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儿童虐待和环境压力的直接和间接影响:逆境和抑郁症状的生命历程视角。

Direct and indirect effects of child abuse and environmental stress: A lifecourse perspective on adversity and depressive symptoms.

机构信息

Graduate School of Social Work and Social Research.

Boys Town National Research Hospital.

出版信息

Am J Orthopsychiatry. 2018;88(2):180-188. doi: 10.1037/ort0000283. Epub 2017 Aug 17.

Abstract

There is a great deal of evidence about the mental health implications of physical child abuse and environmental stressors, or hardships that people experience at the household and neighborhood level (e.g., neighborhood violence; economic hardship, substance abuse, or conflict among family members). Yet, studies often focus on either abuse or environmental stress, not both, or examine abuse and environmental stressors as a combined set of experiences. Less is known, therefore, about how child abuse and environmental stress might work as either distinct or interrelated risks to diminish mental health over time. In this longitudinal study, we used path analyses to examine the cumulative effects of physical child abuse and environmental stressors on adult depressive symptoms among a sample of children followed into adulthood (N = 356). The goal was to assess whether chronic physical child abuse remains an independent predictor of adult outcomes once we accounted for the cumulative effects of household and neighborhood stressors across the lifecourse. Cumulative measures of physical child abuse and environmental stress each independently predicted a higher likelihood of adult depressive symptoms (ß = .122, p < .01 and ß = .283, p < .001, respectively). After accounting for adolescent depressive symptoms, only cumulative environmental stressors independently predicted depressive symptoms (ß = .202, p < .001). Tests of the indirect effect of cumulative environmental stress on the relationship between cumulative physical abuse and adult depressive symptoms were marginally statistically significant. Results add to literature that examines child abuse, adversity, and lifecourse perspectives on health. (PsycINFO Database Record

摘要

有大量证据表明,身体虐待和环境压力源(即人们在家庭和邻里层面所经历的困难,如邻里暴力、经济困难、药物滥用或家庭成员之间的冲突)对心理健康有影响。然而,研究通常要么关注虐待,要么关注环境压力,而不是两者都关注,或者将虐待和环境压力源视为一组综合的经历进行研究。因此,人们对儿童虐待和环境压力如何作为独立或相互关联的风险因素,随着时间的推移对心理健康产生影响了解较少。在这项纵向研究中,我们使用路径分析来检验身体虐待和环境压力源对成年后儿童(n=356)的成年抑郁症状的累积影响。研究目的是评估,一旦我们考虑了一生中家庭和邻里压力源的累积效应,慢性身体虐待是否仍然是成年结果的独立预测因素。身体虐待和环境压力的累积测量各自独立地预测了更高的成年抑郁症状的可能性(β=.122,p<.01 和β=.283,p<.001)。在考虑了青少年抑郁症状后,只有累积环境压力源独立地预测了抑郁症状(β=.202,p<.001)。累积环境压力对累积身体虐待与成年抑郁症状之间关系的间接效应检验结果略具有统计学意义。研究结果增加了关于儿童虐待、逆境和健康的生命历程观点的文献。

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