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中国青少年抑郁症患者中不良童年经历的发生率及其与非自杀性自伤的关系。

Prevalence of Adverse Childhood Experiences and Their Associations with Non-Suicidal Self-Injury Among Chinese Adolescents with Depression.

机构信息

School of Nursing, Anhui Medical University, No. 81 Mei Shan Road, Shu Shan District, He Fei, 230032, Anhui Province, China.

School of Nursing, Peking Union Medical College, No. 33 Ba Da Chu Road, Shi Jing Shan District, 100144, Beijing, China.

出版信息

Child Psychiatry Hum Dev. 2024 Oct;55(5):1441-1451. doi: 10.1007/s10578-023-01508-x. Epub 2023 Feb 22.

Abstract

The presence of adverse childhood experiences (ACEs) in adolescents diagnosed with depression has been associated with an extensive range of mental health issues, including non-suicidal self-injury (NSSI). However, there has been a dearth of research into the prevalence of ACEs and their associations with NSSI among depressed adolescent populations in China. This study aimed to investigate the prevalence of different types of ACEs and their associations with NSSI in depressed Chinese adolescents. Utilizing Chi-squared tests, latent class analysis (LCA), and multinomial logistic regression, the prevalence of different types of ACEs and their associations with NSSI were determined in a sample of 562 adolescents with depression. Among depressed adolescents. 92.9% of depressed adolescents reported ACEs, and the prevalence of emotional neglect, physical abuse, caregiver treated violently, and bullying was relatively high. ACEs, including sexual abuse (OR = 5.645), physical abuse (OR = 3.603), emotional neglect (OR = 3.096), emotional abuse (OR = 2.701), caregiver divorce/family separation (OR = 2.5), caregiver treated violently (OR = 2.221), and caregiver substance abuser (OR = 2.117), were associated with increased odds of exposure among depressed adolescents with NSSI. The high ACEs class (19%), the moderate ACEs class (40%), and the low ACEs class (41%) were identified as latent classes. NSSI was more prevalent in the high/moderate ACEs class compared to the low ACEs class, particularly in the high ACEs class. The situation of the prevalence of ACEs among adolescents with depression was unsatisfactory, and certain types of ACEs were associated with NSSI. Eliminating potential risk factors for NSSI requires the early prevention and targeted intervention of ACEs. Moreover, additional large-scale longitudinal studies are necessary to assess the different development trajectories associated with ACEs, such as the relationships between the different development periods of ACEs and NSSI, and to ensure the adoption of evidence-based prevention and intervention strategies.

摘要

青少年期经历过不良童年经历(ACEs)与广泛的心理健康问题相关,包括非自杀性自伤(NSSI)。然而,中国青少年抑郁患者 ACEs 的流行率及其与 NSSI 的关联的研究相对较少。本研究旨在调查中国青少年抑郁患者 ACEs 的流行率及其与 NSSI 的关联。本研究采用卡方检验、潜在类别分析(LCA)和多变量逻辑回归,在 562 名抑郁青少年样本中确定了不同类型 ACEs 的流行率及其与 NSSI 的关联。在抑郁青少年中,92.9%的抑郁青少年报告 ACEs,情感忽视、身体虐待、照顾者受暴力对待和欺凌的发生率相对较高。包括性虐待(OR=5.645)、身体虐待(OR=3.603)、情感忽视(OR=3.096)、情感虐待(OR=2.701)、照顾者离婚/家庭分离(OR=2.5)、照顾者受暴力对待(OR=2.221)和照顾者物质滥用者(OR=2.117)在内的 ACEs 与抑郁青少年发生 NSSI 的几率增加有关。高 ACEs 类(19%)、中 ACEs 类(40%)和低 ACEs 类(41%)被确定为潜在类别。与低 ACEs 类相比,NSSI 在高/中 ACEs 类中更为普遍,尤其是在高 ACEs 类中。青少年抑郁患者 ACEs 的流行情况不容乐观,某些类型的 ACEs 与 NSSI 有关。消除 NSSI 的潜在风险因素需要对 ACEs 进行早期预防和有针对性的干预。此外,还需要开展更多的大型纵向研究,以评估与 ACEs 相关的不同发展轨迹,例如 ACEs 的不同发展时期与 NSSI 之间的关系,并确保采用基于证据的预防和干预策略。

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