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童年逆境与晚年抑郁症:压力与社会支持的调节中介模型

Childhood adversity and late-life depression: moderated mediation model of stress and social support.

作者信息

Lee Jin-Kyung, Lee Jinhee, Chung Moo-Kwon, Park Ji Young, Shin Taeksoo, Lee Kyoung-Joung, Lim Hyo-Sang, Hwang Sangwon, Urtnasan Erdenebayar, Jo Yongmie, Kim Min-Hyuk

机构信息

Institute for Poverty Alleviation and International Development, Yonsei University Mirae Campus, Wonju, Republic of Korea.

Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.

出版信息

Front Psychiatry. 2023 Jun 26;14:1183884. doi: 10.3389/fpsyt.2023.1183884. eCollection 2023.

Abstract

BACKGROUND

As life expectancy increases, understanding the mechanism for late-life depression and finding a crucial moderator becomes more important for mental health in older adults. Childhood adversity increases the risk of clinical depression even in old age. Based on the stress sensitivity theory and stress-buffering effects, stress would be a significant mediator, while social support can be a key moderator in the mediation pathways. However, few studies have tested this moderated mediation model with a sample of older adults. This study aims to reveal the association between childhood adversity and late-life depression in older adults, taking into consideration the effects of stress and social support.

METHODS

This study used several path models to analyze the data from 622 elderly participants who were never diagnosed with clinical depression.

RESULTS

We found that childhood adversity increases the odds ratio of depression by approximately 20% in older adults. Path model with mediation demonstrates that stress fully mediates the pathway from childhood adversity to late-life depression. Path model with moderated mediation also illustrates that social support significantly weakens the association between childhood adversity and perceived stress.

CONCLUSION

This study provides empirical evidence to reveal a more detailed mechanism for late-life depression. Specifically, this study identifies one crucial risk factor and one protective factor, stress and social support, respectively. This brings insight into prevention of late-life depression among those who have experienced childhood adversity.

摘要

背景

随着预期寿命的增加,了解晚年抑郁症的发病机制并找到一个关键的调节因素对于老年人的心理健康变得更加重要。童年逆境即使在老年时也会增加临床抑郁症的风险。基于应激敏感性理论和应激缓冲效应,应激将是一个重要的中介因素,而社会支持可能是中介途径中的关键调节因素。然而,很少有研究在老年人群体中检验这种有调节的中介模型。本研究旨在揭示童年逆境与老年人晚年抑郁症之间的关联,同时考虑应激和社会支持的影响。

方法

本研究使用了几种路径模型来分析622名从未被诊断为临床抑郁症的老年参与者的数据。

结果

我们发现童年逆境使老年人患抑郁症的优势比增加了约20%。有中介的路径模型表明,应激完全中介了从童年逆境到晚年抑郁症的路径。有调节的中介路径模型也表明,社会支持显著削弱了童年逆境与感知应激之间的关联。

结论

本研究提供了实证证据,揭示了晚年抑郁症更详细的发病机制。具体而言,本研究分别确定了一个关键风险因素和一个保护因素,即应激和社会支持。这为预防有童年逆境经历的老年人的晚年抑郁症带来了启示。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5a2/10331618/45fa7ed6e660/fpsyt-14-1183884-g001.jpg

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