已经报道了心理社会应激源在精神疾病和执行功能障碍中的作用,分开。文献还提出了社会支持和应对策略在这些关系中的参与。然而,在考虑社会支持和应对策略的同时,缺乏对多种应激源和神经精神合并症之间关系的研究。本研究旨在阐明多种心理社会应激源的作用,社会支持,以及随后发生的神经精神合并症的应对策略。
分析的数据来自大规模的第6次数据收集,来自加拿大蒙特利尔西南部的纵向人群队列。通过综合评分和潜在谱分析分别检查了多种压力源的累积效应。使用多项逻辑回归模型来检验累积应激源与神经精神合并症之间的关系。
共有210名参与者被纳入分析。LPA确定了心理社会应激源(低和高)和执行功能(执行功能障碍和无执行功能障碍)的2类模型,分别。有11.8%的参与者患有神经精神合并症。综合应激评分(RR=1.08,95CI=1.01-1.15)和潜在应激组(RR=3.65,95CI=1.15-11.57)均与调整社会支持和应对策略后的神经精神合并症相关。社会支持水平较高时,发生神经精神合并症的风险降低(P<0.05)。
接触多种应激源增加了随后的神经精神合并症的风险,但是风险可以通过更高水平的社会支持来改变。
BACKGROUND: The role of psychosocial stressors in psychiatric disorders and executive dysfunction has been reported, separately. The literature has also suggested the involvement of social support and coping strategies in these relationships. However, there is a lack of research conducted to examine the relationships among multiple stressors and neuropsychiatric comorbidities while considering the presence of social support and coping strategies. This study aims to articulate the roles of multiple psychosocial stressors, social support, and coping strategies in the subsequent occurrence of neuropsychiatric comorbidities.
METHODS: Data analyzed were from the 6th data collection of a large-scale, longitudinal population-based cohort from Southwest Montreal in Canada. The cumulative effects of multiple stressors were separately examined by a composite score and latent profile analysis. Multinomial logistic regression models were used to test the relationship between cumulative stressors and neuropsychiatric comorbidities.
RESULTS: A total of 210 participants were included in the analyses. The LPA identified a 2-class model for psychosocial stressors (low and high) and executive function (executive dysfunction and no executive dysfunction), respectively. There were 11.8% of participants with neuropsychiatric comorbidities. Both the composite stress score (RR = 1.08, 95%CI = 1.01-1.15) and latent stress groups (RR = 3.65, 95%CI = 1.15-11.57) were associated with neuropsychiatric comorbidities after adjusting for social support and coping strategies. The risk of developing neuropsychiatric comorbidities decreased when the level of social support was high (P < 0.05).
CONCLUSIONS: Exposures to multiple stressors increased the risk of subsequent neuropsychiatric comorbidities, but the risk can be modified by a higher level of social support.