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性别调节生活压力事件与精神病理学之间的关系:一项全国性研究的结果。

Gender moderates the relationship between stressful life events and psychopathology: Findings from a national study.

机构信息

Veterans' Administration, Connecticut Healthcare System, CT, USA; Department of Psychiatry, Yale University School of Medicine, CT, USA.

Veterans' Administration, Connecticut Healthcare System, CT, USA; Department of Psychiatry, Yale University School of Medicine, CT, USA; Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.

出版信息

J Psychiatr Res. 2018 Dec;107:34-41. doi: 10.1016/j.jpsychires.2018.09.012. Epub 2018 Sep 20.

Abstract

BACKGROUND

While data suggest a strong relationship between trauma exposure and psychopathology, less research has investigated relationships between psychopathology and stressful life events more broadly, and how these relationships may differ by gender.

AIM

To examine strengths of associations between stressful life events and psychiatric disorders (i.e., past-year Axis I and lifetime Axis II, per DSM-IV) and how they may differ by gender.

METHODS

Data from Wave 1 of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC; n = 43,093) were analyzed using chi-square tests and multinomial logistic regression analyses. Participants were categorized according to occurrence of stressful life events (low, moderate, and high).

RESULTS

Women as compared to men were more likely to report moderate (p < 0.0001) or high occurrence stressful life events (p < 0.0001). Increasing experiences of stressful life events were associated with increasing odds of most past-year Axis I and lifetime Axis II disorders in both gender groups, with the largest odds typically observed in association with more frequent stressful life events. Associations between stressful life events and multiple psychiatric disorders were stronger in women compared to men.

CONCLUSIONS

Stressful life events are associated with multiple Axis I and Axis II psychiatric disorders in both men and women. This relationship is moderated by gender. Screening female patients who endorse significant stressors for mood, anxiety, and substance-use problems might be particularly important. The stronger associations in women between stressful life events and personality disorders in particular warrant further investigation.

摘要

背景

虽然有数据表明创伤暴露与精神病理学之间存在很强的关系,但较少的研究调查了更广泛的精神病理学与压力性生活事件之间的关系,以及这些关系如何因性别而异。

目的

研究压力性生活事件与精神障碍(即 DSM-IV 中的过去一年轴 I 和终身轴 II)之间的关联强度,并探讨它们如何因性别而异。

方法

使用卡方检验和多项逻辑回归分析对来自国家酒精相关条件流行病学调查(NESARC;n=43093)的第 1 波数据进行分析。参与者根据压力性生活事件的发生情况(低、中、高)进行分类。

结果

与男性相比,女性更有可能报告中度(p<0.0001)或高度发生的压力性生活事件(p<0.0001)。在两组性别中,经历更多的压力性生活事件与大多数过去一年轴 I 和终身轴 II 障碍的可能性增加有关,与更频繁的压力性生活事件相关的可能性最大。与压力性生活事件相关的多种精神障碍在女性中的关联比男性更强。

结论

压力性生活事件与男性和女性的多种轴 I 和轴 II 精神障碍有关。这种关系受到性别的调节。对有明显压力源的女性患者进行情绪、焦虑和物质使用问题的筛查可能尤为重要。女性中压力性生活事件与人格障碍之间的关联更强,这一点值得进一步研究。

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