特定生活方式与基于群体的心理健康轨迹之间的逆境维度的关联。

Lifestyle-specific association between adversity dimensions with group-based mental health trajectories.

机构信息

Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China; Center for Big Data and Population Health of IHM, Anhui Medical University, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China; Anhui Provincial Key Laboratory of Environment and Population Health across the Life Course, Anhui Medical University, Hefei, China.

出版信息

J Affect Disord. 2024 Nov 1;364:305-313. doi: 10.1016/j.jad.2024.08.015. Epub 2024 Aug 12.

DOI:10.1016/j.jad.2024.08.015

PMID:39142586

Abstract

BACKGROUND

Childhood adversity (CA) has a substantial correlation with mental health problems. Keeping a healthy lifestyle is essential for mental health interventions; it is unclear, however, how healthy lifestyle affect the relationship between CA and persistent mental health problems.

METHODS

This longitudinal study (n = 1112, 54.5 % male) collected the data on CA (measured through three dimensions: threat, deprivation and unpredictability), mental health problems, and lifestyle factors. Group-based multi-trajectory modeling (GBMTM) was utilized to estimate trajectories for three mental health problems (i.e., depression, ADHD and overanxiety). Close friendships, regular physical activity, appropriate sleep duration, shorter screen time, and healthy eating were combined to establish a healthy lifestyle score (which ranges from 0 to 5). Higher scores indicated a healthier lifestyle.

RESULTS

Three trajectories of mental health problems were identified: persistently low risk (24.9 %), persistently medium-high risk (50.0 %), and persistently high risk (25.1 %). Multinomial logistic regression showed that high adversity (high-threat: β = 2.01, P < 0.001; high-deprivation: β = 1.03, P < 0.001; high-unpredictability: β = 0.83, P = 0.001; high-overall adversity: β = 1.64, P < 0.001) resulted in a persistently high risk of mental health problems; these outcomes were maintained after robust control for covariates. Further lifestyle stratification, null associations were observed among children with a healthy lifestyle, irrespective of their gender; however, after controlling for covariates, the above associations remained relatively stable only among boys.

LIMITATIONS

The generalizability of our findings is restricted by 1) limited racial diversity and 2) missing data.

CONCLUSIONS

This finding underscores the benefits of promoting a healthy lifestyle in children to prevent persistent mental health problems caused by CA.

摘要

背景

儿童逆境（CA）与心理健康问题有很大的相关性。保持健康的生活方式对于心理健康干预至关重要；然而，目前尚不清楚健康的生活方式如何影响 CA 与持续心理健康问题之间的关系。

方法

本纵向研究（n=1112，54.5%为男性）收集了 CA（通过三个维度进行衡量：威胁、剥夺和不可预测性）、心理健康问题和生活方式因素的数据。基于群组的多轨迹建模（GBMTM）用于估计三种心理健康问题（即抑郁、ADHD 和过度焦虑）的轨迹。将亲密友谊、定期体育活动、适当的睡眠时间、较短的屏幕时间和健康饮食结合起来，建立一个健康生活方式评分（范围为 0 到 5）。分数越高表示生活方式越健康。

结果

确定了三种心理健康问题轨迹：持续低风险（24.9%）、持续中高风险（50.0%）和持续高风险（25.1%）。多项逻辑回归显示，高逆境（高威胁：β=2.01，P<0.001；高剥夺：β=1.03，P<0.001；高不可预测性：β=0.83，P=0.001；高总体逆境：β=1.64，P<0.001）导致持续高风险的心理健康问题；在对协变量进行稳健控制后，这些结果仍然存在。进一步的生活方式分层显示，无论性别如何，健康生活方式的儿童之间没有关联；然而，在控制协变量后，这些关联在男孩中仍然相对稳定。