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焦虑/抑郁症状在青少年不良童年经历(ACEs)与躯体症状之间的中介作用。

The mediating role of anxiety/depression symptoms between adverse childhood experiences (ACEs) and somatic symptoms in adolescents.

机构信息

School of Nursing, Columbia University, New York City, New York, USA.

Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, Washington, USA.

出版信息

J Adolesc. 2022 Feb;94(2):133-147. doi: 10.1002/jad.12012. Epub 2022 Feb 2.

Abstract

INTRODUCTION

This study examines the relationships among recent adverse childhood experiences (ACEs), somatic symptoms, and anxiety/depression symptoms during adolescence and whether anxiety/depression symptoms mediate the relationship between ACEs and somatic symptoms.

METHODS

Longitudinal prospective data from the Longitudinal Studies of Child Abuse and Neglect study of 1354 children and their primary caregivers in the United States was used in this study. A longitudinal cross-lagged path analysis among recent ACEs, anxiety/depression symptoms, and somatic symptoms at three points during adolescence (ages 12, 14, and 16 years) was conducted.

RESULTS

The sample was 51% female and 53% African American. The results indicated significant concurrent associations between recent ACEs and increased anxiety/depression symptoms at ages 12, 14, and 16 (β = .27, p < .001; β = .15, p < .001; β = .07, p < .05) and between anxiety/depression symptoms and increased somatic symptoms at ages 12, 14, and 16 years (β = .44, p < .001; β = .39, p < .001; β = .49, p < .001). Moreover, anxiety/depression symptoms significantly mediated the relationship between recent ACEs and concurrent somatic symptoms at ages 12, 14, and 16 years (β = .12, p < .001; β = .06, p < .001; β = .04, p < .05). However, there was no significant relationship between recent ACEs and somatic symptoms.

CONCLUSION

The findings suggest that anxiety/depression symptoms mediate the concurrent relationships between recent ACEs and somatic symptoms at ages 12, 14, and 16. Clinicians should consider assessing anxiety/depression symptoms and possible concurrent exposure to ACEs when caring for adolescents who present with somatic symptoms.

摘要

介绍

本研究考察了青少年时期近期不良童年经历(ACEs)、躯体症状和焦虑/抑郁症状之间的关系,以及焦虑/抑郁症状是否在 ACEs 和躯体症状之间的关系中起中介作用。

方法

本研究使用了美国虐待和忽视儿童纵向研究纵向前瞻性数据,该研究对 1354 名儿童及其主要照顾者进行了研究。在青少年时期(12、14 和 16 岁)的三个时间点,对近期 ACEs、焦虑/抑郁症状和躯体症状进行了纵向交叉滞后路径分析。

结果

样本中 51%为女性,53%为非裔美国人。结果表明,近期 ACEs 与 12、14 和 16 岁时焦虑/抑郁症状的增加(β=0.27,p<0.001;β=0.15,p<0.001;β=0.07,p<0.05)以及焦虑/抑郁症状与 12、14 和 16 岁时躯体症状的增加之间存在显著的同期关联(β=0.44,p<0.001;β=0.39,p<0.001;β=0.49,p<0.001)。此外,焦虑/抑郁症状显著中介了近期 ACEs 与同期 12、14 和 16 岁时躯体症状的关系(β=0.12,p<0.001;β=0.06,p<0.001;β=0.04,p<0.05)。然而,近期 ACEs 与躯体症状之间没有显著的关系。

结论

研究结果表明,焦虑/抑郁症状中介了近期 ACEs 与青少年时期 12、14 和 16 岁时躯体症状的同期关系。当治疗有躯体症状的青少年时,临床医生应考虑评估焦虑/抑郁症状和可能同时存在的 ACEs 暴露情况。

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