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不良童年经历与青少年心理健康:理解性别及青少年风险和保护因素的作用。

Adverse childhood experiences and adolescent mental health: Understanding the roles of gender and teenage risk and protective factors.

机构信息

Department of Human Development and Family Studies, The University of Alabama, Tuscaloosa, AL, United States.

Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United States.

出版信息

J Affect Disord. 2022 Oct 1;314:303-308. doi: 10.1016/j.jad.2022.07.047. Epub 2022 Jul 24.

Abstract

Adverse Childhood Experiences (ACEs) have been linked to a host of negative outcomes in adolescence. However, research on the impact of ACEs on adolescent mental health has produced mixed results, leaving it unclear how ACEs may relate to depression and anxiety during adolescence. Moreover, this body of work has neglected how gender, risk and protective factors may influence these relationships, despite research demonstrating gender differences in both responses to adversity and in the impact of risk and protective factors on maladaptive outcomes in adolescence. Drawing on a sample of at-risk youth from the Fragile Families and Child Wellbeing Study (N = 2455; age 14-18; 48 % female, 50 % Black, 23 % Hispanic), the current study examines the association between ACEs during early childhood (i.e., ages 1 to 5) and anxious and depressive tendencies reported during adolescence. Models are stratified by gender and incorporate six types of teenage risk and protective factors (peer bullying, delinquent peers, low self-control, parental attachment, collective efficacy, and school connectedness). Results showed support for gender differences in the associations between ACEs and boys' and girls' mental health symptoms. Initially, ACEs were associated with an increased risk of both depressive and anxious tendencies in boys, but the total ACEs score was only significantly associated with an increased risk for depressive symptoms in girls. After accounting for teenage protective factors, ACEs were related to a decreased risk of depressive and anxious symptoms among girls only. Findings have important implications for refining intervention and prevention strategies focusing on mitigating the harms of ACEs.

摘要

不良童年经历 (ACEs) 与青春期的许多负面后果有关。然而,ACEs 对青少年心理健康影响的研究结果喜忧参半,不清楚 ACEs 如何与青少年时期的抑郁和焦虑相关。此外,尽管有研究表明,在对逆境的反应以及风险和保护因素对青春期适应不良结果的影响方面存在性别差异,但这一领域的研究忽视了性别、风险和保护因素如何影响这些关系。本研究利用脆弱家庭和儿童福利研究(N=2455;年龄 14-18;48%为女性,50%为黑人,23%为西班牙裔)中处于危险中的年轻人的样本,研究了儿童早期(即 1 至 5 岁)ACEs 与青春期报告的焦虑和抑郁倾向之间的关系。模型按性别分层,并纳入了六种类型的青少年风险和保护因素(同伴欺凌、不良同伴、自我控制能力低、父母依恋、集体效能和学校联系)。结果表明,ACEs 与男孩和女孩心理健康症状之间的关系存在性别差异。最初,ACEs 与男孩的抑郁和焦虑倾向风险增加有关,但总 ACEs 评分仅与女孩的抑郁症状风险增加显著相关。在考虑到青少年保护因素后,ACEs 仅与女孩的抑郁和焦虑症状风险降低有关。这些发现对完善干预和预防策略具有重要意义,重点是减轻 ACEs 的危害。

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