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不良童年经历和家庭、学校和社区积极童年经历对青少年抑郁和焦虑的纵向影响。

The longitudinal influences of adverse childhood experiences and positive childhood experiences at family, school, and neighborhood on adolescent depression and anxiety.

机构信息

Department of Child, Youth, and Family Studies, University of Nebraska-Lincoln, Lincoln, Nebraska.

Department of Child, Youth, and Family Studies, University of Nebraska-Lincoln, Lincoln, Nebraska.

出版信息

J Affect Disord. 2021 Sep 1;292:542-551. doi: 10.1016/j.jad.2021.05.108. Epub 2021 Jun 17.

Abstract

BACKGROUND

Adolescent depression and anxiety are major mental health concerns. Adverse childhood experiences (ACEs) are risk factors for depression and anxiety in adolescence and positive childhood experiences at home, school, and neighborhood are protective factors. Few studies, however, have compared the longitudinal effects of these two sets of contextual risk and protective factors on depression and anxiety among adolescents by framing them together.

METHODS

This study used data on a subsample of 3426 socioeconomically disadvantaged adolescents collected at their birth, ages one, three, five, nine, and fifteen. Logistic regression was used to examine the longitudinal effects of ACEs, focusing on childhood maltreatment and family dysfunctions, and positive childhood experiences with family, school, and neighborhood on the risks of depression and anxiety. Adolescents' characteristics and their families' socioeconomic status were adjusted.

RESULTS

In the two ACEs subcategories, childhood maltreatment exposures increased the risks only for later anxiety; family dysfunction increased the risks for both later depression and anxiety. In the three contexts, positive childhood experiences at family and school protected at-risk adolescents against both mental health concerns, whereas neighborhood collective efficacy protected adolescents only against depression.

LIMITATIONS

Resilience was examined as an outcome only; it can also be examined as a process. Neither teachers' nor grandparents' supports were included.

CONCLUSIONS

ACEs maltreatment and family dysfunction are two different risk dimensions for adolescent depression and anxiety. Positive childhood experiences at family are the strongest protective factors for children exposed to ACEs, followed by these in school and neighborhood. Early interventions building positive relationships may benefit adolescent mental health.

摘要

背景

青少年抑郁和焦虑是主要的心理健康问题。童年逆境经历(ACEs)是青少年抑郁和焦虑的风险因素,而家庭、学校和社区的积极童年经历则是保护因素。然而,很少有研究将这两组环境风险和保护因素综合起来,比较它们对青少年抑郁和焦虑的纵向影响。

方法

本研究使用了在出生、1 岁、3 岁、5 岁、9 岁和 15 岁时对 3426 名社会经济地位低下的青少年进行的子样本数据。采用逻辑回归分析了 ACEs(重点是儿童期虐待和家庭功能障碍)以及家庭、学校和社区的积极童年经历对抑郁和焦虑风险的纵向影响。调整了青少年的特征及其家庭的社会经济地位。

结果

在两个 ACEs 亚类中,儿童期虐待暴露增加了以后发生焦虑的风险;家庭功能障碍增加了以后发生抑郁和焦虑的风险。在三个方面,家庭和学校的积极童年经历保护了处于风险中的青少年免受这两种心理健康问题的影响,而社区集体效能仅保护青少年免受抑郁的影响。

局限性

仅将韧性作为结果进行了考察;也可以将其作为一个过程进行考察。教师和祖父母的支持都没有包括在内。

结论

ACEs 中的虐待和家庭功能障碍是青少年抑郁和焦虑的两个不同风险维度。家庭中的积极童年经历是对 ACEs 暴露的儿童最强有力的保护因素,其次是学校和社区的这些经历。建立积极关系的早期干预可能有益于青少年的心理健康。

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