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负性生活事件与 2 至 30 岁期间的情绪症状。

Negative Life Events and Emotional Symptoms From Ages 2 to 30 Years.

机构信息

Department of Psychiatry, University of Vermont, Burlington.

Harvard University, Cambridge, Massachusetts.

出版信息

JAMA Netw Open. 2024 Aug 1;7(8):e2429448. doi: 10.1001/jamanetworkopen.2024.29448.

Abstract

IMPORTANCE

Exposure to different types of negative life events, including traumatic events, is common across the lifespan and associated with increased mental health symptoms.

OBJECTIVE

To assess whether vulnerability to negative life events varies across 5 developmental periods from preschool to young adulthood.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study analyzed data from 3 community-representative studies set in the southeastern US (1992-2015) with harmonized assessment approaches that included a total of 13 775 assessments of individuals aged 2 to 30 years with up to 21 years of follow-up. Data analysis occurred from July 2023 to June 2024.

EXPOSURES

Each study assessed lifetime exposure to (1) traumatic events (ie, severe events associated with posttraumatic stress disorder) and (2) recent stressful events (eg, loss of a friend or moving). All assessments were completed with structured interviews with participants and/or their caregivers.

MAIN OUTCOMES AND MEASURES

The primary outcome was emotional symptoms (ie, anxiety and depressive symptoms). Associations of both categories of life events with emotional symptoms were compared across preschool (<7 years), childhood (7-12 years), adolescence (13-17 years), late adolescence (18-22 years), and young adulthood (23-30 years).

RESULTS

Analyses were based on 13 775 assessments of 3258 participants (1519 female [weighted percentage, 50.0%]). Recent stressful events were associated with emotional symptoms across each developmental period, ranging from a low in preschool (B =0.14; SE = 0.05) to a high in young adulthood (B = 0.57; SE = 0.12) in cross-sectional analyses and ranging from a low in childhood (B = 0.10; SE = 0.06) to a high adolescence (B = 0.19; SE = 0.05) in longitudinal analyses. Lifetime traumatic events were associated with emotional symptoms across each developmental period, ranging from a low in preschool (B = 0.18; SE = 0.05) to a high in adolescence (B = 0.28; SE = 0.04) in cross-sectional analyses and ranging from a low in childhood (B = 0.09; SE = 0.06) to a high in late adolescence (B = 0.21; SE = 0.05) in longitudinal analyses. Associations had overlapping 95% CIs across the different developmental periods with one exception: stressful events had a larger-magnitude cross-sectional association with emotional symptoms in young adulthood than in other developmental periods. Results were consistent with additive, rather than interactive, associations of traumatic and stressful events with emotional symptoms at each developmental period.

CONCLUSIONS AND RELEVANCE

In this cohort study of 3 community-representative samples, vulnerability to traumatic and stressful events was generally similar across the first 3 decades of life; both types of events had an independent association with emotional functioning. These findings suggest response to stressful events is similar from childhood to adulthood.

摘要

重要性

在整个生命周期中,人们普遍会经历不同类型的负面生活事件,包括创伤性事件,并且这些事件与心理健康症状的增加有关。

目的

评估从学前到青年期的 5 个发育阶段对负面生活事件的易感性是否存在差异。

设计、设置和参与者:本队列研究分析了来自美国东南部 3 项具有协调评估方法的社区代表性研究的数据(1992-2015 年),其中包括对 2 至 30 岁个体的总共 13775 次评估,随访时间长达 21 年。数据分析于 2023 年 7 月至 2024 年 6 月进行。

暴露情况

每项研究都评估了个体一生中经历的(1)创伤性事件(即与创伤后应激障碍相关的严重事件)和(2)近期压力事件(例如失去朋友或搬家)。所有评估均通过与参与者及其照顾者进行的结构化访谈完成。

主要结果和测量

主要结局是情绪症状(即焦虑和抑郁症状)。比较了这两类生活事件与情绪症状之间的关联,这些关联横跨学前(<7 岁)、儿童期(7-12 岁)、青春期(13-17 岁)、晚期青春期(18-22 岁)和青年期(23-30 岁)。

结果

分析基于 13775 次评估中的 3258 名参与者(1519 名女性[加权百分比,50.0%])。在横断面分析中,近期压力事件与每个发育阶段的情绪症状相关,从学前的低值(B=0.14;SE=0.05)到青年期的高值(B=0.57;SE=0.12)不等,而在纵向分析中,从儿童期的低值(B=0.10;SE=0.06)到青春期的高值(B=0.19;SE=0.05)不等。一生中的创伤性事件与每个发育阶段的情绪症状相关,从学前的低值(B=0.18;SE=0.05)到青春期的高值(B=0.28;SE=0.04)不等,而在纵向分析中,从儿童期的低值(B=0.09;SE=0.06)到晚期青春期的高值(B=0.21;SE=0.05)不等。不同发育阶段之间的关联具有重叠的 95%CI,但有一个例外:在横断面分析中,压力事件与青年期的情绪症状关联幅度大于其他发育阶段。结果与创伤性和压力性事件与情绪症状在每个发育阶段的累加性而非交互性关联一致。

结论和相关性

在这项针对 3 个社区代表性样本的队列研究中,个体对创伤性和压力性事件的易感性在生命的前 30 年中大致相似;这两种类型的事件都与情绪功能独立相关。这些发现表明,从儿童期到成年期,对压力事件的反应相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faea/11362870/bb8465ed7b93/jamanetwopen-e2429448-g001.jpg

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