Jilin University, Changchun, China.
McGill University, Montreal, Canada.
J Interpers Violence. 2022 Aug;37(15-16):NP14089-NP14116. doi: 10.1177/08862605211006368. Epub 2021 Apr 15.
Childhood maltreatment is a major public health issue worldwide. It increases a range of health-risk behaviors, psychological and physical problems, which are associated with an increased need for mental health services in adulthood. Identification of mediating factors in the relationship between maltreatment and seeking mental health care may help attenuate the negative consequences of childhood maltreatment and promote more appropriate treatment. This study aims to examine whether the relationship between childhood maltreatment and perceived need for mental health care is mediated by psychological distress and/or moderated by social support. Data from the Canadian Community Health Survey-Mental Health 2012 are analyzed. A total of 8,993 participants, who had complete information on childhood maltreatment and diagnoses of mental disorders or psychological distress, are included in this study. Structural equation modeling and the PROCESS macro were used to identify relationships among childhood maltreatment, perceived needs for mental health care, and psychological distress. Hierarchical linear regression was then used to verify the moderated mediation model. We found that psychological distress partially mediated the effect of childhood maltreatment on perceived needs for mental health care in adulthood. Social support played an important role in terms of moderating the relationship between maltreatment and perceived needs for care. For those with a history of childhood maltreatment, those who perceived a low level of social support were more likely to have higher levels of psychological distress and perceived need for mental health care. This is the first study to identify the separate and combined roles of psychological distress and social support in the relationship between childhood maltreatment and perceived need for mental health care. Selective prevention strategies should focus on social support to improve mental health services among people with a history of childhood maltreatment.
儿童期虐待是一个全球性的重大公共卫生问题。它增加了一系列健康风险行为、心理和身体问题，这与成年后对心理健康服务的需求增加有关。确定虐待与寻求心理健康护理之间关系的中介因素，可能有助于减轻儿童期虐待的负面影响，促进更恰当的治疗。本研究旨在探讨心理困扰和/或社会支持是否在儿童期虐待与寻求心理健康护理的关系中起中介作用，是否起调节作用。本研究使用了 2012 年加拿大社区健康调查-心理健康的数据。共纳入 8993 名参与者，他们在儿童期虐待和精神障碍或心理困扰的诊断方面具有完整的信息。结构方程模型和 PROCESS 宏用于识别儿童期虐待、对心理健康护理的需求和心理困扰之间的关系。然后使用分层线性回归验证中介调节模型。我们发现，心理困扰部分中介了儿童期虐待对成年后对心理健康护理的需求的影响。社会支持在调节虐待与对护理的需求之间的关系方面发挥了重要作用。对于有儿童期虐待史的人来说，那些感知到低水平社会支持的人更有可能出现更高水平的心理困扰和对心理健康护理的需求。这是第一项确定心理困扰和社会支持在儿童期虐待与对心理健康护理的需求之间的关系中的单独和共同作用的研究。有选择性的预防策略应该关注社会支持，以改善有儿童期虐待史的人的心理健康服务。
