背景:尽管虐待儿童(CM)与健康问题和不良的社会心理功能有关,并非所有暴露于CM的个体在以后的生活中都会发展或经历负面后果。这表明一些个体在暴露于CM后表现出韧性。然而,结论受到不同CM亚型和弹性域的不一致发现的限制。目的:制定一个方案,用于进行系统评价和荟萃分析,以量化成年期CM(整体及其亚型)和弹性(全球及其多个领域)之间的关联,并检查这些协会的主持人和调解人。方法:PubMed,PsycINFO,Embase,Scopus,和WebofScience将进行搜索,以确定有关成人(≥18岁)的CM(暴露)和弹性(结果)之间关联的相关研究。数据将由至少两名独立审稿人筛选和提取。纳入研究的方法学质量将通过改良版本的纽卡斯尔-渥太华量表(NOS)进行独立评估。如果认为可行,将使用随机效应模型进行荟萃分析.证据的异质性将用I2统计量来估计,和出版偏见将被评估。潜在调节剂的影响(例如CM的时机和严重程度,年龄,性别,家庭凝聚力,社会经济地位,国家/地区)将使用荟萃回归和亚组分析进行分析,元分析结构方程模型将用于综合间接中介效应。候选主持人和调解员(例如遗传因素,大脑功能,附件样式,人格特质,身体活动,和社会支持)也将进行定性检查。结论:该方案将促进系统评价和荟萃分析,有可能增强我们对早年CM暴露与成年期弹性之间关联的认识。了解CM和韧性之间的关联和潜在机制对于告知具有CM病史的成年人的预防和干预措施以维持健康和改善结果可能很重要。PROSPERO注册:CRD42023394120。
在本研究方案中,我们建议定量总结现有文献中关于虐待儿童与心理弹性之间的关系,涉及心理健康后果和以后生活中的心理社会功能。这项预先注册的系统审查和荟萃分析将建立程序,以调查儿童虐待的总体分类与其不同的相关亚型之间的关联。以及成人复原力及其不同领域的全球/特征分类。该协议将进一步确定分析方法,以探索和总结成年期儿童虐待与复原力之间关联的效果调节者和调解者。由此产生的合成,这将基于这个协议,可以增强我们对虐待儿童和复原力之间关联强度的理解,并为预防策略和临床干预措施提供信息,以改善成年幸存者的健康和社会心理功能。
Background: Although child maltreatment (CM) has been linked to health problems and poor psychosocial functioning, not all individuals exposed to CM develop or experience negative consequences later in life. This suggests that some individuals show resilience after being exposed to CM. However, conclusions have been limited by inconsistent findings across different CM subtypes and resilience domains.Objective: To develop a protocol for conducting a systematic
review and meta-analysis to quantify associations between CM (overall and its subtypes) and resilience (global and its multiple domains) in adulthood, and to examine moderators and mediators of these associations.Method: PubMed, PsycINFO, Embase, Scopus, and Web of Science will be searched to identify relevant studies on the association between CM (exposure) and resilience (outcome) in adults (≥ 18 years). Data will be screened and extracted by at least two independent reviewers. The methodological quality of the included studies will be independently assessed with a modified version of the Newcastle-Ottawa Scale (NOS). If deemed viable, a meta-analysis will be conducted using a random effects model. Heterogeneity of evidence will be estimated with the I2 statistic, and publication bias will be assessed. The effects of potential moderators (e.g. timing and severity of CM, age, sex, family cohesion, socio-economic status, country/region) will be analysed using meta-regression and subgroup analyses, and meta-analytical structural equation modelling will be employed to synthesise indirect mediation effects. Candidate moderators and mediators (e.g. genetic factors, brain functioning, attachment style, personality traits, physical activity, and social support) will be also examined qualitatively.Conclusions: This protocol will facilitate a systematic
review and meta-analysis that has the potential to enhance our knowledge about the association between CM exposure in early life and resilience in adulthood. Understanding associations and underlying mechanisms between CM and resilience is potentially important in informing prevention and interventions to sustain health and improve outcomes among adults with a history of CM.PROSPERO registration: CRD42023394120.
In this study protocol, we propose to quantitatively summarise the existing literature on the relationship between child maltreatment and resilience with regard to mental health consequences and psychosocial functioning later in life.This preregistered systematic
review and meta-analysis will establish the procedures to investigate associations between an overall classification of child maltreatment and its different associated subtypes, and a global/trait classification of resilience and its different domains in adults.This protocol will further determine the analytical approach to explore and summarise effect moderators and mediators of the association between child maltreatment and resilience in adulthood.The resulting synthesis, that will be based on this protocol, could enhance our understanding of the strength of the association between child maltreatment and resilience and inform prevention strategies and clinical interventions to improve health and psychosocial functioning in adult survivors.