体质指数在不良儿童经历、适应力和心理健康关系中的作用：一项多元分析。
Role of body mass index in the relationship between adverse childhood experiences, resilience, and mental health: a multivariate analysis.
机构信息
Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China.
Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.
出版信息
BMC Psychiatry. 2023 Jun 23;23(1):460. doi: 10.1186/s12888-023-04869-8.
OBJECTIVES
Depression among adolescents is a global concern. Adverse childhood experiences (ACEs) have been correlated with negative physical and mental health such as obesity and depression; however, increasing evidence has suggested that their correlation might be moderated by BMI and resilience. In this study, we aim to explore (1) whether resilience moderate the risk of mental health by ACEs; (2) whether BMI is a moderator of this relationship.
STUDY DESIGN
Adolescents were obtained from 4 grade college students by a multi-stage convenience sampling method in the period of May to Jun, 2022.
METHODS
We use the Connor-Davidson Resilience scale, Depression, Anxiety and Stress Scale-21 Item (DASS-21) questionnaires to measure the ACEs, BMI, resilience and mental health. The primary exposure was ACEs and the primary outcome was mental health; while resilience and BMI were moderators. Multivariable linear regression model was used to establish the relationship of ACEs, resilience and BMI against mental health status. Moderate analysis was employed by PROCESS method to explore the relationship between these variables.
RESULTS
A total of 3600 individuals were initially enrolled, after excluding 22 with invalid questionnaires, 3578 adolescents were finally included. The mean age was (20.53 ± 1.65) years old. After adjusted for covariates, multivariable linear regression suggest that the high level ACEs (, β =0.58, , 95%CI:0.54,0.62, P < 0.01), resilience (, β=-0.27, 95%CI: , 95%CI: -0.28,-0.26, P < 0.01) were associated with higher depression symptoms, and BMI (, β =0.073, 95%CI: 0.002-0.15, P < 0.05) was associated with higher depression symptoms. There is also the interaction between resilience, ACEs and mental health (depression, anxiety and stress symptoms). In the relationship between ACEs and mental health, resilience and BMI played a moderator role.
CONCLUSIONS
The moderate analysis also provided further evidence of a link between resilience, ACEs, BMI and mental health. The findings shed new light on potential mechanisms between ACEs and mental health, including the effects of the co-interaction of resilience and BMI, adding to previous literature. ACEs may be a profound variable to measure adolescents' psychosocial environment to influence mental health, and resilience moderate this effect and is also moderated by BMI.
目的
青少年抑郁是一个全球性问题。不良的童年经历（ACEs）与肥胖和抑郁等负面身心健康有关；然而，越来越多的证据表明，它们的相关性可能受到 BMI 和韧性的调节。在这项研究中，我们旨在探讨：（1）韧性是否通过 ACEs 调节心理健康的风险；（2）BMI 是否是这种关系的调节因素。
研究设计
通过多阶段便利抽样法，于 2022 年 5 月至 6 月从 4 所大学的 4 年级学生中获得青少年样本。
方法
我们使用 Connor-Davidson 韧性量表、抑郁、焦虑和压力量表-21 项（DASS-21）问卷来测量 ACEs、BMI、韧性和心理健康。主要暴露因素是 ACEs，主要结果是心理健康；而韧性和 BMI 是调节因素。采用多变量线性回归模型建立 ACEs、韧性和 BMI 与心理健康状况之间的关系。采用 PROCESS 方法进行中介分析，以探讨这些变量之间的关系。
结果
共有 3600 人被初步纳入研究，排除 22 份无效问卷后，最终纳入 3578 名青少年。平均年龄为（20.53±1.65）岁。在调整了混杂因素后，多变量线性回归表明，高水平的 ACEs（β=0.58，95%CI：0.54，0.62，P<0.01）、韧性（β=-0.27，95%CI：-0.28，-0.26，P<0.01）与更高的抑郁症状有关，而 BMI（β=0.073，95%CI：0.002-0.15，P<0.05）与更高的抑郁症状有关。韧性、ACEs 和心理健康（抑郁、焦虑和压力症状）之间也存在交互作用。在 ACEs 与心理健康的关系中，韧性和 BMI 发挥了调节作用。
结论
中介分析还进一步提供了韧性、ACEs、BMI 和心理健康之间联系的证据。这些发现为 ACEs 与心理健康之间的潜在机制提供了新的见解，包括韧性和 BMI 的共同相互作用的影响，为之前的文献增添了新的内容。ACEs 可能是一个重要的变量，用于衡量青少年的社会心理环境，以影响心理健康，而韧性调节这种影响，并且也受到 BMI 的调节。
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