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中国老年人虐待与抑郁症状:不良童年经历的调节作用

Elder abuse and depressive symptoms among older adults in China: The moderating role of adverse childhood experiences.

机构信息

School of Public Administration, Hohai University, Nanjing, China.

出版信息

J Affect Disord. 2023 Oct 15;339:742-749. doi: 10.1016/j.jad.2023.07.070. Epub 2023 Jul 16.

DOI:10.1016/j.jad.2023.07.070
PMID:37463645
Abstract

BACKGROUND

This study aimed to examine: (a) the associations between elder abuse and depressive symptoms among older adults in China, and (b) the moderating role of adverse childhood experiences (ACEs) on the relationships between elder abuse and its subtypes and depressive symptoms.

METHODS

This study used the cross-sectional data from the 2018 China Longitudinal Aging Social Survey (N = 8436, mean age = 71.3, 49.3 % female). Depressive symptoms were measured as CES-D scale. Elder abuse was evaluated by physical abuse, emotional abuse, and financial exploitation. ACEs were assessed via hunger, inadequate medical care, and death of parent(s) during childhood. Multiple linear regression models and interaction terms were used.

RESULTS

Elder abuse was significantly associated with increased depressive symptoms. Regarding elder abuse subtypes, when physical abuse, emotional abuse, and financial exploitation were included separately in regression models, they were all associated with increased depression. However, when all three subtypes were included simultaneously, only emotional abuse remained related to higher depression. Furthermore, ACEs acted as a moderator in the link between elder abuse and depressive symptoms. Specifically, moderate exposure to ACEs (exposure to one or two ACEs) attenuated the detrimental impacts of elder abuse on depression. For elder abuse subtypes, one and two ACEs alleviate the adverse effects of financial exploitation on depressive symptoms.

LIMITATIONS

Cross-sectional design is the major limitation.

CONCLUSIONS

The findings highlight the importance of considering the moderating role of ACEs when examining the association between elder abuse and depressive symptoms in later life.

摘要

背景

本研究旨在检验:(a)在中国老年人中,虐待老人与抑郁症状之间的关联;(b)童年逆境经历(ACEs)对虐待老人及其亚型与抑郁症状之间关系的调节作用。

方法

本研究使用了 2018 年中国纵向老龄化社会调查(N=8436,平均年龄 71.3,49.3%为女性)的横断面数据。抑郁症状用 CES-D 量表衡量。虐待老人通过身体虐待、情感虐待和经济剥削来评估。童年时期的 ACEs 通过饥饿、医疗不足和父母去世来评估。采用多元线性回归模型和交互项进行分析。

结果

虐待老人与抑郁症状显著相关。关于虐待老人的亚型,当身体虐待、情感虐待和经济剥削分别纳入回归模型时,它们都与抑郁增加有关。然而,当同时纳入所有三种亚型时,只有情感虐待与更高的抑郁有关。此外,ACEs 作为虐待老人与抑郁症状之间联系的调节因素。具体来说,中度暴露于 ACEs(暴露于一种或两种 ACEs)减轻了虐待老人对抑郁的不利影响。对于虐待老人的亚型,一种和两种 ACEs 减轻了经济剥削对抑郁症状的不利影响。

局限性

横断面设计是主要的局限性。

结论

研究结果强调了在研究晚年虐待老人与抑郁症状之间的关联时,考虑 ACEs 调节作用的重要性。

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