Associate Professor,Department of Psychological Medicine,University of Otago,New Zealand.
Senior Lecturer,Department of Psychological Medicine,University of Otago,New Zealand.
Br J Psychiatry. 2019 Mar;214(3):153-158. doi: 10.1192/bjp.2018.264.
The extent to which exposure to childhood sexual and physical abuse increases the risk of psychotic experiences in adulthood is currently unclear.AimsTo examine the relationship between childhood sexual and physical abuse and psychotic experiences in adulthood taking into account potential confounding and time-dynamic covariate factors.
Data were from a cohort of 1265 participants studied from birth to 35 years. At ages 18 and 21, cohort members were questioned about childhood sexual and physical abuse. At ages 30 and 35, they were questioned about psychotic experiences (symptoms of abnormal thought and perception). Generalised estimating equation models investigated covariation of the association between abuse exposure and psychotic experiences including potential confounding factors in childhood (socioeconomic disadvantage, adverse family functioning) and time-dynamic covariate factors (mental health, substance use and life stress).
Data were available for 962 participants; 6.3% had been exposed to severe sexual abuse and 6.4% to severe physical abuse in childhood. After adjustment for confounding and time-dynamic covariate factors, those exposed to severe sexual abuse had rates of abnormal thought and abnormal perception symptoms that were 2.25 and 4.08 times higher, respectively than the 'no exposure' group. There were no significant associations between exposure to severe physical abuse and psychotic experiences.
Findings indicate that exposure to severe childhood sexual (but not physical) abuse is independently associated with an increased risk of psychotic experiences in adulthood (particularly symptoms of abnormal perception) and this association could not be fully accounted for by confounding or time-dynamic covariate factors.Declaration of interestNone.
目前尚不清楚儿童期性虐待和身体虐待暴露程度会增加成年后患精神病性体验的风险。
研究儿童期性虐待和身体虐待与成年后患精神病性体验之间的关系,同时考虑潜在的混杂和时变协变量因素。
数据来自一项对 1265 名参与者从出生到 35 岁的队列研究。在 18 岁和 21 岁时,对队列成员进行了关于儿童期性虐待和身体虐待的询问。在 30 岁和 35 岁时,他们被询问了精神病性体验(异常思维和感知症状)。广义估计方程模型研究了暴露于虐待与精神病性体验之间的关联变化,包括儿童时期的潜在混杂因素(社会经济劣势、不良家庭功能)和时变协变量因素(心理健康、物质使用和生活压力)。
共有 962 名参与者的数据可用;6.3%的人在儿童期遭受过严重的性虐待,6.4%的人遭受过严重的身体虐待。在调整混杂和时变协变量因素后,与“无暴露”组相比,遭受过严重性虐待的人出现异常思维和异常感知症状的比率分别高 2.25 倍和 4.08 倍。暴露于严重身体虐待与精神病性体验之间没有显著关联。
研究结果表明,儿童期严重性虐待(但不是身体虐待)暴露与成年后患精神病性体验(尤其是异常感知症状)的风险增加独立相关,这种关联不能完全由混杂因素或时变协变量因素来解释。
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