Mihaila Iulia, Berg Kristin, Acharya Kruti
Department of Disability and Human Development, University of Illinois at Chicago, 1640 W Roosevelt Road, Chicago, IL, 60608, USA.
Matern Child Health J. 2021 Sep;25(9):1482-1490. doi: 10.1007/s10995-021-03186-4. Epub 2021 Jun 15.
To understand the role of adverse child experiences and breadth of participation in the mental health outcomes of youth with special healthcare needs (YSHCN). Breadth of participation refers to the number of different activity contexts within which YSHCN participate.
The present, cross-sectional, study utilized the 2016 National Survey of Children's Health, a nationally representative survey of the physical and emotional health of children in the United States. In total, 5862 YSHCN, aged 12-17 years were included in the sample.
Increased exposure to adverse childhood experiences was associated with an increased risk of both depression and anxiety for YSHCN. Low (versus high) breadth of participation was associated with an increased risk of both depression and anxiety. Breadth of participation altered the association between exposure to adverse childhood experiences and anxiety, such that YSHCN with high breadth of participation had lower rates of anxiety at all levels of exposure to adverse childhood experiences.
YSHCN with greater exposure to adverse childhood experiences and with low breadth of participation may be most vulnerable to depression and anxiety.
了解不良儿童经历及参与广度对有特殊医疗需求的青少年（YSHCN）心理健康结果的作用。参与广度指YSHCN参与的不同活动情境的数量。
本横断面研究使用了2016年全国儿童健康调查，这是一项对美国儿童身体和心理健康具有全国代表性的调查。样本共纳入了5862名年龄在12至17岁的YSHCN。
不良童年经历暴露增加与YSHCN患抑郁症和焦虑症的风险增加相关。参与广度低（与高相比）与抑郁症和焦虑症风险增加相关。参与广度改变了不良童年经历暴露与焦虑之间的关联，即参与广度高的YSHCN在所有不良童年经历暴露水平下焦虑发生率较低。
不良童年经历暴露较多且参与广度低的YSHCN可能最易患抑郁症和焦虑症。
