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童年不良经历在波兰成年普通人群的危险行为、医疗保健利用及一般自我效能感中的作用。

The role of adverse childhood experiences in risky behaviors, health care utilization, and generalized self-efficacy in the general adult Polish population.

作者信息

Berent Dominika, Wojnar Marcin

机构信息

Masovian Regional Psychiatric Hospital Drewnica, Ząbki, Poland.

Medical University of Warsaw, Warsaw, Poland.

出版信息

Arch Med Sci. 2020 Jun 15;20(3):769-789. doi: 10.5114/aoms.2020.96343. eCollection 2024.

Abstract

INTRODUCTION

The present study evaluated whether adverse childhood experiences (ACEs) are significantly and independently associated with six key outcomes in the Polish general population: (1) lifetime suicide attempt, (2) self-mutilation, (3) potential problem drinking, (4) use of street drugs, (5) visiting a psychologist/psychotherapist, and (6) visiting a psychiatrist. We also investigated whether ACEs explain a significant proportion of variability in generalized self-efficacy.

MATERIAL AND METHODS

Six hundred and fifty-nine individuals completed the ACE Study questionnaire (physical, verbal, and sexual abuse; neglect; select family dysfunctions) and three additional questions [ACE (13) questionnaire]: witnessing (1) a family member's suicide attempt or (2) death due to any cause except completed suicide, and (3) a stranger's death due to any cause (e.g., traffic accident). Generalized self-efficacy was assessed with the Generalized Self-Efficacy Scale.

RESULTS

The likelihood of lifetime use of street drugs, potential problem drinking, and visiting a psychologist/psychotherapist and psychiatrist increased as ACE and ACE (13) score increased. As compared to scores of < 4, ACE (13) scores of ≥ 4 were associated with a 10.8-fold increased likelihood of self-mutilation, a 3.26-fold increased likelihood of potential problem drinking, a 5.72-fold increased likelihood of visiting a psychologist/psychotherapist, and a 6.71-fold increased likelihood of visiting a psychiatrist. ACE (13) score explained 1.2% of the variability in generalized self-efficacy.

CONCLUSIONS

The present study identified a strong association between childhood adversity and increased likelihood of lifetime self-mutilation, potential problem drinking, visiting a psychologist/psychotherapist, and visiting a psychiatrist. Generalized self-efficacy may be an important target for secondary intervention following childhood adversity.

摘要

引言

本研究评估了童年不良经历(ACEs)是否与波兰普通人群的六个关键结果存在显著且独立的关联:(1)终生自杀未遂,(2)自残,(3)潜在的问题饮酒,(4)使用街头毒品,(5)拜访心理学家/心理治疗师,以及(6)拜访精神科医生。我们还调查了ACEs是否能解释一般自我效能感中很大一部分的变异性。

材料与方法

659名个体完成了ACE研究问卷(身体虐待、言语虐待和性虐待;忽视;特定家庭功能障碍)以及另外三个问题[ACE(13)问卷]:目睹(1)家庭成员自杀未遂或(2)因除自杀完成以外的任何原因导致的死亡,以及(3)因任何原因(如交通事故)导致的陌生人死亡。使用一般自我效能量表评估一般自我效能感。

结果

随着ACE和ACE(13)得分的增加,终生使用街头毒品、潜在问题饮酒以及拜访心理学家/心理治疗师和精神科医生的可能性增加。与得分<4相比,ACE(13)得分≥4与自残可能性增加10.8倍、潜在问题饮酒可能性增加3.26倍、拜访心理学家/心理治疗师可能性增加5.72倍以及拜访精神科医生可能性增加6.71倍相关。ACE(13)得分解释了一般自我效能感中1.2%的变异性。

结论

本研究发现童年逆境与终生自残、潜在问题饮酒、拜访心理学家/心理治疗师以及拜访精神科医生的可能性增加之间存在强烈关联。一般自我效能感可能是童年逆境后二级干预的一个重要目标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dbf/11264082/32a352b8322b/AMS-20-3-115650-g001.jpg

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