Psychophysiology Laboratory, Department of Social and Behavioral Sciences, City University of Hong Kong, Hong Kong Special Administrative Region of China.
Psychophysiology Laboratory, Department of Social and Behavioral Sciences, City University of Hong Kong, Hong Kong Special Administrative Region of China.
Asian J Psychiatr. 2023 Jun;84:103582. doi: 10.1016/j.ajp.2023.103582. Epub 2023 Apr 6.
To estimate the association between childhood adversity (CA) and depression in Chinese populations in studies using the Childhood Trauma Questionnaire (CTQ), a literature retrieval from established databases between 2005 and 2020 was conducted. A total 40 eligible studies with 145 effect sizes were included in subsequent analyses. Using a multi-level meta-analysis, we found a pooled effect size of r = 0.24, p < 0.001, CI = [0.20, 0.27] for the association between CA and depression. No publication bias was shown by Egger's test, t (160) = -0.27, p = 0.79. The between-study variance was moderate but significant, with 39.75% of the total variance attributable to differences between studies. Results of moderation analysis based on subtypes of CA showed that emotional abuse was associated most strongly with depression. In addition, results of moderation analysis focusing on geographic regions and CTQ subscales showed that the association between SA and depression was stronger in Southern than Central China. Our findings demonstrated clearly the advantages of using a multi-level approach to arrive at a more accurate estimate of pooled effect sizes. The differential associations between CTQ subscales and depression and the moderating effect of geographic regions on the association between sexual abuse and depression point clearly to the need of increased attention to the effects of CA subtypes and socio-cultural factors in future research on CA and mental disorders. These findings provide a preliminary empirical basis for researchers to address specific hypotheses of associations between CA subtypes and specific mental disorders in China.
为了评估童年逆境（CA）与中国人群中使用童年创伤问卷（CTQ）进行的抑郁之间的关联，我们对 2005 年至 2020 年间已建立的数据库进行了文献检索。随后的分析纳入了 40 项符合条件的研究，共包含 145 个效应量。采用多水平荟萃分析，我们发现 CA 与抑郁之间的关联的合并效应量为 r=0.24，p<0.001，CI=[0.20, 0.27]。Egger 检验未显示发表偏倚，t(160)=-0.27，p=0.79。组间方差中等但显著，39.75%的总方差归因于研究之间的差异。基于 CA 亚型的调节分析结果表明，情绪虐待与抑郁的相关性最强。此外，基于地理区域和 CTQ 亚量表的调节分析结果表明，性虐待与抑郁之间的关联在南方比在中部中国更强。我们的研究结果清楚地表明了使用多层次方法来更准确地估计合并效应量的优势。CTQ 亚量表与抑郁之间的差异关联以及地理区域对性虐待与抑郁之间关联的调节作用清楚地表明，在未来的 CA 和精神障碍研究中，需要更加关注 CA 亚型和社会文化因素的影响。这些发现为研究人员提供了初步的经验依据，以解决 CA 亚型与中国特定精神障碍之间特定假设的关联。
