Depression Research Laboratory, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 1N4, Canada.
Alberta Health Services, Suite 1150, 10201 Southport Road SW, Calgary, Alberta T2W 4X9, Canada.
Child Abuse Negl. 2017 Feb;64:89-100. doi: 10.1016/j.chiabu.2016.12.012. Epub 2017 Jan 2.
Adverse childhood experiences (ACEs), such as childhood abuse, neglect, and household dysfunction, have been identified as salient risk factors for adult depression. However, not all individuals who experience ACEs go on to develop depression. The extent to which resilience- or the ability to demonstrate stable levels of functioning despite adversity- may act as a buffer against depression among individuals with a history of ACEs has not been adequately examined. To address the associations between ACEs, depression, and resilience, 4006 adult participants were recruited from primary care clinics. Participants completed self-report questionnaires including: the Adverse Childhood Experiences Questionnaire, a retrospective measure of childhood adversity; the Patient Health Questionnaire-9, a measure of the presence and severity of the major symptoms of depression; and the Connor Davidson Resilience Scale, a measure of psychological resilience. Results from regression analyses indicated that, while controlling for a range of demographic variables, both ACEs and resilience independently predicted symptoms of depression, F(9, 3040)=184.81, R=0.354. Further, resilience moderated the association between ACEs and depression, F(10, 3039)=174.36, p<0.001, R=0.365. Specifically, the association between ACEs and depression was stronger among individuals with low resilience relative to those with high resilience. This research provides important information regarding the relationships among ACEs, resilience, and depression. Results have the potential to inform the development of treatments aimed to reduce symptoms of depression among primary care patients with a history of childhood adversity.
不良的童年经历(ACEs),如儿童期虐待、忽视和家庭功能障碍,已被确定为成年人抑郁的重要风险因素。然而,并非所有经历 ACEs 的人都会发展为抑郁症。在经历 ACEs 的个体中,韧性(或在逆境中保持稳定功能水平的能力)在多大程度上可以缓冲抑郁,这一点尚未得到充分研究。为了探讨 ACEs、抑郁和韧性之间的关联,从初级保健诊所招募了 4006 名成年参与者。参与者完成了自我报告问卷,包括:不良童年经历问卷,这是对童年逆境的回顾性测量;患者健康问卷-9,用于测量抑郁的主要症状的存在和严重程度;Connor-Davidson 韧性量表,用于测量心理韧性。回归分析的结果表明,在控制一系列人口统计学变量的情况下,ACEs 和韧性都独立地预测了抑郁症状,F(9, 3040)=184.81,R=0.354。此外,韧性调节了 ACEs 和抑郁之间的关联,F(10, 3039)=174.36,p<0.001,R=0.365。具体来说,在韧性较低的个体中,ACEs 与抑郁之间的关联比在韧性较高的个体中更强。这项研究提供了关于 ACEs、韧性和抑郁之间关系的重要信息。研究结果有可能为针对有儿童期逆境经历的初级保健患者的抑郁症状的治疗方法的发展提供信息。