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在美国全国代表性样本中,青少年时期的指导关系与儿童虐待幸存者随后的抑郁和肥胖有关。

Mentorship in adolescence and subsequent depression and adiposity among child maltreatment survivors in a United States nationally representative sample.

机构信息

Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA.

出版信息

Prev Med. 2023 Jan;166:107339. doi: 10.1016/j.ypmed.2022.107339. Epub 2022 Nov 9.

Abstract

Child maltreatment (CM) is associated with multiple adverse health outcomes. Hence, there is a great need to identify factors that promote resilience in CM survivors. Mentorship may promote positive coping in CM survivors, but this may vary by health outcome and mentor/mentee characteristics. Among participants in a United States nationally representative sample, the National Longitudinal Study of Adolescent to Adult Health, who retrospectively reported any CM before age 18 (sexual, emotional or physical, abuse or neglect; N = 3364), we examined associations between mentorship during adolescence and body mass index (BMI), obesity, and depressive symptoms at ages 24-32 (in 2008-2009). We utilized linear regression and predictive margins with complex sample weighting. Models were stratified by sex and race/ethnicity. Thirty-one percent and 40% of participants' most influential mentor was inside and outside the family, respectively, and 29% reported no mentor. Any mentorship was associated with decreased depressive symptoms in females (adjusted beta for any mentor = -0.78, 95% CI:-1.54,-0.02). By contrast, any mentorship was associated with increased adiposity, namely among Latinas (adjusted beta for BMI = 2.23, 95% CI:0.45,4.02, adjusted risk ratio for obesity = 1.42, 95% CI:1.03,1.97). The influence of mentorship in CM survivors is heterogeneous. While mentorship was associated with reduced psychopathology, it was also linked with worse physical health, underscoring that mentoring does not necessarily promote long-term resilience to physical health outcomes, particularly in minorities. A better understanding of how mentors influence specific mentee behaviors may be important in informing how mentors can promote better physical health and lower obesity risk among CM survivors.

摘要

儿童虐待(CM)与多种不良健康后果有关。因此,非常有必要确定促进 CM 幸存者适应力的因素。指导可能会促进 CM 幸存者的积极应对,但这可能因健康结果和导师/学员的特点而异。在一项具有全国代表性的美国样本中,全国青少年到成人健康纵向研究的参与者中,回顾性报告了 18 岁之前的任何 CM(性、情感或身体虐待或忽视;N=3364),我们研究了青少年时期指导与体重指数(BMI)、肥胖和 24-32 岁时的抑郁症状之间的关联(2008-2009 年)。我们使用了具有复杂样本加权的线性回归和预测边际。模型按性别和种族/族裔进行分层。31%和 40%的参与者最有影响力的导师分别来自家庭内外,29%的参与者没有导师。任何指导都与女性抑郁症状的减轻有关(任何导师的调整后的β值为-0.78,95%CI:-1.54,-0.02)。相比之下,任何指导都与肥胖有关,尤其是在拉丁裔中(BMI 的调整后的β值为 2.23,95%CI:0.45,4.02,肥胖的调整风险比为 1.42,95%CI:1.03,1.97)。指导对 CM 幸存者的影响是异质的。虽然指导与减少精神病理学有关,但它也与更差的身体健康有关,这突显出指导并不一定能促进身体健康结果的长期适应力,尤其是在少数民族中。更好地了解导师如何影响特定学员的行为可能对于告知导师如何在 CM 幸存者中促进更好的身体健康和降低肥胖风险很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/beff/10032646/0ed3559d5a9d/nihms-1851748-f0001.jpg

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