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童年期虐待与中国高中生非医疗处方类阿片类药物使用的关联:性别因素的调节作用。

Association between childhood maltreatment and non-medical prescription opioid use among Chinese senior high school students: The moderating role of gender.

机构信息

Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.

Center for ADR Monitoring of Guangdong, Guangzhou, China.

出版信息

J Affect Disord. 2018 Aug 1;235:421-427. doi: 10.1016/j.jad.2018.04.070. Epub 2018 Apr 10.

DOI:10.1016/j.jad.2018.04.070
PMID:29677607
Abstract

BACKGROUND

Non-medical prescription opioid use (NMPOU) and childhood maltreatment are currently serious problems among adolescents worldwide, and childhood maltreatment may be associated with the increased rates of NMPOU. This study examined the specific associations between particular types of childhood maltreatment and lifetime NMPOU and assessed whether gender has a moderating effect on these associations.

METHODS

A 3-stage, stratified cluster, randomized sampling method was used to collect data from 11,194 high school students in Chongqing.

RESULT

The prevalence of the lifetime NMPOU among senior high school students in Chongqing was 7.7%. Physical abuse (AOR = 1.11, 95% CI = 1.07-1.14), emotional abuse (AOR = 1.05, 95% CI = 1.03-1.08), sexual abuse (AOR = 1.04, 95% CI = 1.01-1.07), physical neglect (AOR = 1.06, 95% CI = 1.04-1.09), and emotional neglect (AOR = 1.03, 95% CI = 1.02-1.04) were all positively associated with lifetime NMPOU. The moderating effects of gender on emotional abuse (P = 0.004) and sexual abuse (P = 0.019) were statistically significant in the adjusted model of lifetime NMPOU. According to the stratification analyses in which the male and female students were analyzed separately, female students who previously experienced emotional/sexual abuse had a higher prevalence of lifetime NMPOU.

LIMITATIONS

The study sample only contained school students and cross-sectional design limited our ability to make causal inferences.

CONCLUSION

Childhood maltreatment was positively associated with lifetime NMPOU, and gender had a moderating effect on the associations between childhood maltreatment and lifetime NMPOU. Early identification of and intervention for childhood maltreatment victims, particularly female victims, may help reduce the lifetime risk of NMPOU.

摘要

背景

非医疗处方类阿片类药物使用(NMPOU)和儿童期虐待是目前全球青少年面临的严重问题,儿童期虐待可能与 NMPOU 发生率的增加有关。本研究旨在探讨特定类型的儿童期虐待与终生 NMPOU 之间的具体关联,并评估性别是否对这些关联有调节作用。

方法

采用 3 阶段、分层聚类、随机抽样方法,从重庆市 11194 名高中生中收集数据。

结果

重庆市高中生终生 NMPOU 的患病率为 7.7%。身体虐待(AOR=1.11,95%CI=1.07-1.14)、情感虐待(AOR=1.05,95%CI=1.03-1.08)、性虐待(AOR=1.04,95%CI=1.01-1.07)、身体忽视(AOR=1.06,95%CI=1.04-1.09)和情感忽视(AOR=1.03,95%CI=1.02-1.04)均与终生 NMPOU 呈正相关。性别对情感虐待(P=0.004)和性虐待(P=0.019)在终生 NMPOU 的调整模型中具有统计学意义的调节作用。根据对男、女学生分别进行分层分析的结果,曾经历过情感/性虐待的女学生终生 NMPOU 的患病率更高。

局限性

研究样本仅包含在校学生,且横断面设计限制了我们进行因果推断的能力。

结论

儿童期虐待与终生 NMPOU 呈正相关,性别对儿童期虐待与终生 NMPOU 之间的关联具有调节作用。早期识别和干预儿童期虐待受害者,特别是女性受害者,可能有助于降低终生 NMPOU 的风险。

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