Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
J Adolesc Health. 2024 Sep;75(3):442-450. doi: 10.1016/j.jadohealth.2024.05.025. Epub 2024 Jul 12.
Although previous studies have examined the association between youth psychosocial risks and their perceptions of their neighborhood, it is unclear how objective neighborhood characteristics are associated with psychosocial risks and mental health symptoms among adolescents. We investigated how neighborhood characteristics moderate the relationship between youth psychosocial characteristics and mental health symptoms.
This cross-sectional study examined 13,837 emergency department visits by 14-18-year-olds who completed a standardized Behavioral Health Screening in a tertiary pediatric hospital in Philadelphia from 2013 to 2020. Psychosocial risk factors and mental health symptoms were assessed based on self-reported survey responses. We characterized neighborhoods as low-, moderate-, and high-stress based on gun violence incidence from 2013 to 2020 and the census tract-level Child Opportunity Index. Mixed effects logistic regression and Poisson models were used to examine moderation effects.
The 9,814 included patients were 64% female and 64% non-Hispanic Black. The following psychosocial risk factors were associated with two to eight times higher odds of depressive symptoms and suicide risk: exposure to trauma, bullying at school, at-risk substance use, fighting, and retaliation. Adolescents living in high-stress neighborhoods were twice as likely to report fighting and retaliation and reported more psychosocial risk factors than those in low-stress neighborhoods. Odds of mental health symptoms increased with the number of psychosocial risk factors, particularly in youth from low-stress neighborhoods.
Objective neighborhood characteristics had a significant interaction effect on the relationship between psychosocial risks and depression and suicide risk among adolescents seeking care in a pediatric emergency department.
尽管先前的研究已经考察了青少年的心理社会风险与其对邻里环境的感知之间的关系，但尚不清楚客观的邻里特征与青少年的心理社会风险和心理健康症状之间存在怎样的关联。本研究旨在探讨邻里特征如何调节青少年心理社会特征与心理健康症状之间的关系。
本横断面研究纳入了 2013 年至 2020 年期间在费城一家三级儿科医院就诊的 13837 名 14-18 岁青少年，他们在就诊时完成了一项标准化的行为健康筛查。根据自我报告的调查回复评估心理社会风险因素和心理健康症状。我们根据 2013 年至 2020 年的枪支暴力发生率以及普查区层面的儿童机会指数，将邻里特征划分为低压力、中压力和高压力。采用混合效应逻辑回归和泊松模型检验调节效应。
9814 例纳入患者中，64%为女性，64%为非西班牙裔黑人。以下心理社会风险因素与抑郁症状和自杀风险的发生几率增加 2 至 8 倍相关：暴露于创伤、学校欺凌、有风险的物质使用、打架和报复。生活在高压力邻里的青少年报告打架和报复的可能性是生活在低压力邻里的青少年的两倍，并且报告的心理社会风险因素也更多。心理健康症状的发生几率随心理社会风险因素数量的增加而增加，尤其是在来自低压力邻里的青少年中。
客观的邻里特征对青少年在儿科急诊就诊时的心理社会风险与抑郁和自杀风险之间的关系具有显著的交互作用。
