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应对方式是否介导了童年不良经历与青年健康结果之间的关系?

Does Coping Mediate the Relationship Between Adverse Childhood Experiences and Health Outcomes in Young Adults?

作者信息

Solberg Marvin A, Peters Rosalind M, Resko Stella M, Templin Thomas N

机构信息

College of Nursing, Wayne State University, 5557 Cass Avenue, 48202 Detroit, MI USA.

School of Social Work, Wayne State University, 5447 Woodward Avenue, 48202 Detroit, MI USA.

出版信息

J Child Adolesc Trauma. 2023 Feb 22;16(3):1-13. doi: 10.1007/s40653-023-00527-z.

Abstract

Adverse childhood experiences (ACEs) affect 22-75% of American young adults. ACEs are associated with adverse health outcomes that begin in young adulthood. Yet, scant research has examined if coping can mediate the relationship between ACEs and adverse outcomes. The current study determined if coping mediates the relationship between ACEs and body mass index (BMI), substance use, and mental health outcomes in young adults. A community sample of 100 White and 100 Black young adults 18-34 years of age participated in a cross-sectional study conducted via Zoom conferencing. Participants provided demographic data, height/weight, and completed measures of ACEs, coping, substance use, and mental health outcomes. Coping was measured using an established three-factor model consisting of adaptive, support, and disengaged coping. Structural equation modeling (SEM) examined the relationships of ACEs to outcomes as mediated by coping. Participants were predominantly female ( = 117; 58.5%) and mid-young adult ( = 25.5 years;  = 4.1). SEM results indicated good model fit: (CMIN/ = 1.52, CFI = 0.94, RMSEA = 0.05 [90% CI = 0.03-0.07], SRMR = 0.06). Only disengaged coping mediated the ACE and substance use (β = 0.36,  = .008), smoking (β = 0.13,  = .004), and mental health (β=-0.26,  = .008) relationships. Disengaged coping styles may be a critical mechanism in developing adverse mental health and substance use outcomes among ACE-exposed individuals. Future ACE and health outcomes research should examine the role of coping. Interventions focusing on adaptive coping may improve the health of individuals exposed to ACEs.

摘要

童年不良经历(ACEs)影响着22%至75%的美国青年。ACEs与始于青年期的不良健康后果相关。然而,极少有研究探讨应对方式是否能调节ACEs与不良后果之间的关系。本研究确定应对方式是否能调节ACEs与青年人体重指数(BMI)、物质使用及心理健康后果之间的关系。一项针对100名18至34岁白人青年和100名黑人青年的社区样本参与了通过Zoom会议进行的横断面研究。参与者提供了人口统计学数据、身高/体重,并完成了关于ACEs、应对方式、物质使用及心理健康后果的测量。应对方式采用一个既定的三因素模型进行测量,该模型包括适应性应对、支持性应对和脱离性应对。结构方程模型(SEM)检验了由应对方式介导的ACEs与各后果之间的关系。参与者以女性为主(n = 117;58.5%),年龄为青年中期(M = 25.5岁;SD = 4.1)。SEM结果显示模型拟合良好:(CMIN/DF = 1.52,CFI = 0.94,RMSEA = 0.05 [90% CI = 0.03 - 0.07],SRMR = 0.06)。只有脱离性应对方式介导了ACEs与物质使用(β = 0.36,p = 0.008)、吸烟(β = 0.13,p = 0.004)及心理健康(β = -0.26,p = 0.008)之间的关系。脱离性应对方式可能是ACEs暴露个体出现不良心理健康和物质使用后果的关键机制。未来关于ACEs与健康后果的研究应探讨应对方式的作用。侧重于适应性应对的干预措施可能会改善ACEs暴露个体的健康状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a02/10427575/da606310f2d5/40653_2023_527_Fig1_HTML.jpg

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