Bornscheuer Lisa, Landstedt Evelina, B Almquist Ylva
Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.
Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden.
PLoS One. 2025 Jan 28;20(1):e0318231. doi: 10.1371/journal.pone.0318231. eCollection 2025.
Psychiatric disorders are a substantial public health concern, and childhood adversity a well-known risk factor for it. Investigating gender differences in vulnerability and resilience processes following out-of-home care (OHC) as proxy for childhood adversity can help map opportunities for the prevention of psychiatric disorders.
We followed a large birth cohort for psychiatric disorders (anxiety, depression, and self-harm, and substance misuse) between age 25-62 years, comparing individuals with and without OHC experience. We investigated different extra-familial risk and resources factors following OHC via gender-stratified mediation and moderation analyses to approximate risk accumulation (vulnerability processes) and buffers of risk (resilience processes).
OHC is prospectively associated with psychiatric disorders in adulthood. Lower school grades, delinquency, and early parenthood are mediators of the association, with the exception of education in girls in relation to anxiety, depression, and self-harm, and early parenthood in boys in relation to substance misuse. Number of best friends moderates OHC experience in boys, and there is a trend for higher educational achievement to also act as buffer, even though this trend was not statistically significant. Leisure time activities did not act as buffer.
Vulnerability and resilience processes after childhood adversity are gendered: Risk accumulation runs via delinquency and poorer educational outcomes in boys more than in girls, while early parenthood is a more dominant risk factor in girls. Having more best friends and higher grades may act as buffer, especially in boys.
精神疾病是一个重大的公共卫生问题，童年逆境是其众所周知的风险因素。将家庭外照料（OHC）作为童年逆境的代表，研究其在脆弱性和复原力过程中的性别差异，有助于规划预防精神疾病的机会。
我们追踪了一个大型出生队列在25至62岁之间患精神疾病（焦虑、抑郁、自我伤害和药物滥用）的情况，比较了有和没有OHC经历的个体。我们通过按性别分层的中介和调节分析，研究了OHC后的不同家庭外风险和资源因素，以估算风险积累（脆弱性过程）和风险缓冲（复原力过程）。
OHC与成年期精神疾病存在前瞻性关联。较低的学业成绩、犯罪和早育是这种关联的中介因素，但女孩的教育与焦虑、抑郁和自我伤害的关联除外，男孩的早育与药物滥用的关联除外。最好朋友的数量调节了男孩的OHC经历，较高的教育成就也有作为缓冲的趋势，尽管这一趋势在统计学上不显著。休闲活动没有起到缓冲作用。
童年逆境后的脆弱性和复原力过程存在性别差异：风险积累在男孩中更多地通过犯罪和较差的教育结果体现，而早育在女孩中是更主要的风险因素。有更多最好的朋友和更高的成绩可能起到缓冲作用，尤其是在男孩中。
