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童年逆境轨迹对青少年晚期心理健康结果的影响:台湾养育实践的缓冲作用。

Effects of childhood adversity trajectories on mental health outcomes in late adolescence: The buffering role of parenting practices in Taiwan.

机构信息

Department of Social Welfare, Center for Innovative Research on Aging Society, and Advanced Institute of Manufacturing with High-Tech Innovations, National Chung Cheng University, No. 168, Sec. 1, University Rd., Minhsiung, Chiayi, 621301, Taiwan.

Institute of Hospital and Health Care Administration, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Beitou District, Taipei, 112304, Taiwan.

出版信息

Child Abuse Negl. 2020 Nov;109:104705. doi: 10.1016/j.chiabu.2020.104705. Epub 2020 Sep 19.

Abstract

BACKGROUND

Childhood adversities (CAs) have been linked with unfavorable development; however, the chronic trajectories of multiple CAs and possible heterogeneous effects are understudied.

OBJECTIVES

This study examined the trajectories of multiple CAs and their associations with mental health outcomes in adolescence and investigated the buffering effect of parenting practices.

PARTICIPANTS AND SETTING

We used population-representative data from the Taiwan Education Panel Survey (2005 and 2007, n = 10,416).

METHODS

This study was based on retrospectively self-reporting of six CAs, namely physical abuse, family economic hardship, parental problematic drinking, parental catastrophic health problems, parental divorce, and parental death, at three developmental periods: early childhood, middle childhood, and early adolescence. Group-based multitrajectory modeling and multiple regressions were used to identify distinct trajectories of multiple CAs and evaluate the association estimates.

RESULTS

A total of four trajectory groups were identified: increasing family economic hardship (12.3 %), chronic physical abuse (3.3 %), chronic parental problematic drinking (2.8 %), and low adversity (81.6 %). The chronic physical abuse group had the highest levels of depressive symptoms (β = 6.61, p < .001) and suicidal ideation (Adjusted Odds Ratio [AOR] = 2.67, p < .001), whereas the chronic parental problematic drinking group had the highest level of substance abuse (AOR = 4.59, p < .001). Positive parental practices buffered the harmful effects of increasing family economic hardship in late adolescence, particularly for depressive symptoms and substance abuse.

CONCLUSIONS

Adverse mental health outcomes varied among groups with distinct multiple CA trajectories. The provision of social services to train or support positive parenting practices in families experiencing economic hardship is a potentially valuable resilience strategy.

摘要

背景

童年逆境(CA)与不良发展有关;然而,多种 CA 的慢性轨迹及其对心理健康结果的可能异质影响仍研究不足。

目的

本研究考察了多种 CA 的轨迹及其与青春期心理健康结果的关系,并探讨了养育实践的缓冲作用。

参与者和设置

我们使用了来自台湾教育面板调查(2005 年和 2007 年,n=10416)的具有代表性的人群数据。

方法

本研究基于对六个 CA(即身体虐待、家庭经济困难、父母酗酒、父母灾难性健康问题、父母离婚和父母死亡)在三个发展时期(幼儿期、童年中期和青春期早期)的回溯性自我报告。基于群组的多轨迹建模和多元回归用于识别多种 CA 的不同轨迹并评估关联估计。

结果

共确定了四个轨迹组:家庭经济困难增加(12.3%)、慢性身体虐待(3.3%)、慢性父母酗酒(2.8%)和低逆境(81.6%)。慢性身体虐待组的抑郁症状(β=6.61,p<.001)和自杀意念(调整后的优势比[AOR]=2.67,p<.001)水平最高,而慢性父母酗酒组的物质滥用(AOR=4.59,p<.001)水平最高。积极的父母实践缓冲了家庭经济困难增加对青少年晚期的有害影响,特别是对抑郁症状和物质滥用的影响。

结论

具有不同多重 CA 轨迹的组具有不同的不良心理健康结果。为面临经济困难的家庭提供培训或支持积极养育实践的社会服务是一种有价值的弹性策略。

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