between parental SSD and poor social-emotional functioning remained after adjusting for demographic variables and maltreatment.
Childhood maltreatment and history of parental SSD are associated independently with poor early childhood social-emotional functioning, with the impact of exposure to maltreatment on social-emotional functioning in early childhood of greater magnitude than that observed for parental SSDs. The impact of maltreatment was reduced in the context of parental SSDs. The influence of parental SSDs on later outcomes of maltreated children may become more apparent during adolescence and young adulthood when overt symptoms of SSD are likely to emerge. Early intervention to strengthen childhood social-emotional functioning might mitigate the impact of maltreatment, and potentially also avert future psychopathology.
儿童期虐待和精神分裂症谱系障碍（SSD）家族史均与儿童期社会情感功能障碍有关。两者都是成年 SSD 的强危险因素，而儿童期的社会情感功能障碍可能是这些障碍的前兆。我们使用来自澳大利亚大型人群队列的数据，确定虐待和父母 SSD 对幼儿社会情感功能的独立和调节作用。
新南威尔士州儿童发展研究结合了使用记录链接方法的代际多机构数据。对 69116 名幼儿园儿童（年龄约 5 岁）的社会情感功能（社交能力、亲社会/帮助行为、焦虑/恐惧行为；攻击行为和多动/注意力不集中）进行了多项测量，并与政府记录的儿童虐待和父母因 SSD 就诊的健康服务记录进行了关联。多变量分析调查了人群样本中虐待与社会情感功能之间的关联，并调整了人口统计学变量和父母 SSD 病史，以及暴露于父母 SSD 病史和未暴露于父母 SSD 病史的亚队列。我们还检查了父母 SSD 病史与社会情感功能之间的关联，调整了人口统计学变量和虐待。
在调整了父母 SSD 后，虐待与社交能力差、攻击行为和多动/注意力不集中之间存在中等关联；虐待与亲社会/帮助和焦虑/恐惧行为较差之间存在小关联。在没有父母 SSD 病史的儿童中，这些关联的幅度更大。在调整了人口统计学变量和虐待后，父母 SSD 与较差的社会情感功能之间仍存在小关联。
儿童期虐待和父母 SSD 病史与幼儿期较差的社会情感功能独立相关，与父母 SSD 相比，暴露于虐待对幼儿期社会情感功能的影响更大。在父母 SSD 背景下，虐待的影响会降低。在青少年和成年早期，当 SSD 的明显症状可能出现时，父母 SSD 对受虐待儿童的后期结果的影响可能会更加明显。加强儿童社会情感功能的早期干预可能会减轻虐待的影响，并可能避免未来的精神病理学。
