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不良的童年经历、成人创伤与抑郁症状轨迹。

Adverse childhood experiences, adult trauma, and depressive symptom trajectories.

机构信息

College of Public Health, Temple University, Philadelphia, PA, USA.

Independent Research Consultant, Ardmore, PA, USA.

出版信息

Aging Ment Health. 2022 Nov;26(11):2170-2178. doi: 10.1080/13607863.2021.1978926. Epub 2021 Sep 20.

DOI:10.1080/13607863.2021.1978926
PMID:34541986
Abstract

OBJECTIVES

Associations among adverse childhood experiences prior to age 18 (ACEs), subjective reports of trauma during Hurricane Sandy, and trajectories of depressive symptoms reported by community-dwelling older people were examined.

METHODS

We analyzed 6 waves of data from 5,688 people aged 50-74 recruited in 2006 and followed for 12-years using multilevel mixed effects models.

RESULTS

We found that: (1) people who experienced ACEs had trajectories of depressive symptoms in late life that were higher than people not having these experiences, (2) people experiencing two or more ACEs were more likely to report fear and distress when Hurricane Sandy hit than people experiencing either one or no adverse childhood experiences, and (3) while both ACE exposure and peri-traumatic stress were associated with trajectories having higher levels of depressive symptoms, the risk associated with ACEs (especially multiple ACEs) was greater.

CONCLUSION

Findings support life course stress theories including the cumulative inequality theory and stress proliferation theory, suggesting that inequalities are manifested over the life course and that people experiencing adversity during childhood are at increased risk of experiencing adversity in late life. By studying the relationship between adverse childhood experiences and response to Hurricane Sandy our findings demonstrate that adverse childhood experiences can alter the way traumatic events in adulthood are experienced. This finding in turn, has important implications for clinical practice, as it identifies a group of people likely to be at risk for adult trauma.

摘要

目的

本研究旨在探讨 18 岁前不良童年经历(ACEs)、飓风桑迪期间主观创伤报告以及社区居住老年人抑郁症状轨迹之间的关系。

方法

我们使用多层混合效应模型分析了 2006 年招募的 5688 名 50-74 岁人群的 6 波数据,随访 12 年。

结果

我们发现:(1)经历 ACEs 的人在晚年的抑郁症状轨迹高于没有这些经历的人;(2)经历两种或两种以上 ACEs 的人在飓风桑迪袭击时更有可能报告恐惧和痛苦,而经历一种或没有不良童年经历的人则较少报告;(3)尽管 ACE 暴露和创伤前应激都与具有更高水平的抑郁症状轨迹相关,但 ACEs 的风险(尤其是多种 ACEs)更大。

结论

研究结果支持生命历程压力理论,包括累积不平等理论和压力增殖理论,表明不平等现象在生命历程中表现出来,童年时期经历逆境的人在晚年经历逆境的风险增加。通过研究不良童年经历与对飓风桑迪的反应之间的关系,我们的研究结果表明,不良童年经历可以改变成年人经历创伤事件的方式。这一发现反过来又对临床实践具有重要意义,因为它确定了一群可能面临成人创伤风险的人。

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