Asselmann Eva, Wittchen Hans-Ulrich, Lieb Roselind, Beesdo-Baum Katja
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany.
Soc Psychiatry Psychiatr Epidemiol. 2017 Nov;52(11):1353-1362. doi: 10.1007/s00127-017-1436-3. Epub 2017 Sep 9.
To prospectively examine whether higher daily hassles predict a variety of incident mental disorders and respective associations vary by gender, age, perceived coping efficacy and number of negative life events.
Data comes from the Early Developmental Stages of Psychopathology Study (EDSP), a prospective-longitudinal study among adolescents and young adults from the community (n = 2797, aged 14-24 at baseline) followed up in up to 3 assessment waves over 10 years. Mental disorders were assessed at each wave using the DSM-IV/M-CIDI. Daily hassles, perceived coping efficacy, and negative life events were assessed at baseline using the Daily Hassles Scale, Scale for Self-Control and Coping Skills, and Munich Life Event List.
In logistic regressions adjusted for gender, age, other mental disorders, perceived coping efficacy and number of negative life events at baseline, higher daily hassles at baseline predicted the incidence of any anxiety disorder, specific phobia, obsessive-compulsive disorder, any affective disorder, and major depressive episodes at follow-up (OR 1.2-1.9 per standard deviation). Daily hassles interacted with perceived coping efficacy at baseline in predicting incident panic attacks (OR 1.3) and panic disorder (OR 1.3) at follow-up, i.e., higher daily hassles only predicted incident panic pathology among individuals with low perceived coping efficacy (OR 1.6-2.0) but not high perceived coping efficacy. Moreover, the associations between daily hassles and incident mental disorders partially varied by gender and age but not by negative life events at baseline.
Targeted stress management interventions among individuals with increased daily hassles might be useful to prevent the onset of anxiety and affective disorders.
前瞻性研究日常困扰较多是否预示着各种新发精神障碍,以及相应的关联是否因性别、年龄、感知应对效能和负面生活事件的数量而有所不同。
数据来自精神病理学早期发展阶段研究(EDSP),这是一项针对社区青少年和青年成年人的前瞻性纵向研究(n = 2797,基线时年龄为14 - 24岁),在10年中进行了多达3次评估随访。每次随访时使用DSM-IV/M-CIDI评估精神障碍。在基线时使用日常困扰量表、自我控制和应对技能量表以及慕尼黑生活事件清单评估日常困扰、感知应对效能和负面生活事件。
在对性别、年龄、其他精神障碍、感知应对效能和基线时的负面生活事件数量进行调整的逻辑回归分析中,基线时较高的日常困扰预示着随访时任何焦虑障碍、特定恐惧症、强迫症、任何情感障碍和重度抑郁发作的发生率(每标准差的OR为1.2 - 1.9)。日常困扰在基线时与感知应对效能相互作用,预测随访时惊恐发作(OR 1.3)和惊恐障碍(OR 1.3)的发生率,即较高的日常困扰仅在感知应对效能较低的个体中预示着新发惊恐病理(OR 1.6 - 2.0),而在感知应对效能较高的个体中则不然。此外,日常困扰与新发精神障碍之间的关联部分因性别和年龄而异,但不因基线时的负面生活事件而异。
针对日常困扰增加的个体进行有针对性的压力管理干预可能有助于预防焦虑和情感障碍的发作。