农村青少年不同时期家庭逆境与精神病理症状的关联

目的探讨家庭逆境致精神病理症状结局的累积性与关键期效应,为预防与干预逆境伤害提供依据。方法2017年12月,采用方便抽样的方法选取安徽省阜阳地区2所农村学校的710名青少年。采用《童年期不良经历问卷》评估家庭逆境,《MacArthur健康与行为问卷》评价内化症状和外化症状。采用多元线性回归分析家庭逆境发生时间与数量和精神病理症状的关联。结果持续家庭逆境组与内化症状、外化症状增加均有相关性β值(95%CI)分别为0.35(0.15~0.54),0.16(0.01~0.32)]。家庭逆境数量为2和≥3与内化症状β值(95%CI)分别为0.20(0.04~0.36),0.42(0.24~0.60)]、外化症状β值(95%CI)分别为0.14(0.01~0.26),0.23(0.09~0.37)]增加有关。在仅童年期家庭逆境中,家庭逆境数量为2和≥3的内化症状β值(95%CI)分别为0.23(0.06~0.41),0.34(0.11~0.58)]、外化症状β值(95%CI)分别为0.17(0.02~0.31),0.21(0.02~0.39)]的风险增高。在持续家庭逆境组中,逆境数量≥3与内化症状、外化症状相关(β值(95%CI)分别为0.56(0.31~0.82),0.24(0.02~0.45)]。仅青春期家庭逆境与精神病理症状无关。结论家庭逆境的多次发生可增加精神病理症状风险,童年期可能是家庭逆境致精神病理症状的关键期。

Association between family adversity exposed to different period and psychopathological symptoms among adolescents in rural areas

Objective To investigate the cumulative and sensitive period effects of family adversity on the outcome of psychopathological symptoms,so as to provide evidence for the prevention and intervention of adverse events.Methods A total of 710 adolescents were recruited from local schools in rural area of Fuyang,Anhui Province in Dec.2017 by using the convenience sampling method.The Adverse Childhood Experiences Questionnaire was used to assess family adversity.The MacArthur Health&Behavior Questionnaire was used to assess internalizing and externalizing symptoms.Multiple linear regression model was used to analyze the association between number and time of family adversity and psychopathological symptoms.Results Persistent family adversity was associated with increased internalizing symptoms(β(95%CI)=0.35(0.15-0.54)]and increased externalizing symptomsβ(95%CI)=0.16(0.01-0.32)].2 and≥3 family adversities were associated with increased internalizing symptomsβ(95%CI)=0.20(0.04-0.36),0.42(0.24-0.60)]and increased externalizing symptomsβ(95%CI)=0.14(0.01-0.26),0.23(0.09-0.37)].In childhood family adversity group,2 and≥3 family adversities were associated with increased internalizing symptomsβ(95%CI)=0.23(0.06-0.41),0.34(0.11-0.58)]and increased externalizing symptomsβ(95%CI)=0.17(0.02-0.31),0.21(0.02-0.39)].In persistent family adversity group,≥3 family adversities were associated with increased internalizing symptomsβ(95%CI)=0.56(0.31-0.82)]and increased externalizing symptomsβ(95%CI)=0.24(0.02-0.45)].Adolescence family adversity was not associated with psychopathological symptoms.Conclusion The cumulative family adversity may increase the risk of psychopathological symptoms,and that childhood may be the sensitive period for family adversity to cause psychopathological symptoms.