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坚忍还是敏感?生活事件持续积累对老年人抑郁症状影响的纵向研究

Steeling or Sensitizing? A Longitudinal Examination of How Ongoing Accumulation of Negative Life Events Affects Depressive Symptoms in Older Adults.

机构信息

Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health Institute, Amsterdam, The Netherlands.

Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health Institute, Amsterdam, The Netherlands.

出版信息

J Gerontol B Psychol Sci Soc Sci. 2021 Nov 15;76(10):2041-2053. doi: 10.1093/geronb/gbab114.

Abstract

OBJECTIVES

To examine whether (a) as people age, accumulation of negative events increases ("sensitizing") or decreases ("steeling") the detrimental effects of subsequent events on depressive symptoms, and (b) how particular psychosocial factors are associated with the strength of these steeling or sensitizing effects.

METHOD

We used data from 6 measurement waves from 2,069 adults aged 55-84 (M = 68.0) at baseline in the Longitudinal Aging Study Amsterdam, the Netherlands. We included 18 different life events across the life course. Using hybrid multilevel models, we tested whether the effects of proximate life events (<3 years) on depressive symptoms (measured by the Center for Epidemiologic Studies Depression scale) were moderated by previous cumulative events (childhood until previous measurement wave). Additionally, we tested whether education, mastery, emotional support, neuroticism, having strong faith, and loneliness were associated with the strength of steeling/sensitizing effects.

RESULTS

Cumulative and proximate life events were independently associated with more depressive symptoms. Interaction effects indicated that the more cumulative life events, the weaker the effects of recent life events, suggesting a "steeling" effect. Unexpectedly, 3-way interaction effects showed that higher mastery and lower neuroticism were associated with weaker steeling effects. These effects were predominantly attributable to within-person changes rather than to fixed between-person differences. Results from analyses with event severity scores were similar.

CONCLUSIONS

As a population, older adults appear to become more resilient against new stressors as they accumulate experience in dealing with negative life events. Findings on mastery tentatively suggest that accepting limits to one's own control over life circumstances may foster a steeling effect.

摘要

目的

考察随着年龄的增长,(a)负面事件的积累是否会增加(“敏感化”)或减少(“坚韧化”)随后事件对抑郁症状的不利影响,以及(b)特定的心理社会因素与这些坚韧或敏感化效应的强度有何关联。

方法

我们使用了来自荷兰阿姆斯特丹纵向老龄化研究(Longitudinal Aging Study Amsterdam)的 2069 名 55-84 岁(基线时平均年龄为 68.0 岁)成年人的 6 个测量波次的数据。我们纳入了一生中的 18 种不同生活事件。使用混合多层模型,我们检验了近期生活事件(<3 年)对抑郁症状(用流行病学研究中心抑郁量表测量)的影响是否受到先前累积事件(从童年到前一个测量波次)的调节。此外,我们还检验了教育程度、掌控感、情感支持、神经质、强烈的信仰和孤独感与坚韧/敏感化效应强度的关联。

结果

累积和近期生活事件均与更多的抑郁症状独立相关。交互效应表明,累积的生活事件越多,近期生活事件的影响越弱,表明存在“坚韧化”效应。出乎意料的是,三向交互效应表明,较高的掌控感和较低的神经质与较弱的坚韧化效应相关。这些效应主要归因于个体内的变化,而不是个体间的固定差异。使用事件严重程度评分进行的分析结果相似。

结论

作为一个群体,老年人在积累处理负面生活事件的经验时,似乎对新的压力源更具弹性。关于掌控感的发现表明,接受自己对生活环境的控制有限可能会促进坚韧化效应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ed8/8599083/ab3b55f077fe/gbab114f0001.jpg

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