Social and Behavioral Interventions Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
LGBT Health. 2020 Apr;7(3):155-165. doi: 10.1089/lgbt.2019.0036. Epub 2020 Mar 18.
We investigated the relation between adversities in early adolescence and risk of a depressive phenotype in adulthood, and whether stress in adulthood modified these associations. A total of 1138 men who have sex with men (MSM) participated in a Multicenter AIDS Cohort substudy in which they reported on adversities in early adolescence. Poisson regression estimated prevalence ratios (PRs) for associations between adversities and a depressive phenotype in adulthood. Stratified analyses examined the effects of stress in the last year on the depressive phenotype. In adjusted models, men who were verbally insulted; threatened by physical violence; had an object thrown at them; or punched, kicked, or beaten were at higher risk of having a depressive phenotype in adulthood (for ≥1 time per month vs. never, PR = 1.50, 95% confidence interval [CI] = 1.15-1.96; PR = 1.84, 95% CI = 1.45-2.34; PR = 2.00, 95% CI = 1.51-2.66; or PR = 1.78, 95% CI = 1.35-2.34, respectively.) Being threatened with a weapon approached statistical significance (PR = 1.89, 95% CI = 0.96-3.72). Although higher stress was associated with depression overall, early adolescent victimization was only associated with depression among MSM not reporting high levels of stress in the last year (for ≥1 time per month vs. never, PR = 1.68, 95% CI = 1.09-2.59; PR = 2.11, 95% CI = 1.40-3.17; PR = 2.24, 95% CI = 1.24-4.03; PR = 1.98, 95% CI = 1.22-3.22, respectively). The attenuation of relationships between adversities and depression among men reporting high stress may suggest that adult stress overshadows long-term effects of early adolescent victimization on adult depression. Victimization in early adolescence may increase the risk of sustained depressive symptoms in mid- to later life, reinforcing the need for preventive strategies.
我们研究了青少年早期逆境与成年后抑郁表型风险之间的关系,以及成年期的压力是否会改变这些关联。共有 1138 名男男性接触者(MSM)参加了一项多中心艾滋病队列子研究,他们在研究中报告了青少年早期的逆境。泊松回归估计了逆境与成年后抑郁表型之间的关联的患病率比(PR)。分层分析检查了最后一年压力对抑郁表型的影响。在调整后的模型中,受到言语侮辱、身体暴力威胁、被物体投掷、或被拳打、脚踢或殴打过的男性在成年后患抑郁表型的风险更高(每月≥1 次与从不,PR=1.50,95%置信区间[CI]=1.15-1.96;PR=1.84,95%CI=1.45-2.34;PR=2.00,95%CI=1.51-2.66;或 PR=1.78,95%CI=1.35-2.34,分别)。受到武器威胁接近统计学意义(PR=1.89,95%CI=0.96-3.72)。尽管较高的压力与总体抑郁相关,但青少年早期的受害仅与报告最后一年压力水平不高的 MSM 中的抑郁相关(每月≥1 次与从不,PR=1.68,95%CI=1.09-2.59;PR=2.11,95%CI=1.40-3.17;PR=2.24,95%CI=1.24-4.03;PR=1.98,95%CI=1.22-3.22,分别)。在报告压力水平较高的男性中,逆境与抑郁之间的关系减弱,这可能表明成人压力掩盖了青少年早期受害对成人抑郁的长期影响。青少年早期的受害可能会增加中老年期持续抑郁症状的风险,从而加强了对预防策略的需求。