Sanford School of Public Policy, Duke University, Durham, NC, USA.
The Pennsylvania State University, University Park, PA, USA.
J Child Psychol Psychiatry. 2017 Dec;58(12):1310-1318. doi: 10.1111/jcpp.12763. Epub 2017 Jul 13.
Young people exposed to violence are at increased risk for mental health and behavioral problems. However, very little is known about the immediate, or same-day, associations between violence exposure and adolescents' mental health symptoms or whether daily symptom or behavioral reactivity marks future problems.
Young adolescents were assessed three times a day for 30 consecutive days using mobile-phone-based Ecological Momentary Assessment (EMA) (N = 151 adolescents). Over 12,500 assessments and 4,329 person days were obtained via the EMA. Adolescents were recruited from low-income neighborhoods based on parent-reported risk for externalizing symptoms. Mental health symptoms were assessed via parent and child report at baseline, multiple times per day via EMA assessments of the adolescents, and again 18 months later when 93% of the adolescents were reinterviewed.
Results from multilevel models illustrated that young adolescents were more likely to experience symptoms of anger (OR = 1.74, CI: 1.31-2.30), depression (OR = 1.66, CI: 1.26-2.19), and conduct problems (OR = 2.63, CI: 1.71-4.04) on days that they were exposed versus not exposed to violence. Increases in depressive symptoms were also observed on days following violence exposure (OR = 1.46, CI: 1.09-1.97). Adolescents with the highest levels of violence exposure across the 30-day EMA were less behaviorally reactive to violence exposures in daily life, and heightened behavioral reactivity predicted increased risk for substance use across early adolescence.
Findings support the need to focus on both the immediate and long-term associations between violence exposure and adolescents' mental health and behavior. Results also suggest that heightened behavioral reactivity during early adolescence may signal emerging substance use problems.
接触暴力的年轻人患心理健康和行为问题的风险增加。然而,人们对暴力暴露与青少年心理健康症状之间的即时或同日关联知之甚少,也不知道日常症状或行为反应是否标志着未来的问题。
通过基于移动电话的生态瞬时评估(EMA),对 151 名青少年进行了连续 30 天每天 3 次的评估(N=151 名青少年)。通过 EMA 获得了超过 12500 次评估和 4329 个人天。根据父母报告的外化症状风险,从低收入社区招募青少年。通过父母和孩子在基线时的报告、青少年通过 EMA 评估每天多次报告、以及 18 个月后对 93%的青少年进行重新访谈时,评估心理健康症状。
多层次模型的结果表明,与未接触暴力的日子相比,青少年在接触暴力的日子里更有可能出现愤怒(OR=1.74,CI:1.31-2.30)、抑郁(OR=1.66,CI:1.26-2.19)和品行问题(OR=2.63,CI:1.71-4.04)的症状。在经历暴力暴露后,抑郁症状也有所增加(OR=1.46,CI:1.09-1.97)。在 30 天的 EMA 中,暴力暴露水平最高的青少年对日常生活中的暴力暴露的行为反应性较低,而较高的行为反应性预示着整个青春期早期物质使用风险的增加。
研究结果支持需要关注暴力暴露与青少年心理健康和行为之间的即时和长期关联。结果还表明,青春期早期行为反应性增强可能预示着潜在的物质使用问题。