Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
BMC Psychiatry. 2018 Mar 9;18(1):63. doi: 10.1186/s12888-017-1583-9.
College students are at risk of depression. This risk may be increased by the experience of childhood adversity and/or recent stressors. This study examined the association between reported experiences of childhood adversity, recent stressors and depression during the last 12 months in a cohort of South African university students.
Six hundred and eighty-six first year students at Stellenbosch University in South Africa completed a health-focused e-survey that included items on childhood adversity, recent stressors and mood. Individual and population attributable risk proportions (PARP) between experiences of childhood adversity and 12-month stressful experiences and 12-month depression were estimated using multivariate binomial logistic regression analysis.
About one in six students reported depression during the last 12 months. Being a victim of bullying and emotional abuse or emotional neglect during childhood were the strongest predictors of depression in the past year at both individual and population level. With regard to recent stressors, a romantic partner being unfaithful, serious ongoing arguments or break-ups with some other close friend or family member and a sexual or gender identity crisis were the strongest predictors of depression. The predictor effect of recent stressors was significantly reduced in the final model that adjusted for the type and number of childhood traumatic experiences. At a population level, academic stress, serious ongoing arguments or break-ups with a close friend or family member, and serious betrayal by someone close were the variables that yielded the highest PARP.
Our findings suggest a significant relationship between early adversity, recent stressors, and depression here and throughout, consistent with the broader literature on predictors of depression. This study contributes to the limited data on college students' mental health in low and middle income countries including on the African continent. The findings provide information on the population level effect sizes of trauma as a risk factor for depression, as well as on the relationship between specific recent stressors and depression in college students.
大学生有患抑郁症的风险。这种风险可能会因童年逆境经历和/或近期压力源而增加。本研究调查了南非大学生队列中报告的童年逆境经历、近期压力源与过去 12 个月抑郁之间的关系。
南非斯坦陵布什大学的 686 名一年级学生完成了一项以健康为重点的电子调查,其中包括童年逆境、近期压力源和情绪的项目。使用多变量二项逻辑回归分析估计童年逆境经历与 12 个月压力经历和 12 个月抑郁之间的个体和人群归因风险比例(PARP)。
约六分之一的学生报告过去 12 个月有抑郁症状。童年时期遭受欺凌和情感虐待或情感忽视是个体和人群水平上过去一年抑郁的最强预测因素。就近期压力源而言,恋爱伴侣不忠、持续不断的严重争吵或与其他亲密朋友或家人的分手以及性或性别认同危机是抑郁的最强预测因素。在调整了童年创伤经历的类型和数量的最终模型中,近期压力源的预测作用显著降低。在人群水平上,学业压力、与亲密朋友或家人持续不断的严重争吵或分手,以及亲密的人严重背叛,是产生最高 PARP 的变量。
我们的研究结果表明,早期逆境、近期压力源与抑郁之间存在显著关系,这与抑郁预测因素的更广泛文献一致。这项研究为包括非洲大陆在内的中低收入国家大学生心理健康的有限数据提供了信息。研究结果提供了有关创伤作为抑郁风险因素的人群水平效应大小的信息,以及特定近期压力源与大学生抑郁之间的关系。