Department of Child and Adolescent Psychiatry, St. Olavs Hospital, Pb 6810 Elgeseter, 7433 Trondheim, Norway; Norwegian University of Science and Technology (NTNU), Faculty of Medicine, RKBU Central Norway, Pb 8905 MTFS, 7491 Trondheim, Norway.
Norwegian University of Science and Technology (NTNU), Faculty of Medicine, Department of Public Health and General Practice, Pb 8905 MTFS, 7491 Trondheim, Norway; Children's Clinic, St.Olavs Hospital, Pb 3250 Sluppen, 7006 Trondheim, Norway.
Child Abuse Negl. 2017 Aug;70:122-133. doi: 10.1016/j.chiabu.2017.06.012. Epub 2017 Jun 10.
Childhood maltreatment is known to be associated with a broad variety of psychopathology and deteriorated well-being in adolescent populations. In the present nationwide study, we aimed to explore global self-esteem, attachment difficulties and substance use as possible mediators of these associations in a high-risk adolescent population. We included 400 adolescents (aged 12-20 years) living in residential youth care in Norway (response rate 67%). The participants completed a semistructured psychiatric interview (Child and Adolescent Psychiatric Assessment (CAPA)), a study-specific questionnaire, a revised version of the Self-Perception Profile for Adolescents (SPPA) and the Questionnaire for Measuring Health-related Quality of Life in Children and Adolescents (KINDL-R). Information was also provided by the adolescent's primary contact at the institution. Two models were tested using structural equation modelling; one assessed the association between childhood maltreatment and psychopathology, and one assessed the association between childhood maltreatment and well-being. Childhood maltreatment, psychopathology, well-being, global self-esteem and attachment difficulties were treated as latent variables, and substance use was added as an observed variable. The results of this study showed that global self-esteem was a mediator of paths in both models, whereas attachment difficulties and substance use were not. Preventing decline in health and well-being in high-risk adolescents is a main goal, and this study suggests that improving self-esteem, in addition to providing psychiatric health services, could be an important tool for achieving this goal.
童年期虐待与青少年群体中的多种精神病理学和幸福感下降有关。在本项全国性研究中，我们旨在探索在高风险青少年群体中，整体自尊、依恋困难和物质使用是否可能作为这些关联的中介因素。我们纳入了 400 名（年龄 12-20 岁）居住在挪威青年照护机构中的青少年（应答率 67%）。参与者完成了半结构式精神病学访谈（儿童和青少年精神病学评估（CAPA））、一项特定于研究的问卷、青少年自我知觉量表修订版（SPPA）和儿童和青少年健康相关生活质量问卷（KINDL-R）。机构中的青少年主要联系人也提供了信息。使用结构方程模型测试了两种模型；一种评估了童年期虐待与精神病理学之间的关联，另一种评估了童年期虐待与幸福感之间的关联。童年期虐待、精神病理学、幸福感、整体自尊和依恋困难被视为潜在变量，物质使用被添加为观察变量。这项研究的结果表明，整体自尊是两个模型中路径的中介因素，而依恋困难和物质使用不是。预防高风险青少年健康和幸福感下降是主要目标，本研究表明，除了提供精神健康服务外，提高自尊可能是实现这一目标的重要工具。
