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行为问题轨迹与心理社会结局:系统评价与荟萃分析。

Conduct problems trajectories and psychosocial outcomes: a systematic review and meta-analysis.

机构信息

University College London GOS Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK.

School of Social Sciences, Heriot-Watt University, Edinburgh, EH14 4AS, UK.

出版信息

Eur Child Adolesc Psychiatry. 2018 Oct;27(10):1239-1260. doi: 10.1007/s00787-017-1053-4. Epub 2017 Oct 6.

Abstract

There is increasing evidence that youth who follow the early onset persistent (EOP), adolescent-onset (AO) and childhood-limited (CL) trajectories of conduct problems show varying patterns of health, mental health, educational, and social outcomes in adulthood. However, there has been no systematic review and meta-analysis on outcomes associated with different conduct problems trajectories. We systematically reviewed the literature of longitudinal studies considering outcomes of three conduct problems trajectories: EOP, AO, and CL compared with individuals with low levels of conduct problems (low). We performed a series of meta-analyses comparing each trajectory to the low group for eight different outcomes in early adulthood or later. Thirteen studies met our inclusion criteria. Outcomes were mental health (depression), cannabis use, alcohol use, self-reported aggression, official records of antisocial behaviour, poor general health, poor education, and poor employment. Overall, EOP individuals showed significant higher risk of poor outcome followed by AO individuals, CL individuals, and finally participants in the low group. All conduct problems trajectories showed higher risk of poor psychosocial outcomes compared to the low group, but the magnitude of risk differed across trajectories, with a general trend for the EOP to perform significantly worse, followed by the AO and CL. Early intervention is recommended across domains to maximise likelihood of desistance from antisocial behaviour and improvement on several psychosocial outcomes.

摘要

越来越多的证据表明,在青少年时期表现出早期持续(EOP)、青少年期发作(AO)和儿童期有限(CL)行为问题轨迹的年轻人,在成年后表现出不同的健康、心理健康、教育和社会结果模式。然而,目前还没有关于与不同行为问题轨迹相关结果的系统评价和荟萃分析。我们系统地回顾了考虑三种行为问题轨迹(EOP、AO 和 CL)的纵向研究文献,这些轨迹与行为问题水平较低的个体(低水平)进行了比较。我们对每个轨迹与低水平组在成年早期或之后的八个不同结果进行了一系列荟萃分析。符合纳入标准的研究有 13 项。结果包括心理健康(抑郁)、大麻使用、酒精使用、自我报告的攻击行为、反社会行为的官方记录、总体健康状况不佳、教育程度低和就业机会差。总的来说,EOP 个体表现出明显更高的不良后果风险,其次是 AO 个体,CL 个体,最后是低水平组的参与者。所有行为问题轨迹与低水平组相比,都表现出更高的不良心理社会结果风险,但风险程度因轨迹而异,EOP 表现出明显更差的趋势,其次是 AO 和 CL。建议在各个领域进行早期干预,以最大限度地减少反社会行为的持续发生,并改善几种心理社会结果。

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