School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 1/F, 7 Sassoon Road, Pokfulam, Hong Kong, SAR, People's Republic of China.
Community Health Systems, School of Nursing, UCSF, San Francisco, CA, USA.
Soc Psychiatry Psychiatr Epidemiol. 2018 Jul;53(7):673-684. doi: 10.1007/s00127-018-1508-z. Epub 2018 Apr 4.
Prospectively childhood behavioral problems and low self-esteem are associated with depression. However, these mental health changes over time have never been examined. This study assessed the association of childhood behavioral trajectories and self-esteem changes over time with adolescent depressive symptoms.
Parent-reported Rutter behavioral assessments and self-reported Culture-Free Self-Esteem Inventories (SEI) were obtained via record linkage from the Student Health Service, Department of Health (Hong Kong), and the Patient Health Questionnaire-9 (PHQ-9) depressive symptom scores were obtained via active follow-up of the Hong Kong's Children of 1997" Chinese birth cohort. Partitional clustering was used to generate homogenous trajectories between ~ 7 and ~ 11 years for Rutter scores. Changes in low self-esteem between ~ 10 and ~ 12 years were obtained from the SEI. Multiple linear regression was used to estimate their associations with depressive symptom scores at ~ 13 years.
Four trajectories/groups (stable low, declining, rising, and stable high) of Rutter score and self-esteem groups were created. The stable low behavioral trajectory was associated with the fewest depressive symptoms while the stable high trajectory had 1.23 more depressive symptoms [95% confidence interval (CI) 0.84 to 1.61] than the stable low trajectory. Consistently low self-esteem (stable low) was associated with 2.96 more depressive symptoms (95% CI 2.35-3.57) compared to consistently high self-esteem (stable high).
Sustained or worsening childhood behavioral problems and low self-esteem were precursors of adolescent depressive symptoms, and as such could be an early indicator of the need for intervention.
前瞻性地研究儿童期行为问题和低自尊与抑郁之间的关系。然而，这些心理健康变化随时间的推移从未被研究过。本研究评估了儿童期行为轨迹和自尊随时间变化与青少年抑郁症状的关系。
通过记录链接从学生健康服务部（香港卫生署）获取父母报告的 Rutter 行为评估和自我报告的文化自由自尊量表（SEI），通过对香港 1997 年出生队列的积极随访获得 PHQ-9 抑郁症状评分。分区聚类用于生成 Rutter 评分在 7 至 11 岁之间的同质轨迹。从 SEI 中获得 10 至 12 岁之间的低自尊变化。使用多元线性回归估计它们与 13 岁时抑郁症状评分的关系。
创建了四个 Rutter 评分和自尊组的轨迹/组（稳定低、下降、上升和稳定高）。稳定低行为轨迹与最少的抑郁症状相关，而稳定高轨迹比稳定低轨迹有 1.23 更多的抑郁症状[95%置信区间（CI）0.84 至 1.61]。一致的低自尊（稳定低）与 2.96 更多的抑郁症状（95% CI 2.35-3.57）相关，而一致的高自尊（稳定高）则没有。
持续或恶化的儿童期行为问题和低自尊是青少年抑郁症状的前兆，因此可能是干预需求的早期指标。
