Iguacel Isabel, Michels Nathalie, Fernández-Alvira Juan M, Bammann Karin, De Henauw Stefaan, Felső Regina, Gwozdz Wencke, Hunsberger Monica, Reisch Lucia, Russo Paola, Tornaritis Michael, Thumann Barbara Franziska, Veidebaum Toomas, Börnhorst Claudia, Moreno Luis A
GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Edificio del SAI, C/Pedro Cerbuna s/n, 50009, Saragossa, Spain.
Instituto Agroalimentario de Aragón (IA2), Saragossa, Spain.
Eur Child Adolesc Psychiatry. 2017 Sep;26(9):1105-1117. doi: 10.1007/s00787-017-0998-7. Epub 2017 May 12.
The effect of socioeconomic inequalities on children's mental health remains unclear. This study aims to explore the cross-sectional and longitudinal associations between social vulnerabilities and psychosocial problems, and the association between accumulation of vulnerabilities and psychosocial problems. 5987 children aged 2-9 years from eight European countries were assessed at baseline and 2-year follow-up. Two different instruments were employed to assess children's psychosocial problems: the KINDL (Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents) was used to evaluate children's well-being and the Strengths and Difficulties Questionnaire (SDQ) was used to evaluate children's internalising problems. Vulnerable groups were defined as follows: children whose parents had minimal social networks, children from non-traditional families, children of migrant origin or children with unemployed parents. Logistic mixed-effects models were used to assess the associations between social vulnerabilities and psychosocial problems. After adjusting for classical socioeconomic and lifestyle indicators, children whose parents had minimal social networks were at greater risk of presenting internalising problems at baseline and follow-up (OR 1.53, 99% CI 1.11-2.11). The highest risk for psychosocial problems was found in children whose status changed from traditional families at T0 to non-traditional families at T1 (OR 1.60, 99% CI 1.07-2.39) and whose parents had minimal social networks at both time points (OR 1.97, 99% CI 1.26-3.08). Children with one or more vulnerabilities accumulated were at a higher risk of developing psychosocial problems at baseline and follow-up. Therefore, policy makers should implement measures to strengthen the social support for parents with a minimal social network.
社会经济不平等对儿童心理健康的影响仍不明确。本研究旨在探讨社会脆弱性与心理社会问题之间的横断面和纵向关联,以及脆弱性累积与心理社会问题之间的关联。对来自八个欧洲国家的5987名2至9岁儿童在基线期和2年随访时进行了评估。采用两种不同的工具来评估儿童的心理社会问题:使用儿童青少年健康相关生活质量调查问卷(KINDL)来评估儿童的幸福感,使用优势与困难问卷(SDQ)来评估儿童的内化问题。弱势群体定义如下:父母社交网络极少的儿童、来自非传统家庭的儿童、移民家庭的儿童或父母失业的儿童。采用逻辑混合效应模型来评估社会脆弱性与心理社会问题之间的关联。在对经典的社会经济和生活方式指标进行调整后,父母社交网络极少的儿童在基线期和随访时出现内化问题的风险更高(比值比1.53,99%置信区间1.11 - 2.11)。心理社会问题风险最高的是那些在T0时家庭状况为传统家庭、在T1时变为非传统家庭的儿童(比值比1.60,99%置信区间1.07 - 2.39),以及在两个时间点父母社交网络都极少的儿童(比值比1.97,99%置信区间1.26 - 3.08)。累积有一个或多个脆弱性的儿童在基线期和随访时出现心理社会问题的风险更高。因此,政策制定者应采取措施,加强对社交网络极少的父母的社会支持。