Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, United States.
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, United States.
Child Abuse Negl. 2018 Dec;86:223-234. doi: 10.1016/j.chiabu.2018.10.004. Epub 2018 Oct 22.
Socioeconomic disadvantage is associated with increased exposure to victimization and traumatic stress. The present study evaluates longitudinal pathways linking victimization and trauma to depressive symptoms in a socioeconomically disadvantaged sample of African-American adolescent girls seeking mental health services (N = 177, 12-16 years old at baseline). Girls completed four assessments over the course of three years (T1-T4). Depressive symptoms were assessed at T1-T3 using clinical interviews and questionnaires. At T4, lifetime history of victimization and traumatic stressors was evaluated with in-person interviews. Separate structural equation models tested longitudinal pathways from stressor frequency, severity, and duration to depressive symptoms. In all three models, higher levels of victimization and traumatic stressors were associated with significantly higher levels of depressive symptoms. More frequent stressors prior to T1 directly predicted depressive symptoms at T1 and indirectly predicted depressive symptoms at T2, which, in turn, predicted depressive symptoms at T3. A similar pattern emerged in the stressor severity and duration models. Findings support the idea that victimization and traumatic stressors are associated with higher levels of depressive symptoms and that, among treatment-seeking low-income adolescent girls, these effects occur through both direct and indirect paths. Implications of these findings are discussed in the context of the stress-generation and stress proliferation models of psychopathology.
社会经济劣势与更多的受害和创伤性应激暴露有关。本研究评估了在寻求心理健康服务的社会经济劣势的非裔美国少女样本中，受害和创伤性应激与抑郁症状之间的纵向途径（N=177，基线时为 12-16 岁）。女孩们在三年内完成了四次评估（T1-T4）。在 T1-T3 期间使用临床访谈和问卷评估抑郁症状。在 T4，通过面对面访谈评估了一生中的受害和创伤性应激源史。单独的结构方程模型测试了从应激源频率、严重程度和持续时间到抑郁症状的纵向途径。在所有三个模型中，更高水平的受害和创伤性应激源与抑郁症状显著更高水平相关。在 T1 之前更频繁的应激源直接预测 T1 的抑郁症状，并间接预测 T2 的抑郁症状，而 T2 的抑郁症状又预测 T3 的抑郁症状。在应激源严重程度和持续时间模型中也出现了类似的模式。研究结果支持这样一种观点，即受害和创伤性应激源与更高水平的抑郁症状有关，而且在寻求治疗的低收入青少年女孩中，这些影响通过直接和间接途径发生。在精神病理学的应激产生和应激扩散模型的背景下讨论了这些发现的意义。
