Health Services Research Unit, Department of Community Medicine, University of Tromsø, 9037, Tromsø, Norway.
Eur Child Adolesc Psychiatry. 2018 Apr;27(4):481-491. doi: 10.1007/s00787-017-1090-z. Epub 2017 Nov 29.
A number of cross-sectional studies have consistently shown a correlation between childhood physical maltreatment, perceived social isolation and internalizing symptoms. Using a longitudinal, three-wave design, this study sought to assess the mediating role of perceived social isolation in adulthood in the association between childhood physical maltreatment and internalizing symptoms in adulthood. The study has a three-wave design. We used data collected from 1994 to 2008 within the framework of the Tromsø Study (N = 4530), a representative prospective cohort study of men and women. Perceived social isolation was measured at a mean age of 54.7 years, and internalizing symptoms were measured at a mean age of 61.7 years. The difference-in-coefficients method was used to assess the indirect effects and the proportion (%) of mediated effects. Childhood physical maltreatment was associated with an up to 68% [relative risk (RR) = 1.68, 95% confidence interval (CI): 1.33-2.13] higher risk of perceived social isolation in adulthood. Childhood physical maltreatment and perceived social isolation in adulthood were associated with greater levels of internalizing symptoms in adulthood (p < 0.01). A dose-response association was observed between childhood physical maltreatment and internalizing symptoms in adulthood (p < 0.001). Perceived social isolation in adulthood mediated up to 14.89% (p < 0.05) of the association between childhood physical maltreatment and internalizing symptoms in adulthood. The results of this study indicate the need to take perceived social isolation into account when considering the impact of childhood physical maltreatment on internalizing symptoms.
一些横断面研究一致表明，儿童期身体虐待、感知社会孤立与内化症状之间存在关联。本研究采用纵向三波设计，旨在评估成年期感知社会孤立在童年期身体虐待与成年内化症状之间关联中的中介作用。该研究采用三波设计。我们使用了 1994 年至 2008 年期间特罗姆瑟研究（N=4530）框架内收集的数据，这是一项针对男性和女性的代表性前瞻性队列研究。感知社会孤立在平均年龄为 54.7 岁时进行测量，内化症状在平均年龄为 61.7 岁时进行测量。采用差异系数法评估间接效应和中介效应的比例（%）。儿童期身体虐待与成年期感知社会孤立的风险增加高达 68%（相对风险[RR] = 1.68，95%置信区间[CI]：1.33-2.13）相关。儿童期身体虐待和成年期感知社会孤立与成年内化症状水平升高相关（p < 0.01）。观察到儿童期身体虐待与成年内化症状之间存在剂量反应关联（p < 0.001）。成年期感知社会孤立在儿童期身体虐待与成年内化症状之间的关联中存在高达 14.89%（p < 0.05）的中介作用。本研究结果表明，在考虑儿童期身体虐待对内化症状的影响时，需要考虑感知社会孤立。
