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年轻成年墨西哥裔美国人样本中创伤事件的终生史:与物质依赖、情感障碍、文化适应压力和创伤后应激障碍的关系。

Lifetime history of traumatic events in a young adult Mexican American sample: Relation to substance dependence, affective disorder, acculturation stress, and PTSD.

作者信息

Ehlers Cindy L, Kim Corinne, Gilder David A, Stouffer Gina M, Caetano Raul, Yehuda Rachel

机构信息

Molecular and Cellular Neurosciences Department, The Scripps Research Institute, La Jolla, CA 92037, USA.

Molecular and Cellular Neurosciences Department, The Scripps Research Institute, La Jolla, CA 92037, USA.

出版信息

J Psychiatr Res. 2016 Dec;83:79-85. doi: 10.1016/j.jpsychires.2016.08.009. Epub 2016 Aug 15.

Abstract

Mexican Americans comprise one of the most rapidly growing populations in the United States, and within this population, trauma and post-traumatic stress disorder (PTSD) are associated with physical and mental health problems. Therefore, efforts to delineate factors that may uniquely contribute to increased likelihood of trauma, PTSD, and substance use disorders over the lifetime in Mexican Americans are important to address health disparities and to develop treatment and prevention programs. Six hundred fourteen young adults (age 18-30 yrs) of Mexican American heritage, largely second generation, were recruited from the community and assessed with the Semi-Structured Assessment for the Genetics of Alcoholism and an acculturation stress scale. More males (51.2%) reported experiencing traumas than females (41.1%), however, a larger proportion of females received a PTSD diagnosis (15%) than males (8%). Alcohol dependence and affective disorders, but not anxiety disorders, antisocial disorders, nicotine, marijuana, or stimulant dependence, were significantly comorbid with PTSD. Endorsing higher levels of acculturation stress was also significantly associated with both trauma exposure and a diagnosis of PTSD. Logistic regression revealed that female gender, having an affective disorder, alcohol dependence, higher levels of acculturation stress, and lower levels of education were all predictors of PTSD status. Additionally, alcohol dependence generally occurred after the PTSD diagnosis in early adulthood in this high-risk population. These studies suggest that treatment and prevention efforts should particularly focus on young adult second generation Mexican American women with higher levels of acculturation stress, who may be at higher risk for PTSD, affective disorder, and alcohol dependence following trauma exposure.

摘要

墨西哥裔美国人是美国增长最为迅速的人口群体之一,在这一群体中,创伤和创伤后应激障碍(PTSD)与身心健康问题相关。因此,明确那些可能独特地导致墨西哥裔美国人一生中创伤、PTSD和物质使用障碍可能性增加的因素,对于解决健康差距以及制定治疗和预防方案至关重要。从社区招募了614名具有墨西哥裔美国传统的年轻成年人(年龄在18 - 30岁之间,大多为第二代),并使用酒精ism遗传学半结构化评估和文化适应压力量表进行评估。报告经历过创伤的男性(51.2%)多于女性(41.1%),然而,接受PTSD诊断的女性比例(15%)高于男性(8%)。酒精依赖和情感障碍与PTSD显著共病,但焦虑障碍、反社会障碍、尼古丁、大麻或兴奋剂依赖则不然。认可更高水平的文化适应压力也与创伤暴露和PTSD诊断显著相关。逻辑回归显示,女性性别、患有情感障碍、酒精依赖、更高水平的文化适应压力以及更低的教育水平都是PTSD状态的预测因素。此外,在这一高风险人群中,酒精依赖通常在成年早期PTSD诊断之后出现。这些研究表明,治疗和预防工作应特别关注文化适应压力较高的第二代墨西哥裔美国年轻女性,她们在创伤暴露后可能患PTSD、情感障碍和酒精依赖的风险更高。

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