早期童年不良经历对小学生青春发育过程的持续影响

  目的  探讨童年不良经历对男女童青春发育过程的持续影响，为青春发育规律研究提供基础资料。  方法  采用分层整群抽样方法，于2018年9月抽取黄山市城区和乡镇寄宿制和公立小学各1所的三、四年级共1 156名学生，采用儿童期虐待问卷(CTQ)和青春发育问卷(PDS)进行自我评定的基线调查，根据儿童期虐待问卷不同维度得分将童年不良经历分为无暴露组、轻度暴露组和重度暴露组，2年后再次进行PDS问卷的自我评定，分析童年不良经历类型及严重程度对男女童青春发育的持续影响。  结果  基线调查中，女童发育提前53名(11.32%)，男童发育提前51名(7.41%)，差异有统计学意义(χ2=5.21，P < 0.05)。单因素分析显示，童年不良经历虐待类型及严重程度对青春发育的影响在基线和随访中都具有性别差异，童年不良经历不同暴露组基线和随访时发育提前检出率存在性别差异。多元线性回归分析显示，女童情感虐待、情感忽视和性虐待程度越重，PDS得分越高(B值分别为0.22，0.15，0.08)；男童情感虐待越重PDS得分越高，躯体虐待越重PDS得分越低(B值分别为0.20，0.04)(P值均 < 0.05)。  结论  在男女童青春发育过程中要重视童年不良经历的影响及性别差异。应进行更为长期的时间效应观测。

Persistent effects of adverse childhood experiences on the course of pubertal development

  Objective  To explore the influence of adverse childhood experiences (ACEs) on pubertal development of boys and girls and to provide a reference for the development of intervention measures.  Methods  A stratified cluster sampling method was used to select a total of 1 156 students in grades three and four in the boarding school system and public primary schools in Huangshan City and surrounding towns in September 2018, using the Childhood Trauma Questionnaire (CTQ) and the Pubertal Development Scale (PDS). For the baseline self-assessment survey, according to different dimensions, abuse children score no exposure groups. Children were divided into an exposure group and a high exposure level group, according to their childhood experiences. PDS self-report questionnaire was administered two years later, and an analysis of ACE type and severity of the continuous impact of youth development was conducted.  Results  In the baseline survey, there were 53 girls (11.32%) and 51 boys (7.41%) who developed earlier. The rate of early development in girls was higher than that of boys, and the difference was statistically significant(χ2=5.21, P < 0.05). Univariate analysis showed gender differences in the effects of type and severity of ACEs and abuse on adolescent development at both baseline and follow-up. There were gender differences in the rate of early development between boys and girls at baseline and at follow-up between the exposure groups. Regression analysis showed that the higher the degree of emotional abuse, emotional neglect, and sexual abuse in girls, the higher the PDS score(B=0.22, 0.15, 0.08, P < 0.05). In boys, the more severe the emotional abuse experienced, the higher the PDS score, and the more severe the physical abuse experienced, the lower the PDS score(B=0.20, 0.04, P < 0.05).  Conclusion  Attention should be paid to the influence of ACEs and gender differences during youth development among male and female students, and more long-term studies should also be carried out.