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童年逆境与老年人的焦虑和抑郁有关:累积风险和潜在类别分析。

Childhood adversity is associated with anxiety and depression in older adults: A cumulative risk and latent class analysis.

机构信息

School of Psychology, University of New South Wales, Kensington, NSW, Australia; Neuroscience Research Australia, Randwick, NSW, Australia; Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.

School of Psychology, University of New South Wales, Kensington, NSW, Australia; Neuroscience Research Australia, Randwick, NSW, Australia.

出版信息

J Affect Disord. 2024 Jun 1;354:181-190. doi: 10.1016/j.jad.2024.03.016. Epub 2024 Mar 12.

Abstract

BACKGROUND

The long-lasting influence of childhood adversity on mental health is well documented; however empirical research examining how this association extends into older adults is limited. This study operationalises adversity using cumulative risk and latent class analysis (LCA) models to assess how adversity exposure and typologies may predict anxiety and depression in older adults.

METHODS

Data came from the Personality and Total Health (PATH) Through Life Project (N = 2551, age 60-66). Participants retrospectively reported their childhood experiences of domestic adversity on a 17-item scale. Mental health was measured using four validated questionnaires of depression and anxiety.

RESULTS

Linear and generalised additive models (GAM) indicated a dose-response relationship, where a greater number of cumulative adversities were associated with poorer scores on all four mental health measures. LCA identified a four-class solution; with high adversity and high parental dysfunction being associated with poorer mental health outcomes while moderate parental dysfunction and low adversity groups scored at healthy levels. Women reported higher overall anxiety than men, but no notable interactions between ACEs and gender were observed. Patterns revealed by LCA were similar to patterns shown by the cumulative risk model.

LIMITATIONS

There is a large time gap from childhood to assessment, making our study susceptible to recall bias. Also, our findings were based on cross-sectional data, limiting causal inferences.

CONCLUSION

Childhood adversity had independent and additive contributions to depression and anxiety in older adulthood, and both cumulative risk and person-centred approaches captured this relationship.

摘要

背景

儿童时期逆境对心理健康的持久影响已有充分记录;然而,关于这种关联如何延伸到老年人的实证研究有限。本研究使用累积风险和潜在类别分析(LCA)模型来操作逆境,以评估逆境暴露和类型如何预测老年人的焦虑和抑郁。

方法

数据来自人格和整体健康(PATH)贯穿生命项目(N=2551,年龄 60-66 岁)。参与者回顾性地报告了他们在 17 项家庭逆境量表上的童年经历。心理健康使用四个经过验证的抑郁和焦虑问卷进行衡量。

结果

线性和广义加性模型(GAM)表明存在剂量反应关系,即累积逆境数量越多,四项心理健康测量的得分就越差。潜在类别分析确定了一个四类别解决方案;高逆境和高父母功能障碍与较差的心理健康结果相关,而中度父母功能障碍和低逆境组的得分处于健康水平。女性报告的总体焦虑高于男性,但未观察到 ACE 与性别之间的显著相互作用。潜在类别分析揭示的模式与累积风险模型显示的模式相似。

局限性

从童年到评估存在很大的时间差距,使我们的研究容易受到回忆偏差的影响。此外,我们的发现基于横断面数据,限制了因果推论。

结论

儿童时期的逆境对老年人的抑郁和焦虑有独立和累加的贡献,累积风险和以人为中心的方法都捕捉到了这种关系。

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