Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK
Social Research Institute, University College London, London, UK.
BMJ Open. 2022 Apr 29;12(4):e056736. doi: 10.1136/bmjopen-2021-056736.
Children with experience of out-of-home care (OHC) are at an increased risk of adverse outcomes in later life, including poorer levels of psycho-social adjustment. Less is known about the intergenerational transmission of the trauma associated with OHC and psychosocial outcomes in mid-adulthood, particularly during a major health pandemic.
To examine if there is evidence of intergenerational transmission of trauma associated with OHC in mid-adulthood, we used data from the 1970 British Cohort Study 2020 COVID-19 Survey.
Cases were defined as cohort members (CMs) who had themselves experienced OHC (OHC1) and those whose mother reported to have been in OHC (OHC2). Among the 5320 CMs who participated in the second COVID-19 Survey, we have OHC information for n=4236. Our analytical samples range from n=2472 to 3864 depending on outcome: the largest sample comprised 105 (2.5%) CMs with direct OHC experience (OHC1), 93 (2.2%) CMs with a mother who had OHC experience (OHC2) and 3666 CMs with no OHC experience (OHC0).
Self-reported outcomes at age 50 included indicators of depression, health and psychological well-being. Multivariate logistic regression models control for socioeconomic childhood background and current circumstances.
Compared with the majority OHC0, the OHC1 group report higher levels of depression (OR 2.18 (95% CI 1.09 to 4.36) p<.05) and are at a greater risk of poor mental (OR 2.23 (95% CI 1.24 to 4.02) p<0.01) and general health (OR 3.32 (95% CI 1.65 to 6.67) p<0.001) during the pandemic. OHC2 was more than twice as likely to report poor mental health prepandemic (OR 2.52 (95% CI 1.37 to 4.64) p<0.01), but not during the pandemic.
Children of care leaver mothers (OHC2) appear to be better adjusted than those who were themselves in care (OHC1), although compared with those without care experience (OHC0) both groups had an increased risk of poorer adult outcomes. However, the findings point to both continuity and discontinuity of disadvantage.
有过寄养经历的儿童在以后的生活中更有可能出现不良后果,包括心理社会适应水平较差。人们对寄养相关创伤的代际传递以及成年中期的心理社会结果知之甚少,尤其是在重大卫生大流行期间。
为了研究寄养相关创伤是否存在代际传递,我们使用了 1970 年英国队列研究 2020 年 COVID-19 调查的数据。
病例定义为经历过寄养(OHC1)的队列成员(CM)和其母亲曾被寄养的成员(OHC2)。在参加第二次 COVID-19 调查的 5320 名 CM 中,我们有 4236 名的 OHC 信息。我们的分析样本范围从 n=2472 到 3864,具体取决于结果:最大的样本包括 105 名(2.5%)有直接 OHC 经历(OHC1)的 CM、93 名(2.2%)有母亲 OHC 经历(OHC2)的 CM 和 3666 名无 OHC 经历(OHC0)的 CM。
与大多数 OHC0 相比,OHC1 组报告抑郁、健康和心理健康水平较高。多变量逻辑回归模型控制了儿童时期的社会经济背景和当前情况。
与那些自己曾被寄养的儿童(OHC1)相比,照顾离开的母亲的孩子(OHC2)似乎适应得更好,尽管与那些没有寄养经历的孩子(OHC0)相比,他们在成年后都有更高的不良后果风险。然而,这些发现指向了劣势的连续性和非连续性。