Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Centre for Psychological Educational and Consultation, Sichuan University, Chengdu, China.
Depress Anxiety. 2021 Sep;38(9):961-971. doi: 10.1002/da.23201. Epub 2021 Jul 22.
It is widely acknowledged that childhood adversities (CAs) and recent stress are potential risk factors for adult depression. However, the mechanism(s) by which interactions of CAs with recent stress affect adult depression remain unclear.
To investigate the predictive association of the interaction among CAs and recent stress with early-adult depression.
We conducted an annual survey of all freshmen for the period of 2016-2018 in a Chinese comprehensive university, with a sample size of 23,206. An online questionnaire including standardized self-report instruments was used to assess sociodemographic factors, childhood experiences of left-behind (CELB), and maltreatments (CEMTs) including beating (CEB), neglect (CEN), sexual abuse (CESA), recent stress, and current depression (measured by the 9-item Patient Health Questionnaire).
The correlation of Individual CAs and recent stress was significant. In addition to their significant independent/direct incremental effects, all surveyed CAs were associated with increased severity of early-adult depression, and increased frequency of clinically significant depression (CSD), through significant associations with recent stress (mediation effect). History of CEMTs including CEB, CEN, and CESA significantly increased the effects of recent stress on depression (moderation effect).
Chinese undergraduate students reported frequent history of exposure to CAs, which increased the likelihood of depression in early adulthood, not only directly but also through the increasing the likelihood (mediation effect) and impact (moderation effect) of recent stress on depression. These novel findings may help to extend our understanding of environmental determinants of depression, and to guide further research, clinical practice, and policy in this context.
众所周知,儿童逆境(CA)和近期压力是成年抑郁的潜在风险因素。然而,CA 与近期压力相互作用影响成年抑郁的机制尚不清楚。
探讨 CA 与近期压力相互作用对成年早期抑郁的预测关联。
我们对中国一所综合性大学 2016-2018 年期间的所有新生进行了年度调查,样本量为 23206 人。采用在线问卷,包括标准化自报量表,评估社会人口学因素、留守儿童经历(CELB)和虐待(CEMTs),包括殴打(CEB)、忽视(CEN)、性虐待(CESA)、近期压力和当前抑郁(用 9 项患者健康问卷测量)。
个体 CA 和近期压力的相关性显著。除了它们具有显著的独立/直接增量效应外,所有调查的 CA 都与成年早期抑郁严重程度增加有关,并且通过与近期压力的显著关联,与更高频率的临床显著抑郁(CSD)相关(中介效应)。包括 CEB、CEN 和 CESA 在内的 CEMTs 史显著增加了近期压力对抑郁的影响(调节效应)。
中国大学生报告经常接触 CA,这不仅直接增加了成年早期抑郁的可能性,而且还通过增加近期压力对抑郁的可能性(中介效应)和影响(调节效应)来增加抑郁的可能性。这些新发现可能有助于我们更深入地了解环境对抑郁的决定因素,并指导这方面的进一步研究、临床实践和政策。