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儿童期受虐与成年期的复原力:一项系统综述与荟萃分析

Child maltreatment and resilience in adulthood: a systematic review and meta-analysis.

作者信息

Fares-Otero Natalia E, Carranza-Neira Julia, Womersley Jacqueline S, Stegemann Aniko, Schalinski Inga, Vieta Eduard, Spies Georgina, Seedat Soraya

机构信息

Department of Psychiatry and Psychology, Bipolar and Depressive Disorders Unit, Hospital Clínic, Institute of Neurosciences (UBNeuro), Barcelona, Catalonia, Spain.

Fundació Clínic per a la Recerca Biomèdica (FCRB), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.

出版信息

Psychol Med. 2025 Jun 2;55:e163. doi: 10.1017/S0033291725001205.

Abstract

We conducted a systematic review and meta-analysis to quantify associations between overall and subtypes of CM, global/trait resilience, and five resilience domains (coping, self-esteem, emotion regulation, self-efficacy, and well-being) in adults, and to examine moderators and mediators of these associations. A systematic search was undertaken on 12 June 2024 to identify published peer-reviewed articles in five databases (PROSPERO-CRD42023394120). Of 15,262 records, 203 studies were included, comprising 145,317 adults (M = 29.62 years; 34.96% males); 183 studies and 557 effect sizes were pooled in random-effect meta-analyses. Overall CM and its subtypes were negatively associated with global/trait resilience and its domains ( = -0.081 to -0.330). Emotional abuse/neglect showed the largest magnitude of effect ( = -0.213 to -0.321). There was no meta-analytic evidence for an association between sexual abuse and coping, and physical abuse/neglect and self-esteem. Meta-regressions identified age, sample size, and study quality as moderators. Subgroup analyses found that associations between emotional abuse and emotion regulation were stronger, while associations between emotional abuse and self-esteem were weaker, in western non-western countries. No differences were found in associations between CM and resilience in clinical non-clinical samples. Narrative synthesis identified several mediators. Associations were of small magnitude and there were a limited number of studies, especially studies assessing CM subtypes, such as physical neglect, bullying, or domestic violence, and resilience domains, such as coping or self-efficacy, in males, and clinical samples. CM exposure negatively impacts resilience in adults, an effect observed across multiple maltreatment types and resilience domains. Interventions focused on resilience in adults with CM histories are needed to improve health and psychosocial outcomes.

摘要

我们进行了一项系统评价和荟萃分析,以量化成人中儿童期虐待(CM)的总体情况和亚型、整体/特质复原力以及五个复原力领域(应对、自尊、情绪调节、自我效能和幸福感)之间的关联,并研究这些关联的调节因素和中介因素。于2024年6月12日进行了系统检索,以确定五个数据库(PROSPERO-CRD42023394120)中已发表的同行评审文章。在15262条记录中,纳入了203项研究,包括145317名成年人(平均年龄=29.62岁;男性占34.96%);183项研究和557个效应量被纳入随机效应荟萃分析。总体CM及其亚型与整体/特质复原力及其领域呈负相关(相关系数=-0.081至-0.330)。情感虐待/忽视的效应量最大(相关系数=-0.213至-0.321)。没有荟萃分析证据表明性虐待与应对之间、身体虐待/忽视与自尊之间存在关联。元回归确定年龄、样本量和研究质量为调节因素。亚组分析发现,在西方国家与非西方国家中,情感虐待与情绪调节之间的关联更强,而情感虐待与自尊之间的关联更弱。在临床样本与非临床样本中,CM与复原力之间的关联未发现差异。叙述性综合分析确定了几个中介因素。关联程度较小,且研究数量有限,尤其是评估男性以及临床样本中的CM亚型(如身体忽视、欺凌或家庭暴力)和复原力领域(如应对或自我效能)的研究。CM暴露对成年人的复原力有负面影响,这种影响在多种虐待类型和复原力领域中均有观察到。需要针对有CM病史的成年人开展侧重于复原力的干预措施,以改善健康和心理社会结局。

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