childhood maltreatment

童年虐待
  • 文章类型: Journal Article
    儿童时期的虐待对幸存者有不利影响。在儿童中,虐待可以预测认知缺陷以及学业和情绪功能受损。尽管在儿童中进行了广泛的研究,成年后认知缺陷的明显程度已在较小程度上进行了研究。执行功能(EF)是一组认知过程,有助于将行为引导到目标,其特征是长期的成熟时间过程。因此,它特别容易受到早期压力的影响,这给精神病理学带来了风险。因此,评估儿童创伤对成人EF的潜在影响至关重要.本研究试图使用自我报告和基于任务的EF过程度量来评估成年期儿童虐待史对EF的影响。较高的累积儿童虐待水平预示着较差的EF。此外,赤字不是由抑郁和焦虑的当前症状造成的,表明儿童期虐待对成年期认知功能的影响不是当前内化精神病理学的结果。
    Maltreatment during childhood has detrimental consequences for survivors. Among children, maltreatment predicts deficits in cognition and impairment in academic and emotional functioning. Although studied extensively in children, the extent to which cognitive deficits are evident in adulthood has been examined to a lesser extent. Executive functioning (EF) is a set of cognitive processes that help to guide behavior toward goals and is characterized by a prolonged maturational time course. As such, it is particularly vulnerable to the effects of early stress, which confers risk for psychopathology. Thus, it is critical to assess the potential impact of childhood trauma on adult EF. The present study sought to assess the impact of a history of childhood maltreatment on EF during adulthood using both self-reported and task-based measures of EF processes. Higher levels of cumulative childhood maltreatment predicted poorer EF. Furthermore, deficits were not accounted for by current symptoms of depression and anxiety, indicating that the impact of childhood maltreatment on cognitive functioning in adulthood is not the result of current internalizing psychopathology.
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  • 文章类型: Journal Article
    本研究调查了中国医学生自杀意念(SI)的患病率及其相关危险因素。
    河北省某医学院招收医学生6643人(男2383人/女4260人),中国。人口统计数据是通过自我管理的问卷收集的。儿童创伤问卷简表(CTQ-SF)用于评估儿童虐待(CM),青少年生活事件自我评估清单(ASLEC)用于评估压力性生活事件。使用Beck自杀意念量表(BSSI)评估自杀意念。采用单因素和多因素logistic回归模型分析影响SI的因素。
    医学生中SI的患病率为11.5%(763/6643)。多因素logistic回归分析显示SI与年龄显著相关,一个女性,失恋,内向,在童年时期经历CM,在过去的12个月里经历过紧张的生活事件。在CM的五种亚型中,情绪虐待对SI的影响最大(OR=2.76,95%CI:1.72-4.42)。CM和应激性生活事件的联合作用与SI风险增加显著相关(OR=5.39,95%CI:4.15-6.98)。
    医学生中SI的患病率很高,经历过CM和紧张生活事件的医学生对SI的倾向更高。筛查CM和压力性生活事件可能是识别SI高风险个体的有效方法。
    UNASSIGNED: This study investigated the prevalence of suicidal ideation (SI) among Chinese medical students and its associated risk factors.
    UNASSIGNED: A total of 6643 medical students (2383 males/4260 females) were recruited from a medical college in Hebei Province, China. Demographic data were collected via a self-administered questionnaire. The Childhood Trauma Questionnaire Short Form (CTQ-SF) was used to evaluate childhood maltreatment (CM), and the Adolescent Self-Rating Life Events Checklist (ASLEC) was used to evaluate the stressful life events. Suicidal ideation was assessed using the Beck Scale for Suicide Ideation (BSSI). Univariate and multivariate logistic regression models were used to analyze the factors affecting SI.
    UNASSIGNED: The prevalence of SI in medical students was 11.5% (763/6643). Multivariate logistic regression analysis revealed that SI was significantly associated with younger age, a female sex, being lovelorn, being introverted, experiencing CM during childhood, and experiencing stressful life events within the past 12 months. Of the five subtypes of CM, emotional abuse may have the strongest effect on SI (OR=2.76, 95% CI: 1.72-4.42). The joint effects of CM and stressful life events were significantly associated with an increased risk of SI (OR=5.39, 95% CI: 4.15-6.98).
    UNASSIGNED: The prevalence of SI among medical students is high, and medical students who have experienced CM and stressful life events have a higher tendency towards SI. Screening for both CM and stressful life events may be an effective way of identifying individuals at high risk of SI.
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  • 文章类型: Journal Article
    背景:儿童虐待(CM)在整个生命周期的不良健康结果中都被指出,包括严重感染相关结果。然而,关于CM在严重COVID-19相关结局中的潜在作用以及这种关联的潜在机制的数据很少。
    方法:我们纳入了英国生物银行的151,427人,他们在2016年和2017年回答了关于CM病史的问题,并于2020年1月31日还活着。使用二项逻辑回归模型来估计CM病史与严重COVID-19结局(即住院或因COVID-19导致的死亡)之间的关系,以及COVID-19诊断和疫苗接种作为次要结局。然后,我们探讨了社会经济地位的潜在中介作用,生活方式和大流行前的合并症,以及通过多基因风险评分对严重COVID-19结局的效果修饰。
    结果:大流行开始时研究人群的平均年龄为67.7(SD=7.72)岁,56.5%为女性。我们发现CM类型的数量与严重COVID-19结局的风险呈分级关系(pfor趋势<0.01)。与没有CM病史的人相比,暴露于任何CM的个体更有可能因COVID-19住院或死亡(比值比[OR]=1.54[95CI1.31-1.81]),特别是在身体忽视之后(2.04[1.57-2.62])。在高组与高组之间观察到了相当大的风险模式。严重COVID-19结局的低遗传风险(差异>0.05)。中介分析显示,CM和严重COVID-19结局之间的50.9%的关联是由社会经济地位欠佳解释的,生活方式,以及大流行前对精神疾病或其他慢性疾病的诊断。相比之下,任何CM暴露仅与COVID-19诊断弱相关(1.06[1.01-1.12]),而与未接种COVID-19疫苗显著相关(1.21[1.13-1.29])。
    结论:我们的结果增加了不断增长的知识库,表明儿童虐待在整个生命周期的负面健康结果中的作用。包括严重的COVID-19相关结果。确定的这种关联的潜在因素代表了减轻COVID-19和类似未来大流行中儿童虐待的有害影响的潜在干预目标。
    BACKGROUND: Childhood maltreatment (CM) has been indicated in adverse health outcomes across the lifespan, including severe infection-related outcomes. Yet, data are scarce on the potential role of CM in severe COVID-19-related outcomes as well as on mechanisms underlying this association.
    METHODS: We included 151,427 individuals in the UK Biobank who responded to questions on the history of CM in 2016 and 2017 and were alive on January 31, 2020. Binomial logistic regression models were performed to estimate the association between a history of CM and severe COVID-19 outcomes (i.e. hospitalization or death due to COVID-19), as well as COVID-19 diagnosis and vaccination as secondary outcomes. We then explored the potential mediating roles of socio-economic status, lifestyle and pre-pandemic comorbidities, and the effect modification by polygenic risk score for severe COVID-19 outcomes.
    RESULTS: The mean age of the study population at the start of the pandemic was 67.7 (SD = 7.72) years, and 56.5% were female. We found the number of CM types was associated with the risk of severe COVID-19 outcomes in a graded manner (pfor trend < 0.01). Compared to individuals with no history of CM, individuals exposed to any CM were more likely to be hospitalized or die due to COVID-19 (odds ratio [OR] = 1.54 [95%CI 1.31-1.81]), particularly after physical neglect (2.04 [1.57-2.62]). Largely comparable risk patterns were observed across groups of high vs. low genetic risks for severe COVID-19 outcomes (pfor difference > 0.05). Mediation analysis revealed that 50.9% of the association between CM and severe COVID-19 outcomes was explained by suboptimal socio-economic status, lifestyle, and pre-pandemic diagnosis of psychiatric disorders or other chronic medical conditions. In contrast, any CM exposure was only weakly associated with COVID-19 diagnosis (1.06 [1.01-1.12]) while significantly associated with not being vaccinated for COVID-19 (1.21 [1.13-1.29]).
    CONCLUSIONS: Our results add to the growing knowledge base indicating the role of childhood maltreatment in negative health outcomes across the lifespan, including severe COVID-19-related outcomes. The identified factors underlying this association represent potential intervention targets for mitigating the harmful effects of childhood maltreatment in COVID-19 and similar future pandemics.
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  • 文章类型: Journal Article
    背景:儿童虐待(CM)与长期不良健康结果有关,包括加速的生物衰老和认知能力下降。本研究调查了CM与各种衰老生物标志物之间的关系:端粒长度,面部老化,内在表观遗传年龄加速(IEAA),GrimAge,HannumAge,PhenoAge,脆弱指数,和认知表现。
    方法:我们使用已发表的GWAS汇总统计进行了孟德尔随机化(MR)研究。老化的生物标志物包括端粒长度(qPCR),面部老化(主观评价),和表观遗传年龄标记(HannumAge,IEAA,GrimAge,PhenoAge).虚弱指数是根据临床评估计算的,并通过标准化测试评估认知表现。分析包括逆方差加权(IVW),Egger先生,和加权中值(WM)方法,针对多重比较进行了调整。
    结果:CM与端粒长度较短(IVW:β=-0.1,95%CI-0.18至-0.02,pFDR=0.032)和汉诺年龄增加(IVW:β=1.33,95%CI0.36至2.3,pFDR=0.028)显着相关,GrimAge(IVW:β=1.19,95%CI0.19至2.2,pFDR=0.040),和表型(IVW:β=1.4,95%CI0.12至2.68,pFDR=0.053)。还发现与虚弱指数显着相关(IVW:β=0.31,95%CI0.13至0.49,pFDR=0.006)。没有发现与面部老化的显著关联,IEAA,或认知表现。
    结论:CM与加速的生物衰老有关,端粒长度较短,表观遗传衰老标记增加。CM也与虚弱增加有关,强调需要早期干预以减轻长期影响。进一步的研究应探索机制和预防策略。
    BACKGROUND: Childhood maltreatment (CM) is linked to long-term adverse health outcomes, including accelerated biological aging and cognitive decline. This study investigates the relationship between CM and various aging biomarkers: telomere length, facial aging, intrinsic epigenetic age acceleration (IEAA), GrimAge, HannumAge, PhenoAge, frailty index, and cognitive performance.
    METHODS: We conducted a Mendelian randomization (MR) study using published GWAS summary statistics. Aging biomarkers included telomere length (qPCR), facial aging (subjective evaluation), and epigenetic age markers (HannumAge, IEAA, GrimAge, PhenoAge). The frailty index was calculated from clinical assessments, and cognitive performance was evaluated with standardized tests. Analyses included Inverse-Variance Weighted (IVW), MR Egger, and Weighted Median (WM) methods, adjusted for multiple comparisons.
    RESULTS: CM was significantly associated with shorter telomere length (IVW: β = - 0.1, 95% CI - 0.18 to - 0.02, pFDR = 0.032) and increased HannumAge (IVW: β = 1.33, 95% CI 0.36 to 2.3, pFDR = 0.028), GrimAge (IVW: β = 1.19, 95% CI 0.19 to 2.2, pFDR = 0.040), and PhenoAge (IVW: β = 1.4, 95% CI 0.12 to 2.68, pFDR = 0.053). A significant association was also found with the frailty index (IVW: β = 0.31, 95% CI 0.13 to 0.49, pFDR = 0.006). No significant associations were found with facial aging, IEAA, or cognitive performance.
    CONCLUSIONS: CM is linked to accelerated biological aging, shown by shorter telomere length and increased epigenetic aging markers. CM was also associated with increased frailty, highlighting the need for early interventions to mitigate long-term effects. Further research should explore mechanisms and prevention strategies.
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  • 文章类型: Journal Article
    背景:现有证据表明,经历过童年虐待(CM)的儿童和青少年有更高的自杀风险。然而,复原力在这种关联中的中介作用尚不清楚.我们的目的是调查CM和三个自杀风险指标(自杀意念,自杀计划,SP;自杀企图,SA)在大量中国儿童和青少年样本中。
    方法:在中国西南部云南省进行了基于人群的横断面调查。共纳入9723名儿童和青少年,并采用多阶段分层整群抽样设计进行分析。单变量和多变量逻辑回归模型拟合,以探讨CM,弹性,和三个自杀风险指标,剂量反应趋势通过使用有限的三次样条进一步阐明。采用路径模型来估计弹性的中介作用。
    结果:一年SI的估计患病率,SP和SA为32.86%(95%CI:31.93-33.80%),19.36%(95%CI:18.57-20.16%)和9.07%(95%CI:8.51-9.66%)。调整后,CM与所有3个自杀风险指标显着相关,比值比(OR)为2.13(95%CI:1.91-2.37),2.45(95%CI:2.13-2.81),一年期SI为3.61(95%CI:2.90-4.52),SP,SA,分别。路径模型显示,韧性显著介导了CM和三个自杀风险指标之间的关联,在韧性的所有维度中,家庭支持始终是最强有力的调解。
    结论:我们的研究结果表明,以提高心理韧性为重点的干预措施可能有效降低遭受虐待的儿童和青少年的自杀风险。应该进行前瞻性研究以证实我们的发现。
    BACKGROUND: Existing evidence suggests that children and adolescents who had experienced childhood maltreatment (CM) are at higher suicidal risk. However, the mediation role of resilience in this association remains unclear. We aim to investigate the mediation via resilience in the associations between CM and three suicidal risk indicators (suicidal ideation, SI; suicidal plan, SP; suicidal attempt, SA) among a large sample of Chinese children and adolescents.
    METHODS: A population-based cross-sectional survey was conducted in southwestern China Yunnan province. A total of 9723 children and adolescents were included and analyzed by using a multi-stage stratified cluster sampling design. Univariate and multivariate logistic regression models were fitted to explore the associations between CM, resilience, and the three suicidal risk indicators, dose-response trends further elucidated by using the restricted cubic splines. Path models were adopted to estimate the mediation of resilience.
    RESULTS: The estimated prevalence rates for one-year SI, SP and SA were 32.86% (95% CI: 31.93-33.80%), 19.36% (95% CI: 18.57-20.16%) and 9.07% (95% CI: 8.51-9.66%). After adjustment, CM significantly associated with all 3 suicidal risk indicators, and the odds ratios (ORs) were 2.13 (95% CI: 1.91-2.37), 2.45 (95% CI: 2.13-2.81), and 3.61 (95% CI: 2.90-4.52) for one-year SI, SP, and SA, respectively. Path models revealed that resilience significantly mediated the associations between CM and the three suicidal risk indicators, and among all dimensions of resilience, family support presented the strongest mediation consistently.
    CONCLUSIONS: Our study results suggest that intervention measures which focusing on improving psychological resilience might be effective in reducing suicidal risk for children and adolescents who had experienced maltreatment. Prospective studies should be done to corroborate our findings.
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  • 文章类型: Case Reports
    本病例报告对四名虐待青少年进行了全面评估,两个同父异母的兄弟姐妹,和两个异卵双胞胎研究复杂的童年创伤对大脑功能的影响。该研究旨在与数据库规范相比,在这些青少年的脑电图(EEG)数据中确定共享的心理生理特征。定量脑电图,事件相关电位(ERP),并分析了它们的独立成分,以检查与精神病理学相关的电活动模式的变化。在半兄弟姐妹中,在提示Go/NoGo任务期间观察到增强的P1和N1振幅,而在异卵双胞胎中N2振幅降低。创伤的类型似乎也会影响EEG频谱分布和高阶认知过程,如注意力分配和反应抑制(N2波)。具体来说,身体虐待和欺负的青少年在后部区域显示N2振幅降低和α功率降低。与规范相比,虐待青少年的ERP无关成分没有显着差异。对这些病例的分析旨在提供对儿童虐待重叠症状和综合征的神经生物学基础的见解,这可能有助于青少年创伤相关精神病理学的鉴别诊断和针对性干预措施的发展。
    This case report presents a comprehensive assessment of four maltreated adolescents, two half-siblings, and two non-identical twins to investigate the effects of complex childhood trauma on brain functioning. The study aimed to identify shared psychophysiological features in the electroencephalographic (EEG) data of these adolescents compared to database norms. Quantitative EEG, event-related potentials (ERPs), and their independent components were analyzed to examine alterations in patterns of electrical activity associated with psychopathology. In the half-sibling pair, enhanced P1 and N1 amplitudes were observed during the cued Go/NoGo task, while reduced N2 amplitude was present in the fraternal twins. The type of trauma also seems to affect EEG spectral distribution and higher-order cognitive processes, such as attention allocation and response inhibition (N2 wave). Specifically, physically abused and bullied adolescents showed reduced N2 amplitudes and lower alpha power in the posterior region. No significant differences were noted in the ERP-independent components for maltreated adolescents compared to norms. The analysis of these cases aimed to provide insights into the neurobiological substrates underlying the overlapping symptoms and syndromes of child maltreatment, which may aid in differential diagnosis and the development of targeted interventions for trauma-related psychopathology in adolescents.
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  • 文章类型: Journal Article
    背景:虐待儿童是影响全球医疗专业人员和患者的严重问题。它会导致不适,风险,甚至一个孩子的死亡。医生工作中最重要的方面之一是为有需要的人提供援助;因为儿童更依赖他人的护理和安全,他们应该受到质量更特别的关注。因此,这项研究旨在评估意见,专业经验,沙特阿拉伯医学生对儿童虐待和忽视(CAN)的理解。
    方法:本研究在SolimanFakeeh医院进行。它涉及65名学生,他们要么是虐待儿童的受害者,要么是虐待儿童受害者的亲属/家庭成员。
    结果:参与者对CAN的几个关键组件的认识是相当大的。然而,他们对CAN病例报告的理解相当薄弱。此外,他们对CAN的看法和专业经验在质量方面并不出色。
    结论:沙特阿拉伯应实施一项广泛的计划,以防止在任何程度上虐待儿童,考虑到国家在这一领域的临床经验和专业知识。国家的儿科医生应该指导和协助这个过程,从而在预防和解决CAN案件中发挥重要作用。
    BACKGROUND: Child abuse is a severe issue that impacts medical professionals and patients globally. It can lead to discomfort, risk, or even the demise of a child. One of the most significant facets of a doctor\'s work involves providing aid to those in need; since children are more dependent on others for care and safety, they should receive attention that is even more special in quality. Hence, this study aims to assess the views, professional experiences, and comprehension of Saudi Arabian medical students regarding child abuse and neglect (CAN).
    METHODS: This study was carried out at Dr. Soliman Fakeeh Hospital. It involved 65 students who were either victims of child abuse or the relatives/family members of child abuse victims.
    RESULTS: The participants\' awareness of several critical components of CAN was considerable. However, their understanding regarding the reporting of CAN cases was rather meager. Furthermore, their views of and professional experience with CAN were not excellent in terms of quality.
    CONCLUSIONS: Saudi Arabia should implement an extensive plan to prevent the abuse of children at any level, given the nation\'s clinical experience and expertise in this field. The nation\'s pediatricians should direct as well as assist in this process, thereby playing a major role in preventing and addressing CAN cases.
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  • 文章类型: Journal Article
    儿童虐待和精神病发病率都主要通过横断面研究与加速的生物衰老有关。使用前瞻性纵向研究的数据,这些数据来自具有儿童虐待史的个体,并控制参与者进入中年,我们测试了2种假设,研究1)精神症状是否介导了儿童虐待与生物衰老之间的关系,以及2)焦虑的精神症状,抑郁症,或创伤后应激障碍(PTSD)与儿童虐待一起作用,加剧了儿童虐待与衰老的联系。
    有虐待史的儿童(0-11岁)和人口统计学匹配的对照儿童被追踪到成年期(N=607),并在研究的几波中进行了采访。抑郁症,焦虑,和PTSD症状在平均年龄29岁(访谈1)和40岁(访谈2)时进行评估。使用Klemera-Doubal方法从后来收集的血液化学物质(平均年龄=41岁)测量生物年龄。使用线性回归和路径分析对假设进行了检验。
    有儿童虐待史的成年人表现出更多的抑郁症状,创伤后应激障碍,在采访和更高级的生物衰老中焦虑,与对照参与者相比。访谈中的PTSD症状以及仅在访谈2中的抑郁和焦虑症状都预示着生物衰老的加速。没有调解的证据;然而,焦虑和抑郁调节了儿童虐待与生物衰老之间的关系。
    这些新发现揭示了PTSD对生物衰老的短期和长期纵向影响,以及焦虑和抑郁对儿童虐待与生物衰老之间关系的放大作用。
    儿童虐待和精神病发病率与生物衰老有关。我们使用了一项前瞻性纵向研究的数据,该研究对有虐待史的儿童进行了调查,并在成年后进行了人口统计学上匹配的对照参与者的随访和访谈。抑郁症,焦虑,创伤后应激障碍(PTSD)在29岁和40岁时进行评估,生物年龄是从后来收集的血液化学物质中测量的。有儿童虐待史的成年人表现出更多的抑郁症状,创伤后应激障碍,与对照组参与者相比,焦虑和更先进的生物衰老。PTSD症状纵向预测生物衰老加速。焦虑和抑郁放大了儿童虐待与生物衰老之间的关系。
    UNASSIGNED: Childhood maltreatment and psychiatric morbidity have each been associated with accelerated biological aging primarily through cross-sectional studies. Using data from a prospective longitudinal study of individuals with histories of childhood maltreatment and control participants followed into midlife, we tested 2 hypotheses examining whether 1) psychiatric symptoms mediate the relationship between childhood maltreatment and biological aging and 2) psychiatric symptoms of anxiety, depression, or posttraumatic stress disorder (PTSD) act in conjunction with childhood maltreatment to exacerbate the association of child maltreatment to aging.
    UNASSIGNED: Children (ages 0-11 years) with documented histories of maltreatment and demographically matched control children were followed into adulthood (N = 607) and interviewed over several waves of the study. Depression, anxiety, and PTSD symptoms were assessed at mean ages of 29 (interview 1) and 40 (interview 2) years. Biological age was measured from blood chemistries collected later (mean age = 41 years) using the Klemera-Doubal method. Hypotheses were tested using linear regressions and path analyses.
    UNASSIGNED: Adults with documented histories of childhood maltreatment showed more symptoms of depression, PTSD, and anxiety at both interviews and more advanced biological aging, compared with control participants. PTSD symptoms at both interviews and depression and anxiety symptoms only at interview 2 predicted accelerated biological aging. There was no evidence of mediation; however, anxiety and depression moderated the relationship between childhood maltreatment and biological aging.
    UNASSIGNED: These new findings reveal the shorter- and longer-term longitudinal impact of PTSD on biological aging and the amplifying effect of anxiety and depression on the relationship between child maltreatment and biological aging.
    Childhood maltreatment and psychiatric morbidity are associated with biological aging. We used data from a prospective longitudinal study of children with documented histories of maltreatment and demographically matched control participants followed and interviewed in adulthood. Depression, anxiety, and posttraumatic stress disorder (PTSD) were assessed at ages 29 and 40 years, and biological age was measured from blood chemistries collected later. Adults with histories of childhood maltreatment showed more symptoms of depression, PTSD, and anxiety and more advanced biological aging compared with control participants. PTSD symptoms predicted accelerated biological aging longitudinally. Anxiety and depression amplified the relationship between child maltreatment and biological aging.
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  • 文章类型: Journal Article
    艾滋病毒携带者(PLWH)儿童创伤暴露率高,这是创伤后应激障碍(PTSD)发展的重要危险因素。因为生活在城市环境中的美国黑人面临着严重的创伤,患有慢性创伤后应激障碍,并且感染艾滋病毒的风险增加,重要的是要了解艾滋病毒状况如何与儿童虐待相互作用,从而影响PTSD症状的严重程度和潜在的心理生理学.
    当前的横断面研究评估了在88名有(n=30)和没有HIV(n=58)的黑人女性中,在黑暗增强的惊吓(DES)任务中,HIV状况是否与儿童虐待相互作用,以影响PTSD症状的严重程度和心率变异性。
    HIV仅在儿童虐待程度较低的女性中与PTSD症状严重程度相关(p=.024)。DES期间的惊吓增强在没有艾滋病毒和儿童虐待的女性中最高(p=.018)。在经历过低水平童年虐待的女性中,在DES的黑暗阶段,没有艾滋病毒的女性的呼吸窦性心律失常(RSA)低于感染艾滋病毒的女性(WLWH),(p=0.046)。WLWH在DES轻度阶段的RSA低于没有HIV的女性(p=.042)。
    在当前的黑人女性样本中,HIV状态与创伤后应激障碍症状严重程度相关,取决于儿童虐待的程度,提示HIV状态可能是PTSD的行为和药物治疗策略需要考虑的重要因素。此外,在DES的光照阶段,HIV状态与较低的黑暗增强百分比和较低的RSA有关,提示在暴露于低水平儿童虐待的个体中,HIV可能导致PTSD症状的生理机制。
    UNASSIGNED: People living with HIV (PLWH) experience high rates of childhood trauma exposure, which is a significant risk factor for the development of posttraumatic stress disorder (PTSD). Because Black Americans living in urban environments are exposed to high levels of trauma, suffer from chronic PTSD, and are at increased risk for HIV infection, it is important to understand how HIV status interacts with childhood maltreatment to influence PTSD symptom severity and underlying psychophysiology.
    UNASSIGNED: The current cross-sectional study assessed whether HIV status interacts with childhood maltreatment to influence PTSD symptom severity and heart rate variability during a dark-enhanced startle (DES) task in 88 Black women with (n=30) and without HIV (n=58).
    UNASSIGNED: HIV was associated with greater PTSD symptom severity only in women with low levels of childhood maltreatment (p=.024). Startle potentiation during DES was highest in women living without HIV and with high childhood maltreatment (p=.018). In women who had experienced low levels of childhood maltreatment, respiratory sinus arrhythmia (RSA) was lower during the dark phase of DES in women living without HIV than women living with HIV (WLWH), (p=.046). RSA during the light phase of DES was lower in WLWH than in women living without HIV (p=.042).
    UNASSIGNED: In the current sample of Black women, HIV status was associated with PTSD symptom severity in a manner dependent on level of childhood maltreatment, suggesting that HIV status may be an important factor to consider for behavioral and pharmacological treatment strategies for PTSD. Additionally, HIV status is associated with lower percent potentiation to darkness and lower RSA during the light phase of DES, suggesting physiological mechanisms by which HIV may contribute to PTSD symptoms in individuals exposed to low levels of childhood maltreatment.
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  • 文章类型: Journal Article
    背景:晚年抑郁症和儿童虐待已成为主要的全球公共卫生问题,鉴于其患病率以及社会经济和健康后果。然而,以前的研究只关注儿童虐待与抑郁症状平均水平的关系。当前的研究通过同时研究儿童期家庭内和家庭外虐待对中国晚期生活中抑郁症状的年龄轨迹的影响来解决这一知识差距。
    方法:将分层线性模型应用于中国健康与退休纵向研究的数据(2011-2018年,N=12,669名45至80岁的个体,包括N=43,348人年)。抑郁症状通过CES-D-10量表测量。儿童家庭内虐待是通过身体虐待和情感忽视来衡量的,而家族外虐待是通过同伴欺凌来衡量的。在Stata16中,所有分析均按性别分别进行。
    结果:儿童家庭外同伴欺凌(β=1.628,p<0.001),在整个样本中,家庭内身体虐待(β=0.746,p<0.001)和情感忽视(β=0.880,p<0.001)与较高的晚年抑郁症状水平相关。男性和女性的同伴欺凌在抑郁症状方面的差异随着年龄的增长而扩大。在男性的一生中,身体虐待抑郁症状的差异保持稳定,但在女性中却有所增加。男性抑郁症状的情绪忽视差异随着年龄的增长而降低,而女性则先上升后下降。
    结论:这项研究的结果表明,儿童虐待不仅与晚年精神健康状况较差有关,而且随着年龄的增长,精神健康方面的不平等加剧。尤其是在同伴欺凌的受害者和女性中。
    BACKGROUND: Both late-life depression and childhood maltreatment have become major global public health issues, given their prevalence and social-economic and health consequences. However, previous studies have solely focused on the relationship of childhood maltreatment to average levels of depressive symptoms. The current study addresses this gap of knowledge by simultaneously examining the impacts of childhood intra- and extra-familial maltreatment on age trajectories of depressive symptoms in later life in the Chinese context.
    METHODS: Hierarchical linear models were applied to data from the China Health and Retirement Longitudinal Study (2011-2018, N = 12,669 individuals aged 45 to 80, comprising N = 43,348 person-years). Depressive symptoms were measured by the CES-D-10 scale. Childhood intra-familial maltreatments were measured by physical abuse and emotional neglect, while extra-familial maltreatment was measured by peer bullying. All analyses were conducted separately by gender in Stata 16.
    RESULTS: Childhood extrafamilial peer bullying (β = 1.628, p < 0.001), and intrafamilial physical abuse (β = 0.746, p < 0.001) and emotional neglect (β = 0.880, p < 0.001) were associated with higher later-life depressive symptoms levels in the whole sample. Peer bullying differences in depressive symptoms widened with age for both men and women. Physical abuse differences in depressive symptoms remained stable over the life course among men but increased among women. Emotional neglect differences in depressive symptoms decreased with age among men, while it increased first and then decreased among women.
    CONCLUSIONS: Findings in this study suggest that childhood maltreatment is not only associated with later-life poorer mental health but contributes to increasing inequalities in mental health as people age, especially among peer-bullying victims and women.
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