Department of Palliative Care, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Psychiatry, Psychology, and Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
Ann Behav Med. 2019 May 3;53(6):563-572. doi: 10.1093/abm/kay066.
Childhood interpersonal violence is linked to obesity and central adiposity in adulthood. Victimization experiences are likely to co-occur within individuals, but few studies have examined poly-victimization in the context of obesity and central adiposity.
The aim of this study is to evaluate the relationship between poly-victimization and body mass index (BMI) and waist circumference (WC) and to explore whether dysregulation of the hypothalamic-pituitary-adrenal axis, as measured by the cortisol stress response, mediates the relationship.
Healthy undergraduate women were recruited for a laboratory study from an online survey that assessed six different childhood victimization experiences: physical abuse, sexual abuse, peer violence, intimate partner violence, community violence, and witnessing violence. Forty-four women were categorized as poly-victims (2-5 types of violence exposures) and 48 were controls (0 types of violence exposures). Salivary cortisol was measured before and after the Trier Social Stress Test. Cortisol stress response was analyzed by the area under the curve with respect to ground (AUCG).
Compared with controls, poly-victims had higher BMI (B = 2.03, p = .04) and lower cortisol AUCG (B = -6.70, p < .01), independent of covariates. Poly-victims showed blunted AUCG in response to the stress task compared with controls, independent of covariates (B = -6.70, p < .01). Bootstrapping tests of mediation showed that cortisol response was not a significant mediator of the relationship between poly-victimization and BMI. Secondary analyses among poly-victims showed that the more frequent the violence exposure the higher the BMI.
Childhood poly-victimization is linked to higher BMI and blunted cortisol responses in young adult women. Assessment of multiple forms of childhood victimization is recommended.
儿童期人际暴力与成年期肥胖和中心性肥胖有关。受害经历很可能在个体中同时发生,但很少有研究在肥胖和中心性肥胖的背景下研究多受虐现象。
本研究旨在评估多受虐与体重指数(BMI)和腰围(WC)的关系,并探讨下丘脑-垂体-肾上腺轴的失调(以下简称 HPA 轴失调)是否作为皮质醇应激反应来介导这种关系。
通过一项在线调查,从健康的女大学生中招募了参加实验室研究的志愿者,该调查评估了六种不同的儿童期受害经历:身体虐待、性虐待、同伴暴力、亲密伴侣暴力、社区暴力和目睹暴力。44 名女性被归类为多受虐者(有 2-5 种暴力经历),48 名女性被归类为对照组(没有任何暴力经历)。在特里尔社会应激测试之前和之后测量唾液皮质醇。通过皮质醇曲线下面积与基础值的比值(AUCG)来分析皮质醇应激反应。
与对照组相比,多受虐者的 BMI 较高(B = 2.03,p =.04),皮质醇 AUCG 较低(B = -6.70,p <.01),这与协变量无关。多受虐者与对照组相比,HPA 轴失调,对压力任务的 AUCG 反应降低(B = -6.70,p <.01),这与协变量无关。中介效应的 bootstrap 检验显示,皮质醇反应并不是多受虐与 BMI 之间关系的一个显著中介因素。多受虐者的二次分析表明,受虐经历越频繁,BMI 越高。
儿童期多受虐与成年女性 BMI 较高和皮质醇反应迟钝有关。建议对多种形式的儿童期受害进行评估。