McGill Group for Suicide Studies (Geoffroy, Renaud, Perret, Turecki) and Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention (Renaud), Douglas Mental Health University Institute; McGill University (Geoffroy, Renaud, Perret, Turecki), Montréal, Que.; Research Unit on Children's Psychosocial Maladjustment (Geoffroy, Boivin, Turecki, Vitaro, Brendgen, Tremblay, Côté), Montréal and Québec, Que.; Université Laval (Boivin), Québec, Que.; Institute of Genetic, Neurobiological, and Social Foundations of Child Development at Tomsk State University (Boivin), Tomsk, Russian Federation; Institute of Psychiatry, Psychology and Neuroscience (Arseneault), King's College London, London, UK; Centre de recherche INSERM U1219 (Michel, Salla, Côté), Université de Bordeaux, Bordeaux, France; Université de Montréal (Vitaro, Tremblay, Côté); CHU Sainte-Justine Research Center (Vitaro, Brendgen); Université du Québec à Montréal (Brendgen), Montréal, Que.; University College Dublin (Tremblay), Dublin, Ireland
McGill Group for Suicide Studies (Geoffroy, Renaud, Perret, Turecki) and Manulife Centre for Breakthroughs in Teen Depression and Suicide Prevention (Renaud), Douglas Mental Health University Institute; McGill University (Geoffroy, Renaud, Perret, Turecki), Montréal, Que.; Research Unit on Children's Psychosocial Maladjustment (Geoffroy, Boivin, Turecki, Vitaro, Brendgen, Tremblay, Côté), Montréal and Québec, Que.; Université Laval (Boivin), Québec, Que.; Institute of Genetic, Neurobiological, and Social Foundations of Child Development at Tomsk State University (Boivin), Tomsk, Russian Federation; Institute of Psychiatry, Psychology and Neuroscience (Arseneault), King's College London, London, UK; Centre de recherche INSERM U1219 (Michel, Salla, Côté), Université de Bordeaux, Bordeaux, France; Université de Montréal (Vitaro, Tremblay, Côté); CHU Sainte-Justine Research Center (Vitaro, Brendgen); Université du Québec à Montréal (Brendgen), Montréal, Que.; University College Dublin (Tremblay), Dublin, Ireland.
CMAJ. 2018 Jan 15;190(2):E37-E43. doi: 10.1503/cmaj.170219.
Exposure to peer victimization is relatively common. However, little is known about its developmental course and its effect on impairment associated with mental illnesses. We aimed to identify groups of children following differential trajectories of peer victimization from ages 6 to 13 years and to examine predictive associations of these trajectories with mental health in adolescence.
Participants were members of the Quebec Longitudinal Study of Child Development, a prospective cohort of 2120 children born in 1997/98 who were followed until age 15 years. We included 1363 participants with self-reported victimization from ages 6 to 13 years and data available on their mental health status at 15 years.
We identified 3 trajectories of peer victimization. The 2 prevailing groups were participants with little or moderate exposure to victimization (441/1685 [26.2%] and 1000/1685 [59.3%], respectively); the third group (244 [14.5%]) had been chronically exposed to the most severe and long-lasting levels of victimization. The most severely victimized individuals had greater odds of reporting debilitating depressive or dysthymic symptoms (odds ratio [OR] 2.56, 95% confidence interval [CI] 1.27-5.17), debilitating generalized anxiety problems (OR 3.27, CI 1.64-6.51) and suicidality (OR 3.46, CI 1.53-7.81) at 15 years than those exposed to the lowest levels of victimization, after adjustment for sex, childhood mental health, family hardship and victimization perpetration. The association with suicidality remained significant after controlling for concurrent symptoms of depression or dysthymia and generalized anxiety problems.
Adolescents who were most severely victimized by peers had an increased risk of experiencing severe symptoms consistent with mental health problems. Given that peer victimization trajectories are established early on, interventions to reduce the risk of being victimized should start before enrolment in the formal school system.
同伴侵害的暴露相对常见。然而,对于其发展过程及其对与精神疾病相关的损伤的影响知之甚少。我们旨在确定从 6 岁到 13 岁时经历同伴侵害的不同轨迹的儿童群体,并研究这些轨迹与青春期心理健康的预测关联。
参与者是魁北克儿童发展纵向研究的一部分,这是一项对 1997/98 年出生的 2120 名儿童进行的前瞻性队列研究,随访至 15 岁。我们纳入了 1363 名在 6 岁至 13 岁期间报告过受同伴侵害的参与者,且在 15 岁时他们的心理健康状况数据可用。
我们确定了 3 种同伴侵害的轨迹。2 个主要群体是受侵害程度较低或中度的参与者(441/1685[26.2%]和 1000/1685[59.3%]);第 3 个群体(244[14.5%])长期受到最严重和最持久的侵害。受侵害最严重的个体报告严重抑郁或心境恶劣症状(优势比[OR]2.56,95%置信区间[CI]1.27-5.17)、严重广泛性焦虑问题(OR 3.27,CI 1.64-6.51)和自杀意念(OR 3.46,CI 1.53-7.81)的可能性高于那些受侵害程度最低的个体,经性别、儿童期心理健康、家庭困难和侵害实施调整后。在控制同时存在的抑郁或心境恶劣症状和广泛性焦虑问题后,自杀意念的关联仍然显著。
被同伴侵害最严重的青少年患严重精神健康问题的风险增加。鉴于同伴侵害轨迹很早就建立起来,应在儿童进入正规学校系统之前就开始采取干预措施,以降低被侵害的风险。