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童年不良经历集群中的种族/民族差异及其与青少年心理健康的关联。

Racial/ethnic differences in clusters of adverse childhood experiences and associations with adolescent mental health.

作者信息

Zhang Xiaoyan, Monnat Shannon M

机构信息

Lerner Center for Public Health Promotion, Maxwell School of Citizenship and Public Affairs, Department of Human Development and Family Science, Falk College of Sport and Human Dynamics, Syracuse University, 426 Eggers Hall, Syracuse, NY, 13244, USA.

Lerner Center for Public Health Promotion Department of Sociology Maxwell School of Citizenship and Public Affairs, Syracuse University, 426 Eggers Hall, Syracuse, NY, 13244, USA.

出版信息

SSM Popul Health. 2021 Dec 16;17:100997. doi: 10.1016/j.ssmph.2021.100997. eCollection 2022 Mar.

Abstract

Childhood adversity is a well-established risk factor for mental health problems during adolescence. Using data from the Fragile Families and Child Wellbeing Study and latent class analysis (LCA), we examined patterns of exposure to ten adverse childhood experiences (ACEs), including socioeconomic adversity, among non-Hispanic (NH) White, NH Black, and Hispanic 9 year olds and determined associations between membership in ACE exposure "classes" and depression and anxiety scores at age 15 (N = 2849). Parental separation/divorce, economic hardship, and paternal incarceration were the most common ACEs. ACE prevalence was significantly higher among Blacks and Hispanics. ACEs clustered into four classes for Whites and Hispanics and three classes for Blacks. Over half of Whites were classified in the 'Low Adversity' class. Conversely, most Black and Hispanic adolescents were classified in the 'High Socioeconomic Adversity and Paternal Incarceration' class, characterized by above average probabilities of experiencing family economic hardship, parental separation/divorce, low maternal education, and paternal incarceration. A small share of adolescents in all three racial/ethnic groups were in the 'High Global Adversity' class, characterized by high probability of exposure to most ACEs, including physical and psychological abuse. Finally, ACE class membership was differentially associated with anxiety and depression across the three racial/ethnic groups, with generally larger differences in mental health scores across ACE groups for Whites than for Blacks and Hispanics. Our findings suggest that studies on the associations between ACEs and health outcomes that do not include childhood economic adversity risk underestimating the role of ACEs on mental health among racial/ethnic minorities. Moreover, different patterns of ACE exposure are differentially linked to anxiety and depression, and ACE group membership differences in anxiety and depression vary by racial/ethnic group. Findings suggest the need for racially tailored prevention and intervention strategies.

摘要

童年逆境是青少年心理健康问题的一个公认风险因素。利用脆弱家庭与儿童福祉研究的数据以及潜在类别分析(LCA),我们研究了非西班牙裔(NH)白人、NH黑人以及西班牙裔9岁儿童中接触十种童年不良经历(ACEs)的模式,包括社会经济逆境,并确定了ACE暴露“类别”成员身份与15岁时抑郁和焦虑得分之间的关联(N = 2849)。父母分居/离婚、经济困难和父亲入狱是最常见的ACEs。ACEs的患病率在黑人和西班牙裔中显著更高。ACEs在白人和西班牙裔中聚为四类,在黑人中聚为三类。超过一半的白人被归为“低逆境”类别。相反,大多数黑人和西班牙裔青少年被归为“高社会经济逆境和父亲入狱”类别,其特征是经历家庭经济困难、父母分居/离婚、母亲教育程度低和父亲入狱的概率高于平均水平。在所有三个种族/族裔群体中,一小部分青少年属于“高总体逆境”类别,其特征是接触大多数ACEs的可能性很高,包括身体和心理虐待。最后,ACE类别成员身份在三个种族/族裔群体中与焦虑和抑郁的关联存在差异,白人ACE组之间的心理健康得分差异通常比黑人和西班牙裔更大。我们的研究结果表明,不包括童年经济逆境风险的ACEs与健康结果之间关联的研究低估了ACEs在少数种族/族裔群体心理健康中的作用。此外,不同的ACE暴露模式与焦虑和抑郁的关联各不相同,并且ACE组成员在焦虑和抑郁方面的差异因种族/族裔群体而异。研究结果表明需要制定针对不同种族的预防和干预策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c127/8693281/702882799d95/gr1.jpg

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