Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco.
Intramural Research Program, National Institute of Mental Health.
J Clin Child Adolesc Psychol. 2022 Nov-Dec;51(6):970-981. doi: 10.1080/15374416.2021.1875326. Epub 2021 Mar 3.
To examine cross-sectional associations between social capital constructs and 1) adolescent lifetime mental disorders, 2) severity of functional impairment, and 3) psychiatric comorbidity.
Data were from the National Comorbidity Survey Adolescent Supplement, a nationally representative mental health survey of 6,483 U.S. adolescents aged 13-18 years. Information from fully-structured diagnostic interviews, including adolescent and caregiver reports, was used to measure seven social capital constructs and lifetime DSM-IV mental disorders (mood, anxiety, behavior, substance use and eating disorder classes). Disorder severity was divided into severe vs. mild/moderate. Comorbidity was measured as the number of different classes of lifetime mental disorders.
Adjusted for socio-demographics and caregivers' mental health, the most consistent associations with adolescent mental disorder were for supportive friendships (any disorder OR = 0.95, 95%CI = 0.91-0.99), family cohesion (OR = 0.81, 95%CI = 0.75-0.86), school bonding (OR = 0.76, 95%CI = 0.71-0.81), and extracurricular participation (OR = 0.90, 95%CI = 0.86-0.95), although results differed by disorder class. Caregiver-reported neighborhood trust and reciprocity and caregiver community involvement were less consistently associated with mental disorder. Medium levels of adolescent-reported affiliation with neighbors was associated with lower odds of mood (OR = 0.81, 95%CI = 0.66-0.98) and anxiety (OR = 0.78, 95%CI = 0.64-0.96) disorder, while high levels were associated with higher odds of behavior disorder (OR = 1.47, 95%CI = 1.16-1.87). Several associations were stronger for severe vs. mild/moderate disorder and with increasing comorbidity.
Although we cannot infer causality, our findings support the notion that improving actual and/or perceived social capital, especially regarding friendships, family, and school, (e.g., through multimodal interventions) could aid in the prevention and treatment of both individual adolescent mental disorders and psychiatric comorbidity.
研究社会资本结构与以下方面的横断面关联：1）青少年终身精神障碍，2）功能损害严重程度，以及 3）精神共病。
数据来自全国共病调查青少年补充调查，这是一项针对美国 6483 名 13-18 岁青少年的全国代表性心理健康调查。使用来自完全结构化诊断访谈的信息，包括青少年和照顾者的报告，来衡量七个社会资本结构和终生 DSM-IV 精神障碍（心境、焦虑、行为、物质使用和饮食障碍类别）。障碍严重程度分为严重与轻度/中度。共病的衡量标准是不同类别的终生精神障碍的数量。
在调整了社会人口统计学和照顾者的精神健康状况后，与青少年精神障碍最一致的关联是支持性友谊（任何障碍 OR=0.95，95%CI=0.91-0.99）、家庭凝聚力（OR=0.81，95%CI=0.75-0.86）、学校联系（OR=0.76，95%CI=0.71-0.81）和课外活动参与（OR=0.90，95%CI=0.86-0.95），尽管不同的障碍类别结果有所不同。照顾者报告的邻里信任和互惠以及照顾者的社区参与与精神障碍的关联不太一致。青少年自我报告与邻居的关系程度中等与心境（OR=0.81，95%CI=0.66-0.98）和焦虑（OR=0.78，95%CI=0.64-0.96）障碍的较低几率相关，而高水平与行为障碍（OR=1.47，95%CI=1.16-1.87）的较高几率相关。对于严重与轻度/中度障碍以及共病增加，一些关联更为强烈。
虽然我们不能推断因果关系，但我们的研究结果支持了这样一种观点，即改善实际的和/或感知到的社会资本，特别是关于友谊、家庭和学校的社会资本（例如，通过多模式干预）可以帮助预防和治疗个体青少年精神障碍和精神共病。
