Department of Psychosis Studies,King's College London,IOPPN,London,UK.
Cornwall NHS Foundation Trust,Saint Austell,UK.
Epidemiol Psychiatr Sci. 2019 Jun;28(3):300-309. doi: 10.1017/S2045796017000518. Epub 2017 Oct 9.
We have previously reported an association between childhood abuse and psychotic experiences (PEs) in survey data from South East London. Childhood abuse is related to subsequent adulthood adversity, which could form one pathway to PEs. We aimed to investigate evidence of mediation of the association between childhood abuse and PEs by adverse life events.
Data were analysed from the South East London Community Health Study (SELCoH, n = 1698). Estimates of the total effects on PEs of any physical or sexual abuse while growing up were partitioned into direct (i.e. unmediated) and indirect (total and specific) effects, mediated via violent and non-violent life events.
There was strong statistical evidence for direct (OR 1.58, 95% CI: 1.19-2.1) and indirect (OR 1.51, 95% CI: 1.32-1.72) effects of childhood abuse on PEs after adjustment for potential confounders, indicating partial mediation of this effect via violent and non-violent life events. An estimated 47% of the total effect of abuse on PEs was mediated via adulthood adverse life events, of which violent life events made up 33% and non-violent life events the remaining 14%.
The association between childhood abuse and PEs is partly mediated through the experience of adverse life events in adulthood. There is some evidence that a larger proportion of this effect was mediated through violent life events than non-violent life events.
我们之前曾在伦敦东南部的调查数据中报告过儿童期虐待与精神病体验(PEs)之间的关联。儿童虐待与随后的成年逆境有关,这可能是导致 PEs 的途径之一。我们旨在调查儿童虐待与 PEs 之间关联的证据是否通过不良生活事件进行中介。
对来自东南伦敦社区健康研究(SELCoH,n=1698)的数据进行了分析。将成长过程中任何身体或性虐待对 PEs 的总影响估计值分为直接(即未经中介)和间接(总效应和特定效应)效应,通过暴力和非暴力生活事件进行中介。
在调整了潜在混杂因素后,儿童虐待对 PEs 的直接(OR 1.58,95%CI:1.19-2.1)和间接(OR 1.51,95%CI:1.32-1.72)效应具有很强的统计学意义,表明通过暴力和非暴力生活事件对该效应进行了部分中介。受虐待对 PEs 的总效应的估计有 47%是通过成年后不良生活事件进行中介的,其中暴力生活事件占 33%,非暴力生活事件占其余的 14%。
儿童虐待与 PEs 之间的关联部分通过成年后不良生活事件的经历进行中介。有一些证据表明,这种效应的较大比例是通过暴力生活事件而不是非暴力生活事件进行中介的。