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儿童时期因素对近期退伍军人过去一年焦虑和抑郁的影响。

Childhood determinants of past-year anxiety and depression in recently transitioned military personnel.

机构信息

Discipline of Psychiatry, The University of Adelaide, Adelaide, South Australia; Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK.

Discipline of Psychiatry, The University of Adelaide, Adelaide, South Australia.

出版信息

J Affect Disord. 2020 Sep 1;274:59-66. doi: 10.1016/j.jad.2020.04.053. Epub 2020 May 13.

Abstract

BACKGROUND

Anxiety and depression may hamper a smooth transition from military to civilian life and may be important predictors of longer-term health and functioning. However, it is as yet unclear to what extent they are determined by childhood factors in a recently transitioned population.

METHODS

We utilised logistic regression and Generalised Structural Equation Modelling to analyse associations of ICD-10 past-year anxiety and depression with childhood trauma and disorder in a recently transitioned population using detailed interview data from the ADF (Australian Defence Force) Transition and Wellbeing Research Programme.

RESULTS

Past-year anxiety (including PTSD) was prevalent (36.4%, 95% CI, 31.9-41.1) and associated with childhood anxiety (but not other types of childhood disorder), childhood interpersonal trauma (but not other childhood trauma) and adult-onset trauma. Childhood anxiety had a direct and significant association with past-year anxiety. The pathway between childhood interpersonal trauma and past-year anxiety was fully mediated by childhood anxiety. Past-year depression was less prevalent (11.3%, 95% CI, 8.7-14.5) and had no association with childhood disorder or trauma variables.

LIMITATIONS

The main predictor variables utilized in this analysis were childhood experiences recalled from adulthood, thus rendering the responses vulnerable to autobiographical bias.

CONCLUSIONS

Past-year anxiety was highly prevalent in the period of transition and had strong associations with childhood and military factors, suggesting predictability and potentially preventability.

摘要

背景

焦虑和抑郁可能会阻碍军人顺利过渡到平民生活,并且可能是长期健康和功能的重要预测因素。然而,在最近刚退伍的人群中,它们在多大程度上受童年因素的影响,目前还不清楚。

方法

我们利用逻辑回归和广义结构方程模型,利用澳大利亚国防军(ADF)过渡和幸福感研究计划的详细访谈数据,分析了 ICD-10 过去一年的焦虑和抑郁与童年创伤和障碍在最近刚退伍的人群中的关联。

结果

过去一年的焦虑(包括 PTSD)患病率较高(36.4%,95%CI,31.9-41.1),与童年焦虑(但不是其他类型的童年障碍)、童年人际创伤(但不是其他童年创伤)和成年后创伤有关。童年焦虑与过去一年的焦虑有直接且显著的关联。童年人际创伤与过去一年的焦虑之间的关系完全由童年焦虑介导。过去一年的抑郁发生率较低(11.3%,95%CI,8.7-14.5),与童年障碍或创伤变量无关。

局限性

本分析中主要的预测变量是成年后回忆的童年经历,因此,这些反应容易受到自传体偏差的影响。

结论

在过渡时期,过去一年的焦虑症患病率很高,与童年和军事因素有很强的关联,这表明其具有可预测性和潜在的可预防性。

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