Department of Child and Adolescent Psychiatry, Hassenfeld Children's Hospital at NYU Langone, New York City, New York, USA.
Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Depress Anxiety. 2022 Jun;39(6):524-535. doi: 10.1002/da.23269. Epub 2022 May 20.
The association between adversity and psychopathology in adolescents and adults is characterized by equifinality. These associations, however, have not been assessed during early childhood when psychopathology first emerges. Defining adversity using both dimensional and cumulative risk approaches, we examined whether specific types of adversity are differentially associated with psychopathology in preschool-aged children.
Measures of threat, deprivation, and total adversities (i.e., cumulative risk) were calculated based on parent-reported information for 755 2- to 5-year old children recruited from pediatric primary care clinics. Logistic regression was used to estimate cross-sectional associations between type of adversity and anxiety, depression, ADHD, and behavioral disorder diagnoses.
Threat and cumulative risk exhibited independent associations with psychopathology. Threat was strongly related to behavioral disorders. Cumulative risk was consistently related to all psychopathologies.
Using mutually adjusted models, we identified differential associations between threat and psychopathology outcomes in preschool-aged children. This selectivity may reflect different pathways through which adversity increases the risk for psychopathology during this developmentally important period. As has been observed at other ages, a cumulative risk approach also effectively identified the cumulative impact of all forms of adversity on most forms of psychopathology during early childhood.
青少年和成年人的逆境与精神病理学之间的关联具有等效性。然而，在精神病理学首次出现的幼儿期，尚未对这些关联进行评估。我们采用维度和累积风险方法来定义逆境，以检验特定类型的逆境是否与学龄前儿童的精神病理学存在差异关联。
从儿科初级保健诊所招募的 755 名 2 至 5 岁儿童的父母报告信息中计算了威胁、剥夺和总逆境（即累积风险）的测量值。使用逻辑回归来估计特定类型的逆境与焦虑症、抑郁症、ADHD 和行为障碍诊断之间的横断面关联。
威胁和累积风险与精神病理学呈独立关联。威胁与行为障碍密切相关。累积风险与所有精神病理学均有关联。
在使用相互调整的模型中，我们在学龄前儿童中确定了威胁与精神病理学结果之间的差异关联。这种选择性可能反映了逆境在这个发育重要时期增加精神病理学风险的不同途径。正如在其他年龄段观察到的那样，累积风险方法还可以有效地识别所有形式的逆境对幼儿期大多数形式的精神病理学的累积影响。
