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根据儿童虐待的持续或中断,精神病理学轨迹:一项纵向观察研究。

Trajectories of Psychopathology According to Continuation or Discontinuation of Child Abuse: A Longitudinal Observational Study.

机构信息

Department of Psychiatry, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 26426, Gangwon-do, Korea.

出版信息

Int J Environ Res Public Health. 2021 Aug 26;18(17):8968. doi: 10.3390/ijerph18178968.

Abstract

Long-term exposure to childhood abuse and occurrence of mental illness are positively correlated. Using long-term tracking data in Korea, we identified the characteristics of children and adolescents who experienced abuse and impact thereof on their psychopathology. Using the Korea Welfare Panel data, 354 teenagers in grades 4-6 of elementary school participated, were assessed at baseline, and monitored 3 years later. They were categorized into Never, Occurrence, Continuation, and Discontinuation groups according to changes in the abuse experienced. Psychopathology was evaluated using K-CBCL. Childhood abuse experience significantly affected psychopathology. At the baseline, the Continuation and Discontinuation groups had a higher severity of psychopathology than the Never group. Psychopathology at the baseline was associated with whether the patient experienced abuse that year. In the follow-up observation, the risk of psychopathology in the Occurrence and Continuation groups was higher than that in the Never group. The Discontinuation group had decreased psychopathology, which was not clinically significant in the follow-up observation (INT aRR = 2.09; 95% CI 0.61-7.13, EXT aRR = 4.23; 95% CI 1.12-16.07). Stopping abuse in late childhood reduces adolescents' psychopathology in the long term, meaning they can recover their normal developmental trajectory according to risk groups and provide effective interventions including discontinuation of abuse.

摘要

长期暴露于儿童虐待与精神疾病的发生呈正相关。本研究利用韩国的长期追踪数据,确定了遭受虐待的儿童和青少年的特征及其对精神病理学的影响。利用韩国福利面板数据,共有 354 名小学 4-6 年级的青少年参与了本研究,他们在基线时接受评估,并在 3 年后进行监测。根据所经历的虐待情况的变化,将他们分为从未、发生、持续和中断组。采用 K-CBCL 评估精神病理学。儿童虐待经历显著影响精神病理学。在基线时,持续和中断组的精神病理学严重程度高于从未组。基线时的精神病理学与当年患者是否遭受虐待有关。在随访观察中,发生组和持续组的精神病理学风险高于从未组。中断组的精神病理学下降,在随访观察中无临床意义(INT aRR = 2.09;95%CI 0.61-7.13,EXT aRR = 4.23;95%CI 1.12-16.07)。在儿童晚期停止虐待可长期降低青少年的精神病理学,这意味着可以根据风险组提供有效的干预措施,包括停止虐待,使他们恢复正常的发展轨迹。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83f5/8430668/2332e2c53d57/ijerph-18-08968-g001.jpg

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