一种基于数据的方法，用于对 ABCD 研究中的早期生活逆境暴露进行分类。
A data-driven approach to categorizing early life adversity exposure in the ABCD Study.
机构信息
Center for Cognitive Neuroscience, University of California, Los Angeles, CA, USA.
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.
出版信息
BMC Med Res Methodol. 2023 Jul 7;23(1):164. doi: 10.1186/s12874-023-01983-9.
BACKGROUND
Adversity occurring during development is associated with detrimental health and quality of life outcomes, not just following exposure but throughout the lifespan. Despite increased research, there exists both overlapping and distinct definitions of early life adversity exposure captured by over 30 different empirically validated tools. A data-driven approach to defining and cataloging exposure is needed to better understand associated outcomes and advance the field.
METHODS
We utilized baseline data on 11,566 youth enrolled in the ABCD Study to catalog youth and caregiver-reported early life adversity exposure captured across 14 different measures. We employed an exploratory factor analysis to identify the factor domains of early life adversity exposure and conducted a series of regression analyses to examine its association with problematic behavioral outcomes.
RESULTS
The exploratory factor analysis yielded a 6-factor solution corresponding to the following distinct domains: 1) physical and sexual violence; 2) parental psychopathology; 3) neighborhood threat; 4) prenatal substance exposure; 5) scarcity; and 6) household dysfunction. The prevalence of exposure among 9-and 10-year-old youth was largely driven by the incidence of parental psychopathology. Sociodemographic characteristics significantly differed between youth with adversity exposure and controls, depicting a higher incidence of exposure among racial and ethnic minoritized youth, and among those identifying with low socioeconomic status. Adversity exposure was significantly associated with greater problematic behaviors and largely driven by the incidence of parental psychopathology, household dysfunction and neighborhood threat. Certain types of early life adversity exposure were more significantly associated with internalizing as opposed to externalizing problematic behaviors.
CONCLUSIONS
We recommend a data-driven approach to define and catalog early life adversity exposure and suggest the incorporation of more versus less data to capture the nuances of exposure, e.g., type, age of onset, frequency, duration. The broad categorizations of early life adversity exposure into two domains, such as abuse and neglect, or threat and deprivation, fail to account for the routine co-occurrence of exposures and the duality of some forms of adversity. The development and use of a data-driven definition of early life adversity exposure is a crucial step to lessening barriers to evidence-based treatments and interventions for youth.
背景
发展过程中遇到的逆境不仅会在接触后，而且会在整个生命周期中对健康和生活质量产生不利影响。尽管研究有所增加，但仍有 30 多种不同的经验验证工具对早期生活逆境暴露进行了重叠和不同的定义。需要采用数据驱动的方法来定义和分类暴露情况，以更好地了解相关结果并推动该领域的发展。
方法
我们利用 ABCD 研究中招募的 11566 名青少年的基线数据，对 14 种不同措施中记录的青少年和照顾者报告的早期生活逆境暴露情况进行分类。我们采用探索性因素分析来确定早期生活逆境暴露的因素域，并进行了一系列回归分析，以检验其与行为问题结果的关联。
结果
探索性因素分析产生了 6 个因子解决方案，对应于以下不同的领域：1）身体和性暴力；2）父母精神病理学；3）邻里威胁；4）产前物质暴露；5）匮乏；6）家庭功能障碍。9 岁和 10 岁青少年的暴露率主要由父母精神病理学的发生率驱动。具有逆境暴露的青少年与对照组的社会人口统计学特征存在显著差异，描绘了在少数族裔和社会经济地位较低的青少年中，暴露的发生率更高。逆境暴露与更多的行为问题显著相关，主要由父母精神病理学、家庭功能障碍和邻里威胁的发生率驱动。某些类型的早期生活逆境暴露与内化问题行为的关联程度显著高于外化问题行为。
结论
我们建议采用数据驱动的方法来定义和分类早期生活逆境暴露，并建议纳入更多或更少的数据来捕捉暴露的细微差别，例如类型、发病年龄、频率、持续时间。将早期生活逆境暴露广泛分类为虐待和忽视，或威胁和剥夺等两个领域，无法解释暴露的常见共发性和某些形式逆境的双重性。开发和使用数据驱动的早期生活逆境暴露定义是减少针对青少年的循证治疗和干预措施障碍的关键步骤。
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