Hales George K, Saribaz Zeliha E, Debowska Agata, Rowe Richard
Department of Psychology, University of Sheffield, Sheffield, UK.
SWPS University of Social Sciences and Humanities, Poznan, Poland.
Trauma Violence Abuse. 2023 Jul;24(3):1465-1482. doi: 10.1177/15248380221075087. Epub 2022 Feb 28.
Adverse childhood experiences (ACEs) have been associated with causes of early death, addiction, mental illness, and poor health. However, studies investigating underlying mechanisms often rely on cross-sectional data or inappropriate study designs. To prevent the negative sequelae associated with ACEs, it is imperative to understand the mechanisms underlying the prospective relationship. The aim of this present review was to provide a synthesis and critical evaluation of the literature regarding the mechanisms underlying this relationship. A search in SCOPUS, MedLine via Ovid, PsycINFO via Ovid, and Web of Science was performed. Studies that utilised a prospective design assessing ACEs in childhood or adolescence, outcomes in adulthood, and analysed either a mediating or moderating relationship were included, unless the study relied on informant report or official records to assess childhood maltreatment types of ACEs. Twenty-two studies examining a longitudinal mediation or moderation were included in a systematic review. A review of the studies found links to psychopathology, delinquent and problem behaviours, poor physical health, and poor socioeconomic outcomes. A clear image of underlying mechanisms is not forthcoming due to (a) poor study design in relation to assessing longitudinal mechanisms, and (b) heterogeneity in the adversities, mechanisms, and outcomes assessed. Based on the review, several gaps and limitations are highlighted and discussed.
童年不良经历（ACEs）与过早死亡、成瘾、精神疾病及健康状况不佳的成因相关。然而，探究潜在机制的研究往往依赖横断面数据或采用不恰当的研究设计。为预防与ACEs相关的负面后果，理解这种前瞻性关系背后的机制势在必行。本综述的目的是对有关这种关系潜在机制的文献进行综合和批判性评价。我们在SCOPUS、通过Ovid检索的MedLine、通过Ovid检索的PsycINFO以及科学网进行了检索。纳入的研究采用前瞻性设计，评估童年或青少年时期的ACEs、成年期的结局，并分析了中介或调节关系，除非该研究依赖 informant 报告或官方记录来评估ACEs的童年虐待类型。一项系统评价纳入了22项考察纵向中介或调节作用的研究。对这些研究的综述发现了与精神病理学、违法及问题行为、身体健康不佳和社会经济状况不良之间的联系。由于（a）在评估纵向机制方面研究设计不佳，以及（b）所评估的逆境、机制和结局存在异质性，潜在机制的清晰图景尚未形成。基于该综述，突出并讨论了若干差距和局限性。
