School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.
Research Department of Epidemiology and Public Health, University College London, London, England.
Eur Child Adolesc Psychiatry. 2024 Jun;33(6):1907-1920. doi: 10.1007/s00787-023-02289-3. Epub 2023 Sep 7.
The key aim of our study was to examine pathways from exposure to childhood adversities (i.e., deprivation and threat) to adolescent psychopathology. The assessed mediating mechanisms included cognitive ability and emotion regulation, as proposed by the Dimensional Model of Adversity and Psychopathology (DMAP). The study comprised participants from the nationally representative Millennium Cohort Study. Latent scores for deprivation and threat were derived using confirmatory factor analysis from indicators collected when participants were at age of 9 months, 3 and 5 years. Cognitive ability was measured using the Verbal Similarities subscale of the British Ability Scales II at age 11, and emotion regulation was measured using emotion dysregulation subscale of the Child Social Behavioural Questionnaire at age 7. Psychopathology, defined as psychological distress, was assessed using the Kessler 6 scale at age 17. We conducted causal mediation analysis adjusting for multiple confounding factors. We did not find total effect of either exposure to deprivation or threat on psychological distress, but we did find significant indirect effects of exposure to deprivation on psychological distress via cognitive ability (- 0.11, 95% CI - 0.20 to - 0.05) and emotion regulation (0.03, 0.02 to 0.12), and exposure to threat on psychological distress via cognitive ability (- 0.04, - 0.07 to - 0.01) and emotion regulation (0.09, 0.03 to 0.15). The lack of associations between deprivation or threat and psychological distress may be due to reporting bias or developmental period of psychopathology. Results of mediation analysis partially support the DMAP but indicate limited benefits to reduce adolescent psychological distress by targeting cognitive ability or emotion regulation to those exposed to childhood adversities.
我们研究的主要目的是探讨儿童逆境(即剥夺和威胁)暴露与青少年精神病理学之间的途径。所评估的中介机制包括认知能力和情绪调节,这是由逆境和精神病理学的维度模型(DMAP)提出的。该研究包括来自全国代表性千禧年队列研究的参与者。使用验证性因子分析从参与者 9 个月、3 岁和 5 岁时收集的指标中得出剥夺和威胁的潜在分数。认知能力使用英国能力量表 II 的言语相似性分量表在 11 岁时进行测量,情绪调节使用儿童社会行为问卷的情绪失调分量表在 7 岁时进行测量。精神病理学定义为心理困扰,使用 Kessler 6 量表在 17 岁时进行评估。我们进行了因果中介分析,调整了多个混杂因素。我们没有发现暴露于剥夺或威胁对心理困扰的总效应,但我们确实发现了暴露于剥夺对心理困扰的显著间接效应,通过认知能力(-0.11,95%CI-0.20 至-0.05)和情绪调节(0.03,0.02 至 0.12),以及通过认知能力(-0.04,-0.07 至-0.01)和情绪调节(0.09,0.03 至 0.15)对心理困扰的暴露有显著的间接效应。剥夺或威胁与心理困扰之间缺乏关联可能是由于报告偏差或精神病理学的发育时期。中介分析的结果部分支持 DMAP,但表明通过针对认知能力或情绪调节来减少青少年心理困扰,对那些暴露于儿童逆境的人效果有限。